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I
116TH CONGRESS
1ST SESSION H. R. 4622
To amend the Public Health Service Act with regard to research on asthma,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 8, 2019
Mr. CUMMINGS (for himself, Mr. ENGEL, Mr. UPTON, and Mr. KING of New
York) introduced the following bill; which was referred to the Committee
on Energy and Commerce
A BILL
To amend the Public Health Service Act with regard to
research on asthma, and for other purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Family Asthma Act’’.
4
SEC. 2. FINDINGS.
5
Congress finds the following:
6
(1) According to the Centers for Disease Con-
7
trol and Prevention, in 2017 more than 25,100,000
8
people in the United States had been diagnosed with
9
asthma, including an estimated 6,200,000 children.
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(2) According to the Centers for Disease Con-
1
trol and Prevention, asthma usually affects racial
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and ethnic minorities, including African Americans,
3
American Indians, Alaska Natives, Puerto Ricans,
4
and people of multiple races more than non-Hispanic
5
Whites. In 2017, Puerto Ricans and African Ameri-
6
cans had the highest lifetime prevalence of asthma
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at 20.6 and 15.2 percent, respectively.
8
(3) According to the Centers for Disease Con-
9
trol and Prevention, among children, males have
10
higher rates of asthma than females, and in adults
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women have higher rates of asthma than men. Indi-
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viduals living below the poverty threshold also had
13
significantly higher rates of asthma in 2017 than in-
14
dividuals living above the poverty threshold.
15
(4) According to the Centers for Disease Con-
16
trol and Prevention, in 2017 more than 3,500 people
17
in the United States died from asthma. The rate of
18
mortality from asthma is higher among African
19
Americans and women.
20
(5) The Centers for Disease Control and Pre-
21
vention report that asthma accounted for approxi-
22
mately 180,000 hospitalizations and 1,800,000 visits
23
to hospital emergency departments in 2016.
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(6) According to the Centers for Disease Con-
1
trol and Prevention, the annual cost of asthma to
2
the
United
States
is
approximately
3
$81,900,000,000, including $3,000,000,000 in indi-
4
rect costs from missed days of school and work.
5
(7) According to the Centers for Disease Con-
6
trol and Prevention, 5,200,000 school days and
7
8,500,000 work days are missed annually as a result
8
of asthma.
9
(8) Asthma episodes can be triggered by both
10
outdoor air pollution and indoor air pollution, in-
11
cluding pollutants such as cigarette smoke and com-
12
bustion by-products. Asthma episodes can also be
13
triggered by indoor allergens such as animal dander
14
and outdoor allergens such as pollen and molds.
15
(9) Public health interventions and medical care
16
in accordance with existing guidelines have been
17
proven effective in the treatment and management
18
of asthma. Better asthma management could reduce
19
the numbers of emergency department visits and
20
hospitalizations due to asthma. Studies published in
21
medical journals, including the Journal of Asthma
22
and The Journal of Pediatrics, have shown that bet-
23
ter asthma management results in improved asthma
24
outcomes at a lower cost.
25
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(10) In 2016, the Centers for Disease Control
1
and Prevention reported that less than half of people
2
with asthma reported receiving self-management
3
training for their asthma. More education about
4
triggers, proper treatment, and asthma management
5
methods is needed.
6
(11) The alarming rise in the prevalence of
7
asthma, its adverse effect on school attendance and
8
productivity, and its cost for hospitalizations and
9
emergency room visits, highlight the importance of
10
public health interventions, including increasing
11
awareness of asthma as a chronic illness, its symp-
12
toms, the role of both indoor and outdoor environ-
13
mental factors that exacerbate the disease, and other
14
factors that affect its exacerbations and severity.
15
The goals of the Federal Government and its part-
16
ners in the nonprofit and private sectors should in-
17
clude reducing the number and severity of asthma
18
attacks, asthma’s financial burden, and the health
19
disparities associated with asthma.
20
(12) The high health and financial burden
21
caused by asthma underscores the importance of ad-
22
herence to the National Asthma Education and Pre-
23
vention Guidelines of the National Heart, Lung, and
24
Blood Institute. Increasing adherence to guidelines-
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based care and resulting patient management prac-
1
tices will enhance the quality of life for patients with
2
asthma and decrease asthma-related morbidity and
3
mortality.
4
SEC. 3. ASTHMA-RELATED ACTIVITIES OF THE CENTERS
5
FOR DISEASE CONTROL AND PREVENTION.
6
Section 317I of the Public Health Service Act (42
7
U.S.C. 247b–10) is amended to read as follows:
8
‘‘SEC. 317I. ASTHMA-RELATED ACTIVITIES OF THE CENTERS
9
FOR DISEASE CONTROL AND PREVENTION.
10
‘‘(a) PROGRAM FOR PROVIDING INFORMATION AND
11
EDUCATION
TO
THE PUBLIC.—The Secretary, acting
12
through the Director of the Centers for Disease Control
13
and Prevention and the National Center for Environ-
14
mental Health, shall collaborate with State and local
15
health departments to conduct activities, including the
16
provision of information and education to the public re-
17
garding asthma including—
18
‘‘(1) deterring the harmful consequences of un-
19
controlled asthma; and
20
‘‘(2) disseminating health education and infor-
21
mation regarding prevention of asthma episodes and
22
strategies for managing asthma.
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‘‘(b) DEVELOPMENT OF STATE STRATEGIC PLANS
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FOR ASTHMA CONTROL.—The Secretary, acting through
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the Director of the Centers for Disease Control and Pre-
1
vention, shall collaborate with State and local health de-
2
partments to develop State strategic plans for asthma con-
3
trol incorporating public health responses to reduce the
4
burden of asthma, particularly regarding disproportion-
5
ately affected populations.
6
‘‘(c) COMPILATION OF DATA.—The Secretary, acting
7
through the Director of the Centers for Disease Control
8
and Prevention, shall, in cooperation with State and local
9
public health officials—
10
‘‘(1) conduct asthma surveillance activities to
11
collect data on the prevalence and severity of asth-
12
ma, the effectiveness of public health asthma inter-
13
ventions, and the quality of asthma management, in-
14
cluding—
15
‘‘(A) collection of data on or among people
16
with asthma to monitor the impact on health
17
and quality of life;
18
‘‘(B) surveillance of health care facilities;
19
and
20
‘‘(C) collection of data not containing indi-
21
vidually identifiable information from electronic
22
health records or other electronic communica-
23
tions;
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‘‘(2) compile and annually publish data regard-
1
ing the prevalence of childhood asthma, the child
2
mortality rate, and the number of hospital admis-
3
sions and emergency department visits by children
4
associated with asthma nationally and in each State
5
by age, sex, race, and ethnicity, as well as lifetime
6
and current prevalence; and
7
‘‘(3) compile and annually publish data regard-
8
ing the prevalence of adult asthma, the adult mor-
9
tality rate, and the number of hospital admissions
10
and emergency department visits by adults associ-
11
ated with asthma nationally and in each State by
12
age, sex, race, and ethnicity, as well as lifetime and
13
current prevalence.
14
‘‘(d) COORDINATION OF DATA COLLECTION.—The
15
Director of the Centers for Disease Control and Preven-
16
tion, in conjunction with State and local health depart-
17
ments, shall coordinate data collection activities under
18
subsection (c)(2) so as to maximize the comparability of
19
results.
20
‘‘(e) COLLABORATION.—
21
‘‘(1) IN GENERAL.—The Centers for Disease
22
Control and Prevention are encouraged to collabo-
23
rate with national, State, and local nonprofit organi-
24
zations to provide information and education about
25
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asthma, and to strengthen such collaborations when
1
possible.
2
‘‘(2) SPECIFIC
ACTIVITIES.—The Division of
3
Population Health is encouraged to expand its ac-
4
tivities with non-Federal partners, especially State-
5
level entities.
6
‘‘(f) AUTHORIZATION
OF
APPROPRIATIONS.—To
7
carry out this section, there are authorized to be appro-
8
priated $65,000,000 for the period of fiscal years 2021
9
through 2025.
10
‘‘(g) REPORTS TO CONGRESS.—
11
‘‘(1) IN
GENERAL.—Not later than 3 years
12
after the date of enactment of this Act, and once 2
13
years thereafter, the Secretary shall, in consultation
14
with patient groups, nonprofit organizations, medical
15
societies, and other relevant governmental and non-
16
governmental entities, submit to Congress a report
17
that—
18
‘‘(A) catalogs, with respect to asthma pre-
19
vention, management, and surveillance—
20
‘‘(i) the activities of the Federal Gov-
21
ernment, including an assessment of the
22
progress of the Federal Government and
23
States, with respect to achieving the goals
24
of the Healthy People 2030 initiative; and
25
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‘‘(ii) the activities of other entities
1
that participate in the program under this
2
section, including nonprofit organizations,
3
patient advocacy groups, and medical soci-
4
eties; and
5
‘‘(B) makes recommendations for the fu-
6
ture direction of asthma activities, in consulta-
7
tion with researchers from the National Insti-
8
tutes of Health and other member bodies of the
9
Asthma Disparities Subcommittee, including—
10
‘‘(i) a description of how the Federal
11
Government may improve its response to
12
asthma, including identifying any barriers
13
that may exist;
14
‘‘(ii) a description of how the Federal
15
Government may continue, expand, and
16
improve its private-public partnerships
17
with respect to asthma, including identi-
18
fying any barriers that may exist;
19
‘‘(iii) the identification of steps that
20
may be taken to reduce the—
21
‘‘(I) morbidity, mortality, and
22
overall prevalence of asthma;
23
‘‘(II) financial burden of asthma
24
on society;
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‘‘(III) burden of asthma on dis-
1
proportionately affected areas, par-
2
ticularly those in medically under-
3
served populations (as defined in sec-
4
tion 330(b)(3)); and
5
‘‘(IV) burden of asthma as a
6
chronic disease that can be worsened
7
by environmental exposures;
8
‘‘(iv) the identification of programs
9
and policies that have achieved the steps
10
described under clause (iii), and steps that
11
may be taken to expand such programs
12
and policies to benefit larger populations;
13
and
14
‘‘(v) recommendations for future re-
15
search and interventions.
16
‘‘(2) SUBSEQUENT REPORTS.—
17
‘‘(A) CONGRESSIONAL REQUEST.—During
18
the 5-year period following the submission of
19
the second report under paragraph (1), the Sec-
20
retary shall submit updates and revisions of the
21
report upon the request of the Congress.
22
‘‘(B) FIVE-YEAR REEVALUATION.—At the
23
end of the 5-year period referred to in subpara-
24
graph (A), the Secretary shall—
25
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‘‘(i) evaluate the analyses and rec-
1
ommendations made in previous reports;
2
and
3
‘‘(ii) determine whether an additional
4
updated report is needed and if so submit
5
such an additional updated report to the
6
Congress, including appropriate recommen-
7
dations.’’.
8
Æ
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