Elijah E. Cummings Family Asthma Act

I 116TH CONGRESS 1ST SESSION H. R. 5230 To amend the Public Health Service Act with regard to research on asthma, and for other purposes. IN THE HOUSE OF REPRESENTATIVES NOVEMBER 21, 2019 Mr. ENGEL (for himself, Mr. UPTON, Mr. COX of California, 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 ‘‘Elijah E. Cummings 4 Family Asthma Act’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) According to the Centers for Disease Con- 8 trol and Prevention, in 2017 more than 25,100,000 9 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 2 •HR 5230 IH people in the United States had been diagnosed with 1 asthma, including an estimated 6,200,000 children. 2 (2) According to the Centers for Disease Con- 3 trol and Prevention, asthma usually affects racial 4 and ethnic minorities, including African Americans, 5 American Indians, Alaska Natives, Puerto Ricans, 6 and people of multiple races more than non-Hispanic 7 Whites. In 2017, Puerto Ricans and African Ameri- 8 cans had the highest lifetime prevalence of asthma 9 at 20.6 and 15.2 percent, respectively. 10 (3) According to the Centers for Disease Con- 11 trol and Prevention, among children, males have 12 higher rates of asthma than females, and in adults 13 women have higher rates of asthma than men. Indi- 14 viduals living below the poverty threshold also had 15 significantly higher rates of asthma in 2017 than in- 16 dividuals living above the poverty threshold. 17 (4) According to the Centers for Disease Con- 18 trol and Prevention, in 2017 more than 3,500 people 19 in the United States died from asthma. The rate of 20 mortality from asthma is higher among African 21 Americans and women. 22 (5) The Centers for Disease Control and Pre- 23 vention report that asthma accounted for approxi- 24 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 3 •HR 5230 IH mately 180,000 hospitalizations and 1,800,000 visits 1 to hospital emergency departments in 2016. 2 (6) According to the Centers for Disease Con- 3 trol and Prevention, the annual cost of asthma to 4 the United States is approximately 5 $81,900,000,000, including $3,000,000,000 in indi- 6 rect costs from missed days of school and work. 7 (7) According to the Centers for Disease Con- 8 trol and Prevention, 5,200,000 school days and 9 8,500,000 work days are missed annually as a result 10 of asthma. 11 (8) Asthma episodes can be triggered by both 12 outdoor air pollution and indoor air pollution, in- 13 cluding pollutants such as cigarette smoke and com- 14 bustion by-products. Asthma episodes can also be 15 triggered by indoor allergens such as animal dander 16 and outdoor allergens such as pollen and molds. 17 (9) Public health interventions and medical care 18 in accordance with existing guidelines have been 19 proven effective in the treatment and management 20 of asthma. Better asthma management could reduce 21 the numbers of emergency department visits and 22 hospitalizations due to asthma. Studies published in 23 medical journals, including the Journal of Asthma 24 and The Journal of Pediatrics, have shown that bet- 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 4 •HR 5230 IH ter asthma management results in improved asthma 1 outcomes at a lower cost. 2 (10) In 2016, the Centers for Disease Control 3 and Prevention reported that less than half of people 4 with asthma reported receiving self-management 5 training for their asthma. More education about 6 triggers, proper treatment, and asthma management 7 methods is needed. 8 (11) The alarming rise in the prevalence of 9 asthma, its adverse effect on school attendance and 10 productivity, and its cost for hospitalizations and 11 emergency room visits, highlight the importance of 12 public health interventions, including increasing 13 awareness of asthma as a chronic illness, its symp- 14 toms, the role of both indoor and outdoor environ- 15 mental factors that exacerbate the disease, and other 16 factors that affect its exacerbations and severity. 17 The goals of the Federal Government and its part- 18 ners in the nonprofit and private sectors should in- 19 clude reducing the number and severity of asthma 20 attacks, asthma’s financial burden, and the health 21 disparities associated with asthma. 22 (12) The high health and financial burden 23 caused by asthma underscores the importance of ad- 24 herence to the National Asthma Education and Pre- 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 5 •HR 5230 IH vention Guidelines of the National Heart, Lung, and 1 Blood Institute. Increasing adherence to guidelines- 2 based care and resulting patient management prac- 3 tices will enhance the quality of life for patients with 4 asthma and decrease asthma-related morbidity and 5 mortality. 6 SEC. 3. ASTHMA-RELATED ACTIVITIES OF THE CENTERS 7 FOR DISEASE CONTROL AND PREVENTION. 8 Section 317I of the Public Health Service Act (42 9 U.S.C. 247b–10) is amended to read as follows: 10 ‘‘SEC. 317I. ASTHMA-RELATED ACTIVITIES OF THE CENTERS 11 FOR DISEASE CONTROL AND PREVENTION. 12 ‘‘(a) PROGRAM FOR PROVIDING INFORMATION AND 13 EDUCATION TO THE PUBLIC.—The Secretary, acting 14 through the Director of the Centers for Disease Control 15 and Prevention and the National Center for Environ- 16 mental Health, shall collaborate with State and local 17 health departments to conduct activities, including the 18 provision of information and education to the public re- 19 garding asthma including— 20 ‘‘(1) deterring the harmful consequences of un- 21 controlled asthma; and 22 ‘‘(2) disseminating health education and infor- 23 mation regarding prevention of asthma episodes and 24 strategies for managing asthma. 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 6 •HR 5230 IH ‘‘(b) DEVELOPMENT OF STATE STRATEGIC PLANS 1 FOR ASTHMA CONTROL.—The Secretary, acting through 2 the Director of the Centers for Disease Control and Pre- 3 vention, shall collaborate with State and local health de- 4 partments to develop State strategic plans for asthma con- 5 trol incorporating public health responses to reduce the 6 burden of asthma, particularly regarding disproportion- 7 ately affected populations. 8 ‘‘(c) COMPILATION OF DATA.—The Secretary, acting 9 through the Director of the Centers for Disease Control 10 and Prevention, shall, in cooperation with State and local 11 public health officials— 12 ‘‘(1) conduct asthma surveillance activities to 13 collect data on the prevalence and severity of asth- 14 ma, the effectiveness of public health asthma inter- 15 ventions, and the quality of asthma management, in- 16 cluding— 17 ‘‘(A) collection of data on or among people 18 with asthma to monitor the impact on health 19 and quality of life; 20 ‘‘(B) surveillance of health care facilities; 21 and 22 ‘‘(C) collection of data not containing indi- 23 vidually identifiable information from electronic 24 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 7 •HR 5230 IH health records or other electronic communica- 1 tions; 2 ‘‘(2) compile and annually publish data regard- 3 ing the prevalence of childhood asthma, the child 4 mortality rate, and the number of hospital admis- 5 sions and emergency department visits by children 6 associated with asthma nationally and in each State 7 by age, sex, race, and ethnicity, as well as lifetime 8 and current prevalence; and 9 ‘‘(3) compile and annually publish data regard- 10 ing the prevalence of adult asthma, the adult mor- 11 tality rate, and the number of hospital admissions 12 and emergency department visits by adults associ- 13 ated with asthma nationally and in each State by 14 age, sex, race, and ethnicity, as well as lifetime and 15 current prevalence. 16 ‘‘(d) COORDINATION OF DATA COLLECTION.—The 17 Director of the Centers for Disease Control and Preven- 18 tion, in conjunction with State and local health depart- 19 ments, shall coordinate data collection activities under 20 subsection (c)(2) so as to maximize the comparability of 21 results. 22 ‘‘(e) COLLABORATION.— 23 ‘‘(1) IN GENERAL.—The Centers for Disease 24 Control and Prevention are encouraged to collabo- 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 8 •HR 5230 IH rate with national, State, and local nonprofit organi- 1 zations to provide information and education about 2 asthma, and to strengthen such collaborations when 3 possible. 4 ‘‘(2) SPECIFIC ACTIVITIES.—The Division of 5 Population Health is encouraged to expand its ac- 6 tivities with non-Federal partners, especially State- 7 level entities. 8 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 9 carry out this section, there are authorized to be appro- 10 priated $65,000,000 for the period of fiscal years 2021 11 through 2025. 12 ‘‘(g) REPORTS TO CONGRESS.— 13 ‘‘(1) IN GENERAL.—Not later than 3 years 14 after the date of enactment of this Act, and once 2 15 years thereafter, the Secretary shall, in consultation 16 with patient groups, nonprofit organizations, medical 17 societies, and other relevant governmental and non- 18 governmental entities, submit to Congress a report 19 that— 20 ‘‘(A) catalogs, with respect to asthma pre- 21 vention, management, and surveillance— 22 ‘‘(i) the activities of the Federal Gov- 23 ernment, including an assessment of the 24 progress of the Federal Government and 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 9 •HR 5230 IH States, with respect to achieving the goals 1 of the Healthy People 2030 initiative; and 2 ‘‘(ii) the activities of other entities 3 that participate in the program under this 4 section, including nonprofit organizations, 5 patient advocacy groups, and medical soci- 6 eties; and 7 ‘‘(B) makes recommendations for the fu- 8 ture direction of asthma activities, in consulta- 9 tion with researchers from the National Insti- 10 tutes of Health and other member bodies of the 11 Asthma Disparities Subcommittee, including— 12 ‘‘(i) a description of how the Federal 13 Government may improve its response to 14 asthma, including identifying any barriers 15 that may exist; 16 ‘‘(ii) a description of how the Federal 17 Government may continue, expand, and 18 improve its private-public partnerships 19 with respect to asthma, including identi- 20 fying any barriers that may exist; 21 ‘‘(iii) the identification of steps that 22 may be taken to reduce the— 23 ‘‘(I) morbidity, mortality, and 24 overall prevalence of asthma; 25 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 10 •HR 5230 IH ‘‘(II) financial burden of asthma 1 on society; 2 ‘‘(III) burden of asthma on dis- 3 proportionately affected areas, par- 4 ticularly those in medically under- 5 served populations (as defined in sec- 6 tion 330(b)(3)); and 7 ‘‘(IV) burden of asthma as a 8 chronic disease that can be worsened 9 by environmental exposures; 10 ‘‘(iv) the identification of programs 11 and policies that have achieved the steps 12 described under clause (iii), and steps that 13 may be taken to expand such programs 14 and policies to benefit larger populations; 15 and 16 ‘‘(v) recommendations for future re- 17 search and interventions. 18 ‘‘(2) SUBSEQUENT REPORTS.— 19 ‘‘(A) CONGRESSIONAL REQUEST.—During 20 the 5-year period following the submission of 21 the second report under paragraph (1), the Sec- 22 retary shall submit updates and revisions of the 23 report upon the request of the Congress. 24 VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS 11 •HR 5230 IH ‘‘(B) FIVE-YEAR REEVALUATION.—At the 1 end of the 5-year period referred to in subpara- 2 graph (A), the Secretary shall— 3 ‘‘(i) evaluate the analyses and rec- 4 ommendations made in previous reports; 5 and 6 ‘‘(ii) determine whether an additional 7 updated report is needed and if so submit 8 such an additional updated report to the 9 Congress, including appropriate recommen- 10 dations.’’. 11 Æ VerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H5230.IH H5230 kjohnson on DSK79L0C42 with BILLS