,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bhjd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ae1         
#bjad,mrs4 ,gillibr& 7= h]self & ,mr4   
,book]7 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act ) reg>d to rese>* on a/hma1
 & = o!r purposes4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,family ,a/hma    
,act4  #b4 ,f9d+s ,congress f9ds !      
foll[+3 7#a7 ,! numb] ( p ev] diagnos$ )
 a/hma increas$ by #ej p]c5t betwe5     
#aiih & #bjab4 ,accord+ to ! ,c5t]s =   
,disease ,control & ,prev5tion1 9 #bjab 
m ?an #be1ejj1jjj ,am]icans _h be5      
diagnos$ ) a/hma1 includ+ an e/imat$    
#f1hjj1jjj *ildr54  7#b7 ,accord+ to !  
,c5t]s = ,disease ,control & ,prev5tion1
 9 #bjaj m ?an #c1djj ,am]icans di$ f   
a/hma4 ,! rate ( mortality f a/hma is   
high] among ,african-,am]icans & wom54  
7#c7 ,! ,c5t]s = ,disease ,control &    
,prev5tion report t a/hma acc\nt$ =     

approximately #dhj1jjj hospitalizations 
& #b1ajj1jjj visits to hospital em]g5cy 
dep>tm5ts 9 #bjji4  7#d7 ,accord+ to !  
,c5t]s = ,disease ,control & ,prev5tion1
 ! annual co/ ( a/hma to ! ,unit$ ,/ates
 is approximately #ef1jjj1jjj1jjj1      
includ+ #e1ijj1jjj1jjj 9 indirect co/s f
 lo/ productivity4  7#e7 ,accord+ to !  
,c5t]s = ,disease ,control & ,prev5tion1
 #aj1ejj1jjj s*ool days & #ad1bjj1jjj "w
 days are miss$ annually z a result (   
a/hma4  7#f7 ,a/hma episodes c be       
trigg]$ by bo? outdoor air pollution &  
indoor air pollution1 includ+ pollutants
 su* z cig>ette smoke & combu/ion       
by-products4 ,a/hma episodes c also be  
trigg]$ by indoor all]g5s su* z animal  
d&] & outdoor all]g5s su* z poll5 &     
molds4  7#g7 ,public heal? int]v5tions &
 m$ical c>e 9 accordance ) exi/+        
guidel9es h be5 prov5 effective 9 !     
treatm5t & managem5t ( a/hma4 ,bett]    
a/hma managem5t c\ld r$uce ! numb]s (   
em]g5cy dep>tm5t visits &               
hospitalizations due to a/hma4 ,/udies  

publi%$ 9 m$ical j\rnals h %[n t bett]  
a/hma managem5t results 9 improv$ a/hma 
outcomes at a l[] co/4  7#h7 ,9 #bjaa1 !
 ,c5t]s = ,disease ,control & ,prev5tion
 report$ t less ?an half ( p ) a/hma _h 
be5 taught h[ to avoid a/hma trigg]s4 ,m
 education ab\t trigg]s1 prop] treatm5t1
 & a/hma managem5t me?ods is ne$$4  7#i7
 ,! al>m+ rise 9 ! preval5ce ( a/hma1   
its adv]se effect on s*ool att5dance &  
productivity1 & its co/ =               
hospitalizations & em]g5cy room visits1 
highlight ! importance ( public heal?   
int]v5tions1 includ+ increas+ aw>5ess ( 
a/hma z a *ronic illness1 its symptoms1 
! role ( bo? indoor & outdoor           
environm5tal factors t exac]bate !      
disease1 & o!r factors t affect its     
exac]bations & sev]ity4 ,! goals ( !    
,f$]al ,gov]nm5t & its p>tn]s 9 !       
nonpr(it & private sectors %\ld include 
r$uc+ ! numb] & sev]ity ( a/hma attacks1
 a/hma's f9ancial burd51 & ! heal?      
disp>ities associat$ ) a/hma4  #c4      
,a/hma-relat$ activities ( ! c5t]s =    

disease control & prev5tion ,section    
#cag;,i ( ! ,public ,heal? ,s]vice ,act 
7#db ,u4,s4,c4 #bdg;b-#aj7 is am5d$ to  
read z foll[s3  #cag;,i4 ,a/hma-relat$  
activities ( ! c5t]s = disease control &
 prev5tion  7a7 ,program = ,provid+     
,in=mation & ,education to ! ,public ,! 
,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 %all collaborate ) ,/ate & local heal? 
dep>tm5ts to conduct activities1 includ+
 ! provision ( in=mation & education to 
! public reg>d+ a/hma includ+-- 7#a7    
det]r+ ! h>mful consequ5ces (           
uncontroll$ a/hma2 &  7#b7 dissem9at+   
heal? education & in=mation reg>d+      
prev5tion ( a/hma episodes & /rategies =
 manag+ a/hma4  7b7 ,developm5t ( ,/ate 
,a/hma ,plans ,! ,secret>y1 act+ ?r\gh !
 ,director ( ! ,c5t]s = ,disease        
,control & ,prev5tion1 %all collaborate 
) ,/ate & local heal? dep>tm5ts to      
develop ,/ate plans incorporat+ public  
heal? responses to r$uce ! burd5 (      
a/hma1 p>ticul>ly reg>d+                

disproportionately affect$ populations4 
7c7 ,compilation ( ,data ,! ,secret>y1  
act+ ?r\gh ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 %all1 9 
coop]ation ) ,/ate & local public heal? 
(ficials-- 7#a7 conduct a/hma           
surveillance activities to collect data 
on ! preval5ce & sev]ity ( a/hma1 !     
effectiv5ess ( public heal? a/hma       
int]v5tions1 & ! quality ( a/hma        
managem5t1 includ+-- 7,a7 collection (  
h\sehold data on ! local burd5 ( a/hma2 
7,b7 surveillance ( heal? c>e           
facilities2 &  7,c7 collection ( data n 
conta9+ individually id5tifiable        
in=mation f electronic heal? records or 
o!r electronic communications2  7#b7    
compile & annually publi% data reg>d+ ! 
preval5ce & incid5ce ( *ildhood a/hma1 !
 *ild mortality rate1 & ! numb] (       
hospital admissions & em]g5cy dep>tm5t  
visits by *ildr5 associat$ ) a/hma      
nationally & 9 ea* ,/ate & at ! c\nty   
level by age1 sex1 race1 & e?nicity1 z  
well z lifetime & curr5t preval5ce2 &   

7#c7 compile & annually publi% data     
reg>d+ ! preval5ce & incid5ce ( adult   
a/hma1 ! adult mortality rate1 & ! numb]
 ( hospital admissions & em]g5cy        
dep>tm5t visits by adults associat$ )   
a/hma nationally & 9 ea* ,/ate & at !   
c\nty level by age1 sex1 race1 e?nicity1
 indu/ry1 & occupation1 z well z        
lifetime & curr5t preval5ce4  7d7       
,coord9ation ( ,data ,collection ,!     
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 9 conjunction ) ,/ate &  
local heal? dep>tm5ts1 %all coord9ate   
data collection activities "u subsection
 7c77#b7 s z to maximize ! comp>ability 
( results4  7e7 ,collaboration  7#a7 ,9 
g5]al ,! ,c5t]s = ,disease ,control &   
,prev5tion are enc\rag$ to collaborate )
 national1 ,/ate1 & local nonpr(it      
organizations to provide in=mation &    
education ab\t a/hma1 & to /r5g!n su*   
collaborations :5 possible4  7#b7       
,specific activities ,! ,division (     
,adolesc5t & ,s*ool ,heal? is enc\rag$  
to exp& its activities ) non-,f$]al     

p>tn]s1 especially ,/ate-level entities4
  7f7 ,additional fund+ ,9 addition to  
any o!r au?orization ( appropriations t 
is available to ! ,c5t]s = ,disease     
,control & ,prev5tion = ! purpose (     
c>ry+ out ?is section1 !re is au?oriz$  
to be appropriat$ to su* ,c5t]s su* sums
 z may be necess>y = ea* ( fiscal ye>s  
#bjae ?r\gh #bjai = ! purpose ( c>ry+   
out ?is section4  7g7 ,report to        
,congress  7#a7 ,9 g5]al ,n lat] ?an #b 
ye>s aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y %all1 9 consultation )
 pati5t gr\ps1 nonpr(it organizations1  
m$ical societies1 & o!r relevant        
gov]nm5tal & nongov]nm5tal entities1    
submit to ,congress a report t-- 7,a7   
catalogs1 ) respect to a/hma prev5tion1 
managem5t1 & surveillance-- 7i7 !       
activities ( ! ,f$]al ,gov]nm5t1 includ+
 an assessm5t ( ! progress ( ! ,f$]al   
,gov]nm5t & ,/ates1 ) respect to a*iev+ 
! goals ( ! ,heal?y ,p #bjbj initiative2
 &  7ii7 ! activities ( o!r entities t  
p>ticipate 9 ! program "u ?is section1  

includ+ nonpr(it organizations1 pati5t  
advocacy gr\ps1 & m$ical societies2 &   
7,b7 makes recomm5dations = ! future    
direction ( a/hma activities1 9         
consultation ) rese>*]s f ! ,national   
,in/itutes ( ,heal? & o!r memb] bodies (
 ! ,national ,a/hma ,education &        
,prev5tion ,program :o are qualifi$ to  
review & analyze data & evaluate        
int]v5tions1 includ+-- 7i7 description (
 h[ ! ,f$]al ,gov]nm5t may improve its  
response to a/hma includ+ id5tify+ any  
b>ri]s t may exi/2  7ii7 description (  
h[ ! ,f$]al ,gov]nm5t may cont9ue1 exp&1
 & improve its private-public p>tn]%ips 
) respect to a/hma includ+ id5tify+ any 
b>ri]s t may exi/2  7iii7 !             
id5tification ( /eps t may be tak5 to   
r$uce !-- 7,i7 morbidity1 mortality1 &  
ov]all preval5ce ( a/hma2  7,,ii7       
f9ancial burd5 ( a/hma on society2      
7,,iii7 burd5 ( a/hma on                
disproportionately affect$ areas1       
p>ticul>ly ^? 9 m$ically und]s]v$       
populations 7z def9$ 9 section          

#ccj7;b77#c772 &  7,,iv7 burd5 ( a/hma z
 a *ronic disease2  7iv7 ! id5tification
 ( programs & policies t h a*iev$ ! /eps
 describ$ "u clause 7iii71 & /eps t may 
be tak5 to exp& su* programs & policies 
to b5efit l>g] populations2 &  7v7      
recomm5dations = future rese>* &        
int]v5tions4  7#b7 ,updates to ,congress
  7,a7 ,congressional reque/ ,dur+ !    
#e-ye> p]iod foll[+ ! submission ( !    
report "u p>agraph 7#a71 ! ,secret>y    
%all submit updates & revisions ( !     
report ^u ! reque/ ( ! ,congress4  7,b7 
,five-ye> reevaluation ,at ! end ( !    
#e-ye> p]iod foll[+ ! submission ( !    
report "u p>agraph 7#a71 ! ,secret>y    
%all evaluate ! analyses &              
recomm5dations made "u su* report &     
det]m9e :e!r a new report to ! ,congress
 is necess>y1 & make appropriate        
recomm5dations to ! ,congress4  4