Bill to Fight Asthma Meets Last-Minute Opposition

Preston Hedgepeth wheezed and coughed throughout his short life, struggling mightily to breathe. At the age of 12, the Oxnard boy took his final gulp of air, suffering a fatal asthma attack while sitting in music class with his younger brother.

His mother believes that Preston might have lived had she known more about how to manage his asthma, a chronic respiratory disease that has exploded into epidemic levels over the last 20 years.

“There wasn’t even a pamphlet to help me find organizations for people with this condition,” Carolyn Hedgepeth said, remembering the frustrations that preceded her son’s death in 1996. “For some reason, asthma just hasn’t been given the attention it deserves.”

Spurred by the American Lung Assn., lawmakers are trying to close that information gap with a bill that asthmatics and their supporters consider vital.

The measure, sponsored by the lung association, would create a statewide education, prevention and research program aimed at curbing the startling rise of asthma, which kills more than 600 Californians each year.

The bill is supported by 38 organizations, from the California School Nurses Assn. to the Sierra Club and the Union of Concerned Scientists. During its journey through the Legislature, it has drawn solid bipartisan support, including 21 coauthors.

But now, at the 11th hour, it appears to be in trouble. The Department of Finance has come out against the measure, citing its annual price tag of $11 million. And the bill is stalled in the Assembly along with dozens of other measures that carry costs not covered by the recently signed state budget.

“We’re very concerned,” said Tony Najera, a lobbyist for the lung association. “The prevalence of asthma is growing, and the state needs to step in with a comprehensive response soon.”

Asthma is characterized by inflammation of the airways and can be triggered by a range of factors, from air pollution to tobacco smoke, pollen, exercise and stress.

Since the late 1970s, the number of asthma cases has exploded, creating what experts describe as a global epidemic. In the United States, more than 17 million people suffer from the disease--2.3 million of them in California.

More than 5,000 Americans die of asthma each year, despite medical advances and new drugs that have rendered most attacks controllable. African Americans are afflicted at a 22% higher rate than whites. Black children also die of asthma up to six times more frequently.

Asthma is the No. 1 chronic disease afflicting American children, with young patients missing an average of 20 to 40 school days a year.

Although California has the highest estimated number of asthma cases of any state, it lacks a coordinated program to combat the disease. Such programs exist for cancer, diabetes and other chronic diseases, but asthma has received comparatively little attention thus far from state health authorities. Their work has been limited to a few pilot projects looking at asthma in the workplace and in families with smokers.

The rise in asthma cases--despite today’s more effective medications--demonstrates the need for a statewide attack on the disease, said Dr. Richard Kreutzer, chief of environmental health investigations for the state Department of Health Services.

Dr. Marielena Lara, a pediatrician and director of a joint UCLA/Rand Corp. program on Latino children with asthma, agreed. “Unlike AIDS, tuberculosis, cancer,” she said, “the government has not stepped in with a comprehensive approach to the disease.”

Last year, the state convened an asthma summit, inviting experts to help map out a strategy to manage the disease. This year’s legislation by state Sen. Byron Sher (D-Palo Alto) grew out of that event and is a more comprehensive version of a bill vetoed by Gov. Pete Wilson last year.

About $7 million of the Sher bill’s annual price tag would fund community-based prevention programs. The balance of the $11 million would go to research, surveys to document the incidence of asthma across various populations and geographic areas, help for school districts and child care facilities, and an outreach program to raise awareness of the disease.

As Preston’s mother sees it, such a program is just what families of asthmatics need. “The biggest challenge in my son’s treatment was that I didn’t even know what questions to ask,” said Hedgepeth, whose younger son, Jordan, now has asthma as well. “We need to get the word out so parents can be effective partners with their doctors.”

The Sher bill hit its first bit of turbulence earlier this summer, when funds for the asthma program were excluded from the state budget. More recently, the state Department of Finance released an analysis recommending rejection of the bill on fiscal grounds.

Supporters counter with the “ounce of prevention” argument. They believe that $11 million is a small price to pay to fight a disease that requires hospitalizations costing more than $350 million a year in California--$136 million of which is funded by Medi-Cal.

Sher said that although he has not given up hope for the bill, the prospects are grim. Once the budget is signed, it is always difficult to get approval for programs carrying additional major expenditures, he said.

A spokeswoman for Gov. Gray Davis said he has no position on the bill.