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Welcome

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WelcomeTonya Winders, President and CEO,

Allergy & Asthma Network

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Getting into Action on Asthma

Tracy Washington Enger, Environmental Protection Agency

Indoor Environments Division

Communities in Action:

The Indoor Environments Division’s Role in Supporting Communities to Deliver

Sustainable In-Home Asthma Care Services

November 2015Office of Research and DevelopmentFull Name of Lab, Center, Office, Division or Staff goes here.

The Calling

Heroic Journey

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EPA’s Calling

Mobilizing 1,000 Communities to Lead the Nation in the Delivery of

Quality Asthma Care

The System for Delivering High Quality Asthma Care

Poor and Minority Children Have a Greater Asthma Burden

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Asthma Prevalence Among ChildrenPercent of total U.S population of 0-17 year olds (2013)

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Mexican/Mexican American

Puerto Rican

Hispanic

Other Non-Hispanic

Black Non-Hispanic

White Non-Hispanic

> 250% poverty level

100%-249% poverty level

< 100% poverty level

Total

0 5 10 15 20 25

5.620.7

7.47.9

13.47.5

13.68.1

11.7

8.3

Percent

Source:CDC/NCHS, National Health Interview Survey, http://www.cdc.gov/asthma/nhis/2013/table4-1.htm

Federal Efforts to Combat Asthma Disparities

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May 2013

Foundation: Effective asthma care must be comprehensive & address the environment & self management skills

Focus: Environment, in-home asthma care, local capacity

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A national call-to-action to prompt parental and community action through a research-based, public service campaign developed by EPA and the Ad Council.

Audience: Parents/caregivers/youth, especially urban, low-income communities

Media: Radio, newspaper, outdoor, web, social media, posters (English & Spanish)

Resources: Website www.noattacks.org/breathe-easies

A National Call to Action

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Communities in Action

EPA’s ACN.org Network of 1,000+ Programs Delivering Comprehensive Asthma Care

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Opportunity to connect with other health and housing programs

Answering the Call

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Equip health, housing, environmental and health insurance programs to

effectively support the delivery, infrastructure and/or sustainable financing of

environmental asthma interventions at home and school.

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Key Considerations for Securing Sustainable Financing

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• Delivery Provider– Community Health Worker– Nurse, RT, other licensed practitioner

• Program Components– Education– Environmental assessment– Intervention/Remediation

• Community Support System & Infrastructure– Link with clinical care– Connection to housing & environment programs

Population served Program Outcomes & Return on Investment

Our Approach:Securing Sustainable Financing for In-Home Asthma Care Services

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Equip 300 health, housing, environmental and health insurance programs to effectively support the delivery, infrastructure and/or sustainable financing of environmental asthma interventions at home and school.

Influence Health Plans, State Medicaid & Key Stakeholders

Equip Programs to Act

The Role of Medicaid

18Source: ahrq.gov, 2005.

Stakeholders Who Drive Change within State Medicaid Programs

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Key Interests Represented

• People paying for services

• State Medicaid/Legislature• Health Plans

• People delivering services

• People supporting and driving change

• Regional health, housing and environment

Federal Agencies Working to Expand Access to In-Home Asthma Care Services

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HUD Healthy Homes Asthma Summits

• Promote coverage of in-home asthma care services by Medicaid programs and private insurers (summits held in: Cleveland, Kansas City, Baltimore, Denver, Philadelphia and Los Angeles .

• HUD lead with assistance from EPA, CDC, and HHS Asst. Sec for Health.

• EPA is active collaborator and participant (highlights work from “local champions” and organizations that have made progress on the issue).

• Materials from summits are posted on EPA’s Asthma Community Network website: www.asthmacommunitynetwork.org/resources/conferences/

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What is it you are called to do?

Whom are you called to serve?

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How to be

• Open to Assuming a Leadership Role in Asthma

Control

• Aggressively Seeking Out New Approaches

• Focused on Committing to Actions You in Can

Take

• Leaders in Service to One Another

• PRESENT!

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What does it mean to be “Present”?• Present- I am here• Present- In the moment• Present – A gift• Presence – I am here, in the moment as a

gift.

Sharing Our Wisdom“Community is a locus of healing, not the hospital or the clinic.”

“Patients cannot see outside their pain, we cannot see in, relationship is the only bridge between”

Dr. David Loxtercamp, author of “A Measure of My Days: The Journal of a Country Doctor.”

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State of Asthma in the United States: James Sublett, MD, President, American

College of Allergy, Asthma & Immunology (ACAAI) 

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Break In

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Innovative Approaches for Asthma Care in Your Community: Panel Discussion

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• What elements of delivery, infrastructure and sustainability are surfacing in this program’s story?

• What am I hearing that resonates with me?• What can I take away to use in my work?

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What strategies and approaches are successful asthma programs using to deliver services to their target populations?

What are these programs doings to tailor their activities to the local community needs?

What actions can I take to get more powerful results in my work?

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Networking Lunch(I mean it)

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Improving Outcomes for Children with High-Risk Asthma 

Susan Steppe, Le Bonheur CHAMP program. 

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The Emerging Role of Telehealth for Asthma: Panel discussion

Elena KaltsasJay Portnoy, MD

Tania Elliott

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• What did you hear?• What was your reaction?• What do you want to understand

better to get into action?

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Break In

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Climate Change Impact on Indoor and Outdoor Air:

Jay M. Portnoy, MD, FACAAI, Children’s Mercy Hospital, Missouri; Healthy Homes: Indoor-Outdoor

Environmental Interventions to Improve Asthma Outcomes

Michael McKnight, Green and Healthy Homes Initiative (GHHI)

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• What did you hear?• What was your reaction?• What do you want to understand

better to get into action?

Tasks Objectives GoalsMission

Activities Outputs OutcomesImpact

Logic Model

EVALUATION DESIGN

Value Proposition: Your Pitch

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Program Evaluation to Drive Outcomes & Funding for

Sustainability Andrea Jensen, Utah County Health

Department

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Comprehensive Asthma Control Through Evidence-based Strategies

and Public Health—Health Care Collaboration

Paul Garbe, Centers for Disease Control and Prevention.

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• What did you hear?• What was your reaction?• What do you want to understand

better to get into action?

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Closing? (I think not)

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Gratitude