Using Medicaid to Advance Community-Based Childhood Asthma Interventions

On February 6, 2013, the Childhood Asthma Leadership Coalition hosted a webinar entitled: Developing Mechanisms for Sustainable Funding of Community Asthma Management. The webinar examined new and ongoing efforts underway in Massachusetts to address the burden of childhood asthma through delivery system innovations and new reimbursement models that promote community-based interventions to reduce asthma triggers in homes and community settings.

To continue the dialogue started during the webinar, the Coalition has also released a white paper entitled Using Medicaid to Advance Community-Based Childhood Asthma Interventions: A Review of Innovative Medicaid Programs in Massachusetts and Opportunities for Expansion under Medicaid Nationwide. The attached white paper:

• Reviews community asthma interventions;
• Describes new initiatives underway in Massachusetts to promote community-based asthma prevention for children; and
• Discusses opportunities for state Medicaid programs to incorporate these interventions into Medicaid and the Children’s Health Insurance Program (CHIP) programs nationwide.

Medicaid EHB Comments

In late January, the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on the implementation of the Medicaid expansion provisions of the Affordable Care Act. The Childhood Asthma Leadership Coalition submitted comments to CMS.

Click here to see the comments.

Community Action to Fight Asthma (CAFA) Briefing Kit

The Community Action to Fight Asthma (CAFA) Briefing Kit was developed as a tool to educate decision-makers about the problem of asthma and the need for environmental policy changes. Originally developed in 2004 and updated in 2007 and 2009, the kit includes science-based fact sheets on the health impacts of poor air quality in schools, homes, and outdoor environments. It also includes general information about asthma in California, the structure and purpose of the CAFA Network, and broad policy priorities. Copies can be downloaded at http://www.rampasthma.org/advocacy/asthma-briefing-kit/. For hard copies, inquire at info@rampasthma.org.

Continuous Coverage

ACA and Changing Policy: Continuous Coverage

About the Series: In February 2010, the George Washington University School of Public Health and Health Services, Department of Health Policy released Changing pO2licy: The Elements for Improving Childhood Asthma Outcomes. The report provided a comprehensive look at childhood asthma prevalence, risk factors and disparities; described best practices for clinical care and disease management; and, outlined evidence-based policy recommendations to improve the prevention, diagnosis, treatment, and long-term management of childhood asthma.

The report identified five essential elements for improving asthma outcomes in children:

1. 1. Stable and continuous health insurance
   2. High-quality clinical care, case management and asthma education available for all children
   3. The ability to continuously exchange information and monitor progress, using health information technology
   4. Reducing asthma triggers in homes and communities
   5. Learning what works and increasing knowledge

Following the release of these recommendations, Congress passed the Affordable Care Act (ACA), emphasizing expanding access to private health insurance and Medicaid and reforming the healthcare delivery system to improve quality. The ACA includes provisions to eliminate health care disparities, strengthen public health programs and access to preventive services, invest in expanding and improving the health care workforce, and encourage care coordination and disease management.

Many ACA provisions correspond to recommendations in the Changing pO2licy report and have the potential to profoundly impact the prevention and treatment of childhood asthma.

This paper focuses on one of the five essential elements for improving asthma outcomes in children: stable and continuous health insurance. The accompanying chart describes ACA provisions and implementation activities that could be activated to help millions of children most at risk for asthma.

Click here to view the chart.

Health IT

ACA and Changing Policy: Health IT

This paper focuses on one of the five essential elements for improving asthma outcomes in children: the ability to continuously exchange information and monitor progress, using health IT. The accompanying chart describes ACA provisions and implementation activities that could be activated to help millions of children most at risk for asthma.

Click here to view the chart. 

Learning What Works

ACA and Changing Policy: Learning What Works

This paper focuses on one of the five essential elements for improving asthma outcomes in children: learning what works and increasing knowledge. The accompanying chart describes ACA provisions and implementation activities that could be activated to help millions of children most at risk for asthma.

Click here to view the chart. 

Quality Healthcare

ACA and Changing Policy: Quality Healthcare

This paper focuses on one of the five essential elements for improving asthma outcomes in children: high-quality clinical care, case management and asthma education. The accompanying chart describes ACA provisions and implementation activities that could be activated to help millions of children most at risk for asthma.

Click here to view the chart.

Reducing Triggers

ACA and Changing Policy: Reducing Triggers

This paper focuses on one of the five essential elements for improving asthma outcomes in children: reducing asthma triggers in homes and communities. The accompanying chart describes ACA provisions and implementation activities that could be activated to help millions of children most at risk for asthma.

Click here to view the chart.

Federal Asthma Disparities Action Plan

On May 31, 2010, the President’s Task Force on Environmental Health Risks and Safety Risks to Children (“Task Force”) released the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities (“Action Plan”). In general, the Action Plan calls on federal agencies to synergize their actions by coordinating federal programs and partnerships to reduce asthma disparities.

Specifically, the Action Plan provides an outline for federal action over the next 3 to 5 years to combat asthma in the following strategic categories: (1) Reduce barriers to the implementation of guidelines-based asthma management; (2) Enhance capacity to deliver integrated, comprehensive asthma care to children in communities with racial and ethnic disparities; (3) Improve capacity to identify the children most impacted by asthma disparities; (4) Accelerate efforts to identify and test interventions that may prevent the onset of asthma among ethnic and racial minority children. Please refer to the attached document for further details.

The Asthma Disparities Working Group, which is part of the Task Force, will oversee and support the progress of each of the strategies in the plan. The progress that federal agencies have made on the Action Plan’s implementation will be documented semiannually and made public.

Changing Policy

In February 2010, the George Washington University School of Public Health and Health Services, Department of Health Policy (GWU) released Changing pO2licy: The Elements for Improving Childhood Asthma Outcomes (Changing pO2licy). The report was released with support from the Merck Childhood Asthma Network (MCAN) and the RCHN Community Health Foundation and provides a comprehensive look at childhood asthma prevalence, risk factors and disparities; describes best practices for clinical care and disease management; and outlines evidence-based policy recommendations to improve the prevention, diagnosis, treatment, and long-term management of childhood asthma.

The report identified five essential elements for improving asthma outcomes in children, including: (1) stable and continuous health insurance; (2) high quality clinical care, case management, and asthma education available for all children, including those who remain ineligible for insurance coverage; (3) the ability to continuously exchange information and monitor progress, using health information technology (HIT) as much as possible; (4) reducing asthma triggers in homes and communities; and (5) learning what works and increasing knowledge. Please see the attached document for further information on this landmark report.

HUD Smokefree Housing Comments 2013

In October 2012, the Department of Housing and Urban Development (HUD) issued a request for information on the adoption of smoke-free housing policies. The purpose of this request was to provide a meaningful opportunity for stakeholders to assist HUD in its development of guidance to support the implementation of smokefree policies in both public housing and multifamily housing. The Childhood Asthma Leadership Coalition submitted comments to HUD.

Click here to see the comments. 

The Affordable Care Act and Childhood Asthma

On September 13, 2012, the Childhood Asthma Leadership Coalition hosted a webinar examining the Affordable Care Act and opportunities for childhood asthma. The following presenters participated in this webinar:

• Sara Rosenbaum, JD, Harold and Jane Hirsch Professor of Health Law and Policy, The George Washington University School of Public Health and Health Services
• Katherine Horton, JD, MPH, RN, Research Professor, The George Washington University School of Public Health and Health Services
• Mary-Beth Harty, JD, MPH, Assistant Research Professor, The George Washington University School of Public Health and Health Services

Presenters took a close look the opportunities that exist within the Affordable Care Act for advancing the field of childhood asthma, and what advocates can do now to take advantage of new opportunities under health reform. Slides from the webinar can be found in the attached document; a recording of the webinar is also available.

Asthma Task Force Support Letter

Click here to view the letter.

CALC Meeting Minutes, September 2012

Click here to read the notes from the meeting

The Affordable Care Act: Potential Implications for Individuals with Asthma

In October 2012, Professors Katie Horton and Mary-Beth Harty, both of George Washington University, presented at a meeting hosted by the American Lung Association on the Affordable Care Act and asthma. Professors Horton and Harty discussed health reform and its intersection to the programs offered under the National Asthma Control Program. Slides from the webinar can be found in the attached document.