0 Welcome

1 Tonya Winders, President and CEO, Allergy & Asthma Network

2 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 2015 Office of Research and Development Full Name of Lab, Center, Office, Division or Staff goes here.

The Calling Heroic Journey 4

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 7

Asthma Prevalence Among Children Percent of total U.S population of 0-17 year olds (2013) 8 Source: CDC/NCHS, National Health Interview Survey,

Federal Efforts to Combat Asthma Disparities 9 May 2013 Foundation: Effective asthma care must be comprehensive & address the environment & self management skills Focus: Environment, in-home asthma care, local capacity

10 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 easies easies A National Call to Action

11 Communities in Action

EPA’s ACN.org Network of 1,000+ Programs Delivering Comprehensive Asthma Care 12 Opportunity to connect with other health and housing programs

Answering the Call 13 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 15 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 16 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 17 Source: ahrq.gov, 2005.

Stakeholders Who Drive Change within State Medicaid Programs 18 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 19

20 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:

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22 What is it you are called to do? Whom are you called to serve?

23 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!

24 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.”

26 State of Asthma in the United States: James Sublett, MD, President, American College of Allergy, Asthma & Immunology (ACAAI)

27 Break In

28 Innovative Approaches for Asthma Care in Your Community: Panel Discussion

29 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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31 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?

32 Networking Lunch (I mean it)

33 Improving Outcomes for Children with High-Risk Asthma Susan Steppe, Le Bonheur CHAMP program.

34 The Emerging Role of Telehealth for Asthma: Panel discussion Elena Kaltsas Jay Portnoy, MD Tania Elliott

35 What did you hear? What was your reaction? What do you want to understand better to get into action?

36 Break In

37 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)

38 What did you hear? What was your reaction? What do you want to understand better to get into action?

Tasks Objectives Goals Mission Activities Outputs Outcomes Impact Logic Model EVALUATION DESIGN

Value Proposition: Your Pitch 40

41 Program Evaluation to Drive Outcomes & Funding for Sustainability Andrea Jensen, Utah County Health Department

42 Comprehensive Asthma Control Through Evidence-based Strategies and Public Health—Health Care Collaboration Paul Garbe, Centers for Disease Control and Prevention.

43 What did you hear? What was your reaction? What do you want to understand better to get into action?

44 Closing? (I think not)

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46 Gratitude