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2012 National Award Winners Share Strategies for Reaching Children Most Impacted by Asthma Disparities
Moderator:
• Tracy Washington Enger, U.S. Environmental Protection Agency
Presenters:
• Lisa Jordan, Easy Breathing at Connecticut Children’s Medical Center
• Lisa Diaz, L.A. Care Health Plan
• John Dowling, Michigan Department of Community Health, Asthma Prevention and Control Program
• Melinda Shuler, The Regional Asthma Disease Management Program at Mission Children’s Hospital
Welcome to the Webinar
Wednesday, May 30, 2012 Webinar 1:00 – 2:00 p.m. EDT
Live Online Q&A 2:00 – 3:00 p.m. EDT on AsthmaCommunityNetwork.org
Operator Assisted Toll-Free Dial-In Number: (800) 374-0278
Conference ID: 79424747
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Introduction
Tracy Washington Enger
U.S. Environmental Protection Agency
Operator Assisted Toll-Free Dial-In Number: (800) 374-0278 Conference ID: 79424747
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Purpose of Webinar
1. Learn about four exemplary asthma management programs and how they accelerate improvements in asthma care and address asthma disparities.
2. Identify how these programs are built, evaluated and sustained based on the Asthma Change Package/System for Delivering High Quality Asthma Care.
3. Hear about program outcomes and results.
4. Learn how to improve your asthma management program.
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Agenda 1. Introduce EPA’s National Environmental Leadership Award in Asthma
Management and the Asthma Change Package/The System for Delivering
High-Quality Asthma Care
2. Hear from Award Winners:
– Lisa Jordan, Easy Breathing at Connecticut Children’s Medical Center
– Lisa Diaz, L.A. Care Health Plan
– John Dowling, Michigan Department of Community Health, Asthma Prevention and Control Program
– Melinda Shuler, The Regional Asthma Disease Management Program at Mission Children’s Hospital
3. Q&A Session in AsthmaCommunityNetwork.org Discussion Forum
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Do you have questions? The Award Winners will be available online in the AsthmaCommunityNetwork.org Discussion Forum from 2:00-3:00 p.m. EDT today to respond to questions you post in the Discussion Forum. To post a question in the Discussion Forum, follow these directions:
1. If you are a Network member, log-in to your AsthmaCommunityNetwork.org account.
2. Under the “Interact” tab on the homepage navigation, Click on the “Discussion Forum” link.
3. Click on the “Questions for the 5/30/12 Webinar” link at the top of the page. Click on the “post to the forum” button to post your question.
4. When you have finished entering in your question, click the “Save” button at the bottom of the page.
Questions & Answers Session on AsthmaCommunityNetwork.org Discussion Forum
Not a member? Create an account at AsthmaCommunityNetwork.org by clicking the “Join Now” link at the top of the page. Your account will be approved momentarily and you can begin posting questions.
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Using the Webinar Technology
Hide Control Toolbar
Maximize Presentation
Question/Chat Feature
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Using the Webinar Technology
Type your question
here, then click send
Maximize or Minimize
Pop-Out Feature
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Using the Webinar Polling Technology
Select one answer and then click “submit”
The question will be listed
here
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Poll Question Audience Snapshot
Which best describes your organization?
• State or local health department
• Community asthma program
• Federal agency
• Health Plan
• Health care provider
• Other
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EPA’s National Environmental Leadership Award in Asthma Management
“This recognition from the U.S. EPA has validated our past efforts, increased our organization’s
visibility in the community, and empowered us to take a risk in creating new programs for the future.”
Dr. Mamta Reddy, 2011 Award Winner, South Bronx Asthma Partnership, Bronx-Lebanon Hospital Center
Learn more at www.asthmaawards.info
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Who: Champions and Leaders of Community Asthma Assets
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Service
Providers Coalitions
Health Plans
Funders
Non-Profits
Sustain
Evaluat
e
Build
Local
Environmental
Public Officials
State Agencies
Public Housing
Schools Tailored
Environmenta
l Interventions
Integrated
Health Care
Services
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Easy Breathing at Connecticut Children’s Medical Center
Lisa Jordan Program Coordinator, AE-C, RPFT
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• Location: Hartford, Connecticut
• Type of Program: Hospital and Public Health Department Collaboration to provide Community Asthma Management Program for Primary Care Practitioners. The Program is designed to translate the national asthma guidelines into a usable format to assist clinicians in diagnosing and treating asthma.
• Service Area: Statewide
• Population Served: Urban, suburban and rural communities throughout the state
• Results: 35% hospitalizations; 27% ED visits; increased use of appropriate medications; 90% of participants receive a written treatment plan.
Program at a Glance
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Conduct Needs-Based Planning
1998
• 41% of children diagnosed with asthma
• 38% receiving care consistent with NAEPP guidelines
Homes
• Majority pre-1950’s
• Overcrowding and pest infestation
Building the System
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Building the System
Today: • 105,000 children enrolled
(26,000 with asthma) • 340 clinicians • 100 practices statewide
1998 2000 2002 2007
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Evaluating the System Evaluate Interventions
• Use database for informative feedback
Evaluate Program Impact – 3 Cohort Studies
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Promote Institutional Change for Sustainability
• Integrate curriculum
• Keep up with current technology
• Work with EMR companies to integrate program into EMRs
Sustaining the System
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L.A. Care Health Plan
Lisa Diaz, RN, MSN Clinical Health Improvement Nurse
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• Location: Los Angeles, California
• Type of Program: Public, non-profit Health Plan
• Service Area: Los Angeles County
• Population Served: 800,000 of Medicaid's vulnerable managed care members residing in low-income communities
• Results: Member satisfaction reported at 97.6% in 2011; from 2010 to 2011, HEDIS rate for appropriate use of asthma medication ↑ to 84.5% for Medicaid and ↑ to 93.94% for Healthy Families
Program at a Glance
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Identifying Patients:
Building the System
Interventions:
• Quarterly monitoring, complex case management, in-home visits, referrals, and educational mailings
Educational Opportunities:
• Health in Motion – Asthma 101 classes
• Materials available by mail, online, monthly classes
• Asthma telephone resource line and quarterly monitoring
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Monthly Tracking of 24,000 Members:
• Reports generated by geographic region, member age and asthma severity level
Healthcare Effectiveness Data and Information Set (HEDIS):
• Track appropriate medication use (2011, 84.58%)
• Awarded – Certification for Savings Measurement Validity
Annual Evaluation Drives Program Enhancements:
• Target asthma members needs
• Revise education materials and update continuously
Evaluating the System
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Funding:
• L.A. Care Health Plan
• Funding assessed annually based on member growth
Reimburse Community-Based Organizations at Established Case Rate for :
• In-home asthma visits, includes
• Follow-up calls
• Environmental management supplies and tools
Sustaining the System
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Michigan Department of Community Health, Asthma Prevention and Control Program
John Dowling Public Health Consultant & Lead Asthma Coordinator
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• Location: Lansing, Michigan
• Type of Program: Community Asthma Coalition
• Service Area: Statewide, focusing on communities with the highest asthma burden
• Population Served: Low income, urban, suburban and rural communities throughout the state
• Results: 24% asthma mortality; 28% in pediatric hospitalizations; 41% in asthma hospitalizations for children enrolled in Michigan Medicaid programs
Program at a Glance
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Let Data Guide Program Planning, Design and Implementation
Building the System
Today: Third iteration of 2011-2014 Strategic Plan uses collaborative partnerships to achieve success.
High Performing Collaborations: Partnered with University of Michigan School of Public Health to develop presentation to educate participants on asthma triggers in the home.
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• Evaluate Program Implementation
• Utilize partnerships, contract language, funding, application prioritization
• Establish sustainable programs to meet the needs of asthma community
Evaluating the System
• Results: 24% MI asthma mortality ratio (2000-2007); 28% pediatric asthma hospitalization rates (2000-2009); 41% asthma hospitalization for children in MI Medicaid programs (2005-2009).
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Secure and maintain diverse funding streams:
• NACI
• AHRQ
• EPA
• HUD
Utilize integrated partnerships to make policy recommendations and promote community initiatives:
• Asthma 1-2-3 with American Lung Association of Michigan
• Diabetes, arthritis, cancer, disabilities, tobacco and injury prevention programs
Sustaining the System
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The Regional Asthma Disease Management Program at Mission Children’s Hospital
Melinda Shuler Regional Clinical Coordinator
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• Location: Asheville, North Carolina
• Type of Program: Non-profit Community Health System
• Service Area: 21 counties in western North Carolina, including the Eastern Band of the Cherokee Indian Reservation
• Population Served: Remote, rural; Urban; Latino and Slavic communities
• Results: 3,415 children received “asthma friendly” environment interventions; 259 staff educated; 91% of 235 adults pledged to create smoke-free environments for children; significant decreases in ED visits, hospitalizations and school absences.
Program at a Glance
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Conduct Needs Based Planning:
Building the System
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Building the System
Focus on Resource Strategy at Every Step
• Utilize Community Partnerships:
• Cherokee Indian Hospital Authority
• National Asthma and Allergy Supply Company
• Charitable community partners and faith-based organizations
• Conduct Regional Workshops:
• Held in elementary schools, childcare centers and primary care offices
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Collect health data
• Severity level, ED utilization, hospitalization, school absences, quality of life questionnaires, environmental trigger exposure
Encourage patients to pledge to create an asthma friendly environment
Examine patient charts to assess program effectiveness:
• ED visits: 158 to 9 (pre- to post-intervention)
• Hospitalizations: 60 to 3 (pre- to post-intervention)
• Missed school days: 17 to 9 (pre- to post-intervention)
• Lung spirometry and exhaled nitric oxide improved
• Cost of care decreased: ED $142,006 and hospitalizations $687,477
Evaluating the System
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Budget and administrative support provided by Mission Children’s Hospital:
• Public/private grants
• Mission Healthcare Foundation
• Clinical coordinator, PT case manager, PT administrative support
Access to Mission Health System Resources
Applied for Medicaid licensure to bill for services provided
Partners and Mission Health System provide in-kind language services
Sustaining the System
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Conclusion of the Webinar
Post your questions now on
www.AsthmaCommunityNetwork.org
2012 National Award Winners Share Strategies for
Reaching Children Most Impacted by Asthma Disparities
Moderator:
• Tracy Washington Enger, U.S. Environmental Protection Agency
Presenters:
• Lisa Jordan, Easy Breathing at Connecticut Children’s Medical Center
• Lisa Diaz, L.A. Care Health Plan
• John Dowling, Michigan Department of Community Health, Asthma Prevention and Control Program
• Melinda Shuler, The Regional Asthma Disease Management Program at Mission Children’s Hospital
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Do you have questions? The Award Winners will be available online in the AsthmaCommunityNetwork.org Discussion Forum from 2:00-3:00 p.m. EDT today to respond to questions you post in the Discussion Forum. To post a question in the Discussion Forum, follow these directions:
1. If you are a Network member, log-in to your AsthmaCommunityNetwork.org account.
2. Under the “Interact” tab on the homepage navigation, Click on the “Discussion Forum” link.
3. Click on the “Questions for the 5/30/12 Webinar” link at the top of the page. Click on the “post to the forum” button to post your question.
4. When you have finished entering in your question, click the “Save” button at the bottom of the page.
Questions & Answers Session on AsthmaCommunityNetwork.org Discussion Forum
Not a member? Create an account at AsthmaCommunityNetwork.org by clicking the “Join Now” link at the top of the page. Your account will be approved momentarily and you can begin posting questions.