HUD Healthy Homes. Through. g Home Interventions. Marty Nee
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1 HUD Healty Homes Improving Astma Troug g Home Interventions Marty Nee HUD Office of Healty Homes and Lead Hazard Control
2 Healty Homes and Astma Housing Healt Energy
3 Healty Homes Improving Astma Coordinating Home Interventions Inter entions Single Si l Portal P t l Access A to t SServices i Use of Standardized Assessment Tools Compreensive Assessments Resident Education ducation Coordinated Interventions
4 Healty Homes Improving Astma In Home In Home Healt Assessments Wo Community Healt Workers Registered Nurses Environmental Healt Specialist Respiratory Terapists Certified Astma Educators
5 Healty Homes Improving Astma In Home In Home Healt Assessments/Services Wat Home Environmental Assessments In ome resident education on astma management, including trigger avoidance Equipment or Services tat Reduce Astma Triggers Coordination wit appropriate agencies to conduct construction related remediation
6
7 Reducing Etnic/Racial Disparity in Yout Study (MA DPH, Boston and Baystate Medical Centers) Pediatric Astma Home Visiting Intervention Preliminary Results Healt Pre vs Post (N = 119) Pre Post ED Visit Hospitalization Urgent care Use Oral Steroid Medication Used Funded by HUD Healty Homes Tecnical Studies and AARA R01 grants Recived AAP Actually Used te AAP*
8 NHP Astma Population Acievements Te lowest ospitalization rate since te Astma program s inception in % ER use in 2012 at lowest rate in te program s istory at 8.8% 8% Controller /Reliever medication Ratio.72 8
9 Healty Homes Improving Astma Wy Now is te Time for Action ACA canges to ealt care financing and reimbursement for services CMS opportunities for funding non clinical services HUD adoption of priority for ome interventions tat coordinate wit ealt and energy; promotion of Astma Summits DOE adoption of guidance for weaterization programs to clarify ealt related allowable costs
10 Healty Homes Improving Astma ACA moving mo ing from fee for service ser ice to p patient based outcomes Initiatives around ome based astma interventions CMMI grants Aligning patient outcomes wit funding
11 Healty Homes Improving Astma Severity of Illness and Median Carges for Top 25 APR-DRGs, Alfred I. dupont Hospital for Cildren, 2010 Severity of Illness Minor Moderate Major APR DRG # APR-DRG $ # $ # $ Severe # $ ASTHMA 502 $9,229 $ $10,983 $ $9,925 $ $77,818 $ Delaware Healt and Social Services, Division of Public Healt, Healt Statistics Center
12 Healty Homes Improving Astma Medicaid and Home Based Astma Interventions Recent CMS regulatory cange How do p previous Medicaid regulations g limit access to community based services? Wat does te new rule say? Wat impact will tis cange ave on coverage?
13 Healty Homes Improving Astma HUD Policy Priority Points (Value of up to 4 points wen competing for funds) Priority 1 Promoting Access to Healt Care Priority 4 Promoting coordination of ousing reabilitation wit ealt and energy
14 Healty Homes Improving Astma Priority 1 Promoting Access to Healt Care Strategic objective to connect HUD assistance to ealt care programs and benefits in efforts to improve ealt and ousing outcomes Close relationsip p between ealt and ousingg stability wit respect to vulnerable populations. HUD encourages grantees to undertake collaborations wit public, private, nonprofit, and community and fait based organizations to increase access to ealt insurance and to improve ousing and ealt outcomes
15 Healty Homes Improving Astma Priority 4 Coordination of ousing reabilitation wit ealt and energy Applicants are encouraged to coordinate te delivery off ousing repair/reabilitation / bl wit community, ospital or public ealt programs tat utilize community ealt workers, Promotores(as), ealt educators or oter similar positions tat assesses te indoor quality of ome environments for conditions tat may impact resident ealt ealt, for example example, in te coordination of reabilitation activities wit programs tat assess te ome environments of astmatic cildren ild f astma for triggers. i
16 Healty Homes Improving Astma Astma Summits Federal, d l State S and d local l l programs promoting i to Healt Care Providers and Payers (Medicaid, Managed Care Organizations, Private Insurers) te clinical and economic value of ome assessments and intervention for astma triggers.
17 Healty Homes Improving Astma Anticipated Promotion of te model and alignment wit key national messages Examination and discussion of impediments to adoption of te ome focused model Inter program experience saring and lessons learned Adoption by ealt care payers of te ome focused model for pediatric astma patients
18 Healty Homes Improving Astma How can te ealt providers and public ealt agencies influence te targeting of ousing funding? HUD Healty Homes/LHC funding HUD CDBG/HOME ffunding di Consolidated Plans/Action Plans State and Local Resources
19 Healty Homes Improving Astma Questions?
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