RAMP engages in a wide range of policy efforts aimed at addressing the burden of asthma. These efforts range from sponsoring state legislation on cleaning practices in schools to participating in regional and state level regulatory campaigns to improve outdoor air quality.
Below is a sample of the policies RAMP, in collaboration with key partners, including Community Action to Fight Asthma, is actively supporting in 2013.
A rule issued by the Centers for Medicaid and Medicare Services (CMS) has exciting implications for support for asthma management. Beginning January 1, 2014, Medicaid (either directly or through its managed care contractors) will be able to cover and pay for preventive services so long as the services have been initially recommended by a physician or other licensed practitioner. Until this rule goes into effect, current Medicaid regulations limit coverage of preventive services to those that are provided by a physician or other licensed practitioner. The rule may ultimately provide additional support for community-based asthma interventions carried out by asthma educators, healthy homes specialists, or other community health workers. State Medicaid programs have to adopt the rule before it goes into effect.
Outdoor Air Quality/Land Use
- SB 691 (Hancock) – Emission Violation Fines
In response to the Chevron refinery fire in Richmond,CA, this bill seeks to increase the penalties for large-scale air quality violations. This bill will help increase the cost of violations, thus creating additional incentives to maintain practices that prevent such large-scale disasters.
- SB 1275 (de León) – Charge Ahead
SB 1275 aims to 1) bring one million electric cars, trucks and buses to California over the next decade and 2) ensure that low-income Californians, who are disproportionately impacted by air pollution, benefit from the transition to a clean transportation sector. This bill will help improve air quality by increasing the number of electric vehicles on the road. The bill’s emphasis on expanding access to clean cars to low-income communities will particularly help improve air quality in the most impacted communities.
- SB 1204 (Lara and Pavley) – Zero Emission Trucks and Buses
SB 1204 would direct a portion of cap and trade revenue to fund zero- and near-zero emission truck and zero-emission bus technology. This bill also prioritizes funding for disadvantaged communities most impacted by air pollution. By creating incentives for the development of zero-emission technologies for heavy duty trucks and buses, this new program could reduce emissions and help in the transformation of moving freight through communities in California.
RAMP has supported various policies related to California’s effort to reduce greenhouse gas (GHG) emissions. RAMP has focused its attention on those climate change policies that have the most direct health “co-benefits” for those with asthma. For example, policies to reduce GHGs through reducing vehicle miles traveled (VMT) have the added benefit of improving overall air quality. RAMP is paying specific attention to regional and state efforts to reduce GHGs and VMT through land use (see SB 375). For example, within the Bay Area, RAMP and other advocates are pushing for the adoption of a Sustainable Communities Strategy that maximizes environmental benefits. At the state level, RAMP and partners are working to ensure the full implementation of policies like the Low Carbon Fuel Standard, which will bring alternative fuels into the market place and help lower GHGs and pollution in the process. RAMP and partners are also working to ensure that funding from the state’s cap and trade program are invested in projects that have a particular benefit for communities facing the greatest risks and impacts from climate change.
RAMP is working with many partners to address the health problems and social inequities related to the state’s freight transportation system – the infrastructure of ships, ports, trains, rail yards, distribution centers trucks and other equipment that move goods in and across California. In addition to those goods, the freight system brings pollution and quality of life burdens to too many communities, especially low income communities and communities of color. In addition to advocating for the full implementation of the state’s diesel risk reduction regulations, RAMP and its allies are also working with the California Air Resources Board to develop and adopt transformational changes to the freight system.
- Promoting public health in regional land use decisions
RAMP, as part of the Ditching Dirty Diesel Collaborative (DDDC), is working to adopt public health and environmental criteria into land use and transportation planning scenarios for the San Francisco Bay Area’s Sustainable Communities Strategy. Locally, DDDC has been actively engaged with the staff of the Metropolitan Transportation Commission (MTC) to promote health protective measures that highlight land use conflicts, affordable housing developments and freight transport issues within the Bay Area. RAMP and its partners are also working to shape the Alameda County Transportation Commission’s development of a goods movement plan that will shape freight in Alameda and the region for years to come. RAMP continues to advocate for smart growth and healthy development where economic, environmental and public health inequities exist.
- SB 391 (DeSaulnier) – California Homes and Jobs Act of 2013
This bill establishes a permanent source of funding for affordable housing. This funding will make up for funding lost for affordable housing with recent elimination of the state’s redevelopment agencies. A lack of quality affordable housing serves as a force that pushes people into living in unhealthy, substandard housing conditions. This bill would increase access to healthy, affordable housing.
- SB 1167 (Hueso) – Pest-free Housing
SB 1167 would require those cited for a pest infestation to also remediate any housing conditions that contribute to the infestation, such as leaky plumbing and cracks and holes in walls or flooring. Both pests and pesticides can trigger and exacerbate asthma. Relying on extermination alone to manage pests often leads to repeated infestations and repeated exposure to pesticides. Effective pest management requires any underlying conditions that provide pests food, water, entry, and harborage be addressed. This would encourage those cited for a pest infestation to address those underlying conditions.
RAMP has been working with local partners through Alameda County Department of Public Health’s Place Matters Program and the Alameda County Healthy Homes Alliance to develop and promote proactive rental housing inspection policies. Because traditional, complaint-based code enforcement for substandard housing issues puts the burden on tenants to report problems, many problems go unreported due to lack of knowledge, fear of retaliation or rent increases, or language barriers. Proactive systems require routine inspections of rental properties, removing the burden from tenants and ensure all rental housing meets existing health and safety standards.
- AB 2235 (Buchanan and Hagman) – School Facilities Bond
AB 2235 would put a 2014 School Facilities Bond on the November ballot. The bond would create state funding to support the construction and modernization of the state’s public schools. The quality of school facilities plays a key role in the exposure to asthma triggers in schools. With improvements in how the program is run, a new school facilities program could support healthier schools, particularly those needing modernization
- SB 1055 (Liu) – School Based Health Centers
The Public School Health Center Support Program was created in 2006, but has never been funded. SB 1055 would provide funding for the program and add a “population health grant” for the purpose of advancing prevention programs such as those related to obesity, asthma, substance abuse and mental health to the program.
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