2022 Brings Exciting Opportunities for Asthma Home Visits

We are making exciting progress in increasing access to asthma home visiting services for Californians with poorly controlled asthma. Together with our partners, we’re seeing the state advance policies and programs that better integrate in-home education, trigger assessment and environmental remediation into the health care system.

Below is an overview of the various pieces of the integration puzzle.

Asthma Remediation under Community Supports 

January, 2022 marked the launch of a new Medi-Cal program that allows Managed Care Organizations (MCOs) to use Medicaid funding to pay for home trigger remediation for people with poorly controlled asthma.

Medi-Cal’s Community Supports program provides the option for MCOs to provide certain services that aren’t covered by Medicaid in place of traditional health care interventions. With advocacy from RAMP and our partners, the Department of Health Care Services included Asthma Remediation as one of fourteen Community Supports options.

Select MCOs are now offering Asthma Remediation to their beneficiaries with poorly controlled asthma, often by leaning on the network of existing asthma home visiting programs in California. RAMP continues to encourage MCOs that have yet to select Asthma Remediation to do so during the next opt-in window later this year.

Asthma Preventive Services State Plan Amendment 

Effective July 1, 2022, Medi-Cal covers Asthma Preventive Services. The new Medi-Cal benefit covers clinic- and home-based asthma self-management education and in-home environmental trigger assessments provided by non-licensed professionals such as Community Health Workers, promotoras, and other individuals meeting specified qualifications.

Highlights of this new benefit include:

  • Medi-Cal will cover asthma self-management education for all beneficiaries with a diagnosis of asthma. The in-home environmental trigger assessments will be available to beneficiaries with poorly controlled asthma.
  • The new benefit is applicable in a range of settings: the in-home trigger assessments can take place in a client’s home, an assisted living facility, or a group home; asthma self-management education can be provided in any of the aforementioned settings or a clinic setting.
  • Professionals providing Asthma Preventive Services will need to complete a training program that covers components specified by DHCS, which align with current best practices and available training programs, including the Asthma Management Academy.
  • While the federal rules require supervision of the Asthma Preventive Services providers, California is taking a flexible and inclusive approach. The supervising provider can be a physician, physician assistant, nurse practitioner, clinic, hospital, local health jurisdiction, or community-based organization. Such diversity aligns well with California’s diverse home visiting programs.

For more information from DHCS, please see this news release and the Asthma Preventive Services provider manual. Additional details around implementation are still evolving, and we will provide updates as we learn more.

Combined with Medi-Cal’s Asthma Remediation program, which covers environmental trigger remediation, California is now a national leader in providing comprehensive asthma home visiting services, which improve health outcomes, reduce health care utilization costs, and reduce asthma disparities.

The key role of Managed Care Organizations 

MCOs are a fundamental part of California’s Medi-Cal landscape and play a key role in increasing access to asthma home visiting services for their beneficiaries. These services can help fulfill MCOs’ mission, and there are many opportunities MCOs can take advantage of to move forward.

To highlight the MCO-related benefits and opportunities of asthma home visiting services, RAMP produced Leading the Way to Better Breathing: Managed Care Organizations and Asthma Home Visiting Services in California. While it’s designed first for MCOs, asthma stakeholders may also find it a useful tool for initiating conversations with local MCOs.

Elevating the value of partnerships 

RAMP is proud of the leadership role we’re playing in the program and policy progress in California. Equally important to our success is the partnership and collaboration with a wide-range of many other asthma, health, housing and equity stakeholders, including the California Pan Ethnic Health Network, Children Now and dozens of other committed advocates who continue to share their time, expertise and advocacy.

This collaboration thrives in a variety of networks, including the California Asthma Financing Workgroup (facilitated by RAMP) and the Asthma Mitigation Project, a state-funded grant program for asthma home visiting programs administered by The Center at Sierra Health Foundation (RAMP is a technical assistance provider to Project grantees).

Would you like to learn more? Or have clarifying questions? Don’t hesitate to reach out to us at info@rampasthma.org.

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