Thank you for your participation in the CAFA Network conference call yesterday. Here is a brief re-cap:

Coalition Updates

• Thank you to Jessica Tovar for providing an update about the extensive work of the Long Beach Alliance for Children with Asthma.
• Our next two presentations will be: Mao Moua from Merced-Mariposa Asthma Coalition (February 28^th) and Thea Jones from Fresno County Asthma Coalition (March 27^th)

World Asthma Day Funding Opportunity

• A total of $12,000 is available. Award sizes will depend on the number of applications as well as budgetary needs associated with each proposal.
• As a reminder, applications are due March 1^st.

CAFA Annual Meeting

• Please save the date of May 23^rd for the next CAFA Annual Meeting to be held in Sacramento.
• Please share your ideas for sessions with us!

Policy Updates

• Advanced Clean Car Regulations will be voted on by the California Air Resources Board this week.  The deadline to submit comments is 5:00 PM TODAY!  Comments can be submitted online at: http://www.arb.ca.gov/lispub/comm/bclist.php.  Click on “Lev2012” to reach the online form.  Attached is a sample letter you can use if needed.  If you have any questions, contact brandon@rampasthma.org.
• CAFA’s housing focus is being coordinated through the California Healthy Housing Coalition.  We anticipate working on two bills this year.
  • One to increase enforcement authority related to pest infestations.  Currently, that authority is limited to Health Officers who are housed in county government.  Due to budget cuts, some cities no longer contract with counties for the services of health officers leaving those cities without the ability to enforce infestations.  The goal of the bill is to allow cities to use local enforcement agencies when county health officers are not available.
  • The second bill will be focused on requiring landlords to use integrated pest management (IPM) to address pest issues rather than using pesticides.  IPM focuses on addressing the conditions conducive to pests, such as harborage, sources of food and water, and entry points.  By addressing the root cause of pest problems, the issue can be solved long-term and minimize exposure of tenants to pesticides.
• The legislative year has just begun and RAMP will monitor developments around outdoor air quality, schools, and housing.  The deadline to introduce bills is in February, so we’ll have a better idea then what the landscape looks like.
  • One potential opportunity we’ve identified is the state’s interest in putting a school facilities bond on the 2012 ballot.  We will continue to monitor and inform CAFA members as the opportunity becomes clearer.
  • Should any of you come across state policy that relates to asthma, feel free to share it and nominate it for CAFA support by contacting brandon@rampasthma.org.

The Environmental Health Collaborative’s (EHC) project, “Land Use Planning to Reduce Asthma in National City,” focused on addressing poor land use planning. They developed a collaborative approach amongst residents and city officials to implement the pollution reduction element of National City’s new Westside Specific Plan and secure the relocation of 3-5 auto body shops from the vicinity of a neighborhood elementary school. Accomplishments included.

1. Approval of the ranking formula and protecting language for the amoritization goals to relocate offending businesses. Despite challenges, on September 27, 2011 the City Council approved funding to conduct the ranking of businesses for relocation. Data will be collected between October and December and the ranking is expected to be published in January 2012.
2. EHC’s recommendation that a Public Advisory Council be formed to guide the implementation of the OTSP was approved by the city.
3. In January, ten EHC community leaders began conducting code compliance monitoring to support the process of negotiating terms for business relocations. They have recorded 150 violations to date.
4. On June 7, 2011, the City Council approved the first General Plan in California with a comprehensive Health and Environmental Justice Element. The Governor’s Office of Planning and Research has expressed strong interest in requiring General Plans throughout California to include a similar element modeled after EHC’s plan.
5. EHC’s Land Use Team drafted:  A Healthy Place to Live: A People’s Guide to Community Planning. The interactive video guide is modeled on EHC’s Barrio Logan and National City experiences and will be distributed nationally and incorporated into their Leadership Training program.

Chicago Asthma Consortium

The goal of the Chicago Asthma Consortium’s project, “Crossing the Information Divide: What Do Inner City Communities of Color Want to Know About Health and How Do They Prefer to Learn It?” was to formally develop a brief, low-literacy survey in English and Spanish that identifies which asthma-relevant health information is of interest to community members, how they currently access information, how decisions are made with regard to the quality and relevance of health information, and which avenues might be most effective in delivering asthma health information to community members in the future. The following objectives were accomplished:

1. Generated and narrowed a survey pool of questions through a literature review, taking into account community perspectives and reading/literacy levels. The survey was also translated into Spanish.
2. Conducted 15 Cognitive Interviews (in English and Spanish) to identify words, phrases, or survey questions that were confusing and/or did not yield intended responses. The survey tool was modified based upon results.
3. Trained community members to conduct a pilot test of the survey tool in three target communities.
4. Entered and analyzed pilot survey data.
5. Finalized survey tool using suggestions from the surveyors as well as data analysis.

Children’s Hospital & Research Center Oakland

The goal of Children’s Hospital & Research Center’s project, “C³PLAT: An innovative systems change approach to build capacity among California’s new generation of pediatricians to become environmental health advocates, was “to train the next generation’s pediatricians to be more sympathetic, better informed, and better equipped to understand and address their patients’ environmental risk factors, and be better able to advocate for pro-health policies for their patients and the public.” This curriculum fits into the “library” of new and revised curricula being developed over time by the California Collaborative in Community Pediatrics and Legislative Advocacy Training (C³PLAT), which reaches 760 residents per year in California. Their accomplishments include:

1. Designed a 1 week environmental health curriculum for pediatric residents that includes background reading, three hour overview training, a toolkit, and a series of environmental tours of socioeconomically disadvantaged neighborhoods.
2. Piloted the curriculum with 25 pediatric residents at CHRCO. This has been done with overwhelming positive feedback and a new understanding for pediatric practice especially as it relates to asthma, obesity and mental health issues in the context of the social inequities of health.
3. Disseminated materials by sharing the curriculum on a private social networking site designed for their collaborative, presenting a tutorial on how to become “medical champions” on environmental health, and consulting with five pediatric training programs in Northern and Southern California to create similar curricula.
4. Trained pediatric residents to advocate politically on behalf of their patients regarding environmental health topics.
5. Designed a pre and post test evaluation to determine general knowledge gained and to see the way the pediatric residents’ practices and attitudes on environmental health have changed.

BHHSC will enhance their Boston Healthy Family Childcare Initiative by working on systems and policy change to promote eco-healthy family child care provider (FCP) facilities. The goals of the project are for FCP leadership institutions to gain knowledge about the importance of healthy indoor environments in family childcare facilities; for the MA Department of Early Education and Care regulatory policies for FCPs to be reflective of best practices in environmental health; and to create new catalysts that encourage FCPs to reduce environmental triggers in their facilities.

Breathe California of the Bay Area

The Community Risk Reduction Project will target high-pollution areas in San Jose, California to recruit, train, engage, and coordinate community residents. They will work with African American and Latino communities to ensure that their Community Risk Reduction Plans (CRRPs) will address cumulative health impacts and that the plans are implemented as designed. Project activities will be aimed at coalition development, leadership training and policy advocacy to achieve their overall goal of reducing health disparities from asthma in their African American and Latino communities.

Healthy Homes Collaborative

Their Implementing Integrated Pest Management in Privately Owned Multi-family Rental Housing; a multi-prong approach project will work to change the policy that currently cites landlords and essentially orders them to spray poisonous pesticides repeatedly. They will build upon data they have collected and analyzed to make the business case and promulgate policy at the local level. Utilizing peer educators from various trade associations, they will work with landlords and property management companies to gain support for the benefits of integrated pest management.

• A variety of media strategies that asthma coalitions and programs can tailor to fit a variety of needs to get the media to cover critical issues
• How to take advantage of social media to increase the power of messages
• Methods to outreach and educated policymakers – key stakeholders in creating healthier communities.

Susan Frank is known statewide for her expertise in public policy development, coalition management, and nonprofit lobbying/advocacy. Her current project work includes coordinating a large network of environmental and public interest groups from 7 western states and 4 Canadian provinces participating in the Western Climate Initiative process, and providing air quality policy advice to a large California transportation agency as well as to a number of regional and statewide environmental organizations and coalitions.

To see and listen to a recording of the webinar, click here.

Asthma is a major problem for school-aged children.  One in every six children in California has been diagnosed with asthma.  It is a leading cause of school absences due to chronic disease, costing children their education and schools resources in lost attendance-based funding.  All too often, students and school staff are confronted with unhealthy air quality on campus that can trigger or exacerbate their asthma.  Alarmingly, a California Air Resources Board study found significant indoor air quality issues in the state’s portable and traditional classrooms caused by a variety of sources, including: malfunctioning or under maintained ventilation systems; air pollutants from nearby freeways and railyards; asthma triggers like dust, mold, and pests; and chemical fumes and residues from cleaning products, pesticides, furnishings, and building materials.  Importantly, studies have demonstrated that improved indoor air quality in school facilities has a positive impact on student achievement and staff well-being.  Clearly, leadership in addressing school health problems is needed.

The fiscal challenges facing today’s schools makes creating healthier school environments even more pressing as school districts attempt to use resources as efficiently as possible to increase academic achievement.  This endeavor starts by recognizing that every child and school employee has the right to a safe, clean school environment and that unhealthy environments are not conducive to learning and teaching.  Schools around the country have successfully taken steps to help students and staff with asthma be more successful.  For example, districts have switched to certified green cleaning products, prohibited bus and vehicle idling on or near school grounds, implemented integrated pest management practices, and creatively retained school nurses by billing health plans for some nursing services. Especially in today’s fiscal environment, creating healthy schools requires strong leadership with commitment, flexibility, and resourcefulness from a variety of school stakeholders.  Most importantly, education and health advocates can demonstrate their leadership by working together to create State policies that encourage the creation of healthy schools so that students can achieve and teachers can teach without being distracted or debilitated by health conditions like asthma.

Below are a variety of approaches (though not exhaustive) that the state could enact to create a healthy school environment.  Many of these coincide with the school-related goals in California’s State Strategic Plan on Asthma, which was released by the California Department of Public Health in the spring of 2008.

Ensure resources for school facility maintenance and repair

The first line of defense in preserving a healthy school is proper maintenance and repair.  Without adequate funding, even schools with the best policies and most skilled staff will fall short of their health goals.  When resources are cut from maintenance budgets, there are fewer facilities and custodial staff on hand to maintain and repair school infrastructure. Fewer custodial staff, for example, means that classrooms are more likely to accumulate dust and water intrusions are more likely to lead to mold — both known asthma triggers.

The State can:

• Return the minimum funding school districts must set aside for facilities and maintenance from 1% to 3% of a district’s general fund budget.
• Maintain or increase state funding for the Deferred Maintenance and Facilities Hardship Programs.
• Reduce the volatility of school funding so that local leaders do not have to choose between retaining teachers and maintaining a healthy school when budgets are reduced.

Require schools to implement Indoor Air Quality (IAQ) maintenance and prevention practices

The best policies for creating asthma-friendly schools are proactive and prevent unhealthy conditions from taking root.  One of the most comprehensive models is the U.S. EPA’s Tools for Schools program, which provides guidance for schools to identify, correct, and prevent IAQ problems, including simple, low cost options.  The California Teachers Association’s Healthy Air, Healthy Kids program has similar resources.

The State can:

• Mandate, incentivize, and/or facilitate the adoption of comprehensive school-specific IAQ management plans, as Minnesota has modeled.  For example, the state could require an IAQ component in a school/district’s five year maintenance plan.
• Require targeted approaches such as the use of asthma-friendly products (Environmentally Preferable Products) for cleaning and teaching and the implementation of integrated pest management.
• Establish and enforce IAQ standards that ensure healthy indoor air environments in schools.  Currently, such protections for students and staff do not exist.
• Provide schools with resources and assessment tools, such as the Facilities Inspection Toolkit (F.I.T) to adequately monitor school health conditions.

Address the issue of dampness and mold

Mold is an all too common asthma trigger caused by the very preventable build-up of moisture on surfaces.  No safe levels or types of mold have been established, so rapidly addressing water and mold problems is extremely important.  In addition to ensuring mold and water issues are covered in IAQ maintenance plans (see above), additional safeguards could significantly reduce mold exposure at schools.

The State can:

• Provide training and resources for maintenance staff to learn how to properly deal with water and mold problems effectively.
• Help schools navigate a mold remediation process by establishing minimum standards and licensing for mold inspectors and remediators as states such as Texas have done.  Currently, California only provides guidance on hiring mold inspectors.
• Establish and enforce mold standards for schools.  Currently, there are not any mold standards in California.  However, the California Department of Public Health’s recently released new findings on the health impacts of dampness and mold suggest a need to establish health protective standards is schools.  A straightforward solution is modeled in San Francisco’s housing code where the simple presence of mold requires remediation.

Promote the healthy renovation and construction of school facilities

Much can be accomplished in indoor air quality through proper design and materials in school construction, modernization, and renovation.  All too often the building materials used for many of our schools have been found to contribute to unhealthy indoor environments.

The State can:

• Require or incentivize that all new schools use the best available green building, design, and maintenance practices that maximize IAQ for all new construction and renovation during and after construction.  Making healthy school design features eligible for state school construction and modernization funds, an accomplishment from Senate Bill 128 (passed in 2011), is a great step forward.
• Increase the allocation of school construction and modernization bond money to the High Performing Schools Program.

Reduce exposure to unhealthy Outdoor Air Quality (OAQ)

While a great deal of attention and energy should rightfully be spent on improving schools’ indoor environments, the impact of outdoor environments should also be considered.  Children are particularly susceptible to pollutants like diesel particulate and smog, which can cause serious respiratory issues and aggravate asthma.

The State can:

• Actively enforce vehicle idling laws (particularly those pertaining to school buses) as well as help schools develop processes for filing complaints.
• Require schools to notify staff and students of poor air quality days and restrict outdoor activities. Several local asthma coalitions have implemented an Air Quality Flag Program with their local school districts as an innovative notification system. In partnership with the local air district, this program has been expanded to provide schools with real time updates on air quality throughout the day in the Central Valley.
• Establish clear buffer zones between schools and pollution sources, such as, freeways, high traffic corridors, railyards, polluted land or agricultural land with active pesticide use.  The CA Air Resources Board’s land use guidebook and the US EPA’s school siting guidelines serve as excellent resources.
• Maintain or increase funding to clean bus fleets through the purchase of new, cleaner vehicles or retrofitting existing buses in order to meet new state and federal emissions standards.

Support asthma and chronic disease management plans

Finally, while much can be done to make school environments healthier, more needs to happen to support and protect those students that come to school with a variety of chronic conditions such as asthma.

The State can:

• Increase funding for school nurses in California’s schools to ensure care is available, even during challenging economic times.
• Create and disseminate a model comprehensive school health plan that includes an asthma component and/or a district-wide asthma action plan that schools/districts can put in place even without the ideal levels of medical staff.
• Provide support for teacher and staff training, school asthma plans, and parent education to ensure children with asthma get the care and attention they need, especially where school nurses are missing.
• Encourage the use of curriculum that incorporates asthma awareness and understanding.   The National Heart Lung and Blood Institute has developed a curriculum for elementary school.

Below is a list of previous alerts.

Governor Brown Signs Bills

Your support needed for national asthma efforts

President Obama delays new ozone rules; misses opportunity to protect public health

New “Green Cleaning” standard to include asthmagens!

Governor Brown misses opportunity to improve air quality

RAMP urges DHHS Secretary Sebelius to oppose asthma cuts

RAMP co-hosts legislative briefing on asthma and schools

An Open Letter to Governor Jerry Brown

Update: CARB to Close Some Loopholes and Protect Children

Act Now! Tell CARB to Protect Diesel Regulations

RAMP Analyzes Outcome of Propositions 23 & 26

Governor Signs One, but Vetoes Three

It’s Down to the Wire for Propositions 23 & 26

Celebrate Healthy Schools: Switch to Less-toxic Cleaners!

Green Cleaning In Schools: A Guide for Advocates

A.B. 821

Current Policies | Policy Priorities | Policy & Advocacy | Asthma Briefing Kit

To view the materials from previous webinars, see the links below:

• Making Your Voice Heard: Media Advocacy and Policymaker Engagement
• The California Legislature 101: Unscrambling California’s Legislative Process

Check this page in the near future for additional webinars.

If you are not currently a member of CAFA and you’d like to join, see more information here. If you are currently a member with questions about the calls, please contact Brandon Kitagawa at 510-302-3395.

Below are notes from the last six months of the calls. Future notes will be posted soon after the calls occur.

• January
• October
• September
• August
• July
• June
• April

The date of the next CAFA Annual Meeting has yet to be determined. Please check this website later or call RAMP at 510-302-3329.

Honorable Senator/Representative,

The undersigned organizations are writing to ask for your leadership and support for two federal programs related to asthma and health disparities: the National Asthma Control Program (NACP), and Racial and Ethnic Approaches to Community Health across the United States (REACH).

The asthma crisis

Asthma continues to be a major public health concern. According to the Centers for Disease Control, “the number of people diagnosed with asthma grew by 4.3 million from 2001 to 2009. From 2001 through 2009 asthma rates rose the most among black children, almost a 50% increase. Asthma was linked to 3,447 deaths (about 9 per day) in 2007. Asthma costs in the US grew from about $53 billion in 2002 to about $56 billion in 2007, about a 6% increase.” Given the burden of this disease, continued federal support is needed for both NACP and REACH.

National Asthma Control Program

President Obama’s FY 2012 budget proposed to cut funding for the National Asthma Control Program by half and consolidate it with the Healthy Homes/Lead Poisoning Prevention Program. We request your help to keep the two programs separate and to maintain funding for the NACP. The Asthma Program is the federal government’s most comprehensive approach to asthma that promotes a variety of approaches and supports efforts across agencies, at the state-level and in local communities. Consolidating the NACP with the Healthy Homes/Lead Program would severely curtail the comprehensive, systems approach that’s essential since asthma must to be addressed not just in homes but in schools, outdoor environments, the workplace and medical settings.

Racial and Ethnic Approaches to Community Health across the United States

The FY 2012 budget proposes to eliminate funding for the REACH program. REACH is a national, multilevel and multi-disciplinary program that serves as the cornerstone of the CDC’s efforts to eliminate racial and ethnic disparities in health, including asthma. REACH represents a wide range of community-based and culturally-relevant interventions tailored to the needs of each geographically specific racial/ethnic community. It addresses a wide variety of health issues, from asthma to diabetes to breast cancer, among a variety of different populations including African-Americans, Latinos, and Asian-Pacific Islanders. A national evaluation of behavioral risk factors and clinical outcomes in REACH communities between 2001 and 2009 found improvement across racial and ethnic populations at rates significantly larger than national trends. Given that the health status of people of color is increasingly going to shape the health status of the country as a whole, we cannot afford to dismantle the very community infrastructure that has resulted in such landmark achievements.

We respectfully request that you urge your colleagues in Congressional appropriations committees to support these two programs so that the problems of asthma and health disparities can receive the ongoing attention they require.

Sincerely,

Regional Asthma Management and Prevention

(Others to be added)

RAMP’s one-day convening was designed to review the health connectors between transportation and health in the context of SB375. The purpose of the forum was to collaborate with environmental health researchers from the University of California at Berkeley, UC Davis, and the San Francisco Department of Public Health, the Bay Area Air Quality Management District and the Pacific Institute to engage in a dialogue with representatives from land use and transportation planning, environmental justice, public health and academia.  The convening presented a rare opportunity for researchers, planners, public health officers, environmental justice advocates and community members to exchange ideas and identify research gaps.

RAMP staff and others facilitated a broad strategy discussion to address the future of regional planning needs of SB 375 and the SCS.  This involved looking at public health indicators, transit oriented development, and priority development areas and transportation models for the nine counties that make up the Bay Area.  Urban redevelopment and transportation planning decisions made by local and regional decision makers also have an influence on regional green house gas emissions and localized air quality.

RAMP hopes that the event will be one in a series of environmental health forums that will inform, educate and equip our partners and community members to actively engage the local elected officials in their land use and transportation and housing development decisions for the Bay Area.

For more information about the March 15^th convening, click here or contact RAMP Policy Associate Azibuike Akaba at azibuike(at)rampasthma(dot)org.

To watch videos and  PowerPoint presentations from the Public Health Convening, click below:

Organizing for Climate Justice and Health Equity in Context to Senate Bill SB 375

• Video:  Carl Anthony, Break Through Communities
• PowerPoint for Carl Anthony

SB 375: A Public Health Perspective

• Video:  Dr. John Balmes, UCSF, Center for Occupational Safety and Health

• PowerPoint for Dr. John Balmes

Performance Indicators for Human Health in Regional Planning

• Video:  Dr. Rajiv Bhatia, San Francisco Department of Public Health

• PowerPoint for Dr. Rajiv Bhatia

Public Health Indicators in Travel Models and Land Use Models in California

• Video:  Robert Johnston, UC Davis

• PowerPoint for Robert Johnston

Sacramento Sustainable Communities Social Equity Indicators

• Video:  Chris Benner, UC Davis

• PowerPoint for Chris Benner

Community Risk Reduction Plans

• Video:  Phil Martien, Bay Area Air Quality Management District

• PowerPoint for Phil Martien

Infill, Freight and Community Health: The Implications of SB 375 for Communities Struggling for Freight Transport Justice

• Video:  Eyal Matalon, Pacific Institute

• PowerPoint for Eyal Matalon

President Obama’s budget for Fiscal Year 2012 proposes a 30% funding cut for asthma prevention and management services — more than $43 million lost.

The California Dept of Public Health currently receives $600,000 annually.

The impact of cuts on asthma in California would be significant:

• California would have no state asthma program which affects over 5M residents, including 1.3M children and 482K seniors (65+).
• California would lose its capacity to address asthma disparities, where 20% of African-Americans and 25% of American Indians have asthma.
• California would lose its capacity to collect and track data on asthma, which is vital for health programs throughout the state.

How You Can Help:

Please make 3 telephone calls: One to each of your United States Senators and one to your member of the US House of Representatives.

• Step 1:   Call 1-866-308-6259 to reach your US Representative.  After you enter your zip code, your call will be transferred to your Representative’s office.
• Step 2:  Call 1-866-544-7573 to reach your US Senators.  You have two Senators.  Call them both!

Talking Points for Your Calls:

1. Say that you are a constituent. Ask to speak to the staff member who handles health issues.
2. Mention your connection to asthma support:  For instance, that you are an asthma patient or caregiver of a person with asthma; your state or local health department receives funding to support asthma programs; you participate in an asthma coalition; your child benefits from asthma programs at school, and so forth.
3. Congress made the right decision to fund federal asthma, healthy homes and environmental health programs.  Though Congress is being challenged to make tough cuts, it must protect funding for these programs now.
4. Representative (NAME) or Senator (NAME) should support funding for CDC’s school and community based asthma and healthy homes programs in 2011 and 2012.
5. Close by thanking the person for his or her time.

Thank you for making a difference!

Asthma Resources and School Needs

• The organizations who shared information about their resources available for schools included:
  • American Lung Association in California.  For information sheet click here.
  • Breathe California, Golden Gate Public Health Partnership. For information sheet click here.
  • California Breathing, California Department of Public Health. For information sheet click here.
  • US Environmental Protection Agency:  http://epa.gov/iaq/
  • Regional Asthma Management and Prevention (RAMP):  www.rampasthma.org
  • California Schools Environmental Health and Asthma Collaborative (SEHAC). For information sheets click here.

• Participants also identified some additional resources that might be helpful:
  • Information about indoor air quality and what in the air is affecting asthma. Suggested site for more information:  http://www.cal-iaq.org/
  • Information about home visit programs to address home indoor air quality issues that school nurses and other can refer families to. Suggestions included:  contacting code enforcement, local fair housing organizations, local legal aid organizations, county home visit programs (e.g. Asthma Start in Alameda County), and for more information email Barbara Spark (Spark.Barbara@epamail.epa.gov). RAMP also created a housing resource guide for several counties that may include local contact information:  http://www.rampasthma.org/2010/04/county-housing-resource-guides/
  • Simplified materials and materials in various languages. RAMP has a simplified educational tool for school staff, but could also be easily adapted for other audiences:  http://www.rampasthma.org/2008/04/resource-asthma-education-in-15-presentation-and-handout/
  • Additional discussions on how schools can prioritize actions with decreasing funds. Suggestions included:  establish which students have asthma, train staff on important asthma-related issues, and improve indoor air quality; school nurses identified getting a signed medication form over an actual asthma action plan; HIPAA-FERPA Joint Guidance document item FAQ #6 (http://www2.ed.gov/policy/gen/guid/fpco/doc/ferpa-hippa-guidance.pdf); and increase and/or improve partnerships to improve outcomes (e.g., partnering with public health department).

Asthma and Truancy

• A non-traditional partnership between the District Attorney’s office and Alameda Department of Public Health, Asthma Start program.

• Asthma was often being given as the reason why a student had missed enough school for their parents being called to Truancy Court.
• Through the Place Matters work the county was already doing, the connection was made and a partnership was formed between Truancy Court and Asthma Start.
• The court refers cases to Asthma Start and Asthma Start then begins working with the families to identify and address the myriad of needs that may be impacting their inability to control the student’s asthma.
• Asthma Start has found that the cases are resistant to working with them, but once the relationship forms, it is clear that these cases are very complex with high psychosocial needs including:  housing, food, employment, stress, and psychological issues. Things much bigger than the child’s asthma.
• This work has many implications from reducing drop out rates and stabilizing school funding (ADA), to increasing life expectancy and reducing incarceration rates. These concepts are all intertwined.
• They are in the process of collecting data, writing an op ed piece, and will present this work at the upcoming REACH Conference in Los Angeles.
• For more information, contact Brenda Yamashita:  Brenda.Yamashita@acgov.org
• For slides click here.

Implementing Tools for Schools

• Getting Tools for Schools (TfS) implemented can be a daunting task.

• The “box” provided by the US EPA has all the necessary materials including instructions and letters for all those who should be included in the process. They have also had staff available to provide assistance and counsel.
• Modesto is not a wealthy or healthy county, but without being a paid coordinator, Aurora Licudine is finding ways to get TfS implemented.
• By capitalizing on some fortuitous changes in staff and district organization, as well as linking this work to the ultimate goal of schools (students graduating), she has been able to make progress in Modesto.
• She took opportunities to make improving the indoor air quality in the school district relevant to any audience she was trying to engage. She found that using the leverage points of health and personal control was helpful to get people’s attention and begin the buy-in process.
• Unexpected champions and site leaders have emerged which has improved collaboration and possibilities for success.
• It is not always easy to get people to get on board with a new project, but by reinforcing the bottom line of the school (of all schools—graduation), utilizing local data, seizing opportunities, turning apathy into energy by constantly adapting the message to engage the intended audience, and then having a plan for how people can help/be involved, you’d be surprised what can happen!
• For more information and ideas about how Aurora has overcome barriers, contact her at:  Licudine.A@monet.k12.ca.us . For information about TfS, go to:  http://www.epa.gov/iaq/schools/ ; and/or contact Barbara Spark (Spark.Barbara@epamail.epa.gov)
• For slides click here.

Part 2

Part 2

Part 2: