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Puerto Rico Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions

Award Number: NUE1EH001384
ORGANIZATION: NATIONAL CENTER FOR ENVIRONMENTAL HEALTH
OPDIV: CDC
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: HEALTH SERVICES

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Puerto Rico Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions - The World Health Organization (WHO) has recognized asthma as a major public health issue, affecting approximately 235 million people worldwide. Asthma is the most common chronic disease among children and is among the top 20 chronic diseases on the global ranking of disability-adjusted life year in children. This condition disproportionately affects low income and minority communities. For this reason, the economic impact of asthma in United States (US) has been estimated at more than 56 billion annually from direct medical costs, such as missed school and work days. According to utilization data from PR Department of Health (PRDoH), in PR 20.2% of children with current asthma experienced moderate or a lot of limitation of usual daily activities due to asthma in the past 12 months and 41.7% reported at least one missed day at school or daycare. Puerto Rican Americans have almost twice the asthma rate as compared to the overall Hispanic population. In 2017, approximately 2 in 13 children (15.5%) living in PR had current asthma, which represents two times the prevalence in the US (7.4%). Similar to children, adults living in PR have been disproportionately affected by current asthma compared with adults living in US. In 2017, it was estimated that 334,638 (12.2%) of the adults living in PR had current asthma; whereas in US, 22,738,159 (9.1%) of the adults had current asthma. Asthma is one of the chronic diseases with a high burden for the health system. For 2013, a study performed in the health insured population in PR found a total of 104,668 hospitalizations, 56,714 emergency department visits (ED), and 389,273 outpatient visits with a primary diagnosis of asthma (ICD-09: 493.*). Even though, adults accounted for the largest percentage of asthma claims in each healthcare setting, children had the highest asthma claims-rates for hospitalizations and ED visits at 46 and 18 claims per 1,000 persons respectively. In another report done in 2017 with data from Medicaid population, it was observed that females had higher asthma hospitalizations and ED visits claims rates than men. The purpose of this project is to improve the quality of life of people living with asthma in PR by maximizing the reach, impact, efficiency, and sustainability of asthma control services and to reduce asthma morbidity, mortality and disparities by implementing Evidence-Based Strategies across multiple sectors. The project’s foundation is laid on two types of category: Category A: Enhance Program Infrastructure and Category B: Leverage Partnership to expand EXHALE. The principal expected outcomes by the end of the project period, as identified in the Asthma Program (PRAP) logic model, are: 1)Increase the number of asthma patients initiating and attending at least 60% of asthma self-management sessions at school and home based strategies; 2) Increase the number of primary care providers and health professionals trained in National Asthma Education and Prevention Program (NAEPP) EPR- 3 Guidelines and evidence-based strategies to support asthma self-management; 3) Increase the number of school staff, health professionals, community, non-professional, caregivers, and patients trained in AS-ME and Law 56; 4) Expanded access, referral to and delivery of coordinated services in high burden areas; 8) Increase the number of partners implementing the EXHALE strategies; 9) More people with asthma receives appropriate medical assessments, essential medications and devices; 10) Established linkages and coordination across public health and health care systems.; 11) Increased adoption and implementation of asthma friendly environmental policies/best practices; 13) More people have well-controlled asthma, fewer asthma attacks, and fewer missed school or work days; 15) Fewer asthma-related emergency department visits, hospitalizations, and deaths; 16) Improved quality of life.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$445,312 )
2025	2023	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	03	5	3/20/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$130,000
2025	2022	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	03	5	3/20/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$315,312
2025	2021	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	03	5	3/20/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2020	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	03	5	3/20/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2025	2019	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	03	5	3/20/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = -$445,312

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	5	6/4/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	5	3/6/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	5	6/4/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2022	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	5	3/6/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	5	3/6/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2021	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	5	6/4/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2020	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	5	3/6/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2020	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	5	6/4/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2019	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	5	3/6/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2019	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	5	6/4/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $130,000 )
2023	2023	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	5	5/21/2023	NON-COMPETING CONTINUATION	$130,000
2023	2022	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	5	5/21/2023	NON-COMPETING CONTINUATION	$0
2023	2021	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	5	5/21/2023	NON-COMPETING CONTINUATION	$0
2023	2020	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	5	5/21/2023	NON-COMPETING CONTINUATION	$0
2023	2019	Puerto Rico Department of Health	Edificio A, Antiguo Hospital Psiquistria, Calle Periferal, Bo. Monacillos	SAN JUAN	PR	00935	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	5	5/21/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $130,000

Issue Date FY: 2022 ( Subtotal = $510,000 )
2022	2022	Puerto Rico Department of Health	Edificio a, antiguo hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	4	5/29/2022	NON-COMPETING CONTINUATION	$510,000
2022	2021	Puerto Rico Department Of Health	Edificio A, Antiguo Hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	3	3/23/2022	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2022	2021	Puerto Rico Department of Health	Edificio a, antiguo hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	4	5/29/2022	NON-COMPETING CONTINUATION	$0
2022	2020	Puerto Rico Department of Health	Edificio a, antiguo hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	4	5/29/2022	NON-COMPETING CONTINUATION	$0
2022	2020	Puerto Rico Department Of Health	Edificio A, Antiguo Hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	3	3/23/2022	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2022	2019	Puerto Rico Department of Health	Edificio a, antiguo hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	4	5/29/2022	NON-COMPETING CONTINUATION	$0
2022	2019	Puerto Rico Department Of Health	Edificio A, Antiguo Hospital Psiquistria Bo. Monacillos	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	02	3	3/23/2022	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $510,000

Issue Date FY: 2021 ( Subtotal = $510,000 )
2021	2021	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	3	9/22/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2021	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	3	6/7/2021	NON-COMPETING CONTINUATION	$510,000
2021	2020	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	3	9/22/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2020	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	2	10/13/2020	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2020	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	3	6/7/2021	NON-COMPETING CONTINUATION	$0
2021	2019	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	2	10/13/2020	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2019	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	3	9/22/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2019	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	3	6/7/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $510,000

Issue Date FY: 2020 ( Subtotal = $510,000 )
2020	2020	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	2	6/10/2020	NON-COMPETING CONTINUATION	$510,000
2020	2019	Health, Department of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	01	1	8/7/2020	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2020	2019	Health, Department Of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	2	6/10/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $510,000

Issue Date FY: 2019 ( Subtotal = $510,000 )
2019	2019	Health, Department of	Old Psychtrc Hospital Bdlg	San Juan	PR	00909	SAN JUAN	USA	Environmental Public Health and Emergency Response	00	1	7/30/2019	NEW	$510,000
														Subtotal = $510,000

Grand Total All Awards = $1,724,688

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Puerto Rico Comprehensive Public Health Approach to Asthma Control Through Evidence-Based Interventions

Award Number: NUE1EH001384

ORGANIZATION: NATIONAL CENTER FOR ENVIRONMENTAL HEALTH

OPDIV: CDC

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: HEALTH SERVICES

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