Asthma in New York (NY) remains prevalent (adults 10%, children 9%) and costly ($3.5 billion in medical costs and lost productivity). Since 2002, with state and federal funding, NY’s comprehensive Asthma Control Program (ACP) has contributed to reductions in asthma mortality, hospitalizations and improvements in asthma care and management and NY has made progress toward Healthy People 2020 and NYS Prevention Agenda objectives. The Project Narrative describes the ACP’s plans for continuing and expanding efforts to focus resources and interventions in NY’s highest asthma burden regions to reduce asthma-related disparities. Target populations include low-income, Medicaid/CHP eligible, children and adolescents with asthma (aged 0 to 17) and their caregivers statewide, with priority focus on NY’s highest asthma burden counties. Strategies and activities will specifically aim to target audiences with lower SES, non-Hispanic Black, non-Hispanic Multi-racial, and Hispanic populations.
To reduce asthma morbidity, mortality, and disparities, the ACP will focus work in two main categories: 1) Category A efforts will support, maintain and strengthen the current leadership, partnership, communication, surveillance and evaluation infrastructure; and 2) Category B efforts will employ EXHALE strategies to expand the reach of coordinated asthma services across multiple settings including hospitals, primary care clinics, homes, schools and communities. The ACP’s effective leadership and program management infrastructure is actively supported by the NYS Department of Health (DOH) Asthma Guidance Team which convenes partners positioned to lead the prioritization of asthma across NY’s strategic health care reform initiatives. The Asthma Partnership of NY (APNY) supports the ACP’s ability to leverage external partnerships with health systems, health plans, associations, local government, and CBOs to prioritize and expand coverage of guidelines-based asthma care during NY’s transition to a sustainable, value-based purchasing (VBP) framework. The ACP will engage these partners to lead cross-sector asthma interventions designed to address health equity and social determinants of health: Project BREATHE NY and the NYS Healthy Homes VBP Pilot.
Project BREATHE NY and the NYS Healthy Homes VBP Pilot will be designed and implemented in alignment with NAEPP Guidelines and will integrate the evidence-based strategies in CDC’s EXHALE technical package to achieve improvements in asthma control status and avoid asthma-related hospitalizations and ED visits among children ages 0 to 17. NY’s extensive asthma surveillance system will be used to target interventions, allocate resources, and monitor impact. High quality evaluation activities will be conducted to understand the economic impacts, successes, and lessons-learned through intervention implementation. Project BREATHE NY and the NYS Healthy Homes VBP Pilot evaluation findings will inform the business case for expanding coverage and reimbursement of EXHALE strategies including asthma self-management education and home-based asthma services.
Continued funding from the CDC is critical to sustaining and spreading the ACP’s capacity to reach New Yorkers with asthma and their caregivers most in need of support. Through Project BREATHE NY and the NYS Healthy Homes VBP Pilot, the ACP will effectively expand the reach, quality, impact and sustainability of comprehensive asthma control services.