Expanding reach, quality, and effectiveness of asthma control services in California's high burden areas. - Advancing Health Equity in Asthma Control through EXHALE Strategies: CDC-RFA-EH24-0016 California Breathing/California Department of Public Health (CDPH) PURPOSE: CDPH will build on its current asthma program to expand reach, quality, effectiveness, and sustainability of asthma control services in high burden areas to reduce childhood asthma-related Emergency Department (ED) visits and hospitalizations. By strengthening leadership and addressing evidence-based EXHALE strategies, CB will contribute to CA’s quadruple aim by achieving better health outcomes (e.g. reducing asthma-related morbidity and mortality), more coordinated care, lower health care costs, and health equity. OUTCOMES: CDPH will: (1) reduce ED visits and hospitalizations, especially among children ages 0-17; (2) increase capacity among licensed and non-licensed members of the asthma care team to deliver EPR-3 guidelines-based asthma self-management education (AS-ME); (3) expand in-clinic and home-based asthma services; (4) improve asthma control and quality of life; (5) increase coverage and quality of asthma services; (6) coordinate team-based care; (7) increase coverage and quality of asthma services; and (8) increase adoption of environmental policies and best practices to reduce the burden of asthma in California. PROPOSED PROJECT: CDPH will enhance program infrastructure outlined in Category A by: (1) continuing to take a leadership role in coordinating and expanding asthma services and evidence-based strategies; (2) gathering influential partners statewide to expand evidence-based asthma services in the highest burden areas; (3) maintaining the existing robust statewide surveillance system and using data to guide strategic actions; (4) developing and disseminating communications materials and resources for people with asthma, and their caregivers; and (5) collaborating with stakeholders to develop comprehensive evaluation strategies. CDPH will develop a strategic plan for asthma control with partners from health, government, and community sectors that will establish a highly detailed view of the state’s asthma burden. CDPH will leverage partnerships to expand EXHALE strategies outlined in Category B. We will, (E) continue to expand access to and delivery of AS-ME to people with asthma and their caregivers; train licensed members of the asthma care team to deliver AS-ME; (X) encourage partners and health systems to refer patients with asthma who smoke to smoking cessation programs, and track referrals and completion rates; (H) promote 10 existing asthma home visiting programs that include trigger reduction components; (A) expand access to effective medical management by training community health workers and licensed providers to deliver AS-ME; conduct quality improvement initiatives that support such care; (L) encourage linkages within and across health care systems and community services; increase awareness across healthcare sectors of existing coordinated care activities and partnerships; and (E) continue to participate on five coalitions working to adopt environmental trigger reduction policies, reimbursement of CHW home-based asthma services, substandard housing conditions, no smoking policies, and others. CDPH will expand its already robust surveillance system by incorporating additional data sources to guide strategic action. CDPH will continue its qualitative and quantitative evaluation activities by working with over 50 organizations and agencies to collect data and develop and implement comprehensive evaluation strategies.