Montana Asthma Advisory Group meeting

1. Montana AsthmaAdvisory Group meeting August 21st, 2009

2. Update on the CDC Asthma Grant

3. The Award • Awarded grant for 5 years of funding • $350,000 per year • Effectively doubles the asthma control budget for Montana • Allows us to systematically implement the state plan over the next 5 years

4. Thank you! • For writing excellent letters of support • For participating in the creation of the state plan and burden report • For continuing to support our program activities as we move forward

5. Today, ask yourself: • What is the “big picture” for improving asthma control in Montana? • Specifically, what will be my role in this collaborative effort? • What can be done to improve asthma related healthcare in MT?

6. Focus of the Grant • Implementing the Montana Asthma State Plan along with program partners • Surveillance, Partnerships, Interventions and Disparities • Robust evaluation • Use of evidenced-based public health interventions

7. Montana State Asthma Plan Logic Model Input Activities Outcomes Impacts • Surveillance: Establish and maintain a comprehensive state asthma surveillance system • Partnerships: Establish and maintain effective partnerships with stakeholders across the state • Healthcare: Improve systems and quality of asthma care in Montana • Environment: Reduce exposure to environmental irritants and allergens that cause and/or exacerbate asthma • Schools/Daycares: Increase the capacity of Montana schools and childcare facilities to manage asthma • Montana Asthma • Workgroup • Partners • Montana Asthma Control Program Staff • Resources and time from stakeholders statewide • Coordinated planning and implementation of state asthma plan • Reduce activity limitations and school/work days missed due to asthma • Reduce direct and indirect asthma costs • Promote policy and environmental changes to create systems with increased capacity to manage asthma over the long term • Increase public awareness about asthma • Improve the quality of life for all Montanans with asthma • Reduce geographic, racial and socioeconomic disparities in asthma morbidity and mortality • Reduce asthma deaths • Reduce hospitalizations for asthma • Reduce ED visits for asthma Surveillance and Evaluation: Increase knowledge of asthma in Montana through ongoing, systematic data collection and program evaluation. Underlying Themes: Disparities, Communication, Sustainability and Evaluation Montana State Asthma Plan Logic Model Montana State Asthma Plan Logic Model Montana State Asthma Plan Logic Model Montana State Asthma Plan Logic Model Activities Activities Activities Impacts Impacts Impacts Input Input Input Outcomes Outcomes Outcomes Activities Impacts Input Outcomes • Reduce activity limitations and school/work days missed due to asthma • Reduce direct and indirect asthma costs • Promote policy and environmental changes to create systems with increased capacity to manage asthma over the long term • Increase public awareness about asthma • Reduce activity limitations and school/work days missed due to asthma • Reduce direct and indirect asthma costs • Promote policy and environmental changes to create systems with increased capacity to manage asthma over the long term • Increase public awareness about asthma • Reduce activity limitations and school/work days missed due to asthma • Reduce direct and indirect asthma costs • Promote policy and environmental changes to create systems with increased capacity to manage asthma over the long term • Increase public awareness about asthma • Surveillance: Establish and maintain a comprehensive state asthma surveillance system • Partnerships: Establish and maintain effective partnerships with stakeholders across the state • Healthcare: Improve systems and quality of asthma care in Montana • Environment: Reduce exposure to environmental irritants and allergens that cause and/or exacerbate asthma • Schools/Daycares: Increase the capacity of Montana schools and childcare facilities to manage asthma • Surveillance: Establish and maintain a comprehensive state asthma surveillance system • Partnerships: Establish and maintain effective partnerships with stakeholders across the state • Healthcare: Improve systems and quality of asthma care in Montana • Environment: Reduce exposure to environmental irritants and allergens that cause and/or exacerbate asthma • Schools/Daycares: Increase the capacity of Montana schools and childcare facilities to manage asthma • Surveillance: Establish and maintain a comprehensive state asthma surveillance system • Partnerships: Establish and maintain effective partnerships with stakeholders across the state • Healthcare: Improve systems and quality of asthma care in Montana • Environment: Reduce exposure to environmental irritants and allergens that cause and/or exacerbate asthma • Schools/Daycares: Increase the capacity of Montana schools and childcare facilities to manage asthma • Improve the quality of life for all Montanans with asthma • Reduce geographic, racial and socioeconomic disparities in asthma morbidity and mortality • Reduce asthma deaths • Reduce hospitalizations for asthma • Reduce ED visits for asthma • Improve the quality of life for all Montanans with asthma • Reduce geographic, racial and socioeconomic disparities in asthma morbidity and mortality • Reduce asthma deaths • Reduce hospitalizations for asthma • Reduce ED visits for asthma • Improve the quality of life for all Montanans with asthma • Reduce geographic, racial and socioeconomic disparities in asthma morbidity and mortality • Reduce asthma deaths • Reduce hospitalizations for asthma • Reduce ED visits for asthma • Reduce activity limitations and school/work days missed due to asthma • Reduce direct and indirect asthma costs • Promote policy and environmental changes to create systems with increased capacity to manage asthma over the long term • Increase public awareness about asthma • Surveillance: Establish and maintain a comprehensive state asthma surveillance system • Partnerships: Establish and maintain effective partnerships with stakeholders across the state • Healthcare: Improve systems and quality of asthma care in Montana • Environment: Reduce exposure to environmental irritants and allergens that cause and/or exacerbate asthma • Schools/Daycares: Increase the capacity of Montana schools and childcare facilities to manage asthma • Improve the quality of life for all Montanans with asthma • Reduce geographic, racial and socioeconomic disparities in asthma morbidity and mortality • Reduce asthma deaths • Reduce hospitalizations for asthma • Reduce ED visits for asthma Surveillance and Evaluation: Increase knowledge of asthma in Montana through ongoing, systematic data collection and program evaluation. Surveillance and Evaluation: Increase knowledge of asthma in Montana through ongoing, systematic data collection and program evaluation. Surveillance and Evaluation: Increase knowledge of asthma in Montana through ongoing, systematic data collection and program evaluation. Surveillance and Evaluation: Increase knowledge of asthma in Montana through ongoing, systematic data collection and program evaluation. Underlying Themes: Disparities, Communication, Sustainability and Evaluation Underlying Themes: Disparities, Communication, Sustainability and Evaluation Underlying Themes: Disparities, Communication, Sustainability and Evaluation Underlying Themes: Disparities, Communication, Sustainability and Evaluation

8. Work plan: Year 1 • Hire three staff • Epidemiologist/Evaluator • Health Education Specialist • Quality Improvement Coordinator

9. Work plan: Surveillance • Three surveillance reports (2 to include information on asthma disparities) • Partner with 3 hospitals to develop an ED reporting system for asthma • Develop a 5 year evaluation plan for program activities

10. Work plan: Partnerships • Facilitate Montana Asthma Advisory Group (3 times per year) • Develop new partnerships with healthcare payers

11. Work plan: Healthcare • Finish updating Asthma Care Monitoring System (ACMS) and implement at 5 clinics • Recruit 4 hospitals or EDs to participate in an asthma education discharge protocol program (AHEAD protoc0l) • Continue Certified Asthma Educator Initiative

12. Work plan: Environmental Interventions • Sponsor public education campaign detailing link between smoking and asthma • Provide two grants to support community-based environmental asthma programs in low income, rural or Tribal communities

13. Work plan: Schools and Childcare • Continue asthma trainings for school and childcare staff • Award mini-grants to 20 school nurses to provide evidence based asthma management to students

14. Questions? Concerns? • Fill out your sheets? How will you participate with us on our year 1 work plan?

15. Focus on Improving Asthma Care In the MT Asthma State Plan the overall Healthcare Goal: Improve systems and quality of asthma care • Question for the group: What are the greatest needs related to improving systems of care and increasing the quality of asthma related healthcare patients receive?

16. Healthcare Objective 1 • Support delivery of evidence-based healthcare according to EPR-3 Asthma Guidelines in Primary Care setting • Continuing Ed • Spirometry training • Training on EPR-3 guidelines and provision of summary documents • On-line resources • Appropriate referrals to specialty care • ACMS

17. Healthcare Objective 1 Questions for the group: • What are the most pressing needs related to asthma in the primary care setting in MT? • What can we do to improve care in this setting?

18. Healthcare Objective 2 • Support delivery of evidence-based healthcare according to EPR-3 Asthma Guidelines in Emergency Departments and hospitals • Ensure asthma patients receive education, appropriate meds and follow-up appointment upon discharge (AHEAD protocol) • Continuing Education • Target Critical Access Care Hospitals

19. Healthcare Objective 2 Questions for the group: • What can be done to improve care in MT hospitals and EDs related to asthma? • What should be the components of the AHEAD discharge protocol? • How can we ensure that it will be used?

20. Healthcare Objective 3 • Decrease barriers to accessing medical care for persons with asthma • Support CHCs and MT Primary Care Association • Work with Medicaid Disease Management Program • Compile list of pharmacy assistance programs for low income patients with asthma • Target funding and educational opportunities to disparate populations

21. Healthcare Objective 3 • Questions for the group: • From your experience what groups are most at risk for uncontrolled asthma? • What novel ways can we reach out to these groups and target our interventions toward them?

22. Healthcare Objective 4 • Increase access to quality asthma education at multiple points of care • Work with payers to ensure that asthma education is reimbursed • Increase # of AE-Cs through Asthma Educator Initiative • Increase training opportunities through Montana Asthma Educators network • Support programs like UM pharmacy schools project that provide asthma ed in non-traditional settings • Provide useful clinical tools to supplement asthma education • With stakeholders, create culturally appropriate asthma ed materials for American Indians • Ensure ed materials promoted are useful to patients with low health literacy

23. Healthcare Objective 4 • Questions for the group: • How can we better promote the use of asthma education in MT? • Specific settings or groups we should be targeting?