Regional Asthma Management and Prevention Program
The Regional Asthma Management and Prevention (RAMP) program is a collaborative that promotes strategies for reducing asthma through a broad and comprehensive approach that includes clinical management and environmental protection. RAMP brings together diverse partners such as public health and community-based organizations, schools, medical providers, and environmental health and justice groups to join forces in reducing the burden of asthma with a focus on communities inequitably affected by the disease.
Zero Emissions and Community Building: the Next Goals and Strategies of the Moving Forward Network
RAMP is supporting Occidental College’s efforts on its Kresge Foundation funding to launch a 2-year campaign focused on eliminating diesel emissions at ports and in the freight transportation system and to organize a major conference with international participation. RAMP is serving on the project’s Moving Forward Network Advisory Board.
Advancing Support for Prevention Services
This project will increase support for asthma-related prevention services by serving as a link between clinical care and community prevention in California. Asthma best practices will be incorporated into the health home model. Asthma management activities will include advocating for California to implement a rule on reimbursement for CHOWs and supporting development of health impacts bonds to support asthma prevention services.
Asthma Champions Program Services
In collaboration with the University of California, San Francisco, the Regional Asthma Management and Prevention (RAMP) program will provide professional services for the APPPUC 2 Asthma Champions Program. This project provides a partnership in the implementation of an educational outreach program for Bay Area physicians interested in asthma management and prevention.
Asthma Management: Advancing Collaborative Efforts to Improve Land-Use, Transportation & School Health Policies
Through this project, the Regional Asthma Management and Prevention (RAMP) program provides state-level policy leadership to improve environments and public health. RAMP will leverage the structure of the Community Action to Fight Asthma (CAFA) Network to mobilize on-the-ground work in order to influence land use and transportation policies as well as school health.
Asthma Prevention Innovations in Health Care Reform
Regional Asthma Management and Prevention will build on its current advocacy work through a multi-pronged approach to use asthma as a starting point for broader health care financing reform.
Bay Area Community Health Workers & Asthma Management
RAMP supports increased access to culturally-competent quality clinical care, and has long been committed to building the field of Community Health Workers (CHWs). The role of CHWs in asthma management and prevention interventions has been well-documented with robust evidence supporting their impact on improved outcomes and reduced healthcare utilization. Funding will support efforts to shape California policy strategies to include CHWs as key to linking health care finance and community-based prevention, enhance the capacity of Bay Area CHWs focused on asthma to effectively support 750 families, and increase the awareness of CHW-related advocacy opportunities among asthma advocates across California and facilitate their engagement in advocacy activities.
Building Public Health Engagement in Climate Change
This project will: (1) engage the public health community in local and state government efforts to address climate change; (2) develop and implement pilot projects, funded through competitive mini-grants, which demonstrate models for engagement in community climate action; and (3) deliver targeted communications, public policy and advocacy leadership.
Building Systems to Sustain Home-Based Asthma Services
RAMP will serve as a lead technical assistance provider to the National Center for Healthy Housing to guide and support states as they establish and/or grow systems to sustainably deliver home-based asthma services.
California Healthy Housing Coalition Conference
Regional Asthma Management and Prevention (RAMP) will support the expansion of the California Healthy Housing Coalition’s (CHHC) annual meeting.
The goal of this expansion, as envisioned by the CHHC’s Steering Committee, is to equip coalition members with tools and training to improve their ability to advocate and educate on important healthy housing policy issues both locally and at the state level.
Collaboraton with the Bay Area Environmental Health Collaborative
This grant will support the participation by the Regional Asthma Management and Prevention (RAMP) program in the Bay Area Environmental Health Collaborative, a broad partnership among six coalitions and numerous organizations working to protect public health in communities heavily impacted by air pollution.
Comprehensive Approach to Asthma
This funding provides general operating support to reduce asthma disparities through advocacy, policy change, improving clinical care and management, and reducing asthma triggers in Alameda and Contra Costa counties.
Connecting Health and Housing in California
Regional Asthma Management & Prevention (RAMP) will expand its work to utilize housing as a platform for improving health and well-being by building bridges across sectors addressing healthy housing, housing affordability and advancing opportunity.
Health Resources in Action
The Regional Asthma Management and Prevention will provide a training for Health Resources in Action.
The Regional Asthma Management & Prevention program is working with the Rose Foundation to 1) Draft and/or present community comments regarding health impacts of poor outdoor air quality; 2) Support youth environmental justice education, specifically linking to health equity; 3) Support youth participation in youth advocacy efforts, including identifying and translating policy opportunities, developing and presenting public comments and 4) Track additional policy efforts.
Healthy Housing and Asthma Coalitions
Funding supports RAMP coalitions: national housing learning collaborative and its efforts to advance healthy housing and California-based Community Action to Fight Asthma Network and its work to reduce environmental asthma triggers.
Incorporating Environmental Management of Asthma into School-Based Health Centers Across the Nation
RAMP aims to reduce indoor environmental asthma triggers by: collecting and disseminating best practices nationally, developing key tools tailored to use by School Based Health Centers (SBHCs); designing and conducting national and state trainings; and convening and supporting a national learning collaborative to stimulate and support local action at SBHCs across the nation.
National REACH Coalition partnership
RAMP, in partnership with the National REACH Coalition, will develop and implement a Community Transformation Plan using evidence-based and practice-based strategies to reduce or eliminate racial or ethnic health disparities in chronic disease risk factors and outcomes. Strategies will be tied to proper nutrition and physical activity outcome measures and include implementing, maintaining, and/or strengthening policy, systems, or environmental improvements.
Promoting Healthy Housing and Freight Transportation in California
In order to expand the impact of our healthy housing work beyond California, RAMP and the California Health Housing Coalition (CHHC) will build a growing community of organizations and agencies across several states with experience or interest in state policy approaches to healthy housing. We will support these states in pursuing state policy action through: exposure to lessons and tools developed by CHHC; engagement in peer learning discussions; opportunities to educate their state legislators; and connections with experts and tools from other organizations.
Public Policy Efforts to Address Asthma and Other Air Pollution Related Health Issues
RAMP will: 1) continue efforts to promote health and equity through public policy campaigns related to outdoor air quality and/or the built environment; 2) sustain RAMP’s clearinghouse role, reaching a broad network with asthma research, promising practices, events, and policies; and 3) support local asthma coalitions and/or other public health or environmental justice programs to engage in public policy related to environmental asthma triggers.
RAMP Training for HRiA
RAMP will provide a training for Health Resources in Action.
RAMP Web Development Related Expenses for the California Healthy Housing Coalition
RAMP developed and beta tested a website and web-based communications tools for the California Healthy Housing Coalition.
RAMP's Advocacy to Support Prevention
RAMP has a strong history as a leader in approaching asthma management through a broad, upstream understanding of prevention. With an evolving health care system that offers new opportunities for financing prevention, RAMP has applied our existing knowledge and experiences with prevention to our developing capacity in the field of health care finance and policy. We dived deep into understanding how prevention may fit into various health care financing opportunities and developed a broad-based collaborative approach to advocating for changes. Over the coming year, we will advance these policy opportunities while continuing to disseminate information to the broader field to ensure a broader uptake in organizational and policy best-practices.
RAMP: Advocating to Create Healthy Environments
RAMP proposes to build on past successes in pursuing new and improved efforts related to the built environment and school environments. RAMP has a long and strong history of successfully influencing policy at the regional and state levels as well as providing technical assistance and training for asthma coalitions and a broad array of advocates in the fields of public health and environmental justice.
REACH Center of Excellence
RAMP serves as the only asthma-related Center of Excellence in the Elimination of Disparities as part of the Center for Disease Control and Prevention's REACH US program. RAMP focuses on diesel pollution, housing quality, land use and transportation policies, school and child care interventions, and clinical management.
Reducing Asthma Disparities through Comprehensive Community Action
As a CDC Center for Excellence in Eliminating Disparities (CEED) in asthma, the Regional Asthma Management and Prevention (RAMP) program uses a socio-ecological approach to work to reduce asthma disparities in African American and Latino populations. In this project, RAMP aims to reduce environmental triggers in homes, schools, and in the outdoor air, and to improve culturally competent clinical management.
Rules of the Road: How to Engage Public Agencies in Land Use, Transportation and Air Quality Decisions to Promote Equity and Public Health
One barrier to meaningful community involvement in land use and transportation issues related to public health and equity concerns is a lack of knowledge about how various agencies make decisions and how the public can influence the process. This project will help bridge that engagement gap by providing trainings and follow-up technical assistance to under-represented communities.
Sponsorship of California Healthy Coalition’s Annual Meeting
Sponsorship of RAMP’s California Healthy Coalition’s annual meeting.
Here's How We're Making a Difference
Advancing Health Equity Through Healthy Housing Policies
In 2015, PHI's Regional Asthma Management & Prevention program (RAMP) played an important role in advocating for two new healthy housing policies passed in California—SB 328 and SB 655—that will reduce exposure to asthma triggers, particularly in low-income communities and communities of color.
In recognition of this work and ongoing efforts in this area, RAMP received the 2016 Housing and Urban Development Secretary’s Award for Healthy Homes on behalf of the California Healthy Housing Coalition. The award recognizes excellence in healthy housing innovation and achievement.
RAMP continued its successful work with California Healthy Housing Coalition partners to improve housing quality. Closing a loophole in legislation RAMP worked to get signed last year (SB 328-Hueso), RAMP co-sponsored and the governor signed AB 2362 (Chu) to ensure tenants are notified of pesticide use, including those living in condominiums and townhomes.
In 2016, RAMP also co-sponsored a bill in California that gives tenants new rights when they discover dangerous mold, which is linked to asthma and other respiratory diseases. Now listed as a condition of substandard housing, tenants can hold landlords accountable if the problem is not fixed. Until the bill passed, tenants had few options if their residence had mold. With the new legislation, renters can now for the first time report mold problems to the city, which can then demand repairs and fine landlords who don't comply.
RAMP has plans to continue advocating for healthier housing in the years to come.
Advocating to Fund At-Home Services for Californians with Asthma
Asthma prevention starts at home—saving money and improving health. That’s why PHI’s Regional Asthma Management & Prevention program championed California policies to support reimbursement for asthma home visiting services, and developed a toolkit, "Leading the Way to Better Breathing: Managed Care Organizations and Asthma Home Visiting Services in California.” RAMP’s efforts buoyed a $15 million budget appropriation that will help some of the nearly two million child and adult Medi-Cal beneficiaries with asthma receive more prevention-based services and support. Learn more.
Boosting National Leadership Capacity to Act on Asthma
To share the best practices and learnings from California Healthy Housing Coalition model with other states, RAMP has developed a “National Healthy Housing Learning Community” focused on state–level approaches to healthy housing. This network meets every other month to share experience on coalition building, policy development, and political strategies for healthy housing.
Participants are from Colorado, Nebraska, Montana, Minnesota, Georgia, Rhode Island, Michigan, Mississippi, New Mexico, Louisiana, Ohio, Georgia, and several regional offices of HUD and EPA. Based on member feedback, RAMP also added the National Center for Healthy Housing to provide updates on potential impacts from federal policy changes.
Ensuring Strong Health Measures in the California Sustainable Freight Action Plan
In response the Governor Brown’s 2015 executive order on reducing emissions from the freight sector, the California Air Resources Board and several other state agencies collaborated to develop the California Sustainable Freight Action Plan, released in July 2016. The Plan outlines a wide range of strategies that, in the long term, can transform the freight system.
As part of the California Cleaner Freight Coalition, PHI's Regional Asthma Management and Prevention program (RAMP) joined partners from across the state to advocate for strong, protective health measures in the Plan. In the months ahead, RAMP intends to help shape its implementation to continue their commitment to healthy, clean air for all.
Finding Innovative Ways to Sustainably Finance Asthma Management and Prevention
RAMP is leading the way in advocating for sustainable financing for asthma services in California, working to build significant momentum with asthma advocates across the state.
Through a multi-faceted approach, RAMP has advanced the incorporation of evidence-based prevention activities in health care policies and practices—for example, working to increase the understanding of the Department of Health Care Services (DHCS) staff on effective asthma interventions that improve health outcomes and reduce utilization, which will impact 1.1 million Medi-Cal beneficiaries diagnosed with asthma. They've also trained 100 asthma advocates and policymakers on best practices and opportunities to influence state policy. And some of RAMP’s advocacy efforts are reflected in California's policies, such as the Health Homes Program development, the 1115 waiver language, a draft State Plan Amendment invoking the Preventive Services Rule, and the selection of asthma quality metrics for Medi-Cal Managed Care Organizations.
To learn more about RAMP's efforts to help secure sustainable financing for asthma education and home environmental trigger remediation programs in California, read the full report: A Path Forward: Sustainable Financing for Asthma Education and Home Environmental Trigger Remediation in California.
Improve Healthy Living Opportunities for Children by Advancing Policy and Systems Change
With support from the WK Kellogg Foundation, RAMP worked to reduce health inequities among vulnerable children. The project included three objectives: 1) Advance advocacy efforts to increase access to services aimed at preventing/reducing asthma and other housing illness and share such efforts as a model; 2) Advance policies aimed at protecting vulnerable children from environmental asthma triggers int heir homes and share policies as a model; 3) Increase the number of school-based health centers around the country engaged in interventions aimed at reducing environmental asthma triggers. As a result, RAMP produced "Sustainable Financing for Asthma Education and Home Environmental Trigger Remediation: Lessons Learned from the Field," provided funds and technical assistance to four school-based health centers in New Mexico, each of which conducted a small-scale environmental asthma intervention, and worked with the California Healthy Housing Coalition developed a series of narrated presentations to support landlords and affordable housing developers in making the switch to Integrated Pest Management.
Improving Air Quality Across California
Climate change worsens air quality, yet many climate strategies reduce other air pollutants as well. In California, PHI has assessed the health impact of proposed cap and trade regulations and been an active voice for health equity in the implementation of California’s Global Warming Solutions Act.
PHI’s Regional Asthma Management and Prevention program helped pass California diesel emissions regulations that are projected to prevent 150,000 cases of asthma, 12,000 cases of acute bronchitis and 9,400 premature deaths over 15 years.
Mobilizing School-Based Health Centers in Managing Children's Asthma
PHI's Regional Asthma Management and Prevention (RAMP) program is working to strengthen the capacity of school-based health centers (SBHCs) in the environmental management of asthma. In 2017, RAMP built the capacity of over 450 SBHC staff through trainings in 6 states and through national webinars, equipping them to improve asthma management and prevention for up to 2 million children.
The program also developed the Asthma Environmental Interventions Guide for School-Based Health Centers and disseminated it to over 3,000 people; supported 18 SBHCs in the implementation of asthma environmental interventions; and developed and disseminated 10 case studies to show what works.
Partnering with Community Health Workers to Better Manage and Prevent Asthma in California
RAMP is committed to increasing access to culturally-competent quality clinical care, and has long been committed to building the field of Community Health Workers (CHWs), who are often very successful in improving health outcomes and reducing healthcare utilization. Supporting CHWs also reflects the program's social justice focus, in that—as so many CHWs are members of the communities they serve—RAMP is building the capacity and workforce of community members.
In 2015-2016, RAMP convened Bay Area CHWs to help enhance their asthma management and prevention capacities, who in turn support over 900 families every year. In 2017, RAMP continued to host regular capacity-building workshops for CHWs across the Bay Area. Regular participants include CHWs and other asthma educators who work with vulnerable populations.
In 2017, RAMP also advocated strongly for a California bill authorizing Medi-Cal reimbursement for CHWs and others to provide asthma education and in-home environmental assessments—a bill that passed through every legislative vote with bi-partisan near-unanimous support.