Policies Play Critical Role in Reducing Asthma’s Burden on Low-Income, Communities of Color in California

Asthma disproportionately affects low-income communities and communities of color. The Public Health Institute’s Regional Asthma Management & Prevention (RAMP) program remains committed to addressing health inequities and bridging the health gaps that exist in asthma care, management and outcomes and does this by advocating for much-need policies and programs.

The Impact of Asthma Policies on Programs and Communities

In California, recent Medi-Cal policies help to sustain the important work of community health workers/Promotoras and others providing asthma home visiting services, as well as increase access to asthma home visiting services. Through the California Department of Health Care Services “California Advancing and Implementing Medi-Cal (CalAIM)” program, Medi-Cal managed care plans can offer beneficiaries with poorly controlled asthma, environmental trigger remediation as part of the Asthma Remediation option under the Community Supports Program, a new policy and program that RAMP and its partners advocated for.

Additionally, through the Department’s Asthma Preventive Services benefit, Medi-Cal now covers asthma education and home environmental asthma trigger assessments conducted by community health workers, Promotoras and other non-licensed professionals. RAMP and its partners advocated for this new policy.

Asthma home visiting programs, many of which are part of the Asthma Mitigation Project, provided their expertise, experiences and critical feedback which shaped the development of the two Medi-Cal policies on Asthma Remediation and Asthma Preventive Services.

Asthma Mitigation Project (2020-2023)

The Asthma Mitigation Project is a statewide grant program made up of 28 asthma home visiting programs and over 100 community health workers who are serving low-income neighborhoods throughout the state, focusing on asthma management and environmental trigger remediation, and decreasing the health impacts of asthma on adults and children. The project is a $15 million investment from the state and was brought about as a result of years of policy and advocacy efforts by RAMP and its partners.

From 2020-2023, RAMP served as a technical assistance provider, supporting and building the capacity of the 28 asthma home visiting programs to provide comprehensive asthma education and environmental asthma trigger mitigation through home visits using a culturally responsive, participant-centered and holistic approach.

A 2024 evaluation, released by the Center at Sierra Health Foundation (AMP administrator), found that funded partners successfully reached AMP’s priority populations, including communities of color and other historically underserved or under-resourced communities with higher rates of poorly controlled asthma. In total, 4,745 participants were enrolled in the AMP program between August 2020 and May 2023, and partners conducted 19,478 home visits—including both in-person and virtual visits, as well as environmental assessments. AMP participants reported a positive experience with AMP services. Almost all participants (95%) were satisfied with the AMP services provided to them.

The Role of Community Health Workers & Promotoras

Many asthma home visiting programs rely on community health workers to provide home visiting services and offer critical tools to help adults and children control their asthma and be healthy and active.

Community health workers or Promotoras are a central part of the success of the Asthma Management Project and work closely with community members and partners to address disparities related to asthma and bridge the health gap. The community health workers serve as an extension of public health or healthcare and build their capacity to improve asthma management through RAMP workshops which offer training, tools and support and are held multiple times throughout the year.

The Asthma Mitigation Project also helped to create jobs and opportunities for community health workers and Promotoras to continue to build their skills in asthma management and public health. The community health workers/Promotoras come from and live in low-income communities of color in which the project serves. They represent the diversity of these communities, speak the same languages and are trusted by community members who live there.

Sustained Funding for Asthma Home Visiting Programs

For years, asthma home visiting programs have had to be dependent on grants to help sustain themselves. These new Medi-Cal policies will not only increase patients’ access to important asthma home visiting services but also serve as a key component to sustaining asthma home visiting programs across the state.

Learn more about asthma home visiting services: Explore RAMP’s asthma home visiting services directory, which provides basic information about asthma home visiting programs in California, including service areas, services provided, client eligibility and contact information.