GOAL 1: Implementation, Monitoring, and Evaluation of the Strategic Plan for Asthma and State Infrastructure Enhancement

Goal Statement

A coordinated and integrated infrastructure built upon public-private partnerships will exist statewide, regionally, and locally to support collaboration in implementing the Strategic Plan for Asthma in California, in monitoring progress towards its objectives, and in sustaining its accomplishments.

1. Raise public awareness of asthma and the Strategic Plan for Asthma in California.
2. Develop a comprehensive and coordinated asthma program within the Department of Health Care Services (DHCS) and the California Department of Public Health (CDPH); one that collaborates with other departments and divisions at the state level.
3. Develop and revise, as needed, work plans to meet goals and objectives outlined in the Strategic Plan for Asthma in California.
4. Implement, monitor, and evaluate the Strategic Plan for Asthma in California at the local and state levels.
5. Enable and empower local public and private organizations to implement the Strategic Plan for Asthma in California.
6. Interface, coordinate, and collaborate with other states as well as national and international organizations on the prevention and management of asthma.

GOAL 2: Surveillance and Research

Goal Statement

California policy makers, health plan leaders, health care providers, employers, and the public will understand the importance of asthma and its continued threat to public health. Asthma data will be utilized to plan, implement, and evaluate interventions, with particular attention to vulnerable populations

Objectives

1. Maintain and expland asthma surveillance in California at the state, county, and sub-county levels.
2. Use surveillance data to document disparities and target interventions that may eliminate disparities in asthma prevalence, diagnosis, treatment, and outcomes, and monitor progress.
3. Develop necessary infrastructure in DHCS and CDPH that provides organization, accessibility, integration, management, evaluation, and linkage of asthma data.
4. CDPH will establish collaborative partnerships with research institutions, health plans, health care providers, pharmacists, independent practice associations, medical groups, managed care providers, Medi-Cal and Medicare, community-based organizations, and others to identify a range of asthma research priorities, to study asthma and to evaluate and translate interventions for preventing and managing asthma.
5. Policy regarding asthma in California will be informed by analysis and interpretation of data.

GOAL 3: Health Care

Goal Statement

Comprehensive, culturally appropriate, patient- and family-centered asthma care will be accessible to all people in California, resulting in optimal prevention, diagnosis, treatment, and management of asthma consistent with or exceeding national guidelines.

Objectives

1. Develop and promote statewide implementation of "standards of asthma care" for the diagnosis and management of asthma in collaboration with California's public and private health care delivery and payer systems.
2. Facilitate coverage and reimbursement for a comprehensive chronic disease management approach to asthma within public and private health care payer systems.
3. Expand quality improvement (QI) for asthma care within public and private health care delivery and payer systems to assess, improve, and sustain the provision of high-quality asthma care within and across systems.
4. Ensure seamless/integrated asthma care and enhance communication between primary care providers, emergency departments/urgent care centers, hospital inpatient settings, and community settings within public and private health care delivery systems.
5. Improve asthma knowledge and competency of health care practitioners, allied health professionals and community health workers, with a high priority on those serving underserved populations.
6. Increase access to high quality asthma care for underserved populations in California by implementing best practice policies and strategies to reduce the following barriers to care: cost, culture, language, and location/distance.

GOAL 4: Indoor Environment

Goal Statement

All communities in California will benefit from schools, child care centers, workplaces, homes, and institutional facilities that meet the needs of people with asthma and provide, to the greatest extent possible, indoor spaces and adjacent environments that are free from air pollutants, allergens, and chemicals that cause or exacerbate asthma.

A. Schools Objectives

1. Establish comprehensive and coordinated asthma policies and procedures in school districts to ensure the health and well-being of students with asthma.
2. Assess schools/districts compliance with existing codes and best practices that impact asthma, and ensure that laws and regulations adequately address indoor environmental quality issues and asthma management in schools.
3. Increase the number of qualified personnel in schools and districts to better meet the needs of students with asthma.
4. Institute targeted and specialized trainings for all district personnel on asthma and on environmental factors that impact asthma in schools; include health personnel, administrators, teachers, front office staff, coaches, maintenance and facility personnel, food preparation workers, and bus drivers.
5. Minimize exposure to contaminated outdoor air and promote safe and healthy outdoor school environments

B. Child Care Objectives

1. Ensure the health and well-being of children with asthma in child care settings through a set of comprehensive and coordinated asthma policies and procedures.
2. Increase the availability of child care health consultants, health personnel, and technical assistance resources to help child care providers manage asthma.
3. Work with the California Department of Social Services (Community Care Licensing) to ensure that laws and regulations for licensed child care facilities adequately address asthma-related and indoor environmental quality issues, that education about laws is sufficient, and that regulations are enforced.
4. Minimize exposure to contaminated outdoor air and promote safe and healthy child care facility outdoor environments.

C. Homes, Housing, and Institutional Settings Objectives

1. Improve understanding of asthma trigger exposure in home environments and assess effectiveness of exposure reduction interventions (e.g., the problem of second-hand smoke in multi-unit housing environments).
2. Develop and promote standards, guidelines, and model policies for asthma-safe healthy housing that minimize indoor environmental risk factors that contribute to asthma.
3. Educate various stakeholder groups on the importance of reducing indoor environmental risk factors in housing that contribute to asthma.
4. Ensure healthy home environments for people with asthma through augmenting home assessments, remediation, and legal advocacy.
5. Reduce asthma morbidity and exposure to asthma triggers for people in institutional settings, such as foster and group homes, prisons, nursing homes, and mental institutions.

D. Workplace Objectives

1. Improve data collection, surveillance, and evaluation of data on work-related asthma (WRA), and ensure data are used for prevention.
2. Develop and implement strategies to prevent WRA.
3. Increase awareness and knowledge about WRA and its prevention among health care providers, employers, workers, and communities.

GOAL 5: Outdoor Environment

Goal Statement

A healthy and safe outdoor environment will exist for all Californians, with a particular focus on optimizing respiratory health

Objectives

1. Support policies and community plans that improve conditions for people with asthma.
2. Ensure public awareness, participation and transparency in public policy decisions and improve communication between Air Quality Management Districts (AQMDs) and the communities they serve.
3. Target the elimination of disproportionate exposure to outdoor air pollution among specific groups or communities.
4. Reduce air pollution from sources such as "goods movement" industries, stationary industries, and transportation.
5. Reduce worker and public exposure to asthma triggers related to agricultural practices, forestry practices, and other outdoor workplaces.
6. Decrease exposure to second-hand smoke.