Many Americans not receiving recommended home visit services for lead poisoning and asthma

November 19, 2014

COLUMBIA, MD and WASHINGTON, DC (November 19, 2014) - Today, the National Center for Healthy Housing (NCHH) and Milken Institute School of Public Health at the George Washington University released Healthcare Financing of Healthy Homes Services: Findings from a 2014 Survey of State Reimbursement Policies, a report documenting current Medicaid reimbursement practices for environmental health services in the homes of lead-exposed children and people with asthma and highlighting opportunities for increasing access to these benefits.

"ASTHO applauds NCHH and Milken Institute School of Public Health for undertaking this effort," said Dr. Paul E. Jarris, executive director at the Association of State and Territorial Health Officials. "This report provides critical information to help policymakers understand where reimbursement policies are in place for vulnerable populations and the challenges that states face in implementing them. This is the first step toward ensuring that Americans have access to the high quality, evidence-based care they deserve."

The report shows that while 27 states have some Medicaid reimbursement policy in place for either home-based asthma services or follow-up services for children with lead exposure, these important services are not mandatory in most states.

The survey showed that although follow-up services are required by Medicaid's Early Periodic Screening, Diagnostic, and Treatment benefit for children with lead exposure, only 18 states require provision of these services for Medicaid beneficiaries with elevated blood lead levels. Similarly, despite recommendations by the Community Guide to Preventive Services and the Clinical Guidelines for the Diagnosis and Management of Asthma (EPR-3), only 13 states have any reimbursement in place for home-based asthma trigger control services, such as asthma education and environmental assessments.

"Asthma and lead poisoning are costly problems for our society and our healthcare system. These costs can be reduced by closing critical gaps in the delivery of recommended services and ensuring that once policies are in place they are translated into actual services for people who need them," said Amanda Reddy, director of programs and impact at NCHH.

The researchers plan to undertake additional analysis to understand how states successfully convert policies into services on the ground and how to address potential barriers to assist state and local agencies further in exploring healthcare financing for healthy homes.

Outside of Medicaid reimbursement, the survey showed that, in some states, private payers, hospitals, and other providers are beginning to explore integration of home-based asthma and lead services with clinical care through avenues such as accountable care organizations, hospital community benefits, and social impact bonds. These arrangements, though less common, may be gaining momentum.

The estimated annual cost of housing-related illness and injury, including asthma and lead exposure, is $53 billion; attributable in part to the half million plus U.S. children with elevated blood lead levels and the approximately 26 million U.S. children and adults with asthma.

"We know what works when it comes to home services that take aim at lead poisoning and asthma," said Mary-Beth Malcarney, assistant research professor at Milken Institute School of Public Health at the George Washington University. "Public and private payers nationwide should adopt and reimburse for these evidence-based practices to save healthcare costs and improve the lives of millions of vulnerable people."
To read the report or explore NCHH's healthcare financing resource library, please visit

About the National Center for Healthy Housing

The National Center for Healthy Housing is the preeminent national nonprofit dedicated to securing safe and affordable healthy housing for America's families. A highly regarded and credible change agent, NCHH has successfully integrated healthy housing advocacy, research, and capacity building under one roof to reduce health disparities nationwide. You can follow NCHH on Twitter @nchh or become a fan on Facebook at

About Milken Institute School of Public Health at the George Washington University

Established in July 1997 as the School of Public Health and Health Services, Milken Institute School of Public Health is the only school of public health in the nation's capital. Today, nearly 1,534 students from almost every U.S. state and more than 45 countries pursue undergraduate, graduate and doctoral-level degrees in public health. The school also offers an online Master of Public Health, MPH@GW, and an online Executive Master of Health Administration, MHA@GW, which allow students to pursue their degree from anywhere in the world.

George Washington University Milken Institute School of Public Health

Related Asthma Articles from Brightsurf:

Breastfeeding and risks of allergies and asthma
In an Acta Paediatrica study, exclusive breastfeeding for the first 3 months was linked with a lower risk of respiratory allergies and asthma when children reached 6 years of age.

Researchers make asthma breakthrough
Researchers from Trinity College Dublin have made a breakthrough that may eventually lead to improved therapeutic options for people living with asthma.

Physics vs. asthma
A research team from the MIPT Center for Molecular Mechanisms of Aging and Age-Related Diseases has collaborated with colleagues from the U.S., Canada, France, and Germany to determine the spatial structure of the CysLT1 receptor.

New knowledge on the development of asthma
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways.

Eating fish may help prevent asthma
A scientist from James Cook University in Australia says an innovative study has revealed new evidence that eating fish can help prevent asthma.

Academic performance of urban children with asthma worse than peers without asthma
A new study published in Annals of Allergy, Asthma and Immunology shows urban children with poorly controlled asthma, particularly those who are ethnic minorities, also suffer academically.

Asthma Controller Step Down Yardstick -- treatment guidance for when asthma improves
The focus for asthma treatment is often stepping up treatment, but clinicians need to know how to step down therapy when symptoms improve.

Asthma management tools improve asthma control and reduce hospital visits
A set of comprehensive asthma management tools helps decrease asthma-related visits to the emergency department, urgent care or hospital and improves patients' asthma control.

Asthma linked to infertility but not among women taking regular asthma preventers
Women with asthma who only use short-acting asthma relievers take longer to become pregnant than other women, according to research published in the European Respiratory Journal.

What are the best ways to diagnose and manage asthma?
A team of experts from The University of Texas Medical Branch at Galveston examined the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults and summarized them.

Read More: Asthma News and Asthma Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to