Green & Healthy Homes Initiative's Asthma Program Helps Families Breathe Easier

Forty percent (PDF) of asthma episodes are caused by preventable hazards found in homes, including mold and dust mites. Social Innovation Fund (SIF) grantee Green & Healthy Homes Initiative (GHHI) is helping low-income individuals and families reduce such asthma triggers in their households.

It is doing so using a cost-effective and integrated approach that utilizes a comprehensive environmental assessment based on eight elements of “green and healthy homes:” dry, clean, pest-free, safe, contaminant-free, well-ventilated, well-maintained, and energy-efficient. A review of published studies (PDF) by the U.S. Department of Health and Human Services suggests that such home-based, multicomponent asthma interventions provide substantial return on investment.

GHHI’s asthma program is part of its integrated intervention services that also includes remediation and education for home health, safety, and energy efficiency. Its first pay for success project is located in Baltimore, Md., and will include Calvert Foundation and other investors providing up-front capital to scale the program. Program partners Johns Hopkins Health Care and the Johns Hopkins Health System will then pay back to the Calvert Foundation a portion of avoided medical costs if the program achieves agreed-upon outcomes, such as decreased asthma-related emergency room visits and hospitalizations.

To show funders the program was worthy of their support and investment, GHHI needed evidence demonstrating that its program leads to reduced Medicaid expenditures among residents of affected households. GHHI utilized a partnership it had formed with the Hilltop Institute at the University of Maryland, Baltimore County to collect data on Medicare expenditures for the treatment of lead paint-based health effects. As Michael McKnight, Vice President for Policy and Innovation at GHHI, notes, “The use of Medicaid data helps build interest in root cause remediation for health problems, but you need to have the data straight [to build a successful program].”

GHHI’s asthma prevention program yielded promising results (PDF) in Baltimore, including significantly reducing asthma-related emergency room visits (by 28%), hospitalizations (by 66%), doctor visits (by 22%), and school absences (by 27%). The U.S. Environmental Protection agency recently recognized the success of the program by awarding GHHI its National Environmental Leadership Award in Asthma Management.

Based in part on this success, in 2014 GHHI in partnership with Calvert Foundation received a SIF Pay for Success (PFS) grant. PFS is a contracting and financing model that leverages philanthropic and private dollars to fund services up front, with providers getting reimbursed after they generate results.

Through the SIF PFS program, GHHI and Calvert Foundation will conduct feasibility studies of PFS models that fund home-based asthma interventions in five communities. One healthcare entity, acting as a private payor, and one service provider were selected per project site, for a total of ten project subrecipients:

  • Buffalo, NY: Heart of the City Neighborhoods, Inc. and the Community Foundation for Greater Buffalo with Monroe Plan for Medical Care
  • Grand Rapids, MI: Health Net of West Michigan in partnership with the Asthma Network of West Michigan and Healthy Homes Coalition of West Michigan with Spectrum Health
  • Memphis, TN: Habitat for Humanity of Greater Memphis with Le Bonheur Children’s Hospital 
  • Salt Lake City, UT: Salt Lake County Office of Regional Development with University of Utah Health Plans 
  • Springfield, MA: Partners for a Healthier Communities’ Pioneer Valley Asthma Coalition with Baystate Health

GHHI and Calvert Foundation will work with the healthcare organizations and service providers to advance their projects. Among other tasks, they will help subrecipients create work plans, assess needs, model financial transactions, engage investors and stakeholders, conduct evaluations, and document processes and costs.

As SIF Deputy Director Lois Nembhard noted, “GHHI has already shown their partners in Baltimore that safe and healthy housing is worth supporting. Now, as they scale their program model to five new geographic locations, GHHI will be able to point to evidence that healthcare networks can benefit from investing in this intervention.”

GHHI President and CEO Ruth Ann Norton is enthusiastic about working with the SIF to serve more communities.

“We are doing this work to find new funding pathways for housing interventions that directly impact the health and well-being of families in communities across the country,” she said. "By advancing the field of healthy housing, we advance our collective mission to ensure that families thrive.”

More information about GHHI’s SIF project can be found online.

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