Creating Healthy Housing to Alleviate Childhood Asthma

The Social Innovation Fund’s (SIF) Pay for Success (PFS) initiative has the potential to change the way government serves the public. It’s a new approach to funding social outcomes and addressing some of the country’s most pressing challenges across the SIF’s three priority areas: economic opportunity, youth development and healthy futures. As an inaugural grantee of the SIF’s PFS program, it allows GHHI to continue to lead the national effort in increasing the stock of affordable, healthy housing by exploring the feasibility of asthma-related Pay for Success projects benefitting low-income, asthmatic children.
Today we’re excited to announce our Pay for Success service recipients who will advance and evaluate new models of funding home-based interventions that produce measurable outcomes such as reduced hospitalizations, reduced emergency department visits and less missed school days.
In 2014, GHHI received $1.011M from SIF, a program of the Corporation for National and Community Service (CNCS) to help address childhood asthma by finding effective interventions and mobilizing public and private resources. So why did we engage in Pay for Success?
It’s innovative. Instead of paying for permitted activities, private healthcare payors pay for demonstrated results. This gives organizations the chance to bring proven interventions to scale.
It’s evidence-based. Investors are repaid once a rigorous, third-party evaluation determines that the program has achieved outcomes agreed upon by all parties.
It’s cost-effective. Preventative services are often the first to be cut from government budgets, even though remedial and emergency services are more expensive in the long run. By directing funds to preventive services, Pay for Success transactions have the potential to generate long-term savings for taxpayers.
It’s collaborative. By establishing public-private partnerships, Pay for Success transactions mobilize new sources of capital and minimize the financial risk to taxpayers. Social interventions benefit from additional funding, and “impact investors” and other private and philanthropic organizations can marry financial goals and public good.
I invite you to learn more about our service recipients, and the work we are doing together to break the link between unhealthy housing and unhealthy children. With a healthy home free of asthma triggers, the opportunities for families can only increase—children are in the classroom ready to learn and parents are able to work. 

Rehabilitation to Combat Unhealthy Housing

The Green & Healthy Homes Initiative (GHHI) has long been an advocate for healthy housing, realizing the crucial role it plays in determining health, social and economic outcomes. Robert Wood Johnson Foundation in partnership with National Public Radio (NPR) and  Harvard T.H. Chan School of Public Health (HSPH) recently called attention to the importance of healthy housing and other factors in their new poll and webcast series, “What Shapes Health?”
NPR’s related article, Improving Housing Can Pay Dividends in Better Health, included excellent case studies of families experiencing negative health impacts that improved after relocating to healthy homes. We commend the great work of the National Housing Conference and Bridge Housing as referenced in this article.
For most families, rehabilitation is the primary answer since relocation is not always an option. More than 20 million people in the U.S. live in unhealthy housing. There are simple not enough affordable, healthy homes available. Families are often aware that hazards in their home are affecting their health, but are unable to relocate because of lack of funds or lack of affordable options near their place of work or their children’s school. When families are lucky enough to move, another family will eventually move into the same unhealthy home, continuing the cycle.
GHHI is working to break this cycle by rehabilitating occupied housing and teaching families how to maintain the home. This allows families to stay in place and provides an enormous opportunity to revitalize and stabilize at-risk neighborhoods.
GHHI’s recent work in Baltimore, as published in Environmental Justice, shows that remediating home-based health hazards in occupied housing improves a family’s health. Simply removing asthma triggers, like mold and pests, while concurrently teaching families how to reduce dust mites and manage medication has resulted in a decrease of asthma-related hospitalizations, emergency department visits and missed days of school and work.
We are grateful that Robert Wood Johnson Foundation, NPR and HSPH are bringing attention to the social determinants that impact health and housing in our most vulnerable communities. I encourage everyone to follow this series and further the dialogue on the importance of healthy housing for all.  

Thank You, Senator Mikulski

Today in Baltimore, Senator Barbara Mikulski announced that she would not seek a 6th term as a United States senator for Maryland.
The Green & Healthy Homes Initiative sincerely thanks Senator Mikulski for being a tireless advocate for children and leading voice in the senate for the eradication of childhood lead poisoning. She championed of the Lead Hazard Reduction Demonstration Grant Program, funded by the Department of Housing and Urban Development (HUD), and played a vital role in helping reduce childhood lead poisoning in Maryland by 98%.
The Senator is the longest-serving woman in the history of Congress. We are proud to call her a friend and neighbor. We look forward to her continued work on behalf of children, Marylanders and families across the nation. There is no better example of a caring, constructive leader than “Senator Barb.”

11 Ways to Stay Warm and Save Energy this Winter

As much of the country is experiencing a colder than average winter, energy bills are rising. For many, this significant drop in temperature also results in colder homes. To help keep your home warm and your energy expenses down, follow these 11 DIY tips for a warmer, more energy efficient home.
1. Stop the drafts. Do you feel a draft near exterior doors? Apply weather-stripping along the frame and door sweep on the bottom of the door to keep cold air from getting in and warm air from getting out.
2. Seal the cracks. Inspect the exterior of your home and search for any cracks or holes in the foundation and siding. Not only are cracks an entryway for pests, it’s also another way cold air is entering your home. Be especially observant for cracks on window and door frames. Use weather-resistant caulk to fill in cracks.
3. Lock your windows. Locking your windows will ensure that they are as tightly closed as possible. Still feel a draft? Apply weather-stripping and seal cracks and holes.
4. Use the sun. When the sun is shining, open your blinds and curtains to allow sunlight in to naturally heat the room. When the sun is not shining, shut your blinds and curtains to contain any draft you may feel from the cold glass.
5. Program your thermostat. If you have a programmable thermostat, use it! Set the thermostat to as low a temperature as is comfortable when you are active in the home. When you are away or asleep, set the thermostat 10 to 15 degrees lower. Never set your thermostat below 55 degrees to prevent your pipes from freezing.
6. Insulate your attic. Use a non-combustible foam sealant to close any gaps and cracks, especially around pipes and chimneys. Use flexible caulk around any electrical boxes. Install weather-stripping to ensure the attic door or hatch closes completely. Use this chart to determine the insulation R value recommended for your area. Make sure the insulation covers the entire floor without blocking the attic vents. Complete the same upgrades to your crawl space.
7. Tune your furnace. Just like cars, your furnace needs an annual tune-up. A tune-up increases the efficiency of the furnace, ensuring maximum value and impact. Replace the filter each month to ensure warm, clean air is circulating efficiently.
8. Wrap the water tank. Is your water tank warm to the touch? If so, it is not properly insulated and uses more energy to keep the water warm. Water heater insulation blankets are available at your local hardware store for about $20.
9. Invest in the little things. There are several changes you can make around your home for a minimal investment and high return. Replace incandescent lightbulbs with compact fluorescents or LEDs; install low flow shower heads and faucet aerators; use surge protectors for electronics and turn off the base when not in use.
10. Dig Deep. If you haven’t noticed an improvement in your energy bills or have trouble maintaining a comfortable temperature in your home, hire a professional to conduct an energy audit. An energy auditor will be able to determine exactly where air is entering the home and what additional steps need to be taken. For free, rebated or discounted energy audits, contact your energy provider or local housing department.
11. Make it Healthy. Before weatherizing your home, make sure your home and the air you breathe inside it is healthy. Take GHHI’s quiz to evaluate your home’s health and learn how to maintain it with GHHI’s 8 elements of healthy home.

Seizing Healthcare Funding Opportunities for Asthma Interventions

As the interest among stakeholders in data demonstrating the health and cost-savings benefits from in-home asthma resident education and housing interventions is mounting around the country, GHHI is helping local and state governments, healthcare organizations, housing providers and community agencies take advantage of these opportunities to pursue prevention funding for their communities.
GHHI provides training and technical assistance in the development of strategies to access Medicaid, private insurer and social impact investment to pay for in-home asthma resident education and Healthy Homes housing interventions to reduce asthma triggers. GHHI offers customized Pathways to Healthcare training sessions, including instruction on the GHHI comprehensive service model, asthma home intervention and education best practices, asthma social impact bonds planning, other financing tools, public and private healthcare reimbursement, healthy homes and more. Other sample training topics include:

How to pursue effective healthcare funding strategies

Medicaid rule changes

Medicaid waivers

Examples of healthy homes reimbursement currently in practice

Opportunities through managed care organizations

State Innovation Models overview

ACA’s changes in hospital community benefit investment rules

ACS’s hospital readmission reduction program

Best practices on engaging state Medicaid offices and hospitals

Integrated GHHI service delivery model
As an example of our customizable trainings, here’s a look at a recent training GHHI conducted for the State of Vermont by Vice President of Policy and Innovation Michael McKnight:
Organized and sponsored by the Vermont Housing and Conservation Board (VHCB), more than 40 individuals from across the state attended, including staff from the state health department, hospitals, accountable care organizations, the state innovation model program funded by the Centers for Medicare and Medicaid Innovation, the weatherization and lead poisoning prevention programs, as well as home visiting and asthma management programs. The training explored how Vermont housing programs and their related services can be more closely tied to clinical services. It included an in depth look at existing opportunities to incorporate health-related funding into a comprehensive model that includes home interventions.
Participants also reviewed the evidence of the effectiveness of healthy homes and weatherization interventions, the importance of the home environment to patient health, and how much of a business case already exists for integrating these two fields. Attendees then discussed the current Vermont healthy homes, lead poisoning prevention and weatherization work, and the potential for coordinated service delivery.
Mr. McKnight reviewed all of the available pathways to incorporating health related payment and reimbursement streams for home interventions and discussed with participants the Vermont healthcare landscape, including ongoing programs addressing asthma and efforts to reduce the homeless population by paying for housing through healthcare streams. (The state of Vermont is very focused on the triple aim of improving the quality of care delivered to patients, improving population health and reducing healthcare costs. Incorporating home education and interventions was viewed as an opportunity to reach all of these aims.)
This training, as well as others on a variety of green and healthy housing topics is available through GHHI’s Client Services Division for communities both in and out of the GHHI network. If you are interested in scheduling a Pathways to Healthcare training or learning more about other GHHI training options, please contact me at gwstewart@ghhi.org or 410-534-6447 ext. 130.

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