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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Missouri Medicaid to Support Asthma Care at Home

Hope Kirwan

TaNisha Webb points out a leak in the furnace room of an apartment in Kansas City, Mo. She explains the damp conditions are not ideal, especially right next to the system that circulates air throughout the home.

"It's going to pull in any other issues, airborne mold spores, bacteria growth potentially through the furnace and kind of distribute it in other places," Webb said.

Webb, an Environmental Health Coordinator at Children's Mercy Hospital, is visiting the home of a child with asthma to help identify environmental factors that could be triggering the child’s condition, like the mold she just found growing on the furnace room's walls.

Webb said many families can be overwhelmed when their child is hospitalized for asthma, so visiting them in their homes is a better opportunity for families to ask questions and fully understand their child’s medical condition.

“Not everybody's on the same level of education,” Webb said. “We may have someone that doesn't understand, that maybe doesn't read as well. So we have to take all of that into consideration and understand exactly where they're at.”

Credit Hope Kirwan / KBIA
Ryan Allenbrand takes a surface sample to test for mold and other asthma triggers.

  But families can’t always afford their own home assessment.

Ryan Allenbrand, Manager of the hospital's Healthy Homes Program, is also along on the assessment. He said the program tries not to limit access if a family can’t pay.

“We had decided if [families] had a certain insurance or a certain income level, then they would automatically qualify for our program and we would just do it,” Allenbrand said.

This year’s Missouri state budget included $400,000 for programs that help prevent asthma attacks in children, like the Healthy Homes program at Children’s Mercy. Providers who do home assessments and education are now eligible for reimbursement through Medicaid. And some experts believe this spending could end up saving money for the state.

“We're spending a lot of money because these kids are repeat offenders to the emergency room and hospitalizations,” said Joy Krieger, Executive Director of the Asthma and Allergy Foundation of St. Louis. “So not only is it bad for the state of Missouri to spend their money on repeated emergency room visits but it's bad for the healthcare of these kids.”

With these new reimbursements, Krieger estimates that each year the state could save $1,500 for every child with asthma on Medicaid.

Credit Hope Kirwan / KBIA
Ryan Allenbrand takes down information on his iPad during the in-home assessment. The data he collects will later be given to the family in a report with steps to improve the home environment.

  Allenbrand said in-home assessments help families make simple environmental changes to better manage their child’s asthma.

“A lot of times they're easily attainable actions,” Allendbrand said. “They don't cost a lot of money if any, just a little elbow grease.”

And most families appreciate the extra advice on how to make their home a healthy one. Clarissa has a three-year-old son who was hospitalized last month for his asthma. After her visit from the Healthy Homes team, she says she has already learned a lot about what she can do to make the apartment a healthy environment for her son.

“What to look for and what should I do you know and be cautious of and also to keep the environment healthy for him and anyone else that comes around,” Clarissa said.

The hope is that access to Medicaid reimbursements will create more programs for asthma education and healthier homes for families.

Hope Kirwan left KBIA in September 2015.
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