Alaska Native Tribal Health Consortium
The Alaska Native Tribal Health Consortium (ANTHC) is a large tribally owned and managed health organization that provides comprehensive medical and preventative health services for Alaska Natives and American Indians residing in the state. Program activities begin each year in late summer and early fall when pulmonologists from ANTHC and partner hospitals in Southwest Alaska search electronic medical records for Alaska Native children between the ages of 1 and 12 who are suffering from the most severe and recurring respiratory conditions. After obtaining participation consent from the local tribal councils and individuals, environmental health specialists conduct home assessments, in partnership with the local housing authority, to determine the appropriate modifications to improve air quality in each home. Potential modifications include addressing mold and moisture issues, increasing or installing ventilation, and replacing old leaky woodstoves with more efficient EPA-certified models. Building professionals from HUD-funded tribal housing authorities complete the home modifications.
In addition to modifications to the built environment, education is provided through community presentations, school activities, in-person discussions in the homes of participants, and distributions of informational pamphlets to reinforce healthy behaviors that improve air quality. Target behaviors include burning dry instead of wet wood, proper use of home ventilation systems, storing gasoline outside, best cleaning practices, and smoking outside the home, if at all. Education activities are designed to be culturally appropriate and tailored to address the specific behaviors and motives for change of each household. Participants also receive an in-home visit from a regional hospital’s respiratory therapist to discuss compliance with their medical treatment plan and to reinforce educational messages from environmental health specialists.
Children’s Mercy Hospitals and Clinics
In 1996, when Children’s Mercy Hospitals and Clinics (CMH), a nonprofit academic hospital in Kansas City, Missouri, conducted an audit to ascertain the level of care being delivered to asthma patients, deficiencies were discovered that indicated a lack of effective asthma disease management. These findings prompted the development of an asthma disease management program and a new focus on the role that effective case management combined with home environmental assessment and interventions plays in managing children’s health. Now, CMH has developed a comprehensive Center for Environmental Health where the mission has been to provide patient-based services, provider education, professional training, and community outreach and advocacy, while supporting environmental research on children’s environmental health.
One of the key programs at the center is the Healthy Home Program (HHP). Since 2003, the HHP has served thousands of families and hundreds of pediatric patients with asthma, allergies, lead poisoning, and other significant chronic health conditions. Through a series of successful HUD Healthy Home Demonstration grants, EPA grants, and foundation grants combined with help and collaboration from dedicated community partners, the HHP assessed environmental conditions and performed repairs or provided healthy home supplies in over 700 homes. These efforts resulted in the development of an environmental case management service model that has been shown to be effective at improving the health of pediatric patients with asthma, allergies, or lead poisoning. CMH has educated over 3,000 health providers and students, trained over 2,000 public health and environmental professionals, and offered educational workshops to contractors, consumers, and homeless people.
Breathe Easy Coalition of Maine
In response to a mounting number of complaints about secondhand smoke from residents in multi-unit housing and their health care providers, the Smoke-Free Housing Coalition of Maine, a program of the Breathe Easy Coalition of Maine was formed in 2002. Its stated mission was to protect residents in multi-unit housing from involuntary exposure to secondhand smoke. Key partners such as the American Lung Association of Maine were consulted, tenants in public housing were surveyed, and strategies for educating landlords and empowering tenants were researched and adopted.
Paramount to the Coalition’s mission were the facts that 1) smoke-free housing is much less expensive for landlords than maintaining rental units where smoking is allowed, and 2) providing smoke-free housing is legal in the U.S. The Coalition focuses on distributing information, educational activities, data collection through surveys of residents and property owners/managers regarding smoke-free policies, and providing decision-makers and housing authorities with information and technical assistance needed to adopt smoke-free policies. The Coalition has made a substantial impact that has resulted in smoke-free housing becoming the norm, rather than the exception, for thousands of tenants in Maine.
Wisconsin Housing and Economic Development Authority
With loans and a Low-Income Housing Tax Credit allocation, the Wisconsin Housing and Economic Development Authority helped finance Highland Commons, a 50-unit housing project that has been serving individuals experiencing severe and persistent mental illness since 2012. All of the units receive project-based Section 8 vouchers and are available to low-income households at 60 percent of the county median income. Highland Commons incorporates a supportive living model of services that allows individuals with a mental illness to live independently in permanent housing that provides them with the services best suited to their individual needs.
Services and activities are provided at no charge to residents through a Wellness Recovery Action Plan that is designed for each resident based on their individual needs. Highland Commons is designed to reduce stress, and the often resulting aggression, by addressing the need for privacy, a sense of security and serene surroundings. Well lit, bright apartments and common spaces, an attractive and calming color palette, a fitness room, a computer lab and free internet access, and landscaped grounds with outdoor patio and vegetable garden are all geared to help residents live the healthiest life possible. For many residents this is the first time they have lived in a neighborhood where they feel safe to walk outdoors. There is a grocery store and Dollar General Store within easy walking distance and the building is located directly on a public bus line. Easy access to a grocery store has helped residents improve their diets and make healthier food choices. A full-time supportive apartment coordinator works onsite to ensure that residents have access to counseling, case management, psychiatry, pharmacy and other health care services. Three trained and certified peer support specialists oversee and work with a variety of support groups and activities.