Partnership delivers asthma care to children whose care centers were flooded by Katrina

NEW ORLEANS, October 20, 2011 – The disappearance of reliable healthcare services in New Orleans following Hurricane Katrina left many children with asthma no choice but to seek treatment in emergency rooms across town – if they sought care at all. Xavier University of Louisiana's Center for Minority Health & Health Disparities Research and Education (CMHDRE), Daughters of Charity Services of New Orleans (DCSNO) and the Children's Health Fund (CHF) have teamed up to help reverse that trend by bringing reliable health care directly to these children. The organizations are partnering on the second phase of Head-off Environmental Asthma in Louisiana (HEAL), a program that has been helping New Orleans families manage their children's asthma since Katrina struck. The program is funded by non-profit Merck Childhood Asthma Network, Inc. (MCAN) and The Merck Company Foundation.

HEAL Phase II, a four-year program aimed at improving childhood asthma management in New Orleans, will use a unique, well-documented approach to deliver care through community health centers and mobile clinics placed in neighborhoods that lack a central source of healthcare. This approach is especially important given the burden of asthma on New Orleans' children. Asthma prevalence rates in New Orleans are three times higher than the national rate – among the highest in the nation – and death rates from childhood asthma are the highest in Louisiana.

"We are doing something that's never been done in New Orleans because waiting for things to return to 'normal' just wasn't an option for kids with asthma," said Leonard Jack, Jr., Ph.D., MSc, CHES, Director of the CMHDRE, Xavier University and principal investigator for HEAL Phase II. "Innovation and science-based approaches are crucial in post-Katrina New Orleans, where thousands now have the daunting task of managing health conditions like asthma in the absence of consistent healthcare and in the face of new environmental challenges."

HEAL Phase II will extend and build upon the lessons learned from the first phase, the most significant of which was that successful childhood asthma management requires access to continuous, evidence-based care that incorporates the home, healthcare setting and school. The program will enroll children (ages 2-18) who receive care at any of the DCSNO clinic locations and the Children's Health Fund-Tulane University Health Sciences Center Department of Pediatrics mobile clinic that currently serves Fredrick Douglas High School and A.D. Crossman Esperanza Charter School. HEAL Phase II will use the following elements to provide coordinated care for children with asthma and their families:

• Provider Training: Studies have shown that using the National Heart, Lung and Blood Institute asthma guidelines in practice improves health outcomes. HEAL will retain the services of an allergist who will train providers at DCSNO to enhance their skills and help them deliver care that is compliant with these guidelines.
• Asthma Educators: Asthma educators have been shown to effectively reduce the number of days with symptoms, emergency department visits and hospitalizations. During the program, two asthma educators will provide counseling to children and their families that: 1) addresses the child's specific severity of symptoms, sensitivities and exposures to allergens; 2) identifies and addresses barriers to care and empowers them to acquire the skills to effectively self-manage the disease and communicate with physicians; and, 3) includes follow-up calls between clinic appointments and home visits, where necessary.
• Electronic Medical Records: The effective use of electronic medical records can improve access to care, doctor-patient communication, efficiency and patient satisfaction. Most importantly they can decrease medical errors. Both DCSNO and CHF will implement important changes to existing electronic medical systems to enhance delivery and documentation of state-of-the-art asthma care.
• Community Outreach and Asthma Awareness: The program will use community health workers to engage schools, churches, social services and community-based organizations located near the care sites to enhance the child's network of support outside of the clinical setting.

"For years, the Daughters of Charity have been a major provider of primary care in the New Orleans area, and we are honored to be able to help residents at such a pivotal time for the healthcare system in our city," said Michael G. Griffin, President and CEO, Daughters of Charity Services of New Orleans. "This partnership will not only enhance the services we already provide to the community, but it will improve the lives of some of our most vulnerable residents – children with asthma."

In 2007, the unique conditions in New Orleans after Katrina – the flooding and subsequent proliferation of mold – prompted MCAN to launch the HEAL project alongside the National Institutes of Health (NIH). The outcome of the first phase of HEAL revealed the need to take key learnings into "real world" settings. The second phase will hopefully make the important case for incorporating training, education, evidence-based care, technology and outreach into sustainable, community-based asthma interventions across the country. In addition, partners and funders are hopeful the findings will provide a basis for advancing national policies that remove barriers to better asthma management and care.

"Since Hurricane Katrina, many children and families have had difficulty accessing health care in New Orleans. Our mobile program allows us to bring comprehensive primary and specialty care directly to children who are otherwise not getting the help they need," said Delaney Gracy, MD, Chief Medical Officer, Children's Health Fund. "Our partnership with Xavier University and Daughters of Charity Services of New Orleans brings together groups with a common interest and increases the impact any one of us could have on these kids exponentially."

For more information on the HEAL program, visit www.xula.edu/heal.

Asthma is the single most common chronic condition among children. In 2009, one in every 11 children – 7.1 million – had asthma, a number that has grown steadily over the 1997-2009 time period. It is also costly. The nation spends between $8 and $10 billion alone on treating childhood asthma, more than any other childhood condition. Additionally, indirect costs which include missed school days and lost wages for a parent or care giver who is caring for a child, approach $10 billion annually. While asthma affects children in every community across the country, low income and minority children bear the heaviest burden of the disease and its consequences, including death. Compared with white non-Hispanic children, data reported in 2009 indicate that asthma is nearly twice as high among Puerto Rican children and twice as high in African-American children.

Xavier University Center for Minority Health & Health Disparities Research and Education

The Xavier University Center for Minority Health & Health Disparities Research and Education (CMHDRE) is an education center in the College of Pharmacy supported through funding from the National Institutes of Health. The Center works to eliminate health disparities by providing an environment that supports research, experiential training and community outreach education to students and faculty at Xavier University. CMHDRE partners local, regional and national organizations, including the Merck Childhood Asthma Network, Inc., Wal-Mart, the Louisiana Office of Public Health and the Louisiana Department of Health and Hospitals, Chronic Disease and Prevention Unit, to provide services and education to the community on various health topics. For more information, visit www.xula.edu/cop/centers-cmhhdre.

For more than 175 years, the Daughters of Charity have provided access to high-quality, compassionate health care for the greater New Orleans community, including the insured and uninsured. Our three state-of-the-art health centers are conveniently located in Bywater, Carrollton and Metairie, and patients can receive care for chronic illnesses such as asthma, cardiovascular disease and diabetes. Behavioral/mental health, prenatal care, pediatric care, optometry, dental and pharmacy services are also available. Daughters of Charity Services of New Orleans is a member of Ascension Health, the nation's largest Catholic and non-profit health care system. For more information, visit www.dcsno.org.

Founded in 1987 by singer/songwriter Paul Simon and pediatrician/advocate Irwin Redlener, M.D., Children's Health Fund (CHF) is the nation's leading pediatric provider of mobile-based health care for homeless and low-income children and their families. CHF's mission is to bring health care directly to those in need through the development and support of innovative medical programs, response to public health crises and the promotion of guaranteed access to health care for all children. CHF currently has 50 mobile medical clinics serving hundreds of locations across the country. Over the past 24 years, the organization has supported more than two million health care visits for disadvantaged children, often in places where doctors and health care providers are in short supply. For more information, visit www.childrenshealthfund.org.

The Merck Childhood Asthma Network, Inc. (MCAN) is a separately incorporated, non-profit, 501(c)(3) organization established to address the complex and growing problem of pediatric asthma. Funded by the Merck Company Foundation, and led by Floyd Malveaux, MD, PhD, a nationally recognized expert in asthma and allergic diseases and former Dean of the Howard University College of Medicine, MCAN is specifically focused on enhancing access to quality asthma care and management for children in the United States. For more information, visit www.mcanonline.org.

The Merck Company Foundation is a U.S.-based, private charitable foundation. Established in 1957 by Merck, a global healthcare leader, the Foundation is funded entirely by the company and is Merck's chief source of funding support to qualified non-profit, charitable organizations. Since its inception, The Merck Company Foundation has contributed more than $600 million to support important initiatives that address societal needs and are consistent with Merck's overall mission to help the world be well. For more information, visit www.merckresponsibility.com.