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AB 391 (Chiu) – the “Asthma Preventative Services Act” Advances

AB 391 (Chiu) – the “Asthma Preventative Services Act” Advances

Assembly Bill 391 (Chiu), successfully passed out of the Assembly Health committee with bipartisan support (11-0). The bill is co-sponsored by CPEHN and the Regional Asthma Management & Prevention and Children Now, and it will allow California to better deliver care for Medi-Cal beneficiaries with asthma by adopting policies to expand access to cost-effective preventative care and provide healthcare workforce opportunities for communities of color.

Asthma is a significant public health problem and driver of health care costs. Over 5 million Californians have been diagnosed with asthma[i] -- about 1 in 7 state residents. Asthma is of particular concern for low-income Californians enrolled in Medi-Cal. Low-income populations, like the nearly two million Medi-Cal beneficiaries who have been diagnosed with asthma at some point in their lives,[ii] have higher asthma severity, poorer asthma control, and higher rates of asthma emergency department visits and hospitalizations. [iii] In 2010, Medi-Cal beneficiaries represented 50% of asthma hospitalizations and 42% of asthma emergency department visits, even though they represented only 30% of Californians. [iv]

Learning all of the facts behind asthma and how to properly care for a child with asthma can be extremely challenging for parents from communities for which English is not their native language. As Mariasmin Mejia, whose son has asthma, testified:

“When my son, Angel, was just one year old we took him to the Emergency Room and we discovered he suffered from asthma. My husband and I were in shock, before my son, I had never known anyone in my family who has had asthma, much less taken care of someone with asthma.

Looking back now, the information the hospital shared with me was not sufficient. I left the hospital doubting my ability to care for my son. In 2009, my friend--whose son also has asthma--recommended I seek out asthma prevention education from the community health worker at the clinic. That is when I met Silvia, thanks to her and their entire health team who work in unity, I no longer need to return to the ER as often because I know how to care for his asthma.”

Working with Silvia, Mariasmin was able to better understand the environmental changes that trigger her son’s asthma, how to manage her son’s medication, and learned to listen closely for the difference between a cough with phlegm and the dry cough from asthma.

AB 391 will increase access for Medi-Cal beneficiaries to asthma education and home environmental asthma trigger assessments by enabling DHCS to cover these services provided by qualified professionals that fall outside of the state’s clinical licensure system as long as the services have been initially recommended by a licensed practitioner. Increasing access to asthma education and home environmental asthma trigger assessments will help fulfill California’s Quadruple Aim of strengthening the quality of care, improving health outcomes, reducing health care costs and advancing health equity. 

The bill will be heard in the Assembly Appropriation committee in the upcoming weeks. Contact Kimberly Chen, Government Affairs Manager, at kchen@cpehn.org to learn more about how you can support this bill.


[i] Milet M. Asthma Prevalence in California: A Surveillance Report. Richmond, CA: California Department of Public Health, Environmental Health Investigations Branch, January 2017.

[ii] California Health Interview Survey data. 2015. UCLA Center for Health Policy Research. http://ask.chis.ucla.edu/main/default.asp. Accessed February 21, 2017.

[iii] Milet M, Lutzker L, Flattery J. Asthma in California: A Surveillance Report. Richmond, CA: California Department of Public Health, Environmental Health Investigations Branch, May 2013.

[iv] Calculated using data from Milet M, ibid, pp. 109, 121, 143.

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