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February 01, 2014

Medicaid-Covered Treatments May Help Poor Children Suffering from Asthma

The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.

Recent media coverage has shed light on urban families battling asthma who find little help for removing what can be deadly triggers in their home. These triggers lead to thousands of costly emergency room visits. But according to the American College of Allergy, Asthma and Immunology (ACAAI) there is help for these families—help which shouldn’t be kept a secret.

“Superior medical care may seem out of reach for less fortunate families, but one of the best kept secrets is that board-certified allergists are within arm’s reach, with many treatments covered by Medicaid,” said allergist Michael Foggs, MD, ACAAI president. “Parents should ask their primary care provider or pediatrician for a referral to an allergist. Many of these children are seen in either urgent care centers or emergency departments. They, too, would benefit by being referred to a board-certified allergist.”

Not only are allergists experts in treating asthma, they are trained to help assess home environments to help identify and reduce environmental exposures that may cause or worsen asthma.

Allergist Jay Portnoy, MD, ACAAI past-president, heads the Center for Environmental Health the Healthy Home Program at Children’s Mercy Hospitals & Clinics in Kansas City, where their Asthma-Friendly Home Partnership is just one example of local programs designed to help conquer asthma triggers in inner city homes.

As part of this program, families can have free phone consultations regarding home health concerns and if deemed necessary, can have an in-home environmental assessment. This assessment is usually a visual evaluation and includes checks for air quality, excessive moisture, allergens and dust, and injury prevention. Intervention recommendations are given and families can receive kits with cleaning products, furnace filters, room air cleaners, dehumidifiers, and even vacuum cleaners.

“When a landlord is slow to respond, help might seem out of reach, but families need to go beyond the landlord and seek expert help,” said Dr. Portnoy. “When nothing is done, this leads to increased emergency room visits where children’s breathing problems are merely patched up. They are sent back home and find themselves back in the emergency room weeks later. This becomes a revolving door of problems that only worsen.”

Dr. Portnoy and James L. Sublett MD, president-elect of the American College of Allergy, Asthma, and Immunology, have been working, along with other allergists, indoor environment and building science experts, over the past several years to develop a series of Parameters on Indoor 

Environments, which are guidelines on how to deal with these issues. To date they have published guidelines on cockroach, furry animals, rodents, and dust mites with the mold paper in progress.

Allergists are experts in diagnosing and treating asthma and allergic diseases. After diagnosis, allergists teach patients the best way to avoid exposure to potential allergy and asthma triggers and select the most effective treatments to allow them to lead a normal, healthy life. Treatment for asthma can include inhaled proper medications and specific allergen immunotherapy, also known as allergy shots. Allergy shots are the best source of relief when triggers cannot be eliminated from the home.

According to ACAAI, an estimated 85 percent of asthma patients have allergies, which makes seeing an allergist crucial for proper testing and evaluation. If allergies are present, asthma can be a life-threatening symptom which can be eliminated when proper precautions are taken.

“Asthma is a serious disease that affects 26 million Americans, a number that is increasing annually,” said Dr. Sublett. “Asthma results in 4,000 deaths and 2.1 million emergency room visits every year. Studies have shown that these statistics are reduced when asthma sufferers are under the care of an allergist.”

The greatest rise in asthma rates is among African American children with an almost 50 percent increase from 2001 through 2009.    

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