New Medi-Cal Benefit: Asthma Preventive Services

RAMP is thrilled to announce that, effective July 1, 2022, Medi-Cal covers Asthma Preventive Services. This policy change will both increase access to in-home asthma services for people with poorly controlled asthma and help sustain and expand California’s asthma home visiting programs.

The California Department of Health Care Services (DHCS) confirmed the coverage of this new service upon the federal approval of the Asthma Preventive Services State Plan Amendment (SPA). The new Medi-Cal benefit covers clinic-based and home-based asthma self-management education and in-home environmental trigger assessments provided by non-licensed professionals such as Community Health Workers, promotoras, and other individuals meeting specified qualifications.

Combined with Medi-Cal’s Asthma Remediation program, which covers environmental trigger remediation, California is now a national leader in providing comprehensive asthma home visiting services, which improve health outcomes, reduce health care utilization costs, and reduce asthma disparities.

Some highlights we’re excited about include:

  • While the in-home environmental trigger assessments will be available to beneficiaries with poorly controlled asthma, Medi-Cal will cover asthma self-management education for all beneficiaries with a diagnosis of asthma.
  • The new benefit is applicable in a range of settings: the in-home trigger assessments can take place in a client’s home, an assisted living facility, or a group home; asthma self-management education can be provided in any of the aforementioned settings or a clinic setting.
  • Professionals providing Asthma Preventive Services will need to complete a training program that covers components specified by DHCS, which align with current best practices and available training programs, including the Asthma Management Academy.
  • While the federal rules require supervision of the Asthma Preventive Services providers, California is taking a flexible and inclusive approach. The supervising provider can be a physician, physician assistant, nurse practitioner, clinic, hospital, local health jurisdiction, or community-based organization. Such diversity aligns well with California’s diverse home visiting programs.

While the Asthma Preventive Services benefit is effective July 1, details around implementation are still evolving. Additional details will be included in the forthcoming Provider Manual update, which is scheduled to be released on July 15. We will update our website as we learn more.

We’re pleased that, along with the Asthma Preventive Services SPA, DHCS has also finalized a SPA allowing Medi-Cal reimbursement for CHWs/promotoras to conduct a broad array of activities. RAMP has long supported development of the CHW workforce. RAMP staff participated on DHCS’s stakeholder group to develop the SPA and we are excited about expanded opportunities for this important profession. For more information, click here.

RAMP is proud of the leadership role we’ve played in advancing these policy changes. Of course, equally important to our success are the partnerships with many other asthma, health, housing and equity stakeholders, including the California Pan Ethnic Health Network, Children Now and dozens of other committed advocates who continue to share their time, expertise and advocacy. Thank you!

Warm regards,
RAMP staff