Asthma Cooperative Agreement Partner Profile – Puerto Rico

The Puerto Rico Asthma Program (PRAP) has been part of CDC’s National Asthma Control Program since 2006. PRAP and its partners work to reduce asthma disparities by improving the quality of asthma care, improving asthma management in schools, and fostering policies to help reduce exposure to asthma triggers in outdoor, indoor, and workplace environments.

• In 2020, the Puerto Rico Department of Education and the Department of Health issued Regulation 9224 (https://www.salud.gov.pr/CMS/DOWNLOAD/5931) to foster continuity of treatment for students with asthma. Also in 2020, the Puerto Rico Department of Health issued Administrative Order 473 (https://www.salud.gov. pr/CMS/DOWNLOAD/5932), an asthma management action plan for all patient with asthma. The plan included annual medical certification for students with asthma. In response, PRAP started the Asthma School Registry, which requires completion and submission of students’ asthma action plans to their schools. The registry ensures that children with asthma have an asthma action plans as an essential part of their treatment and that the document is submitted to the school for use, resulting in better asthma management and control. The data collected by the registry allow PRAP to identify the schools and municipalities with more students with asthma and the severity of their condition. This invaluable information is used for program planning.
• PRAP conducted a business case analysis for their interactive home visiting project for trigger reduction and asthma self-management education (Visitas Interactivas acerca del Asma en el hogar [VIAS]) in 2021. The business case describes the reasons and justification for the project in terms of business process performance, needs and/or problems, and expected benefits. PRAP developed the business case to assess the costs and effectiveness of the home visiting project in helping participants control their asthma. The business case provides information on where to focus program efforts to help determine project cost-effectiveness. Data analysis determined that the home visiting project has a return on investment (ROI) of 0.35. This means, for every $1 of the program cost, the intervention resulted in $1.35 of healthcare saving, or 35% in return. This ROI is an indicator of project effectiveness and supports pursuit of a Medicaid reimbursement code for the home visiting project. These data also provide an opportunity to bring awareness of this project to Puerto Rico’s health insurance companies.
• Thirty families benefitted from the virtual VIAS project in 2021.These families were referred to the project by collaborating partners. This project promoted asthma control behaviors and helped families reduce asthma triggers. Trained staff members from PRAP educated families about asthma and how to identify and manage symptoms, including asthma triggers. Photos of spaces in the home where children spent most of their time were used to evaluate and identify sources of asthma triggers. PRAP provided recommendations to the families on how to reduce the identified triggers along with supplies such as cockroach traps, mousetraps, hypoallergenic covers, and educational materials help reduce triggers.