The Northern California
Breathmobile® Program

Keeping Children out of the Emergency Room and in the Classroom!
Learn More Donate Today

About

The Northern California Breathmobile® Program
Keeping Children out of the Emergency Room and In the Classroom.

The Northern California Breathmobile® Program is a sustainable, accessible, community-wide asthma management program that shifts acute episodic care to regular preventative care in accordance with national standards. Staffed by asthma specialists, the Breathmobile® visits pre-schools and K-12 schools and community centers every 4-6 weeks seeing children with asthma. This mobile Asthma Clinic is staffed by asthma specialists, doctors, nurse practitioners, registered nurses, and respiratory therapists. The program provides a full service asthma action plan, medication, or means to obtain medication; all at no charge to the patient.
The statements and information contained on this website are intended to assist patients, the community, and healthcare professionals by providing clinical and scientific information. Documents reflect current available guidance on clinical topics relevant to Breathmobile® patients. These statements are not to be construed as dictating an exclusive course of action; nor are they intended to replace the medical judgment of healthcare professionals. The unique circumstances of individual patients and environments are to be taken into account in any diagnosis or treatment plan. Informational pages contained within the website are subject to change.

Meet The team

Washington Burns, MD

Washington Burns, MD

Executive Director
Mary Frazier, RN, MSN, AE-C

Mary Frazier, RN, MSN, AE-C

Project Director
Elaine Davenport, MD

Elaine Davenport, MD

Geetika Sengupta, MD

Geetika Sengupta, MD

Donna C. Carey, MD

Donna C. Carey, MD

Patricia Granberg, MD

Patricia Granberg, MD

Spencer Weir, RN, FNP, AE-C

Spencer Weir, RN, FNP, AE-C

Operations Manager
Priscilla Ward, RRP, AE-C

Priscilla Ward, RRP, AE-C

Respiratory Therapist
Elizabeth

Elizabeth "Liz" Bellow

Respiratory Therapist
Lisa Herndon, MA

Lisa Herndon, MA

Medical Assistant
Keiko Barfield

Keiko Barfield

Program Specialist (Esp/Eng)
Janet Magana, MA

Janet Magana, MA

Patient Services Rep & Driver (Esp/Eng)
Washington Burns, MD

Washington Burns, MD

Executive Director
Mary Frazier, RN, MSN, AE-C

Mary Frazier, RN, MSN, AE-C

Project Director
Elaine Davenport, MD

Elaine Davenport, MD

Geetika Sengupta, MD

Geetika Sengupta, MD

Donna C. Carey, MD

Donna C. Carey, MD

Patricia Granberg, MD

Patricia Granberg, MD

Spencer Weir, RN, FNP, AE-C

Spencer Weir, RN, FNP, AE-C

Operations Manager
Priscilla Ward, RRP, AE-C

Priscilla Ward, RRP, AE-C

Respiratory Therapist
Elizabeth

Elizabeth "Liz" Bellow

Respiratory Therapist
Lisa Herndon, MA

Lisa Herndon, MA

Medical Assistant
Keiko Barfield

Keiko Barfield

Program Specialist (Esp/Eng)
Janet Magana, MA

Janet Magana, MA

Patient Services Rep & Driver (Esp/Eng)
25

% of children with asthma
from ages 5-17 in Oakland

24

% of children with asthma
in West Oakland

24

% of children with asthma
in West Contra Costa County

16

% of children with asthma
in Bay View Hunter’s Point

The Problem

Largely because of inequities, there are severe asthma disparities in low income people living in the Bay Area. Alameda County has the 3rd highest hospitalization rates of all counties in California. 25% of the children ages 5-17 have asthma in Oakland. 24% of the children in West Oakland have asthma. 24% of children in West Contra Costa County and 16% of children in Bay View Hunter’s Point in San Francisco have asthma. Asthma is one of the top 3 reasons for school absenteeism and low academic performance. Rates of asthma hospitalizations are highest among children from birth to 4 years of age.

In West Oakland, a prototypical low income community, African American children are 5 times more likely to be hospitalized for asthma than other ethnic groups. 20% of the children and 37% of adults have asthma in West Oakland. Other areas with similar demographics, Emeryville, South-West Berkeley, parts of Contra Costa County (such as Richmond) and Bay View Hunter’s Point in San Francisco have similar asthma problems.

screen

Latino children have a higher rate of ED visits than Caucasian children. Currently in California, there are 1.1 million Latinos, including approximately 400,000 children who suffer from asthma. Since Latinos are currently the fastest growing ethnic group in the State, the potential impact of asthma in California in this group in coming years is enormous.

Data from the Department of Health Services of California looking at ED visits, hospitalizations and medication purchases show that generally speaking, Zip Code 94607 (West Oakland), ranks very high for events reflecting severe asthma and/or poor access to preventive care, and ranks very low for events reflecting the standards of care such as maintenance medication purchases.

  • Urban Living
  • Poverty
  • Education
  • Economics
  • Lack of access to healthcare
  • Cultural behavior patterns
  • Use of emergency services, rather than routine care by African-Americans and Hispanic (children & adults)
  • African-American and Hispanic children less likely to receive timely follow-up care after ER visit for asthma
  • Under-use of asthma maintenance medications
  • Less likely to visit a physician or specialist
  • Availability of health care facilities, including pharmacies a problem
  • Lack of transportation and excess waiting lines in clinic
  • Socio-economic status, low literacy, high stress levels
  • Inadequate medical management
  • Inadequate control of asthma triggers
  • Environment
  • Use of emergency services, rather than routine care by African-Americans and Hispanic (children & adults)
  • African-American and Hispanic children less likely to receive timely follow-up care after ER visit for asthma
  • Under-use of asthma maintenance medications
  • Less likely to visit a physician or specialist
  • Availability of health care facilities, including pharmacies a problem
  • Lack of transportation and excess waiting lines in clinic
  • Socio-economic status, low literacy, high stress levels

girl

The Background

Who has asthma?

Asthma is a chronic disease involving inflammation and constriction of the airways that makes breathing difficult. 80% of life-threatening asthma attacks occur at night.

U.S. Data

  • 150 Million Asthma sufferers in the world
  • 31 million in the US
  • In the US, from 1980 to 1996, the number has doubled
  • The largest increase, 160% for children under 5 years
  • Death rate in the US in 1977 was 4,500-5,000/year. Since 1977, it has increased almost four-fold.
  • Since 1980, asthma rates have risen most dramatically among African-American Children.
  • Both African Americans and Hispanics have higher rates than Caucasians and are more likely to have fatal asthma attacks.
  • Asthma is a debilitating and scary disease. In severe episodes it kills.
  • There is no cure, but it is manageable
  • It is expensive, costing Americans $16.5 billion annually in healthcare and lost workdays
  • 1.8 million trips to the ER
  • 1/3 of all Pediatric ER visits are for asthma
  • Puerto Ricans have four times the asthma rate of African-Americans, who have over-all the highest rates in the Country
  • In Harlem, 28% of kids under 12 have asthma
  • In Alameda County, 25% of 5-17 year olds have asthma
  • In West Oakland, 20% of 5-17 year olds have asthma, 37% Adults

California Data

In California, about 1.5 million (23.6%) or 1 in 6 children have asthma in the age group 5–17 years. In Alameda County, 1 in 4 children have asthma in this age group. Of all the cities in Alameda County, Oakland has the highest rate of Emergency Department (ED) visits, 40% higher than the County rate. African American children visit the ED at a rate 12 times higher than Asian/Pacific Islanders and 4 times higher than Latinos and Whites.

A survey of providers serving patients in the West Oakland community in 2007 showed that only one health care provider is located in the heart of West Oakland. This institution lacked an Allergist, a Pulmonologist, and a pulmonary function laboratory. Because of this, most asthma patients must seek outside medical assistance. Over 70% of residents in West Oakland are covered by MediCal, the remaining 30% have no coverage at all. The demographic composition of West Oakland is 64% African Americans, 16% Latinos, 9% Asian/Pacific Islanders.

The Solution

Low income people, particularly African Americans and Latinos, rely on episodic rescue trips to the Emergency Rooms to manage their asthma when inhalers fail them. What is needed is an accessible asthma specialty clinic in their communities regularly seeing them either asthma specialists or clinicians that know asthma very well to thoroughly evaluate them not only with histories and physicals but pulmonary function studies and skin testing for allergens if warranted, treatment, all according to national standards, education about their disease, asthma triggers, medications and case management, then provide medications if no insurance plans are available to patients and an appointment system, all at no charge to the patients.

There are so many diseases that we cannot control, but asthma is a controllable disease. We can drastically reduce medical costs, absenteeism from school and work, morbidity and mortality by teaching patients how to control their asthma. Asthma is the leading cause of school absenteeism. Concern has been expressed by many school districts about school absenteeism due to asthma. One solution is the Breathmobile program.

The Breathmobile® has been operating in Southern California since 1995 in Los Angeles, Orange, San Bernardino and Riverside counties, including some medical centers, and County School Districts.

In response to the factors contributing the asthma disparities, Prescott Joseph Center (PJC) brought the first Northern California Breathmobile® program – mobile asthma clinic — to Alameda County in 2009. The program is a sustainable, accessible community-wide asthma management program that shifts acute episodic care to regular preventative care in accordance with national standards. Staffed by asthma specialists, the Breathmobile® visits pre-schools and K-12 schools every 4-6 weeks seeing children with asthma. The program provides a full service asthma evaluation, treatment and education for asthma. Every patient leaves with an asthma action plan, medication, or means to obtain medication; all at no charge to the patient. Education about their disease, asthma triggers, as well as medication for families without a healthcare plan, is provided at no charge, only MediCal is billed; all children must be accompanied by their parents.

We do all of the above and in addition children will be referred to a nutritionist for obesity problems and home inspections will be arranged to look for asthma triggers and arrangements will be made for remedial work to reduce triggers when help is available. Education about triggers and use of proper cleaning products will be done. Medications, use and care of asthma devices, treatment on board with inhalation albuterol if necessary, skin testing for allergens, available if warranted.

Benefits

An accessible asthma specialty clinic in the community!

  • Increased regular, provider visits
  • Provide education and case management
  • No patient leaves without an action plan, medication, or the means to get medication
  • Standardized care through a computerized asthma disease management program
  • An appointment system

Success Outcomes

BREATHMOBILE BY THE NUMBERS

Breathmobile Outcomes (2012-2013)
Project Goals are 70% Reduction in Patient ER Visits, Hospitalizations and School Absenteeism
Total Patients Seen (Total Encounters) 242
Total Emergency Room (ER) Visits Reduction from 120 to 6
Total Hospitalizations Reduction from 114 to 0
Total School Absenteeism Reduction from 322 to 27
Estimated Healthcare Dollars Saved = $2,005,325
School Absenteeism (2012-2013)
295 Days Saved x estimated average per diem of $35 per day = $10,325
Breathmobile Outcomes (3 Years: September 2009 through July 2012)
Project Goals are 70% Reduction in Patient ER Visits, Hospitalizations and School Absenteeism
Total Patients Seen (Total Encounters) 283 (984)
Total Emergency Room (ER) Visits Reduction from 247 to 11
Total Hospitalizations Reduction from 92 to 4
Total School Absenteeism Reduction from 613 to 38
Estimated Healthcare Dollars Saved in 3 years = $1,400,000
School Absenteeism (3 Years:  September 2009 through July 2012)
575 Days Saved x estimated average per diem of $35 per day = $20,125

There are Breathmobile® clinics operating in Chicago, Illinois; Baltimore, Maryland; Tuscaloosa, Alabama; Phoenix, Arizona; and in California: Los Angeles County, Orange County, Riverside County, and Northern California. All programs are achieving a 73-83% reduction in Emergency Room visits and hospitalizations.

Other Approaches

Other organizations are approaching the problems with traditional response or they are in the planning phase. Although school-based didactic asthma education programs are good in principle, they fail to address many major reasons for the disparities, such as access and social behavioral patterns that contribute to the disparities. Many school-based clinics do not have routine pulmonary function studies.

School based clinics likewise do not fully address the problems because of diversity of personnel and lack of standard approach. They do not encourage the understanding of preventative care. Many clinics do not offer skin testing for allergens. It has been shown that identification of allergens that cause asthma attacks and teaching people how to reduce exposure to their allergens reduces the use of expensive controller medications. We are already on the ground with proven record of success.

By The Numbers

Currently, the Northern California Breathmobile® serves 17 sites
located in 9 cities residing in 3 Bay Area Counties. They include:

Alameda County

  • PLACE @ Prescott Elementary
  • Lafayette Elementary
  • Martin Luther King Jr. Elementary
  • Woodrow Wilson Elementary
  • John Muir Middle School
  • Anna Yates Elementary
  • Malcolm X Elementary
  • King Child Development Center
  • Rosa Parks Elementary School
  • Bohannon Middle School
  • The Breathmobile has a partnership with Alameda Head Start/Early Head Start. It serves the children in the Head Start program as well as other families at the following sites
  • Boys & Girls Club of Alameda
  • Alameda Point Collaborative

 

West Contra Costa County

  • Lake Elementary in San Pablo
  • Grant Elementary in Richmond
  • Verde Elementary
  • The Verde Head Start Center
  • The Las Deltas Head Start
  • The Project Pride Center
  • Bret Harte Elementary
  • FranDelJA Enrichment Center
  • Dr. George Washington Carver Elementary

 

Future sites include Grass Valley Elementary in East Oakland and Malcolm X Elementary in Bay View Hunter’s Point in San Francisco.

Community

Because asthma is a community problem, we feel a significant part of the solution is the broad community participation in the Bay Area working together to address this problem. Some may suffer from asthma or have relatives or friends that do, but all of us are directly or indirectly affected by asthma costs, and the decreased productivity that it causes.

Hidden costs of asthma include 911 calls, ER visits, lost school district revenue from absenteeism, and lost wages. Working together we can manage this controllable disease.

Our mission is to reduce the effects of asthma among economically challenged families by creating a sustainable asthma management program by using the Breathmobile® to shift people away from acute episodic care to regular preventive care.

Our vision is to develop a fleet of Breathmobiles® maintaining scheduled visits to Bay Area schools in Alameda County, Contra Costa County and San Francisco County.



20/20 Campaign

The 20/20 Campaign is an appeal to the community to help support the Northern California Breathmobile. Asthma is a “community disease.” It affects the community directly and indirectly. Children suffer and miss school. Parents miss work. Thus the economy is affected. For every day that a child misses school, $75 is not given to the school by the federal governments. Education is affected. Life is disrupted. Sure the Breathmobile can get donations from foundations and corporations, but we need the community to support a community problem.


2020

The 20/20 Campaign asks people to donate $20 (or any amount). Our goal is to reach 20,000 people. $400,000 is 4/5th the amount it costs to run the Breathmobile for one year. A significant response from the community will generate enough funds to ensure a successful community effort to fight asthma effectively. Asthma is not curable, but it is very treatable and manageable- IF we provide the community with the services it needs to manage it.

Asthma is increasing very quickly. Genetics plays a role, but environmental factors such as air pollution, poor air quality; and social factors, such as poverty, lack of education, and little access to doctors are significant in the prevalence of asthma we see today. The most severely impacted are young African Americans, Latinos, and the poor. Limited access to services and socioeconomic conditions are contributing factors to people managing their asthma by going to the emergency room when they are in crisis. YOU can be a part of the change in the way we deal with asthma, asthma education, and the policies impacting health inequities in low income communities. The Breathmobile is that change. The 2o/20 Campaign is an appeal to you, your networks, businesses, and communities, and anyone interested in addressing the asthma epidemic.

Please join us in our effort to increase asthma awareness, raise funds… and SAVE LIVES!

Donate Now

 

The Breathmobile

In response to the asthma disparities in low income people living in West Oakland and West Berkeley, the Prescott-Joseph Center (PJC), with the help of grants from the California Endowment, started Asthma management classes in West Oakland and Berkeley Public Schools in 2001. After discovering the Breathmobile® Program, a mobile asthma clinic program started by the Pediatric Allergy and Immunology Department at the University of Southern California (USC), PJC replicated and tailored this highly effective program to serve children in Northern California starting in 2009 with a personal loan from the volunteer executive director. A federal grant secured by U.S. Congressional Representative Barbara Lee funded the purchase and medical outfitting of the Breathmobile®.

The Port of Oakland offered the first $50k to support the operations of the program, joined by the Bay Area Air Quality Management District and California Wellness Foundation who in year one provided multi-year funding totaling more than $225k each to serve children in asthma hot-spots primarily in the Bay Area. The Air District and California Wellness continue to be champions and contributors of the Breathmobile® along with newer funding coming from the following: The San Francisco Foundation, Thomas J. Long Foundation, CISCO Foundation, Genentech Foundation, Kaiser Permanente, Chevron, and others.

The Northern California Breathmobile® is a 33 ft. Winnebago RV outfitted with the latest equipment to function as a mobile asthma clinic. Inside the van, there is an intake station, a small waiting space, a testing area for vital signs, including Oximetry, allergen skin testing and spirometry, and an exam room. On board are two computer systems, a health risk assessment system for asthma, a screening module for pre-diabetes, and a state of the art electronic medical records system called “AsthmaTrax.” A video system is also on board to play educational videos and CDs. Breathmobile® Personnel consists of Pediatric Asthma Specialists, including a Pediatrician (Medical Doctor), a Registered Nurse and/or Nurse Practitioner, a Respiratory Technician, Medical Assistant, all asthma-certified, and a Patient Service Worker/Driver. Services are available with bilingual Spanish/English speakers.

There is a consortium of nine Breathmobile® programs across the country, each owned and operated independently with the financial support of private and public foundations, corporations and individuals to help bring awareness; treat and manage this chronic disease.

We are very pleased to partner with the following foundations,
corporations, and organizations to bring the Breathmobile® to our community

Prescott Joseph Center
Port of Oakland
Asthma and Allergy Foundation of America

Stay in touch!

You can follow us on these social networks to stay in touch with our latest.

Get in touch with us!