Program Details

Practice Type:	Model
Program Name:	The San Francisco Asthma Task Force
Organization:	San Francisco Department of Public Health
Web site:	www.sfdph.org/eh
Overview:	The San Francisco Board of Supervisors created an Asthma Task Force, charged to advise the Board how to prevent asthma and to improve the quality of life for people with asthma, especially the underserved, who live or work in San Francisco. Department of Public Health serves as staff and voting participant to Asthma Task Force.
Year Submitted:	2005
Responsiveness and Innovation:	The public health concern being addressed focuses on a ten year plus pattern of asthma hospitalization discharge data showing local health disparities by ethnicity and geographic location. In addition, there is a high reporting of school days missed due to asthma flares. The community had a concern about the impact of asthma on medically-underserved children and adults, their families and communities, and the lack of coordinated response by city government to address the problem. The Task Force focuses on responding to issues identified in the Strategic Plan as clinical, environmental, and schools/child care focuses. A Clinical Committee researches and makes recommendations intended to improve the clinical standard of care, reducing the burden on health caused by medically uncontrolled asthma, and the burden on health care systems caused by urgent care/ER visits and hospitalization. The Environmental Committee researches and makes recommendations to lessen environmental risk factors for asthma, particularly those needed in public housing developments and in the private rental housing stock. The Schools and Childcare Committee researches and makes recommendations to improve the SF Unified School District’s asthma management and education programs. These areas of need were determined by the strategic planning fact-finding process as well as the personal and professional experience of those serving on the Asthma Task Force. Most asthma coalitions in the U.S. have originated from the need to generate and coordinate direct services to those affected by asthma. This Task Force does not provide direct services, but instead advocates systems change. Local legislation specifically appoints Task Force members to represent certain constituencies and charges them with: Developing a comprehensive and coordinated Strategic Plan to effectively manage and prevent asthma in San Francisco; Assisting and advising the Board of Supervisors regarding funding priorities, legislative action, and city asthma policies; and, Advocating for federal, state, and local funding to support and sustain asthma prevention activities.
Agency and Community Roles:	Asthma Task Force members are appointed by the Board of Supervisors to represent: community-based organizations; key government agencies; hospitals; HMOs/insurers; lung health/asthma organizations; health care professionals; childcare coordinating/ advocacy organizations; academia; community asthma advocates; persons with asthma or a parent of a child with asthma; property owner and tenant advocacy organizations; environmental health/justice organizations. Members should live in San Francisco or work in agencies that affect San Francisco residents. Many city agencies representatives are also appointed to the Task Force to serve in non-voting seats. Members attend monthly meetings of the Task Force, and often bi-monthly meetings of the committees on which they serve. Committees are provided the support of an advocacy coordinator through grant funding administered by the American Lung Association. The Department of Public Health (DPH) worked with community stakeholders to draft the authorizing legislation for the Task Force and the Board of Supervisors, to recruit interested parties to serve on the Task Force, to write and implement bylaws, and to guide community participants gaining an understanding of city government functions and procedures. DPH representative, Karen Cohn, is an active voting participant of the full Task Force, currently serves as Chair of the Task Force and of the Environmental Committee, and participates in the Planning and Clinical Committees. DPH also provides clerical support to uphold the requirements of public meeting law. Many efforts are made by DPH to foster collaboration, including publishing a newsletter for World Asthma Day illustrating the programmatic asthma efforts of community stakeholders.
Costs and Expenditures:	Costs incurred by the strategic planning process include the following: Hiring of strategic planning coordinator and subsequent advocacy coordinator. Work with public relations media consultant for press events. Work with evaluation firm for conducting focus groups and retreats and analyzing results. Photocopying and printing costs. Extension of work timeline to implement advocacy strategies, which led to need to extend staffing term of service.
Implementation:	The public health concern being addressed focuses on a ten year plus pattern of asthma hospitalization discharge data showing local health disparities by ethnicity and geographic location. In addition, there is a high reporting of school days missed due to asthma flares. The community had a concern about the impact of asthma on medically-underserved children and adults, their families and communities, and the lack of coordinated response by city government to address the problem. The Task Force focuses on responding to issues identified in the Strategic Plan as clinical, environmental, and schools/child care focuses. A Clinical Committee researches and makes recommendations intended to improve the clinical standard of care, reducing the burden on health caused by medically uncontrolled asthma, and the burden on health care systems caused by urgent care/ER visits and hospitalization. The Environmental Committee researches and makes recommendations to lessen environmental risk factors for asthma, particularly those needed in public housing developments and in the private rental housing stock. The Schools and Childcare Committee researches and makes recommendations to improve the SF Unified School District’s asthma management and education programs. These areas of need were determined by the strategic planning fact-finding process as well as the personal and professional experience of those serving on the Asthma Task Force. Most asthma coalitions in the U.S. have originated from the need to generate and coordinate direct services to those affected by asthma. This Task Force does not provide direct services, but instead advocates systems change. Local legislation specifically appoints Task Force members to represent certain constituencies and charges them with: Developing a comprehensive and coordinated Strategic Plan to effectively manage and prevent asthma in San Francisco; Assisting and advising the Board of Supervisors regarding funding priorities, legislative action, and city asthma policies; and, Advocating for federal, state, and local funding to support and sustain asthma prevention activities.
Sustainability:	Costs were only sustained by private foundation grant funding. In-kind clerical and public notice support by Department of Public Health staff occurs without funding, based on legislative mandate. Stakeholder members participate without compensation, and are sufficiently committed to perpetuate the practice beyond the initial authorized period. The American Lung Association continues to seek grant funding supporting the advocacy coordinator position.
Lessons Learned:

Back to main page.