The Home Preservation Initiative (HPI) for Healthy Living seeks to improve asthma outcomes related to unhealthy housing in five neighborhoods in West Philadelphia. By combining home repairs and community health worker home visits, HPI aims to significantly reduce emergency department visits and hospitalizations due to pediatric asthma. For these primarily African-American communities, substandard housing, unemployment, low wages and a lack of education are barriers to the overall health and well-being of residents. Using outcome data, the collaboration will show health care cost savings, aiming to make a strong case for Medicaid reimbursement for home repairs.


BUILD and its communities apply bold, upstream, integrated, local, and data-driven (BUILD) approaches to improve health in communities that are adversely affected by upstream factors.


In July 2014, the Centers for Medicare & Medicaid Services ruled that non-traditional personnel, like community health workers, could be reimbursed for home visits if practitioner ordered. This project extends these reimbursements to include home repairs. This is  a game-changing policy update, creating a sustainable source of funding for similar projects. While limited to homeowners, HPI for Healthy Living is already thinking about renters.



With most people spending 70% or more of their time inside their home, the health of a home clearly impacts the health of the families living there. By combining home repairs and community health worker visits, HPI aims to reduce emergency department visits and hospitalizations due to pediatric asthma. Families receive home visits providing asthma self-management education, smoking cessation referral, and green cleaning and pest management supplies.


The shared vision to reduce pediatric asthma draws upon the strengths of all partners: neighborhood transformation, home repair, population health, and medical care.


Goals were built upon the community-identified housing needs of two comprehensive community plans and a Needs Assessment. In addition, Drexel’s Dornsife School of Public Health interviewed 42 residents who received home repairs and results were shared in community meetings to build community engagement and identify priorities. Ongoing outreach with residents and attendance at regularly-held civic meetings, also allows for input by community leaders.


CHOP is developing a hot-spotting approach for the communities. Emergency and hospital-based utilization for children in these communities is almost exclusive to CHOP, therefore they are creating mapping software to geographically encode groups with the highest propensity for asthma emergency department and hospital use. Mapping strategies are used for this project to identify which homes to target for combining home visits and home repair.