1. First Look: Weatherization Plus Health Model Program Evaluation Opportunity Council Oak Ridge National Laboratory

2. Partners Opportunity Council is a Community Action Agency serving Whatcom, Island and San Juan Counties in Washington State Oak Ridge National Laboratory

3. Health & Housing Connection: Link between health & indoor environment is well established and evidence is growing Asthma triggered by indoor environmental conditions Lead poisoning from old paint Radon, carbon monoxide and other toxic substances cause health threats

4. Weatherization Plus Health = House/ structure as a system Air Movement and pressures Humidity and Temperature Heating and cooling systems Insulation & Related Repairs Weatherization Infrastructure + Weatherization Plus Health Program Health Focus Asthma Education Rodent & Pest Exclusion Advanced Ventilation Flooring Change outs Additional Services 123

5. Weatherization Plus Health REFERRAL Head Start Homeless Hse Community Physician Energy Assistance Appointment Conservation Education & Healthy Homes Home Visit Weatherization plus Health Audit Weatherization plus Health Scope of Work Quality Assurance Inspection 6-month follow up

6. Weatherization Plus Health Basic Weatherization Education Component Visual survey of indoor air and health issues Interview with client Develop action plan for behavior changes and implementation Low cost, no cost materials Improve Indoor Environment A weatherization audit, energy saving measures combustion safety Do No Harm adds to Basic Weatherization such elements as Lead Safe work practices, Asbestos Awareness Conservation education Additional measures that improve the indoor environment and build on basic weatherization and education component; Ex: Enhanced ventilation and solid surface flooring

7. Evaluation Partners Opportunity Council Oak Ridge National Laboratory Department of Energy APPRISE Snohomish County CAP, Skagit Housing Authority, CAC of Lewis, Mason, Thurston

8. Purpose of Study The purpose of this study is to explore cost savings and the potential impacts of Weatherization Plus Health on the health of clients.

9. Research Questions 1. Does the Opportunity Council's Weatherization Plus Health program result in decreased direct medical expenditures related to asthma treatment? 2. Do the direct medical expenditures also correlate with self-reported and caregiver reported improvement in health related asthma symptoms and episodes? 3. Does the level of impact on direct medical expenditures correlate with specific weatherization or asthma reduction measures provided through Weatherization Plus Health?

10. Research Questions 4. By linking the Medicaid or health care assistance records and school attendance, academic and nursing care records is a relationship observed between the Weatherization Plus Health program, asthma episodes and treatment needs, and school attendance and on-site care?

11. Research Questions 5. If a relationship is observed, what are the cost savings related to the decrease in direct medical expenditures, increased school attendance, performance, and on-site care, and caregiver productivity? How do the physicians attribute change in asthma status and episodes per physician records and report? Are there any adults in the household that self-report a change in asthma conditions as a benefit for treating the home for the children?

12. Evaluation Design Comparison of Treatment Group and Control Group 35 Treatment Homes 15 Control Homes Home Visit with $200 incentive Quality of Life Survey Medicaid Release Asthma Control Test Walk Through checklist Physician Release School Release Satisfaction Survey

13. Evaluation Challenges WA State IRB Approval for Medicaid Small sample Difficulty locating appropriate control homes Working with schools

14. Initial Findings

15. Next Steps