Asthma

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Asthma Program
health.asthma@state.mn.us

Asthma Home-Based Services

On this page:
Toolkit and AHBS manual
Health impact
Demonstration projects
Get started
MDH model
Make a referral

The Minnesota Department of Health (MDH) Asthma Program encourages local public health and other health-based agencies to incorporate asthma home-based services into their routine home visiting programs.

Home-based services are a unique opportunity for a health care professional to visit the asthma patient in their own home. Meeting with families at their home creates the opportunity to provide:

  • Individualized patient education.
  • Review asthma action plans.
  • Assess patient’s questions in an environment in which they are comfortable.

It is important that asthma patients understand what triggers may cause their asthma to flare up and learn ways to reduce exposure or eliminate triggers as much as possible. What may trigger a person’s asthma is very specific to that individual. Some of the more challenging asthma triggers are inside the home. These include tobacco smoke, dust mites, mold, saliva and dander from furry and feathered pets and pests like cockroaches and mice.

Home-based services afford more time with the patient and give the health care professional an opportunity to assess the home for potential asthma triggers. Health care professionals can use the results of the environmental home assessment to understand trigger exposure and better tailor a plan to support daily patient self-management.

Toolkit and AHBS Manual

Asthma Home-Based Services Toolkit provides resources and educational tools to support local public health or other health-based organizations interested in developing asthma home-based service programs. Peer-to-peer mentoring is available by pairing experienced local public health staff with agencies that are interested in providing asthma home-based services in their community.

Health impact

Projects conducted by MDH have repeatedly demonstrated the effectiveness of home-based services that include both asthma self-management education and home environmental assessments for people with asthma. Our model has demonstrated:

  • A positive return on investment (ROI) – the ROI ranged from $5.25 to $1.61 for every dollar spent.
  • Improved asthma control.
  • Fewer asthma symptoms.
  • Reduced missed days from school and work.
  • Reduced use of unscheduled clinic, emergency department, urgent care visits, and inpatient hospitalizations.

In our most recent project, the number of missed school days was reduced by an average of 2.42 days in the previous three-month period. This is equivalent to increasing school attendance by seven days over a nine-month school year. The number of work days missed was reduced by 0.48 days over three months.

Demonstration projects

Past MDH Demonstration Projects provide good examples to understand home visits, how they happen, and what the impact could look like.

Get started

A referral, potentially coming from the patient’s prescribing health care provider, is the first step in getting an asthma home visit scheduled for a client/patient with poorly controlled asthma.

Health care systems, clinics, and providers struggle with sufficient time to provide asthma education in the clinic setting and they do not have the opportunity to see what triggers may be affecting their patients asthma in the patient home. Home visits can provide asthma care that meets the medical and educational needs of the individual patient. Medical treatment, including daily medications, in addition to effective management of asthma environmental triggers in the home can reduce the number and severity of an individual’s asthma episodes.

Home services are provided by a trained:

Some programs may use a Community Health Worker to follow up with the initial recommendations, which support, and reinforce patient understanding and learning.

MDH model

This model presents one way of delivering asthma home-based services. Many other models can be adapted to different settings, including public health organizations, community health centers, clinics, hospitals and schools. This model’s approach is consistent with the National Guidelines for Diagnosis and Management of Asthma (EPR-3).

Assessing asthma control and provide asthma self-management education (ASME)

  • Managing asthma successfully means regularly assessing how well controlled a patient’s asthma is, monitoring symptoms and risk factors, and the risk for developing symptoms,
  • and taking medications according to an individualized asthma action plan.
  • Providing individualized asthma self-management education is included during an initial home visit and with subsequent follow-up visits. The goal is to assess and increase the patient’s ability to understand and follow their personalized written asthma action plan and to take action according to the plan.
  • An asthma action plan provides a list and guidance on what asthma medications the patient takes and when, what symptoms to watch for that indicate asthma is not being well controlled, and when to seek emergency medical care.
  • The asthma educator also provides an overview of how asthma affects a person’s ability to breathe and gives them guidance on how to manage their asthma every day.

Environmental assessment of triggers in the home

  • Assessment of the home environment – a walk-through (visual assessment) that includes the person with asthma or a family member (the focus is on the sleeping area).
  • Review the results of the home assessment with the individual and family – asthma triggers will be identified and action steps recommended to reduce or eliminate asthma triggers found in the home.
  • Additional visits by local public health staff are scheduled to reinforce asthma self-management education and to deliver/set up recommended environmental products.
  • Refer out or provide additional community resources as needed to support the social needs of the family and patient.
  • Access local environmental health and healthy homes staff with expertise in housing to support more complex building and asthma trigger issues.

Make a referral

The following Minnesota programs currently offer in-home services for asthma. Please see contact information to inquire about services provided and current eligibility.

Anoka County offers free asthma consultations for children up to age 18 who live in Anoka County and have an asthma diagnosis.

A public health nurse can visit clients in their home up to three times to:

  • Provide education on current asthma action plan.
  • Provide education on medication use.
  • Provide an asthma home assessment to look for asthma triggers.
  • Connect to community resources.

Submit a referral by one of the following:

  1. Visit Anoka County Asthma Program.
  2. Complete the online submission form at Anoka Public Health Nursing Referral.
  3. Call our Public Health Nurse Intake Line at 763-324-4240 and complete a referral over the phone. 

Email: Public.Health.Nursing@anokacountymn.gov

Brochures:

Asthma Brochure - English (PDF)
Asthma Brochure - Spanish (PDF)
 

Brown County offers free asthma consultations for children up to age 18 who live in Brown County and have an asthma diagnosis. A public health nurse can visit clients in their home up to three times to: 

  • Provide an asthma home assessment.
  • Identify asthma triggers to improve asthma control and reduce asthma symptoms.
  • Provide individualized asthma self-management education.
  • Connect to community resources. 

For more information or to sign up:

Contact email: Melissa.Hoffmann@broncountymn.gov 

Flyers: 

Dakota County offers free asthma consultations for children ages 0 to 18 who live in the Dakota County and have an asthma diagnosis.

A public health nurse can visit and work with the family on ways to reduce the child’s symptoms. The nurse can help the family learn about asthma, discuss community resources available to decrease exposure to triggers in the home, and assist in developing an asthma action plan. Families may be eligible to receive free trigger-reducing equipment.

Contact Dakota County Public Health:

Des Moines Valley Public Health is dedicated to supporting children ages 0 to 18 with asthma who live in Cottonwood or Jackson counties.

Our asthma home-visiting program can provide free in-home visits provided by a public health nurse with special education in asthma management.

A home visit allows more time with children and their caregiver (s) to learn more about asthma and self-management, discover and mitigate potential asthma triggers, and receive guidance on how to use asthma medications and maintain an asthma action plan. To schedule a visit, call Des Moines Valley Public Health or email asthma@dvhhs.org.

Contact Des Moines Valley Public Health:

Hennepin County will provide asthma home visits for eligible county residents, including families who live in Minneapolis. Families living in Bloomington, Edina, and Richfield may contact 952-563-8900.

A public health nurse specializing in pediatric asthma will:

  • Educate regarding asthma diagnosis and what it means for the child and the child’s family.
  • Provide asthma self-management education; understanding the different roles of medication and devices.
  • Conduct home environmental assessment for asthma triggers and make referrals for possible home remediation or other resources.
  • Reinforce and educate regarding the child's asthma action plan.
  • Coordinate clinic and provider appointments to ensure continuity of care.

Contact Hennepin County Public Health:

Kandiyohi offers free asthma home visits for all individuals (children and adults) who live in Kandiyohi County and have poorly controlled asthma or are newly diagnosed. A trained public health nurse will:

  • Educate about asthma and provide asthma self-management education.
  • Conduct home environmental assessment for potential asthma triggers and education about how to reduce identified triggers.
  • Provide area resource information, coordination, and support.
  • Educate and provide individual instruction on how to use asthma medications.
  • Assistance with developing an asthma action plan.
  • Individuals may be eligible to receive free trigger-reducing products.

Contact Kandiyohi County Public Health at 320-231-7800, Select Option 4, or email at publichealth@kcmn.us.

Minneapolis Asthma Program offers asthma home visits for Minneapolis residents with children under 21 years of age diagnosed with asthma. The Minneapolis Health Department will provide the following:

  • A trained specialist to conduct a free walk-through of your home to find common asthma triggers and discuss ways to reduce or remove asthma triggers. Includes up to three visits from a public health nurse - more visits may be added if necessary.
  • Free allergen-reducing products, such as a HEPA air purifier, furnace filter, HEPA filter vacuum, and dehumidifier to improve the indoor air quality.
  • Free allergen pillow and mattress covers.
  • Free professional pest control.

Contact the Minneapolis Health Department at 612-673-2301, or text 612-449-0778, or email at health@minneapolismn.gov.

For additional information: City of Minneapolis Asthma Program.

The Healthy Homes program sends an environmental health inspector and a public health nurse to assess homes for asthma triggers and to provide asthma self-management education. This program teaches families how to reduce environmental triggers of asthma and to create a healthier home environment for their children. Families may be eligible to receive free products from Ramsey County to help manage their children’s asthma. Some of these products may include a HEPA air cleaner, high efficiency vacuum, bed and pillow encasements, cleaning supplies, radon monitor, and pest control supplies.

A home assessment includes:

  • An opportunity to discuss any issues that children are experiencing with asthma or allergies.
  • Lead, mold/moisture, and pest checks.
  • Radon testing.

Contact Ramsey County Healthy Homes Program at HealthyHomes@ramseycounty.us or call 651-266-1199 to schedule a healthy homes visit.

For additional information: Ramsey County Healthy Homes Program.

Southwest Health & Human Services (SWHHS) is a multicounty agency offering free asthma home consultations for children ages 0-17 years who have asthma and live in one of the following counties: Lincoln, Lyon, Murray, Pipestone, Redwood, or Rock.

A SWHHS public health nurse that specializes in asthma management can visit and work with the family on ways to reduce the child's symptoms. These visits can help the family learn about asthma, discuss community resources available to decrease exposure to triggers in the home, and assist in developing an asthma action plan.

Contact Southwest Health and Human Services:

St. Louis County offers free asthma home visits for children (0-18) living in St. Louis County who have poorly controlled asthma. A St. Louis County public health nurse can:

  • Conduct a home assessment for asthma triggers.
  • Provide asthma self-management education.
  • Offer care coordination and support.
  • Provide one-on-one instruction on how to use asthma medications and on the importance of following an individualized asthma action plan.
  • Tools and equipment may be available to help reduce asthma triggers in the home.

Contacts for St. Louis County:

  • North St. Louis County contact: Sarah Wipf, public health nurse, at 218-471-7608 or wipfs@stlouiscountymn.gov (Hibbing, Virginia, Ely and surrounding areas).
  • South St. Louis County contact: Kelly Bruels, public health nurse, at 218-725-5212 or bruelsk@stlouiscountymn.gov (Duluth, Proctor, Hermantown, Saginaw and surrounding areas).

For additional information: St. Louis County Asthma Home Visiting Program.

Wright County offers free asthma consultations for children 0-17 or through high school who live in Wright County and have been diagnosed with asthma.

Wright County's asthma home-based services are a unique opportunity for a public health nurse to meet with you and your child in your own home. The nurse can provide individualized education, review asthma action plans, assess home environment, suggest equipment to help manage asthma, and answer questions in a comfortable environment for both child and caregivers. Families may be eligible to receive free trigger-reducing equipment.

Contact Wright County Public Health:

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Last Updated: 05/07/2025