Breathmobile’s asthma specialists will see your child

When Tami Pickel, 43 and a single mom, was laid off from her job at a mortgage bank in 2007, she lost her health insurance too. Medi-Cal provided health coverage for her kids, but Pickel worried as asthma symptoms worsened for her son Ethan, now 11.

In October, a nurse at Ethan’s school recommended that Pickel take Ethan and his brother, Aaron, 9, who has milder asthma symptoms, to the local Breathmobile, a free, rolling asthma and allergy diagnosis and treatment clinic.

Ethan’s lung capacity measured at only about 30% when he first visited the Breathmobile. But once there, he was prescribed a new drug and, at a visit last week (his fourth since October), Ethan was at 93% capacity and doing fine, according to his Breathmobile doctor.

His mom attributes part of his improvement to the length of his first appointment at the clinic — 2 1/2 hours for a history, physical exam, medical tests and treatment review.

“It’s a pretty straightforward program,” says Dr. Maria Garcia-Lloret, assistant professor of pediatric allergy and immunology at UCLA’s Mattel Children’s Hospital, which operates the Long Beach-area Breathmobile. “Parents bring their kids, and we figure out how to best treat them so that they improve and stay stable.”

The Long Beach Breathmobile is the newest in the Breathmobile fleet; 10 others are on the road in Southern California. The California chapter of the Allergy and Asthma Foundation launched the project at USC in 1995 in an attempt to better control asthma in underserved areas. If patients couldn’t always get care, the thinking went, then specialists would take the care to them. Since then, the program has expanded within California as well as into Alabama, Arizona and Maryland.

The rolling clinics offer diagnosis and treatment of asthma and allergies. Most serve children, but a few also see adult patients, says Felita Jones, director of the national Breathmobile program. Children are generally referred by school nurses, but parents can also contact the program directly to sign up.

The Breathmobiles, really RV Winnebagos, are staffed by physicians, nurses and patient care workers. They offer physical exams, allergy skin testing and lung-capacity testing.

There is no cost for diagnosis or treatment and often no cost for medications; bills for treatment are sent to insurers if patients have insurance, but no bill is sent to the family if the insurer does not cover the charges. “The program is open to anyone, whether you have insurance or not, and whether someone is under care for asthma or not,” Jones says.

If a child’s asthma or allergies are already being treated by a physician, Breathmobile workers update the physician after visits. The clinics are generally stocked with drugs donated by pharmaceutical firms, and clinic employees can help families sign up for need-based financial-assistance drug programs run by pharmaceutical firms.

For families with prescription drug insurance, physicians try hard to prescribe drugs covered by the insurer; families may have to pay a co-pay of $10 to $20 or more. Breathmobiles make repeated visits to specific sites every six to eight weeks, and parents have contact information for the medical staff if an emergency, question or concern crops up between visits.

Tricia Morphew, a biostatician with the Breathmobile program, says children with mild to moderate asthma usually get their condition under control after two visits to the Breathmobile; those with more severe asthma usually need at least three visits.

The Breathmobiles park at public schools and public health clinics, but the service is open to any child, regardless of where he or she attends school or the family’s insurance status.

Jones says that program staff is updating the Breathmobile website to include all contact information for sites in Southern California. In the meantime, find contact information below.

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