The group is a pediatric asthma subcommittee of a county-wide Medicaid care management entity. Since every pediatric primary care provider is represented, and all providers are Medicaid participants, the scope of the program is pediatric asthma in general, not limited to the Medicaid program. The first goal was to implement NIH asthma guidelines, with group organization occuring 10 years ago. Collaborative efforts include a school nurse program, the local public health department, a medical school with pediatric and family practice teaching and provider services, a hospital-sponsored asthma care management program, quality-care systems of the Medicaid program and local quality assessment, and exemplary participation by the local physicians in their practice settings. The results have shown by data analysis the effectiveness of following NIH guidelines in dramatic decreases in asthma hospitalizations and emergency department utilization. The education component has included public and private schools as well as day care centers, resulting in application of instructions and education about asthma in Asthma Action Plan format for use at the asthma-educated home as well as the learning environment.