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Healthy Homes Section PLAN TO ELIMINATE CHILDHOOD LEAD POISONING IN MICHIGAN UPDATE Efforts in Michigan Decreased childhood EBL cases in both severity and numerically Increased number of children tested and reported to MDCH Positive trend causes - possible Epidemiological survey

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update
UPDATE
  • Efforts in Michigan
    • Decreased childhood EBL cases in both severity and numerically
    • Increased number of children tested and reported to MDCH
    • Positive trend causes - possible Epidemiological survey
  • Current prominent initiatives
    • National and state level
    • Latest efforts to reduce exposures to leadover a short time frame
  • Future work
    • Eliminate childhood lead poisoning in our state over next two years
    • Foster this change as a state and individual areas of responsibility and expertise.
    • Steps toward a national and international vision to provide our children with the ability to live, learn and prosper
initiatives
INITIATIVES
  • Outreach/Education
  • Federal Initiatives
  • Housing
  • Health
  • Funding
outreach education
OUTREACH & EDUCATION
  • Advocacy
  • Statewide Lead Conference
  • Media Campaign
  • Lead Safe Housing Registry
advocacy
Advocacy
  • The number of groups has increased in the past 10 years and dispersed across the state.
  • Upper Peninsula and the northern Lower Peninsula lack any known advocacy groups
  • Meet monthly or quarterly and are open to new participants
statewide lead conference
April 22, 2008, first statewide Lead Safe and Healthy Homes Conference.

Sponsored by MDCH and 13 additional organizations.

Local, state and national health and housing experts.

200 were in attendance and MDCH plans to host a second conference in the next two years.

Statewide Lead Conference
media campaign
Media Campaign
  • As a result of receiving state Healthy Michigan Funding for Lead Poisoning Prevention, the MDCH funded an annual statewide media campaign.
  • The first two campaigns focused attention on the need to have children’s blood tested for lead.
  • This year’s campaign currently focuses on the importance of “Do-it-Yourselfers” working safely around lead painted surfaces. The campaign consists of radio announcements and fliers. The two previous campaigns also included bus placards.
lead safe housing registry
Lead Safe Housing Registry
  • First statewide Lead Safe Housing Registry developed
  • Lead identification and abatement activities on rental properties statewide.
  • Located at www.michigan.gov/ismyhomeleadsafe
  • One of the only web based interactive housing registries in the country.
  • Expand to include known lead information on all properties. Drafted revised legislative language for the changes.
federal initiatives
FEDERAL INITIATIVES
  • Pre Renovation Notification Rule
  • EPA Renovation Remodeling and Painting Rule
  • HUD Lead Hazard Control Grants
  • EPA Target Lead Grants
pre renovation notification rule
Pre Renovation Notification Rule

June 1, 1998

  • EPA published the final rule on the requirements for Hazard Education before renovation of Target Housing.
    • Provide a lead hazard information pamphlet to owners and occupants prior to renovation
    • Written acknowledgement from the owner and/or occupant that they have received the pamphlet

June 19, 2008

  • Healthy Homes Section applied to EPA for self-certification authorization to enforce this rule in Michigan.
    • With this approval, MDCH will receive additional funding for enforcement of this rule in Michigan.
epa renovation remodeling and painting rule
EPA Renovation Remodeling and Painting Rule
  • EPA Renovation Remodeling and Painting Rule (RRP) implemented nationwide on April 22, 2010.
  • Purpose: prevent the disturbance of lead-based paint during remodeling projects in pre-1978 homes and child occupied facilities, such as day cares.
  • Each renovation contractor, property manager and others who disturb lead paint will be required to implement lead safe work practices that will protect occupants and their belongings by limiting dust generation and migration into other rooms.
  • Modified clearance sampling protocol will be instituted to ensure work surfaces are clean at the completion of the project.
  • Extensive record keeping by the renovators.
  • Each renovation firm and their employees will need to obtain certification.
  • The Rule can be found on the MDCH website, www.mighigan.gov/leadsafe.
  • MDCH will be working with stakeholders in the next two years to adopt this rule in Michigan.
  • Contact: Wesley F. Priem, Section Manager, MDCH Healthy Homes Section.
hud lead hazard control grants
HUD Lead Hazard Control Grants
  • Over the past five years, the state and its partners have worked aggressively to apply for and receive HUD Office of Healthy Homes and Lead Hazard Control, Lead-Based Paint Hazard Control Grants.
  • Current grant recipients: State of Michigan, Cities of Detroit, Grand Rapids, Lansing and Muskegon and the counties of Wayne, Jackson, and Saginaw.
  • Many of these agencies have been supported in their efforts with funding for technical assistance through Healthy Michigan Funds.
  • “It takes money to make money”, with technical assistance dollars of roughly $10,000 per application and the awards received in the millions.
  • Michigan is now on par or exceeding other states in receiving federal dollars.
epa target lead grants
EPA Target Lead Grants

Healthy Homes Coalition of West Michigan

  • Outreach to the Hispanic communities using culturally appropriate outreach strategies including:
  • Create strategies, train mentors/coaches that can share lead safe work practices, demonstrate the risk of unsafe work practices through dust sampling, and develop culturally appropriate HUD/EPA Lead Safe Work Practices lesson plans in Spanish.

Contact: Paul Haan, Healthy Homes Coalition of West Michigan (616) 241-3300

epa target lead grants15
EPA Target Lead Grants

CLEARCorps Detroit & Wayne State University

  • Eliminating Repeat Offender Houses
    • Target several zip codes in the City of Detroit . About 1200 housing units in Detroit have poisoned at least two children
  • Address "repeat offenders“:
    • Evaluate each unit
    • Inform property owner and resident that the property has had more than one lead poisoned child in the unit.
    • Provide educational material, grant/loan programs information, and relocation options
    • Lead hazard reduction programs
    • Research the demolition option
    • Rental property owners must address lead hazards in their properties
    • Code Improvement Task Force - rental properties lead-safe before occupancy.

CONTACT: Mary Sue Schottenfels, CLEARCorps Detroit

(313) 924-4000

housing
HOUSING
  • Michigan Lead Safe Home Program
  • Michigan State Housing Development Authority
  • Landlord Penalty Bill
  • Mandatory Lead Inspections Prior to Occupancy
  • Licensing Rules for Family and Group Child Care Homes
michigan lead safe home program
Michigan Lead Safe Home Program
  • Since 1996, the MDCH, Healthy Home Section has administered the Michigan Lead Safe Home Program (LSHP) providing funding statewide for remediation of residential lead hazards in low and moderate income housing.
  • To date, abated over 1500 homes in 44 counties statewide with an average cost per unit of $7,000 in abatement dollars.
  • Through Regional Field Consultants, including internal staff, local health departments and non-profit agencies, the program is administered regionally to include lead hazard control interventions within specific target communities where a child under six years of age resides, as well as statewide in units occupied by an EBL child.
  • Funding: U.S. HUD, Clean Michigan Initiative Bond funding (CMI), Maternal Child Health Block Grant dollars (MCH) and Healthy Michigan funding.
michigan state housing development authority
Michigan State Housing Development Authority
  • Michigan State Housing Development Authority (MSHDA) receives federal HUD funding to provide assistance to housing programs throughout the state.
    • Rental assistance, or for improving housing conditions.
    • Detailed information available on their website, www.michigan.gov/mshda.
  • Governor’s Lead Commission recommendation: funds provided by MSHD used to further the common goals of reducing and preventing further childhood lead poisoning in housing units receiving funding.
  • MDCH and MSHDA met to review program policy and procedures.
  • MSHDA drafted an Office of Community Development Policy memo that provides directions to all recipients of Community Development Block Grant (CDBG) and HOME funding. This Memo provides clear and concise directives to local recipients as to measures that must be taken to ensure that these funds will be used with lead identification and hazard reduction efforts consistent with state and federal rules and guidelines.
  • Further information : William Parker, newest Commission Member, with MSHDA at (517) 373-1462.
landlord penalty bill
Landlord Penalty Bill
  • On January 2, 2005, Legislation (MCL 333.5475a) was passed - Landlord Penalty Law.
  • Punishes landlords who knowingly rent or continues to rent to a family with a minor child who is found to have 10 micrograms or more of lead per deciliter of venous blood living within their residential housing unit.
  • Great success in Wayne County, by Assistant Prosecuting Attorney, Mary Morrow. Ms. Morrow is one of the more recent Commission Members.
  • Over 125 residential units inpected and abated as a result of her efforts in enforcing this law.
  • Work is underway now in several other jurisdictions across the state to assist the local Prosecuting Attorney’s office to begin to enforce this law.
  • More details: Mary Morrow, Wayne County Office of the Prosecuting Attorney at (313) 224-7270.
mandatory lead inspections prior to occupancy
Mandatory Lead Inspections Prior to Occupancy
  • Several cities have started requiring mandatory lead inspections prior to occupancy of rental units
    • City of Highland Park
  • The City of Detroit is considering revising the property maintenance code to require that the unit be lead-safe prior to issuing a certificate of compliance and occupancy.
licensing rules for family and group child care homes
Licensing Rules for Family and Group Child Care Homes
  • April 2008, Department of Human Services (DHS) amend sections of the Licensing Rules for Family and Group Child Care Homes that went into effect on January 1, 2006. There are two sets of licensing rules, one for Child Care Centers (which, by definition, serve more than 12 children, not located in a home setting), and another for smaller, home-based child care serving up to 6 children (Family Child Care Home), or up to 12 children.
  • Both sets of rules are available at the DHS website, at http://www.michigan.gov/dhs/0,1607,7-124-5455_49572_50051---,00.html. This information pertains to the latter.
licensing rules for family and group child care homes22
Licensing Rules for Family and Group Child Care Homes
  • A request was made to consider adding rules and/or technical assistance materials for providers that would enhance the rules related to possible lead exposure.
  • Childhood Lead Poisoning Prevention Program and the Healthy Homes Section, along with other Child Health staff, proposed a number of new rules.
    • Steps to educate both child care home providers and parents about lead hazards, in lieu of a risk assessment, which could be so costly that it would put the home child care out of business, or cause them to choose to operate without a license
licensing rules for family and group child care homes23
Licensing Rules for Family and Group Child Care Homes
  • Rules recommended for addition:
    • Children’s records
    • Home maintenance and safety
  • Enhancements include additions to the Family and Group Home Rules Technical Assistance and Consultation Manual regarding:
    • available training about lead hazards and lead poisoning;
    • hand-washing practices;
    • HEPA filters for vacuum cleaners;
    • lead safe wet-cleaning practices; and
    • pamphlets and other resources about lead-based paint hazards. (http://www.michigan.gov/documents/dhs/Home_TA_manual_9_06_173064_7.pdf).
licensing rules for family and group child care homes24
Licensing Rules for Family and Group Child Care Homes

Next steps

  • Review by the State Office of Administrative Hearings and Rules (SOAHR).
  • Public hearings - Fall of 2008.
  • Plans to have the new rules in place early in 2009.
  • Information about the public hearings will be forwarded to the Lead Commission, Lead Advisory Committee, and other interested parties so that they can support the inclusion of these new rules in the final package.
health
HEALTH
  • Assessment and Care
  • Early On® Redesign Process
assessment and care
Assessment and Care

EBL

In 2003, the number of children with an EBL greater than 10ug/dL was 3,141 (3.2% of those tested). In 2007, that number dropped to 2,031 (1.4% of those tested)

More than 50% decrease, even though more children were tested.

This pattern persists during this period for:

1- and 2-year olds

Children insured by Medicaid

Various ranges of elevated levels (10 to 14ug/dL, 15 to 19ug/dL, 20ug/dL and up).

Testing in some of the target communities has leveled.

From 2006 to 2007, testing among 1- and 2-year olds in the 13 target communities together declined slightly.

The greatest increase was in the city of Lansing due mainly to testing in WIC clinics.

Progress of the Task Force and the publication of its final report

Testing

  • In 2003, there were 100,181 children tested. In 2007, there were 149,445 children tested
    • 50% increase.
assessment and care27
Assessment and Care

A new version of the Statewide Screening/Testing Plan has been drafted, shifting the geographic focus from ZIP codes to the now 14 Target Communities.

Dearborn was added

Muskegon target community expanded to include Muskegon Heights.

2008 goal for each target community:

20% increase in testing among 1- and 2-year olds over 2007.

In 2007, while the statewide rate of EBL children identified was 1.4%, smaller areas within the state showed much higher rates.

Detroit had a rate of 3.5%,

Benton Harbor was at 5.3%

Highland Park was at 10.4%

One Detroit ZIP code was over 10%, while ZIP codes from several cities around the state were over 5.0%.

27 different Census Block Groups, from Detroit, Flint, Grand Rapids, Highland Park and Muskegon, with EBL rates over 20% (minimum 10 children tested).

early on redesign process
Recommendations:

Reviewing eligibility criteria based upon:

1) a developmental delay, and/or

2) a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.

Criteria for eligibility related to lead poisoning should be clarified to include the blood lead level at which a child would be eligible for Early On.

“Lead – blood lead level at or above 10 micrograms per deciliter (> 10 μg/dL)”.

Michigan Department of Education held public hearings related to eligibility criteria in November 2007.

Recommendations are being finalized.

Approval from the U.S. Department of Education, Office of Special Education Programs, has been sought.

Early On® Redesign Process
  • November 2004, Early On redesign - resolve issues for the current Part C system
funding
FUNDING
  • Healthy Michigan Funds
  • DEQ Bond Proposal
  • Kresge Foundation Proposal
healthy michigan funds
Healthy Michigan Funds

MDCH has been awarded $1,000,000 per year for the past three years for lead poisoning prevention activities.

  • Allocation of funds:
    • Lead testing
    • Case management and follow-up of children
    • Abatement of lead hazards in homes
    • Lead Ombudsman position,
    • Lead Safe Housing Registry,
    • Statewide Media Campaign
    • Funding for lead advocacy groups.
  • Funding for fiscal year 2009 has been secured
deq bond proposal
DEQ Bond Proposal
  • Approximately eight years ago, the Department of Environmental Quality (DEQ) issued a bond proposal, the Clean Michigan Initiative.
  • Clean abandoned industrial sites for future reuse, improve parks and harbors and for other environmental improvement and maintenance projects across the state.
slide32

MDCH was the recipient of Clean Michigan Initiative Bond funding for in fiscal year 2000 through 2004. The funds were allocated as follows:

TABLEI

deq bond proposal33
DEQ Bond Proposal
  • The funds were used statewide to abate homes with lead poisoned children residing there.
    • Highest risk areas:
      • Berrien, Calhoun, Genesee, Ingham, Kent, Saginaw and Wayne Counties.
      • Many have developed successful local lead coalitions and have directly received lead hazard control funds from HUD.
  • The Clean Michigan Initiative created 326 lead-safe homes. Using an estimate of 3 children per household at $45,360 per child, the related savings to the State for health and social services equals $44,362,080.
  • House Bills 6227 and 6228: request a ballot issue by the voters to request a Clean Michigan II bond in the amount not to exceed $1,300,000,000.
    • Allocate $20,000,000 for the abatement of lead hazards.
  • Information by the media suggests that these bonds will not be put forth to the voters this fall citing that it would not be a good time to put more debt burden on the state.
kresge foundation proposal
Kresge Foundation Proposal
  • MDCH along with CLEARCorps Detroit and Wayne State University have been requested by a consulting firm retained by the Kresge Foundation to submit a request for funding.
  • Kresge Foundation met with representatives of each agency and are working with the consulting firm to determine if funding will be provided for the state and the City of Detroit.
  • No further information is available at this time.
thanks for all your hard work
Thanks For All Your Hard Work

Presented by:

Wesley F. Priem

Section Manager

Healthy Homes Section

Michigan Department of Community Health

Power Point by:

Leslie Jaquette, Section Secretary