Recommendations to Governor Frank O'Bannon by IKE's Lead Poisoning Prevention Task Force

Finalized on April 26, 2000

Executive Summary

Governor Frank O’Bannon and Ms. O’Bannon have been outspoken advocates to reduce lead poisoning in Indiana. Both have made it clear that lead poisoning is a devastating problem that permanently damages our children. Recent statistics indicate than one of nine Hoosier children younger than six may have lead poisoning. In some neighborhoods, especially low income and minority neighborhoods, one out of every two children may have lead poisoned. Yet, it is entirely preventable. It is no surprise, therefore, that eliminating lead poisoning is a part of the Governor’s Building Bright Beginnings Campaign to help our children reach their full potential.

In addition, Lt. Governor Joe Kernan and officials from several state agencies, including the Indiana Department of Environmental Management and the Indiana State Department of Health, have spoken out on the issues and set up strong programs to protect children from lead. Improving Kids’ Environment applauds the administration for its efforts on behalf of Indiana’s children.

It is in this spirit that the IKE Lead Poisoning Prevention Task Force submits this report to the Governor, making recommendations to enhance the administration’s effectiveness.

The Task Force’s membership is diverse and open to all. While individuals who work in local health departments play a significant role, individuals from law firms, state agencies, local advocacy and education groups, and others are active members. About 25 individuals have regularly participated in the Task Force and its three committees since the Task Force’s inception in September 1999. The common link for all participants is a commitment to reducing childhood lead poisoning in Indiana.

In general, the IKE Task Force believes that the State must do the following:

1. More effectively coordinate the existing programs. Many agencies at the State and local level have a critical role in preventing lead poisoning. Each does its part. But there does not appear to be a clear leader who has the authority and resources to coordinate the work of the agencies. While it is important to most of them, lead poisoning prevention does not appear to be a top priority for any agency, and, without that priority, tangible and significant progress may be delayed or, possibly, lost.
2. More clearly articulate and enforce the program objectives. The State has done well educating people. But people need a stronger incentive to pay attention when the damage is as subtle or as masked as lead poisoning. The State needs to move beyond broad education to more clearly articulate and enforce the legal requirements that are in place. People are not following the law in some cases and undermining the intent of the law in others. Without State action, this practice will not change.
3. Provide additional resources. Lead is a legacy of the past. But the damage caused to children today could be our legacy. With a strong push, Indiana can virtually eliminate lead poisoning in 10 years. However, success will require additional resources. Indiana needs to leverage more federal funding and provide State funding to fill in the gaps in federal support. It will take a significant State investment, especially in the areas of education and enforcement, to make that happen.

Specifically, the IKE Task Force recommends that the Governor initiate the following ten actions and announce the interim results at the ISDH’s Lead Conference on May 11. All ten actions are critical to success. Therefore, they have not been prioritized. However, the first two actions will provide the most significant benefits to the children most in need.

1. Implement federal mandate that all Medicaid eligible children are tested.
2. Implement federal mandate that treatment services are reimbursed.
3. Require mandatory reporting for all blood lead tests.
4. Encourage school districts serving at-risk neighborhoods to require blood lead testing.
5. Ensure that the new HUD lead-based paint regulations are fully and effectively implemented in Indiana with as little disruption in the availability of low-cost housing as possible.
6. Provide $250,000 in funding to ISDH to support lead-based paint education efforts statewide.
7. Ensure that the key lead hazard reduction practices in the new HUD regulations become common work practices in the residential maintenance industry.
8. Provide funding or tax credits for bricks-and-mortar improvements to target housing (such as window replacement) and other efforts to eradicate lead poisoning in Indiana.
9. Consistently enforce IDEM’s application of open dumping rules to lead-based paint releases.
10. License a sufficient number abatement contractors and risk assessor to meet the need.

IKE recommends that the Governor support two additional efforts:

• Support ISDH in its efforts to achieve its short-term commitments to CDC established on December 30, 1999. IKE fully supports these commitments. They include:

• Appointing a State Advisory Task Force for Lead Poisoning to assist ISDH in formulating policy and operation protocols to reduce lead poisoning and leading regular meetings of the group; and
• Complete testing by July 1, 2000 of 75% of children younger than 6 with blood-lead levels above 10 ug/dL living in census block groups where 20% or more of the children are expected to be lead poisoned.

• Encourage IDEM to finalize its proposal not to relax its regulations for secondary lead smelters simply to be consistent with U.S. EPA standards. IDEM has proposed holding to its stricter standards to protect the residents of Muncie but the local smelter is objecting.

Request that EPA conduct a residual risk assessment of the federal air pollution standards for secondary lead smelters. IDEM has stated that EPA’s standards were inappropriately lax. A residual risk assessment may be needed to correct the errors. But the power of the Governor’s office may be needed to make it happen.

While these recommendations may seem costly to implement, please keep in mind that:

• Each one ug/dL increase in blood lead level reduces the lifetime earnings potential of a one-year-old child by $2,367 (a 10 ug/dL increase represents a loss of $23,670);
• Public schools, especially urban schools, bear a significant burden from lead poisoning to teach children with reduced attention spans, more behavioral problems, and violent tendencies as a result of lead poisoning;
• State and local government bear an additional burden to prosecute and incarcerate adults who had lead poisoning as children;
• The federal government already has set a goal of eradicating childhood lead poisoning by 2010; and
• There is no clear safe level of exposure – lead poisoning can occur at 10 ug/dL.

Improving Kids’ Environment encourages the Governor to expand his administration’s efforts to virtually eliminate lead poisoning. Together we can succeed and our next generation will have a better chance to reach its full potential!