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Indiana Lead-Safe & Healthy Homes Newsletter September 2003 Edition Improving Kids’ Environment (IKE) and the Indiana Lead-Safe Task Force publish this newsletter every two or three months at no charge for anyone interested in issues and events involving lead poisoning prevention and healthy homes in Indiana. Distribution is by email or fax – preferably by e-mail. We try to keep the newsletter to five pages. Contact the editor, Tom Neltner, at mccabe@ikecoalition.org or 317-442-3973 if you want to contribute articles, edit the draft newsletter, have an article to contribute, or want to get on or off the distribution list. All editions are available on IKE’s web page at http://www.ikecoalition.org/publications.htm. Apologies for the length of this edition, it has been an active 80 days. DON’T FORGET TO REGISTER FOR THE 2003 INDIANA LEAD-SAFE AND HEALTHY HOMES CONFERENCE ON OCTOBER 15 & 16 IN INDIANAPOLIS. EARLY REGISTRATION ENDS SEPTEMBER 26.
Mark Your Calendars
CDC Grant to Indiana - $669,047 The Centers for Disease Control and Prevention awarded Indiana $669,047 in June for its Childhood Lead Poisoning Prevention Program. It had received $510,000 in two grants – one to ISDH and one to Marion County Health Department – in previous years. Three counties – Allen, St. Joseph, and Lake – received $25,000 each from the grant – primarily to support a local lead elimination committee. Marion County received about $240,000. This is less than it received directly from CDC in the previous year. We are excited about what Indiana can accomplish over the next year.
ISDH Establishes Lead Elimination Committee – First Meeting September 19 Pursuant to its CDC grant, ISDH has formed a Lead Elimination Committee. John Hall, the director of Indianapolis’ HUD office and former senior manager with Marion County Health Department, will chair the committee. ISDH will provide staff support. The committee’s task is to develop a plan to eliminate lead poisoning in Indiana by 2010. This effort provides a wonderful opportunity for Indiana to take its lead poisoning prevention program to the next level. It is the first comprehensive evaluation of lead poisoning in the State and the strategy the committee develops has the potential to pull together the pieces and fill the remaining gaps to provide children with the protection they deserve. Lake, Allen, St. Joseph and Marion Counties will be forming similar committees. Thanks to Nancy Cobb of ISDH for making this happen.
IDEM Calls In Risk Assessments The risk assessment is a critical piece in Indiana’s efforts to protect children from lead poisoning. Missed hazards mean children will be unwittingly exposed. On August 5, IDEM requested that Indiana’s licensed risk assessors submit a copy of their two most recent risk assessment reports. State regulations require compliance with the request. These reports will help IDEM understand where problems may be and target compliance assistance and inspection efforts to overcome shortcomings. IKE will review the risk assessments and have a preliminary analysis ready at the conference. Thanks to IDEM for taking this critical step!
Allen County Aims High – 900 Kids in 90 Days Fort Wayne – Allen County Health Department launched an aggressive program to screen 900 kids in 90 days in high-risk neighborhoods. It has hired a phlebotomist who is ready to start screening. 22 sites are scheduled for screening. The phlebotomist is going to be set up at the Women and Infant Children (WIC) clinic one day a week and here at the department’s office one day a week. The project has the dual benefit of identifying children who may be lead poisoned and getting a better assessment of the prevalence is Fort Wayne. We are looking forward to seeing the results!
Leveraging the Federal Lead Disclosure Rules – IKE’s Offer Improving Kids’ Environment is providing limited technical and legal support to tenants in Indiana who are forced to live in substandard housing due to problem landlords. It is strategically taking cases where the home is not habitable and where the landlord has failed to follow the lead disclosure laws. IKE has consistently found that where the home is not habitable or lead hazards have been found, the landlord has not made the proper disclosures. IKE is already working with residents in Indianapolis and Fort Wayne. IKE is not acting on behalf of or representing HUD or EPA in this effort. Instead it is trying to leverage Indiana’s warranty of habitability at IC 32-31-8-6 and the private right of action authorities under 40 CFR 745.118 and 24 CFR 35 to provide immediate relief and protection for tenants and use the situation as an example to bring about broader improvements in how some property managers handle their rental property. IKE urges local health departments to refer to us tenant-clients whose homes have documented lead hazards. IKE will follow-up with the tenant and keep the local health department in the loop. The goal is to work through the issues by helping the landlord understand the issues and the solutions. In some cases, IKE may arrange for a local attorney to handle the case. This effort is funded by a grant from the Alliance for Healthy Homes. For more information, contact Tom Neltner at mccabe@ikecoalition.org or 317-442-3973. Progress of Several Fronts in St. Joe County The Get the Lead Out Task Force of St. Joseph County is multi-tasking again. Here is a rundown of recent efforts.
Responsible Contractors Know Their Limits Many painting and remodeling contractors don’t know when to say, “I don’t know.” It may be frustrating for a client but the true professional knows his or her limits. Working safely with lead-based paint is an area that professionals often misunderstand – to the detriment of their customers. The job may look good when it is done but invisible lead hazards remain to poison children. A Hoosier recently called me to say that a contractor told her that he would not do a job because it involved lead-based paint. He knew that special training and work practices are required. She called me and for the first time understood the significance of lead-based paint on her home. For a true professional, check out Funkhouser Finishes, 2893 S. C.R. 775 West, Morgantown, IN 46160 at (317) 422-5428.
Learning About the New Lead Rules Thanks to IDEM’s Dave White, Vicki Schoen and Linda Williams for their August 5 workshop on the new state lead licensing rules. The session lasted about 90 minutes and provided a concise introduction to the rule changes and the common problems in licensing.
Revisions to the State Lead Licensing Rules – Copy on Line The new Indiana lead licensing rules should be effective in mid-October if all goes to plan. The goal is to have it in effect for the 2003 Indiana Lead-Safe and Healthy Homes Conference on October 15 so the Indiana Rules Awareness Course can be offered to out-of-state lead professionals. Special thanks to Susan Gard of the Office of the Indiana Attorney General for her quick review and approval of the rules.
The rule may not be published in the Indiana Register until November. Click here for a copy of the rule in Word. Thanks to IDEM for excellent work on the rule.
HUD and EPA Agree to Lead-Safe Work Practices Course EPA and HUD have issued a joint updated training course on lead-safe work practices for painters, renovators, and maintenance personnel. This interactive course provides hands-on step-by-step activities on how to perform work activities safely to avoid disturbing lead paint in residential homes, including work area containment, safe repair methods to minimize lead dust, and hazard clean-up. The course is HUD-approved for contractors working in federally owned or assisted housing. EPA strongly recommends this course for anyone working in pre-1978 housing. The course duration is 6.5 hours, making it possible to learn the information in less than a day or as few as two evenings. This latest interagency collaboration provides a widely accepted and practical curriculum for making lead safety the standard of care in all work projects in older homes. Visit www.epa.gov/lead/epahudrrmodel.htm or www.hud.gov/offices/lead/training/rrp/ rrp_course.cfm for to view the course. Indiana’s Environmental Management Institute is credited in the manual for contributing to the hands-on exercises in the course.
Lead Supervisor – Certified v. Licensed If you are doing an abatement project, you must have a licensed supervisor and licensed workers doing the work. The contractor must also be licensed. But when it comes to interim controls regulated by HUD, it gets confusing. Project managers have a choice under 24 CFR 35.1330(a)(4). They can either go with:
From a practical standpoint, if your organization plans on doing more than a few interim control projects regulated by HUD, it makes sense to have licensed lead abatement supervisor handle the work. With this approach, you have the flexibility to bring in new workers without waiting on the specialized lead-safe work practices training. It is the supervisor’s job to make sure all workers follow the HUD rules. Naturally, the workers should get the specialized training to help them work more effectively.
Disclosing Addresses – HIPPA v. HEA-1171 Local health departments are struggling to reconcile the Indiana’s HEA-1171 mandate in IC 16-41-39.4-4 that they disclose blood lead testing results collected after July 1, 2002 with the new federal HIPAA regulations at 45 CFR 164.512 providing privacy of Individually Identifiable Health Information. Recognizing that the federal regulations trump state law, some health departments are taking a cautious approach and withholding the information – an understandable approach giving the complexity of HIPAA. I believe that disclosure is allowed under HIPAA at 45 CFR 164.512(j). That subparagraph allows "Uses and disclosures to avert a serious threat to health or safety." A local health department is allowed to disclose if it meets the following two conditions under (j)(1)(i): (A) Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and (B) Is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat; Lead poisoning certainly qualifies as a serious threat to health and safety. The damage from lead is irreversible. ISDH regulations require that local health officers intervene with an environmental assessment and case management in order to reduce the damage. If it were not a serious threat, ISDH would not have mandated that a local health department provide the child with scarce public health resources. Keep in mind that (j)(4) states creates a presumption of good faith belief. It says "A covered entity that uses or discloses protected health information pursuant to paragraph (j)(1) of this section is presumed to have acted in good faith with regard to a belief . . ., if the belief is based upon the covered entity's actual knowledge or in reliance on a credible representation by a person with apparent knowledge or authority.
Grant Opportunities
The best scenario is for a community action agency to partner with a local health department. The local health department can serve as the applicant. The agency can do the work under contract. Even though a county health department is the applicant, some of the work can be done outside the county if the partners agree. Several partnerships are beginning to form. IHFA is offering training to help with the applications on October 2. I have taken the training and would be willing to help craft an application that could serve as a model for the state. To apply, you must submit a form by October 15. The application is due November 21. Problem Landlords in IndianapolisIndianapolis’ Mayor Peterson took a critical and bold step and identified the top ten worst landlords. The ten landlords have more than 950 code violations in 350 properties and owe the City more than $160,000. The mayor committed to this action six months ago and is making good on his promise. See the Indianapolis Star article at www.indystar.com/print/articles/9/070659-1219-092.html.
Indianapolis’ Citizen’s Healthy Homes Initiative IKE, the Citizen’s Multi-Service Center and the Concerned Clergy teamed up in July 2002 to form the Citizen’s Healthy Homes Initiative. CHHI plans to conduct low-tech sampling for environmental hazards in more than 200 homes in neighborhoods with extensive substandard housing. The work is funded by the Alliance for Healthy Homes and the Nina Mason Pulliam Charitable Trust. On August 28, CHHI published its research on housing issues in the Kennedy-King Park Neighborhood on Indianapolis’ northside. The Needs Assessment made the following findings:
For more information on the report and CHHI, go to www.ikecoalition.org. AECLP Becomes the Alliance for Healthy Homes The Alliance to End Childhood Lead Poisoning has changed its name to the Alliance for Healthy Homes. With the name change comes an expanded mission to address other housing-related health hazards. AFHH will continue to build on its work to protect children from lead hazards in their homes. But it will use new strategies are needed to address the persistent high prevalence of lead poisoning in low-income communities of color despite the dramatic decline in national prevalence. Properties that contain the worst lead hazards typically pose other health risks as well, such as mold, pesticides, respiratory allergens, and carbon monoxide. Protecting children’s health requires solutions that address all hazards in their home environment. Addressing lead hazards in substandard housing offers natural opportunities for tackling additional health hazards that contribute to higher asthma rates and other health disparities burdening low-income families. The Alliance’s evolution emerged from an organizational assessment begun three years ago. It recognized that while significant progress had been made in reducing lead poisoning, continuing to do more of what it had historically done could not achieve the goal of protecting all children. In June 2001, the Alliance began to provide more proactive support to community-based and local advocacy organizations, most notably through the Community Environmental Health Resource Center (www.cehrc.org). The organization’s newsletter, the Alliance Alert, will now appear monthly and cover policy developments, research findings, funding opportunities, and other news on healthy homes as well as lead poisoning prevention. To subscribe to Alliance Alert, receive action alerts on important policy developments or to subscribe to the Alliance’s list serves, visit their new website www.afhh.org/aa/aa_subscribe.htm. Asthma and Healthy HomesISDH and IDEM formed the Indiana Joint Asthma Council (InJAC) in May 2003. The goal of the Council is to establish a statewide collaborative effort to develop a state strategic plan that is designed to reduce asthma morbidity and mortality in Indiana. The Environmental Quality Committee will develop recommendations to reduce environmental exposures to asthma triggers, including healthy homes. It is too early to tell what the recommendations will be but the committee is off to a great start. Thanks to Paula Smith, Tami Johnson and Cheri Storms for the committee support. News from Outside Indiana
Thanks for improving kids' environment! If you have any questions or comments about this newsletter, IKE, or the Indiana Lead-Safe Task Force, contact Tom Neltner at mccabe@ikecoalition.org, 317-442-3973 or 5244 Carrollton Avenue, Indianapolis, IN 46202-3181. If you need more information on national events, check out the Alliance Alert Newsletter at www.afhh.org and click on newsletter. This newsletter was produced with the assistance of IHFA through federal funds made available by IHFA under the National Affordable Housing Act of 1990, as amended, using HOME Investment Partnerships Program funds allocated by the U.S. Department of Housing and Urban Development. Please let us know if you do not want to receive this newsletter. You may get enough emails and faxes already. We do not want to add to the burden if you are not interested in receiving the materials. IKE publishes two additional newsletters on a quarterly basis. Contact Tom Neltner at mccabe@ikecoalition.org if you want to subscribe to either of those newsletters.
EARLY REGISTRATION BY SEPTEMBER 26. SCHOLARSHIPS ARE AVAILABLE. CONTACT TOM NELTNER AT NELTNER@IKECOALITION OR 317-442-3973 FOR MORE INFORMATION. |