Volume IV / Issue I
HEALTHY HOMES, HAPPY FAMILIES
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THE NEED FOR A FEDERAL TASK FORCE TO ATTACK LEAD POISONING
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A CRITICAL LINK: HEALTHY HOMES & GRADE-LEVEL READING
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THREE QUESTIONS FOR HUD SECRETARY JULIÁN CASTRO
13 GHHI ADDS FIVE NEW PAY FOR SUCCESS SITES
A Note from Our President & CEO As we mark the first National Healthy Homes month, it is difficult to think about our challenge to provide every child, family and senior a healthy home without the tragic circumstances that unfolded in Flint, Michigan front and center in our minds. Clearly the consciousness of the nation has been raised around the issues and impact of lead poisoning. It is incumbent upon those of us dedicated to improving housing conditions for all Americans to step forward and step up to end lead’s toxic legacy once and for all. To do this, we must come together in this mission behind a strategic action plan that addresses not only lead in paint, water and soil, but incorporates standards of health in housing at every level of government, in every community. Never has the call to action been so loud or the business case so sound. As part of National Healthy Homes month, GHHI will be releasing its proposed national strategic plan to address lead poisoning for philanthropy and government. You can also read more about GHHI work to support and advance lead poisoning prevention legislation in this issue. In addition to the national conference, we will be participating in the Clinton Global Initiative to highlight healthy housing and outcomes based financing, as well as the U.S. Environmental Protection Agency’s Asthma Summit in Chicago. This spring, with support from the Robert Wood Johnson Foundation (RWJF), GHHI’s Social Impact Finance team expanded its Pay for Success (PFS) work with health care payers and state Medicaid programs to five new sites in New York City, Chicago, Philadelphia, Houston and Rhode Island. This PFS work will replicate previous efforts funded by RWJF, the JPB Foundation and the Corporation for National and Community Service, bringing our total cohort of Pay for Success sites to 11. Working with local health care organizations, GHHI will continue to advance and evaluate this new model of funding home-based interventions that produce measurable outcomes, such as reduced asthmarelated hospitalizations and missed school and work days. You can read more about the program on page 13 of this issue of Healthy Homes, Healthy Families. HUD recently released data that identified 509,726 Green & Healthy Homes units produced between FY2010 and FY2015. We’re tremendously proud of these numbers, as the units were rehabilitated using the GHHI comprehensive model for healthy home interventions. GHHI works with HUD and other federal agencies to integrate energy efficiency and healthy housing interventions with other housing rehabilitation and construction programs. Since 2009, HUD has supported the adoption of the GHHI comprehensive approach for HUD funded programs. Another highlight this year was GHHI’s partnership with the Building Performance Institute (BPI) to develop a new
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BPI Healthy Homes Evaluator (HHE) credential for energy auditors and contractors, critically needed to foster the comprehensive housing assessment and intervention model. Currently in its pilot phase, 180 BPI certified professionals have taken the HHE exam as of June. The HHE is a key driver of market transformation in support of the GHHI model, by increasing training and certification of contractors to assess home-based environmental health hazards and create comprehensive scopes of work. To learn more about the scope of the new certification, see page 14 in this issue.
are proud to team with the U.S. “WeDepartment of Housing and Urban Development and the National Environmental Health Association to present the National Healthy Homes Conference in San Antonio.
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Also this year, GHHI and our partners have established six new GHHI sites in Austin, Syracuse, Pittsburg, Springfield, Staten Island and Memphis. GHHI works collaboratively with local and state partners to break down silos between agencies and integrate services to low and moderate income families. You can read more about Austin’s compact signing on page 3 of this issue. We are proud to team with the U.S. Department of Housing and Urban Development and the National Environmental Health Association to present the National Healthy Homes Conference in San Antonio. Later this summer we return to Texas, to host our 7th Annual Executive Leadership Institute. So from the heart of Texas to the heartland of America, we continue to work with all dedicated to creating green & healthy homes so that every child and family can thrive. Thank you for all that you do to advance the mission of healthy homes, and I hope you enjoy the magazine.
Ruth Ann Norton
Making Texas Green & Healthy NEHA 2016 AEC HUD Conference GHHI is thrilled to be in San Antonio as the presenting sponsor for the NEHA 2016 AEC and HUD Healthy Homes Conference. We are proud to take part in the environmental health training, education and networking to advance the healthy homes movement.
GHHI Staff & Mia Hodges
Kids Are Great Advocates! Last April Mia Hodges, a fifth grader
from Pond Springs Elementary in Austin, Texas, needed answers. She was inspired by the national problem of lead poisoning, and had chosen it as her subject for a study project. She contacted GHHI to ask for 10 minutes of our time to learn more about the issue. What she got surprised Mia, her family and her school! On May 13th Ruth Ann Norton, President and CEO of GHHI, and her team, paid a visit to Mia’s school. In a school assembly they addressed the long term effects and cure for lead poisoning, and explored its social and economic consequences. Thank you to Mia and Pond Springs Elementary for engaging the next generation of concerned citizens, bringing us closer to a future without lead poisoning!
GHHI - San Antonio
GHHI continues to support the great work of San Antonio, one of GHHI’s original sites. As a HUD Lead Grant recipient, San Antonio is producing
green and healthy units that are both lead safe and comfortable for local families. GHHI San Antonio has crosstrained and re-certified local home inspectors to comprehensively assess homes, enabling them to identify a full range of hazards, such as lead based paint, energy efficiency defects, and home based asthma triggers.
Ruth Ann Norton, Steve Adler, Mayor of Austin, Elizabeth “Betsy” Spencer, Director of Neighborhood Housing and Community Development, Sabino “Pio” Renteria, Councilman, District 3
GHHI - Austin
Last February GHHI signed an agreement to partner with the City of Austin and local organizations to develop a comprehensive intervention model to make Austin homes safer, healthier and more energy-efficient. The GHHI Austin Compact was signed by more than a dozen City of Austin stakeholders committed to systemic changes that will help the city more effectively provide home-intervention services to Austin residents. “This compact turns an incomprehensible bureaucratic labyrinth into a single open doorway,” Austin Mayor Steve Adler said. “Now, these families only have to go to one place to get home improvements that will make their lives healthier and safer.” Austin residents have access to multiple interventions that address health and safety hazards as well as energy-saving deficiencies. Services can include lead abatement, hazard remediation, safety upgrades and weatherization.
Join us for the 2016 Annual Executive Leadership Institute August 29 - 30, 2016 Austin, Texas
GHHI’s Executive Leadership Institute offers the best and brightest thinking in the green and healthy housing movement. It stands as the preeminent annual meeting of practitioners reforming government, public health, housing, energy and workforce systems. Twenty-five GHHI cities will be engaged learning to improve and expand their program models. This year’s Institute will include sessions on the business case for healthy homes, emerging philanthropic models, healthy housing impact on improving school attendance, nonenergy benefits of energy efficiency, aging in place, certifications and training, and data and evaluation. There will also be a track for partners in our Pay for Success feasibility projects. Attendees will have opportunities for direct dialogue with leaders from key sectors, cross-sector discussions, peer exchange and networking. Register at http://bit.ly/1XIVRk1
Pay For Success Houston In Houston, GHHI has launched a Pay
for Success feasibility study site with UnitedHealthcare, part of a cohort of healthcare partners across five sites participating in asthma-focused Pay for Success feasibility studies led by GHHI. Funded by a grant from the Robert Wood Johnson Foundation, the project will focus on asthma trigger reductions to improve the health, social and economic outcomes of families in Houston.
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The Need For A Federal Task Force to Attack Lead Poisoning By Ruth Ann Norton President and CEO of the Green & Healthy Homes Initiative How can anyone be comfortable with the idea of 535,000 American children being currently lead poisoned? That’s an average of 10,700 kids in each of our 50 states. Think that number must be exaggerated? It’s real and the evidence has been there for some time. The poison is lead, present in paint in tens of millions of homes in the US and also easily administered through drinking water. Lead is a horrible toxin with irreversible, lifelong effects on our children. A USA TODAY NETWORK investigation published in March 2016 illustrates the extent of the problem in our environment and adds new urgency to the need for action by President Obama. Analyzing data from the U.S. Environmental Protection Agency, the newspaper found that 350 schools and day-care centers had failed lead tests of their drinking water on 470 occasions between 2012 and 2015. And the real kicker: only schools and day-care facilities that draw their own water are required to test for lead. The other 90 percent that depend on municipal water systems get a free pass, no matter how old their internal plumbing. Lead poisoning can cause severe problems for children, including neurological and organ damage. It can lower intelligence, degrade fine motor skills and sap the mind of its ability to concentrate. Lead poisoning often falls hardest on low-income families and communities of color. I am haunted by the story of Freddie Gray in my hometown of Baltimore, who was poisoned by lead as an infant, setting his life on a disastrous course. What would his life have been like if he had not been poisoned? Would he have been safely employed or studying in school instead of dying in a police van last year? A quarter century ago, our nation was well served by a Presidential Task Force on Lead Poisoning, whose work led to the federal Residential Lead-based Paint Hazard Reduction Act of 1992. We learned much from this task force about the dramatic impact of lead-based paint as well as the effects of lead exposure through any source. In 2012, the Centers for Disease Control & Prevention formally declared what had long been established: there is no safe level of lead in a child’s body. By correlation, there is no meaningful maximum that we should tolerate of lead in our water, soil or homes that will inevitably end up in the blood of our children. Fast forward to 2016, and we’re losing ground. Over 37 million homes in the United States still contain lead-based paint. Responses to lead issues are typically locally focused and often inadequate to meet the enormous challenge. The lead in water crisis in Flint, Michigan has highlighted the number of sources of lead that remain in our environment, generating justifiable outrage. We must channel that public outcry into tangible policy changes and new prevention resources to
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reduce lead hazards. That’s why I urge President Obama to appoint an expert Task Force to conduct a new examination of lead poisoning in the United States. It’s time for a renewed nationwide examination of lead poisoning to assess the real breadth of the problem, develop solutions through a national strategic plan and earmark resources to protect our children from what is an entirely preventable disease. Our organization, formerly known as the Coalition to End Childhood Lead Poisoning, was founded in 1986 by parents whose children were hospitalized due to high levels of lead poisoning. In Maryland, our efforts have reduced poisoning rates by 98 percent although the sad fact is, we still have more than 2,300 children poisoned in the state each year with levels of 5 µg/dl or higher. We now are working across the country to support and implement promising practices, yet far too many communities are left behind by a lack of access to training and resources to implement effective prevention. As a child, I watched with awe as our astronauts fulfilled a pledge made a decade earlier by President Kennedy and stepped onto the moon. It’s time to set another bold goal: to reduce current lead poisoning levels by 75 percent over the next five years. It won’t be easy, but it’s achievable if we follow our moral compass and commit to ending the widespread poisoning of children. It will require us to convene key stakeholders, update our prevention strategies and coordinate efforts nationally. I am calling on President Obama to create a President’s Task Force with the purpose of aligning resources and efforts to eliminate lead poisoning as a public health threat, with clear deliverables and deadlines. The Task Force would address the major sources of lead hazards and produce a comprehensive, national prevention strategy that incorporates housing intervention programs, water quality initiatives, Superfund investments, and health and education services. We need to braid the activities of these often siloed programs and take lessons from the last three decades as well as current needs to adopt an urgency to commit to smart, effective prevention. Our organization stands ready to help in any way possible to get this done and we plan to release a National Lead Poisoning Prevention Strategic Action Plan in the coming months that will outline a number of our national prevention recommendations. We owe it to our nations’ children and families to follow our moral compass and implement strategies and deploy substantially more hazard reduction resources to end this entirely preventable disease. Preventing childhood lead poisoning has one of the best known returns on investment in terms of improved educational and lifetime earnings outcomes and reductions in special education and criminal justice costs. CONTINUED ON PAGE 5.
The payoff will be profound: hundreds of thousands of children with a better chance to learn to read, compete in the classroom and excel in life. Over time, it will lead to higher graduation rates and reduced incarceration. For a disease that is irreversible and has incredibly tragic and lifelong effects, primary prevention is, in fact, the only cure. It’s time to act.
Lead in Water: Prevention Tips Some key tips for sites that are assisting local clients and stakeholders in addressing possible lead in water hazards:
General Tips to Reduce Lead in Water Risks in Homes:
• Use only water from the cold water tap for drinking and cooking • Run water for 1-2 minutes before drawing water to drink or cook • Have your home’s water tested
Tips if Pipes are Known to Contain Elevated Lead in Water Levels:
• Run higher volume taps (shower, etc.) for 5 minutes and then draw drinking water from the cold water kitchen tap • Use only water from the cold water tap for drinking and cooking • Use bottled water until the identified lead piping is replaced or the lead in plumbing issues are remediated • Have your water retested regularly
How Do I Get My Water Tested?
Home Lead in Water Testing Kits: The EPA recommends using an EPA state certified laboratory to conduct the lead in water sample analysis. The laboratories will send out a water bottle testing kit that the consumer can fill and send in for analysis. The EPA has a list of certified labs in each state that can be accessed. For More Information: https://www.epa.gov/dwlabcert/contactinformation-certification-programs-and-certified-laboratories-drinking-water Water Testing Companies: Some water testing companies will come to the consumer’s home and collect a water sample for analysis. Free Testing: Ask your local public water system if they will test your home for free. Some public water systems, such as New York City, offer a free lead in water testing kit for residents through free residential lead testing programs. Once you get your results, be aware that the Lead in Water Action Level under the Lead and Copper Rule is 15 PPB. If it is above the Action Level, contact your local public water system to see they are responsible for remediating the lead in water source in your home. If not, address the hazards or explore local funding sources to help pay for remediation.
Public Water Systems
• Public water systems are tested annually. • The annual Water Quality Report is available online or you can request a copy.
What Water Filtering System Should I Use?
Water Filter Pitchers: Zero Water is a NSF (industry standard) certified pitcher to filter lead in water. Installed Water Filtering Systems: The EPA recommends that a water filtering system installed in homes be certified by either NSF, Water Quality Association or Underwriters Laboratories. For more information on lead in water in homes or schools, the EPA has a number of resources on lead in water related laws at: https://www.epa.gov/ground-water-and-drinking-water/basic-information-about-lead-drinking-water
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A Critical Link: Healthy Homes & Grade-Level Reading Ralph Smith, Managing Director, Campaign for Grade-Level Reading The research is clear. Reading proficiently by the end of third-grade is an important predictor of school success and high school graduation. Yet, 80 percent of low-income children miss this critical milestone. That number is even higher for low-income children of color. Over 240 communities have taken up the challenge of moving the needle and closing the gap on reading proficiency at the end of third grade. The opportunity to work closely with communities participating in the Campaign for Grade-Level Reading Network in 42 states has led to a sobering realization: there is a large and growing number of children who are falling beyond the reach of schools. School-based education is widely acknowledged as the pathway out of poverty, the portal to opportunity. The nation has no back-up plan when schools cannot meet that expectation. The consequences are dire for those children who start out so far behind that it is unlikely that they will catch up, then miss so many days of school that they fall farther behind during the school year. By the end of third
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grade, the children facing this trifecta have been effectively eliminated from on-grade academic performance and are on course to dropout status. The array of approaches and initiatives employed by those GLR Network Communities that report the most progress make clear that bringing these most vulnerable children back within the gravitational pull of schools will require three big commitments: 1) Systems of care with the capacity to provide 24/7/365 two-generation services and family supports; 2) Data-rich technology-enhanced early warning and response systems to sound the alarm when a child heads off track; 3) Attention to two key determinants of early school success--ensuring healthy on track child development and supporting parent success. Both of these attach urgency to focusing on the place where most children spend most of their time: home. This shared focus on the home environment has fostered a strong partnership between the Campaign for Grade-Level Reading and GHHI.
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Three Questions For HUD Secretary Julián Castro To help mark the first Annual National Healthy Homes Month GHHI posed three questions to HUD Secretary Julián Castro to learn more about his vision to advance healthy housing in America. As you enter the final six months of your term as Secretary of Housing and Urban Development (HUD), and in light of the continued toxic legacy of leadbased paint that this country faces, how do you see HUD’s role in helping lead the country toward elimination of this tragic, costly and entirely preventable problem for our children, families and communities? Safe, healthy housing is the foundation for every part of our lives. And the costs— both personal and financial—of lead hazards in housing are tremendous, particularly for young children. HUD directs the largest effort by the federal government to make homes safer. We’ve recently improved how we identify and control lead hazards and strengthened our partnerships with federal and local leaders to keep families safe. That includes a proposed rule we recently submitted to the Office of Management and Budget that would align HUD’s guidelines with the Centers for Disease Control’s definition of an elevated blood lead level for children younger than six years old in HUDassisted homes. The rule would put in place more comprehensive testing and evaluation in homes where those kids live. But we won’t stop there. We’ll continue challenging ourselves and Congress to protect kids, whether they’re in HUD-assisted housing or private homes. HUD remains committed to ensuring that our lead hazard control grant funding continues to support small businesses so that local firms can play a leading role in rehabilitating homes. There is a lot of new research that ties health outcomes to one’s home and
neighborhood, like the discrepancies between life expectancy from zip code to zip code. One statistic that you’ve quoted is that residents in 14 Baltimore neighborhoods have lower life expectancies than people in North Korea. What role do you believe HUD should play in using housing as a platform for health, educational and social outcomes? You’re absolutely right that a ZIP code all too often is a strong predictor of a child’s course in life. It means that access to decent housing, quality schools, good jobs, and healthcare all play a role in shaping a person’s opportunities. At HUD, we believe that where you grow up should never determine where you end up. That’s why we’re focused on making investments to strengthen underserved communities while also giving people of modest means the chance to live in areas of higher opportunity. This year alone, HUD is investing more than $4 billion to lift up distressed neighborhoods across the nation. Healthy housing is critical for the kinds of strong, sustainable communities we want to create. We know from research that homes with fewer hazards have families that are healthier, children who do better at school, and adults that don’t need to take as many days off of work. You call HUD the Department of Opportunity – what are the key actions you would like to achieve or implement during your tenure to advance this idea?
Recently, I was proud to announce that, for the first time ever, HUD allocated $174 million through the National Housing Trust Fund to create affordable housing specifically for lowincome families. And we’re also taking a number of steps to support middleincome Americans who are also feeling the crunch from rising rents. Our nation’s rental affordability crisis is making it harder for families to invest in their children’s futures or save for their retirement. That’s why HUD is working with cities and states to develop regional development plans that invest in affordable housing, quality public transit, new schools, and other assets that all neighborhoods need to thrive. We have also made historic progress in the fight to end homelessness, particularly among our nation’s veterans. Since 2010, veteran homelessness has declined an incredible 36 percent. To date, 24 communities and two states have effectively ended veteran homelessness. We’ve got a lot of work to do to get more youth, families, and those who are chronically homeless into stable housing, but our progress has been a remarkable example of government leadership in action. We’ve brought together the federal government, state and local officials, the private sector, non-profits, and philanthropic groups. It shows how much we can really accomplish when we work together toward a common goal and, in the case of homelessness, achieve something that most people once thought was impossible.
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Legislation & Policy: Action to Eliminate Lead Poisoning By Ruth Ann Norton, President & CEO, & Michael McKnight, Vice President of Policy and Innovation Green & Healthy Homes Initiative This past year has witnessed a number of key events, including the lead in water crisis in Flint, that have reinvigorated efforts in Congress and at the state legislature level to remediate sources of lead in paint, water and soil and to establish more proactive lead poisoning prevention strategies and policies. Highlights include: In February, GHHI President and CEO Ruth Ann Norton joined U.S. Senator Sheldon Whitehouse at a press conference in Rhode Island to introduce his bill, The Home Lead Safety Tax Credit Act of 2016. The legislation would help Americans cover the cost of reducing lead hazards in their homes, and would dramatically broaden the national response to this critical public health challenge by providing financial resources in the form of tax credits for homeowners, landlords, tenants, and others to address lead hazards from homes. The bill would create a tax credit worth up to $3,000 to cover half the cost of abating lead hazards. It would also create a smaller tax credit worth up to $1,000 to cover half the cost of steps taken to control—but not
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completely remove—lead hazards, like sealing in lead paint. These new tax credits would supplement any state and local lead hazard control programs, and would be more widely available to offset costs in households with annual income under $110,000. Senator Whitehouse co-sponsored the bill with Senators Charles E. Schumer and Bob Casey. In March, GHHI and the Health Justice Project at the Loyola University School of Law supported Senators Jack Reed and Richard Durbin and Congressman Dan Kildee among others in introducing the Lead Safe Housing for Kids Act of 2016 that will ensure that the federal Lead Safe Housing Rule and other lead related laws are updated to reflect the current science and the Centers For Disease Control’s guidance. The Act would modernize federal Title X and require HUD and EPA to revise current regulations and policies to: conform to the new CDC blood lead reference level of 5 µg/dL, update the lead contaminated dust and soil standards and other lead inspection requirements, eliminate exemptions from the law for zero bedroom dwelling units that are occupied by children and allow for greater relocation options for families residing in federally assisted housing where lead hazards exist.
Buffalo Mayor Initiates Lead Poisoning Prevention in New York In April, Senate Democrats led by U.S. Senator Ben Cardin introduced the Testing, Removal and Updated Evaluations of Lead Everywhere in America for Dramatic Enhancements that Restore Safety to Homes, Infrastructure and Pipes Act of 2016, or True LEADership Act. The comprehensive legislation recommits the federal government to a critical role in water infrastructure investment, lead remediation and the strengthening of drinking water protections through the Environmental Protection Agency. Meanwhile, several states and cities are achieving regulatory and legislative successes aimed at increasing prevention measures in the fight against lead poisoning:
Moving Maryland Legislation Forward
With support from GHHI, the Maryland General Assembly has achieved or is pursuing several recent lead poisoning prevention strategies in Maryland including: Medicaid Lead Poisoning Prevention Pilot Project – In an effort to develop innovative and sustainable funding sources for lead hazard reduction in lower income properties, GHHI supported the passage of legislation in the Maryland General Assembly that created a $600,000 Medicaid pilot project. This groundbreaking Medicaid pilot will provide Medicaid funding for lead hazard reduction interventions in Maryland homes where children with elevated blood lead levels reside. Lead Safe Demolition Practices Many contractors across the country performing demolition work fail to use safe work practices to contain lead dust emissions, fail to remove lead debris in a timely manner or not at all, and fail to prevent lead dust and debris from being disbursed throughout the community as debris is hauled from the property. The unsafe demolition of older homes threatens the immediate health of children and residents who live near demolition sites while also
leaving behind potential hazards for years. In partnership with the Annie E. Casey Foundation, GHHI helped to gain adoption of model demolition standards and codes in Baltimore City. GHHI is helping to modernize and enhance those codes in conjunction with the Baltimore City Department of Housing and Community Development, the Maryland Stadium Authority and other key stakeholders as Baltimore City is planning to dramatically increase the scale of demolition over the next several years. In most other jurisdictions in Maryland, there are no lead safe demolition standards at all for the demolition of properties constructed prior to 1978. GHHI is working on the passage of statewide demolition standards in Maryland that will improve lead safety practices during demolition.
that allowed for claimants to receive pennies on the dollar for their lead poisoning judgments.
Universal Blood Lead Testing - In March 2016, new regulations requiring universal blood lead level testing went into effect in Maryland. With support from GHHI, the State of Maryland has adopted universal blood lead testing of children under age 6 residing in Maryland for the next three years to: increase lead testing rates, better evaluate the actual rate of lead poisoning in Maryland and test the accuracy of the state’s prior targeted blood lead testing/screening methodology. Previous targeted testing methods created gaps in prevention and treatment for children living in other parts of the state. GHHI is supporting the new regulations with trainings and education on the law’s implementation.
This May, the City of Buffalo unveiled a new aggressive, multi-pronged lead poisoning prevention initiative in partnership with Erie County to target lead poisoning hazards in rental properties. Buffalo Mayor Byron Brown announced a program that provides key amendments to the City Charter, City Code, and the City’s Rental Registry Law. See page 11 for more details on Buffalo and Erie County’s campaign.
Structured Settlements – In 2016, the Maryland General Assembly passed legislation enhancing protections for formerly lead poisoned children who had agreed to accept less than the full settlement value of their lead poisoning lawsuit judgment through a lump sum payout of their settlement benefits. Spearheaded by the Maryland Attorney General Brian E. Frosh and supported by GHHI and other partners, the new law provides protections for lead poisoning victims from predatory settlement practices
Landmark Lead Law in Maine
Last year, the Maine Affordable Housing Coalition and other advocates were successful in revising Maine’s law relating to the blood lead reference standard for children under the age of six to conform to the Centers for Disease Control’s recent guidance. See page 12 for more details on the state’s landmark law that established Maine as the first state in the country to establish an action level of 5 µg/ dL and to provide for the financial resources to fully implement the law.
Buffalo Mayor Initiates Lead Poisoning Prevention in NY
GHHI is Here to Help! GHHI’s policy and technical assistance staff are available to support your jurisdiction’s programs and projects. Let us know how we can help. Contact G. Wesley Stewart, Senior Director of Technical Assistance and Legal Services at gwstewart@ghhi.org or at 443-842-5727.
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Task Force Releases Findings on Flint, Michigan Leslie Zarker, VP of Communications Green & Healthy Homes Initiative The lead in water crisis in Flint, Michigan has raised the profile of lead in water issues across the country. The Flint Water Advisory Task Force, established by Michigan Governor Rick Snyder, analyzed what went wrong in Flint, provided guidance on remediation and recommended policies to safeguard residents from future lead in water exposure. The Task Force released its Final Report in March and includes 36 findings and 44 recommendations. Among the findings are issues critical to the work GHHI and its partners undertake around the country to integrate communications and resources amongst government agencies, non-profit organizations and others: • Too few children in Michigan are screened for lead through routine blood tests as recommended for children ages 1 and 2. Statewide screening goals for children enrolled in Medicaid are met in very few instances at the
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county level or within Medicaid health plans. • The consequences of lead exposure for Flint residents are expected to be long-term and will necessitate sustained investments in education, public and mental health, juvenile justice, and nutrition needs over the next 10 to 20 years. • Communication, coordination and cooperation between GCHD, the City of Flint and the Michigan Department of Health and Human Services (MDHHS) were inadequate to protect Flint residents from public health threats resulting from inadequately treated Flint River water. • The rate of follow-up on children with elevated blood lead levels through January 2016 was unacceptable, illustrating a low level of coordination between Genesee County Health Department (GCHD) and MDHHS and insufficient resources devoted to this task. For more information see the Flint Water Advisory Task Force FINAL REPORT.
Advancing Primary Prevention in Buffalo, New York By Cara Matteliano Vice President, Community Impact Community Foundation for Greater Buffalo Just last month, in its annual survey, Travel + Leisure readers voted Buffalo, New York “America’s Favorite City.” It’s not just Buffalonians who are taking note of the monumental change that is happening in this once gritty, rust belt city. Buffalo has become a tale of rebirth and revitalization that is being hailed throughout the country. Essential to these revitalization efforts is the collaboration between different local, state, and national agencies to tackle one of the most pressing dangers in the city—lead poisoning. Buffalo is home to the oldest housing stock in the United States. Though these timeworn houses enhance the community’s character and add to the city’s charm, they also put children at a much greater risk of being poisoned by lead. In fact, Buffalo’s lead poisoning rates are higher than Flint’s, with children testing positive for elevated blood lead levels at more than triple New York State’s average. Though the dangers from lead are daunting, Buffalonians are not discouraged. They realize that in order to make the city lead safe, it is necessary to work together. This mindset started six years ago, when the Green and Health Homes Initiative approached Buffalo with an innovative, integrated housing model. GHHI Buffalo working with the Erie County Department of Health and the City of Buffalo brought together 64 partners across local, state, and national levels and braided resources to make nearly 400 homes lead safe, energy efficient, and healthy for their residents. Comprehensive wholehouse solutions replaced what was
once a siloed, piecemeal approach. But with more than 300,000 homes at risk for lead hazards and nearly 15,000 children under the age of six living in “high risk” zip codes for lead poisoning, resources were still stretched thin. Enter Mayor Byron Brown. This May, the City of Buffalo unveiled an aggressive, multi-pronged initiative and with the County in stepping up enforcement of lead violations. Recognizing the need for collaboration, Mayor Brown announced a program that provides key amendments to the City Charter, City Code, and the city’s Rental Registry Law. It will enhance the collaborative efforts that already exist in Buffalo by providing additional funding for inspection and remediation, increasing educational services for residents, and strengthening code enforcement. Fortifying code enforcement in the city is already making headway. NYS Attorney General Eric Schneiderman, borrowing from GHHI’s cross-sector model, combined local, state, and federal enforcement resources in the fight against lead poisoning hazards in rental properties. The AG recently brought two landlord companies to justice. First Nationle Solution LLC and affiliate Lucian Development LLC were forced to give up six properties and pay a settlement of $350,000 that will be used to resettle tenants and rehabilitate distressed housing.
The settlement shows that government collaboration works. Each entity brought its strengths to the table. The Attorney General lifted First Nationle/ Lucian’s corporate veil, identified their property holdings, and in cooperation with City, County and HUD personnel, cataloged hundreds of violations of federal, state and local law. First Nationle/Lucian’s properties were rife with chipped lead paint, bedbugs, and fire hazards. When confronted with the full roster of these violations, the landlords—Rochester-based property speculators—chose to pay restitution that far exceeded the value of the properties, and leave town. We all know government enforcement resources are strained, but by creating models that synergize available resources, we can accomplish more together than we could achieve on our own. It is an exciting time for Buffalo. A new vitality has breathed life into the once rusted industrial giant. The energy in the city is palpable. The downtown is surging, the waterfront is bustling, and with the continued collaborative efforts, a healthy, lead free future is even closer to being realized. Lead poisoning is, after all, 100 percent preventable, but prevention requires collaboration on every level. It’s exciting to see this at work in Buffalo. Learn More: www.cfgb.org/leadership/ green-and-healthy-homes-initiative/
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New Blood-Lead-Level Law in Maine Is Moving the Bar Wendy Collet, Outcome Broker Green & Healthy Homes Initiative Maine has taken a bold step to better protect its children from the devastating effects of lead poisoning. Last year, the state changed its law relating to the blood-lead-level standard for children under the age of six. Now, any child with a blood-lead-level of 5 micrograms per deciliter (µg/dL) will be diagnosed with lead poisoning. The blood-lead-level is used to determine if an official environmental investigation of the child’s home is warranted. The previous threshold for lead poisoning was three times as high – 15 µg/dL . “Thanks to the hard work of practitioners, advocates and state legislators on both sides of the aisle, Maine is stepping up to become a national leader in better responding to the devastating effects of childhood lead poisoning”, said Greg Payne, Director of the Maine Affordable Housing Coalition. “We look forward to working with state officials, landlords and lead abatement contractors to ensure that the new law is implemented as effectively as possible.”
Once a child is diagnosed with lead poisoning, the law mandates nurse case management and an investigation into the child’s home environment. The new, lower standard reflects recommendations from the U.S. Centers for Disease Control and Prevention, released in 2012, that concluded there is no safe level of lead in a child’s system. Maine is setting an example for the country, as the first state to officially adopt the 5 microgram threshold. Several other jurisdictions are aspiring to this goal, but have not yet officially changed their policies.
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Even a few specks of lead can be harmful to a child’s system, leading to a lifetime of learning disabilities and health problems. While lead paint is often the main culprit, children can come into contact with lead through a number of other sources, including food, water, dust and soil. In Maine, the new standard is expected to lead to as many as 500 more children being diagnosed with lead poisoning, more than doubling the number of cases each year. Once a child is diagnosed with lead poisoning, the law mandates nurse case management and an investigation into the child’s home environment. If lead is found at the property, the Maine Center for Disease Control, responsible for enforcing the new law, may require that potential problems be addressed. For families who rent, the landlord must correct problems and provide temporary housing during renovations, if necessary. Maine’s new law will go a long way to helping children stay healthy and safe. However parents still need to be aware of home health hazards and, if renting, their rights as tenants. Maine advocates are concerned about ensuring adequate state funding for case management, home investigations and lead abatement. However, they will continue to explain that using public funds to prevent lead poisoning is far more efficient than dealing with the lifelong health effects of lead exposure. Past research has shown that every dollar invested in prevention generates $17 - $221 in savings. Local lawmakers are also exploring other ways to make Maine’s children even safer, including expanding testing for lead exposure and screening for lead hazards in homes. Currently, Maine does not have a universal program mandating testing for all children. This puts considerable numbers of youngsters at risk, as the Maine State Housing Authority estimates nearly 30,000 children live in homes that were built prior to 1950 and are likely to contain high levels of lead paint. GHHI is hopeful that Maine will continue to be a leader protecting children from lead poisoning, and that other states will follow Maine’s lead to reduce the poisoning threshold as soon as possible. At GHHI, our goal is to prevent lead poisoning entirely. Adopting the 5 microgram bloodlead-level moves us one major step closer to that goal.
GHHI Adds Five New Pay For Success Sites By Michael McKnight, Vice President of Policy and Innovation Green & Healthy Homes Initiative The Robert Wood Johnson Foundation has awarded the Green & Healthy Homes Initiative (GHHI) a $1.8 million grant to expand GHHI’S innovative Pay for Success (PFS) program – focused on reducing childhood asthma through home-based interventions – to five U.S. cities, and to support the organization’s operating capacity. GHHI programs in these five cities will work with local health care organizations to advance and evaluate new models of funding home-based interventions that produce measurable outcomes such as reducing asthmarelated hospitalizations, emergency department visits and missed school and work days. GHHI will provide ongoing technical support to these cities as they explore viable models of care. GHHI’s first Pay for Success site began in Baltimore in 2014, and is a transaction among GHHI, the Calvert Foundation and Johns Hopkins Hospital and Healthcare System. In 2015, GHHI and its partners replicated the Baltimore program in five other cities through a major grant from the federal Social Innovation Fund. This new Robert Wood Johnson Foundation grant will allow GHHI to expand its program to five additional cities including New York City, Philadelphia, Chicago, Rhode Island and Houston. “We are honored to continue our relationship with the Robert Wood Johnson Foundation and expand our work in Pay for Success as a means to scale effective programs to advance healthy housing,” said GHHI President and CEO Ruth Ann Norton. “Our partners around the country are working to develop viable approaches to reducing childhood asthma caused by poor-quality housing. Implementing proven, evidence-based measures will reduce hospitalizations, improve school attendance and strengthen parents’ ability to work.”
Seven million children in the United States suffer from asthma and research shows that 40 percent of asthma episodes are attributable to home-based environmental health hazards such as mold or pests.
is the number of children severely injured by conditions inside their own homes,” said Norton. “Programs like our Pay for Success project are leading the way for children to be more resilient and healthy and achieve their full potential.”
The Robert Wood Johnson grant will support GHHI’s additional Pay for Success sites, where GHHI will work with the following partners: Affinity Health Plan, New York City; UnitedHealthcare, Houston; Health Partners Plans, Philadelphia; the State of Rhode Island; and Presence Health, Chicago. With federal Social Innovation Fund support, GHHI previously launched similar efforts with partners in Buffalo, NY; Grand Rapids, MI; Memphis, TN; Salt Lake City, UT; and Springfield, MA, to explore promising projects benefitting low-income children with asthma. “We need to invest in the future health of our children and the vitality of our communities, and GHHI is helping to pioneer ways that health care systems and state Medicaid programs can both pay for prevention and save money,” said Donald Schwartz, Vice President of Programs at the Robert Wood Johnson Foundation. Working in more than two dozen cities, Baltimore-based GHHI is the nation’s largest organization focused on healthier housing. GHHI has worked for three decades to improve living conditions for children, families and seniors by making systemic home improvements that reduce the risks of lead-paint poisoning, asthma and other health hazards. GHHI’s efforts help low-income families by reducing in-home triggers for child asthma, improving school and work attendance and lowering energy costs while shifting the focus from emergency remediation to prevention. GHHI’s Pay for Success program supports efforts that bring together private, public and nonprofit sectors to solve social problems. “One of our nation’s greatest tragedies
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A Critical Link: Healthy Homes & Grade-Level Reading
GHHI’s nationally recognized work to reduce and prevent childhood lead poisoning is proving invaluable as the GLR Campaign deepens its commitment to early screening and intervention as the cornerstone of its Healthy Readers portfolio. And its pioneering work around eliminating the triggers for asthma and other respiratory ailments plays a leading role in the overall effort to reduce chronic absence. These successful efforts to eliminate environmental hazards in the home are significant contributors to advancing gradelevel reading, closing the achievement gap and allowing more children access to a pathway out of poverty. Our focus on where children live requires us to commit to doing more than preventing harm. This commitment undergirds our Memorandum of Understanding with HUD to work jointly to improve overall prospects of the more than 1 million children aged birth to eight years old who are living in our nation’s public housing communities. This MOU will allow us to build on the important work already being done by
dozens of public housing agencies across the country. HUD Secretary Julian Castro gets it exactly right: “Empowering our children with the basic skills they need to become successful helps them to reach their full potential,” said Secretary Castro. “There’s no more important mission than to use housing as a platform for success; we need to make certain that our residents, particularly their children, have every opportunity that education can provide.” Public housing agencies, along with public libraries and museums, are becoming proof points of more robust public platforms to assure more hopeful futures for our nation’s most vulnerable children. For More Information: www.gradelevelreading.net
Raising Standards: The New BPI Healthy Homes Evaluator Credential By Larry Zarker, Chief Executive Officer Building Performance Institute On any given Wednesday afternoon, Alex Aviles, Vice President of Aviles Construction in Cleveland, Ohio, can usually be found in one of the 100 year-old duplex houses that fill Cleveland’s East side, leading his crew in whole house energy retrofits for low income families participating in Cuyahoga County’s Home Weatherization Assistance Program (HWAP). On Wednesday, April 6th however, Aviles, 39, sat in a classroom, waiting to take an exam and possibly become one of the first certified Healthy Home Evaluators in the country. Launched on April 4th, the Healthy Home Evaluator (HHE) certification was created by the Building Performance Institute (BPI), the nation’s credentialing body for the home energy upgrade workforce. The credential verifies competency to carry out in-depth healthy home environmental risk assessments. Developed in partnership with GHHI, the HHE is a response to growing demand for consistent training and nationally portable credentials for assessing home health hazards and developing scopes of work for retrofits. Aviles is one of 180 BPI certified professionals to have taken the pilot HHE exam to date. He says when it comes to the health of children and the elderly, he better know more than everybody involved. “I have to be on top of everything that gets done [in healthy home remediation],” says Aviles. “When it comes to the health of children and elderly, that’s nothing to play with.”
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Aviles is a second generation contractor in his family business, which focuses on home energy weatherization work for low income families in Cleveland. The company did 150 healthy home retrofits as part of the Cleveland Health Department’s program for families with kids at risk of asthmatic episodes. Retrofits involved remediating moisture and lead paint dust, and installing insulation and air sealing measures. Momentum is building for a national credential that bridges the knowledge gap between energy efficient buildings and healthy housing. Public health programs, housing agencies and consumers are calling for energy auditors and contractors with a background in building science, who have the diagnostic skills to evaluate the home and prepare a scope of work to remediate hazards. GHHI is currently in 25 cities working to bring whole home assessments and interventions to 300,000 low and moderate income families, and works with BPI Building Analysts in each city to conduct evaluations. Combining BPI certified professionals’ expertise with healthy homes training in the HHE credential provides public health and housing programs, employers and families with an important measure of quality assurance for the workforce. GHHI thanks BPI, the Interstate Renewable Energy Council and all of the Healthy Homes Subject Matter Experts who contributed their time and resources to developing this important workforce credential.
Register to take the pilot Healthy Home Evaluator Exam The HHE credential builds upon BPI’s Building Analyst, Energy Auditor or Quality Control Inspector certifications, which serve as prerequisites for the HHE. • 50 question written exam • Exam cost: $200.00 • Prerequisite: BPI Building Analyst (BA), Energy Auditor (EA) OR Quality Control Inspector (QCI) certification To take the pilot exam at any BPI Test Center, find a Test Center near you at www.bpi.org/hhe or contact BPI at pilot@bpi.org.
GHHI President and CEO Ruth Ann Norton Receives BPI’S 2016 Tony Woods Award for Excellence in Advancing The Home Performance Industry On April 5th, 2016 The Building Performance Institute, Inc. (BPI) honored Ruth Ann Norton of the Green & Healthy Homes Initiative by naming her the 2016 recipient of the Tony Woods Award for Excellence in Advancing the Home Performance Industry, at the ACI National Home Performance Conference in Austin, Texas. Ruth Ann Norton was nominated by industry peers and selected by an independent panel of impartial judges for her tireless efforts to integrate energy efficiency upgrades with healthy home interventions on a national scale. As President and CEO of GHHI, Norton’s work in 25 cities across the U.S. has helped make thousands of low-income families safer and healthier by improving the health and safety outcomes and energy efficiency of their homes. GHHI thanks BPI and the building science community for the honor.
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About the Green & Healthy Homes Initiative The Green & Healthy Homes Initiative (GHHI), formerly known as the Coalition to End Childhood Lead Poisoning, replaces stand-alone programs with a comprehensive strategy to improve health, economic and social outcomes for children, families and seniors through a proven integrated housing intervention framework. GHHI is supported by the U.S. Department of Housing and Urban Development, the Centers for Disease Control and Prevention, the U.S. Department of Energy, and national and local philanthropies. Currently, GHHI is working in 25 locations: Atlanta, Austin, Baltimore, Buffalo, Chicago, Cleveland, Denver, Detroit, Dubuque, Flint, Grand Rapids, Jackson, Lansing, Lewiston Auburn, Marin County, Memphis, New Haven, Newark, Philadelphia, Pittsburgh, Rhode Island, Salt Lake, San Antonio, Springfield, Staten Island and Syracuse.
Healthy Homes, Happy Families Ruth Ann Norton, President & CEO Editor: Leslie Zarker, Vice President of Communications & Marketing Editor: Bianca Quintana, Communications and Social Media Manager Photo Credit: Copyright: Š 2012 AndrÊ Chung/all rights reserved
Green & Healthy Homes Initiative Baltimore, Maryland 2714 Hudson St Baltimore, MD 21224 410-534-6447
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