Maryland Environmental Health Network

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Maryland Environmental Health Network

July 11, 2013

8 Elements of a Green & Healthy Home

A Green and Healthy Home is:

• Dry • Safe

• Clean • Well-Maintained

• Contaminant Free • Well-Ventilated

• Pest Free • Energy Efficient

H UD DOE HHS Treas ur y Le ad C SBG LIH_EA P WA P EE CBG EE_R E Le ad M e d ic ar e M e d ic ai d C D FI Fed Lo an Ba n k Bo ard IA Q DOL ETA Gr ee n Jo b s WIA P hil an thr op y St at e P ri va te

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GHHI- How does it work?

Interventions $

GHHI

The Results

How Residents

Experience the GHHI

Model

Efficient Delivery of Investment and Services for Improved Health, Economic and Social Outcomes through Healthier, Energy Efficient

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GHHI National Collaborative

• US Department of Energy

• White House Office of Recovery Implementation • Council on Foundations and Philanthropy

• Coalition to End Childhood Lead Poisoning

• Centers for Disease Control and Prevention / HHS • Environmental Protection Agency

• National League of Cities • U.S. Conference of Mayors

• The National Grade Level Reading Campaign

Atlanta Providence Baltimore• Philadelphia Cleveland ChicagoDetroit Flint Denver Oakland

Cowlitz Indian Tribe

Spirit Lake Nation Tribe

San Antonio

Leading a Movement – Current &

Next Generation GHHI Sites

New Haven Austin Houston St. Louis Omaha Seattle Portland

New York City

Buffalo Minneapolis /

St. Paul

Green – Current GHHI sites

Blue – possible next generation GHHI sites

San Francisco New Orleans Boston Montgomery Boise Cedar Rapids Dubuque Erie Greensboro Raleigh Los Angeles Miami Milwaukee Riverside State of Delaware State of Connecticut Jackson Spokane

Salt Lake County

Mesa Santa Fe Albuquerque Kansas City Nashville Toledo Newark Syracuse Rochester

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Elements of GHHI Baltimore Model

2. GHHI Baltimore Compact

3. Single Portal Intake, Enrollment, and Eligibility Determination 4. Shared Data Platform

5. Comprehensive Health & Safety Environmental Assessment/Energy Audit

6. Resident Education/Owner Post Remediation Education 7. Comprehensive Scope of Work

8. Integrated Green & Healthy Homes Interventions Using Braided Funding Streams

Comprehensive Interventions

• Integrated, single stream interventions

• Systematic braiding of funds to achieve goals and

maximize existing resources

• Reduced inefficiencies of multiple contractors

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GHHI Baltimore Braided Funds-

Federal Funding

CECLP HUD Healthy Homes Demonstration and Production Grants Baltimore City HUD Lead Hazard Reduction Demonstration Grant CECLP DOE Weatherization Innovation Pilot Program Grant

DOE Weatherization Assistance Program/MEA Programs

DOE Energy Efficiency & Conservation Block Grant Program (EECBG) Regional Greenhouse Gas Initiative

Community Development Block Grant Program (CDBG) Community Service Block Grant Program (CSBG)

GHHI Baltimore Braided Funds-

State and City Funding

•Maryland Housing Rehabilitation Program (Structural and H&S) •Baltimore City Roof Repair Program

•Maryland Energy Administration Grant Programs (Energy Efficiency) •Maryland Lead Hazard Reduction Grant and Loan Program

•Maryland Department of the Environment (Education and Enforcement)

•Maryland Department of Health and Mental Hygiene (Asthma and Lead; CDC and MCH Block Grants; Medicaid)

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GHHI Baltimore Braided Funds- Private and

Philanthropic Funding

• PSC - Exelon/Constellation Energy Merger Funds (Housing Interventions)

• Constellation Energy (Roofing, Audits and Furnaces)

• Local and National Philanthropies (Data, Health & Safety, and Staffing) • Rebuilding Together (Trip and Fall Injury Prevention)

• Civic Works (Roofing and Energy Efficiency)

• Fee for Service/Social Enterprise (e.g., foster care inspections, market rate housing interventions)

Impact of GHHI

Unit production is underway with over 4,288 GHHI units completed and 2,892 units in pipeline - initial goal was 3,500 units

Corporate & philanthropic foundations have committed over $25 million to support local GHHI efforts

Health and Safety Benefits - 67% reduction in asthma episodes – increasing

school attendance, lowering missed work days for parents, and reducing medical costs

Energy Consumption reductions ($404/year per home) Government Program cost savings (up to 20 to 25%)

Creation of a Single Portal of Intake and Assessment saving work days for

clients and generating cost efficiencies

Over 1,800 persons trained for the Green & Healthy Homes Workforce with a

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Veal Family – 612 N. Curley Street (Homeowner)

Malfunctioning furnace – Heating with kitchen stove/unvented space heaters 2 asthmatic children – repeated hospitalizations and missed school days

Significant Allergens (mold, mice, VOCs, poor IAQ) and lead hazards in the home

Cost: $18,780 – GHHI Savings $2,958

Partners: CECLP, HUD Healthy Homes Demonstration Grant, DOE WAP, Constellation

Energy, CDBG, Foundations, MCO, JHU School of Nursing

Results: • New Furnace, New Stove, Weatherization, Lead Hazard Control; Moisture

Control/Mold; Health & Safety; Client Pre and Post Resident Education

-No repeat ER/Hospitalizations or missed school days due to asthma episodes -Poorly weatherized home before now has lower energy and maintenance costs

-Youngest child’s school performance has improved from being a “C” student to an “A” student post intervention

Maryland Environmental Health Network

July 11, 2013

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Nations prohibiting white lead in paint

US did not ban the use of lead paint in homes until 1978

1909 France, Belgium and Austria ban white lead interior paint

1923 Czechoslovakia, Sweden 1924 Austria, Poland, Spain 1925 Bulgaria, Chile, Romania 1926 Belgium, France, Greece 1928 Cuba, Luxembourg

1929 Finland, Norway, Yugoslavia 1933 Columbia, Nicaragua,

Uruguay, Venezuela

1936 Argentina 1938 Mexico

1939 Afghanistan, the Netherlands 1952 Italy

1953 Vietnam

1956 Hungary, Morocco, Tunisia 1960-1988 19 more

Effects on Children

Violent, Aggressive Behavior Language Delay

Attention Deficit Disorder Hyperactivity

Decreased Intelligence (I.Q.) Reduced Motor Control

Hearing and Memory Problems

Children poisoned by lead are

• 7 times more likely to drop out

of school

• 6 times more likely to be in the

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Lead’s Impact on Reading Levels

(Miranda 2007)

Effects on Adults

46% increased rate of early mortality

16% to 19% increased risk of

cardiovascular disease

Hypertension

Depression

Reproductive Problems

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Lead & Murder

Source: Rick Nevin, “How Lead Exposure Relates to Temporal Changes in IQ, Violent Crime, and Unwed Pregnancy,” Environmental Research 83:1, 1-22 (2000).

Lead & Assault

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Criminal Justice

• The Criminal Mind

(Wall Street Journal, April 26, 2013) • America’s Real Criminal Element

The Criminal Mind

(Wall Street Journal, April 26, 2013)

“Rising lead levels in the U.S. from 1950 through the

1970s neatly track increases in violence 20 years later,

from the '70s through the '90s. (Violence peaks when

individuals are in their late teens and early 20s.) As lead

in the environment fell in the '70s and '80s—thanks in

large part to the regulation of gasoline—violence fell

correspondingly. No other single factor can account

for both the inexplicable rise in violence in the U.S.

until 1993 and the precipitous drop since then.”

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(1993)

0

5

10

15

20

25

30

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EBL 10 - 19

EBL 20 and above

Nationally

Baltimore City

Maryland Counties

In 1993, over 12,908 children annually in

Baltimore had elevated blood lead levels

Census Tract Percentage of

children tested and found to have

elevated blood lead levels (10 ug/dl or higher) 806-Broadway/ East Oliver 82.23% 807-Broadway/ East Oliver 70.89%

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Brought together local, state

and federal partners

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Increase Capacity for Primary Prevention - Lead Hazard Reduction

Increase Enforcement of Lead Safe Laws Increase Public Education and Awareness Establish Effective Relocation Program Change Critical Public Policies

Create Functional, Sustainable Partnerships Leverage Private Resources

Secured $50 million commitment to lead poisoning prevention

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Delivered Direct Prevention Services

• 20,000 Clients Served

• 6,500 Resident Education Home Visits Performed

• 1,460 Lead Hazard Reduction Interventions Performed • 1,400 Healthy Homes Interventions Performed

• 550 Families Represented in Rent Court for the Repair of Lead

Hazards

• 3,000 Rental Property Owners Receiving Compliance Assistance on

The number of lead poisoned children (≤10 ug/dl) annually in Maryland has decreased 98% since 1993

1993 2011

Children under age 6 with elevated lead levels

14,546 452

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The number of lead poisoned children (≤10 ug/dl) annually in

Baltimore City has decreased 98% since 1993

1993 2011

Children under age 6 with elevated lead levels 12,908 258

Producing Progress in Baltimore City

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National Landscape – CDC Reference Level

Change from 10ug/dl to 5 ug/dl

535,000

Children Nationally

38 million leaded homes

Congressional Budget Cuts

State Cooperative Agreements in FY11: 35

($29.3 million for Healthy Homes/Lead Poisoning Prevention) State Cooperative Agreements in FY12/FY13: 0

($1.99/$2.52 million for Healthy Homes/Lead Poisoning Prevention)

Proposed HUD OHHLHC Budget – FY14

House Version - Lead Programs: $45,000,000 Senate Version - Lead Programs: $95,000,000

House Version - Healthy Homes Programs: $5,000,000 Senate Version - Healthy Homes Programs: $25,000,000

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Current Maryland Landscape-

Challenge following CDC’s Action

3,192 Maryland Children at 5 ug/dl or higher

452 Maryland Children at 10 ug/dl or higher

1,400,000 million leaded homes

526,300 million homes with imminent lead hazards

Maryland Legislation – HB644 (2012)

Expands the definition of “Affected Property” under the Maryland Reduction of Lead Risk in Housing Law to include rental properties built from 1950-1978

Authorizes MDE and/or a local jurisdiction to order lead abatement in any CHILD

CARE CENTER, FAMILY CHILD CARE HOME, OR PRESCHOOL FACILITY

where there is a lead poisoned Person at Risk

Authorizes MDE to enforce a lead abatement order issued by a local jurisdiction or health department

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HB644 (2012)

Increases the registration fee with MDE for affected rental units to $30.00 per unit, per year

Authorizes MDE to seek authority to enforce the EPA Renovation, Repair, and Repainting Rule in Maryland

Requires lead-dust clearance testing for properties undergoing renovation activities in Maryland covered by the EPA RRP Rule

Monetized Benefits of Lead Poisoning

Monetized Benefits of Prevention = 2.2 to 4.7 IQ

point increase results in increased lifetime worker

productivity @ $723,000 per child = $110 to $319

billion

(discounted 2000 dollars for each year’s group of

3.8 million

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Ruth Ann Norton

Executive Director

www.ghhi.org

ranorton@ghhi.org

410-534-6447