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					    Improving                        Indiana Lead-Safe & Healthy
    Kids’                                 Homes Newsletter
    Environment                          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 neltner@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                                                                            In This Issue:
    September 19 – Indy. ISDH will hold the first meeting of
     its Lead Elimination Committee at 10:00. John Hall, the                      Mark Your Calendars
     director of HUD’s Indianapolis office is chair of the                        CDC Grant to ISDH - $669,047
                                                                                  ISDH Forms Lead Elimination Committee
     committee. Contact Nancy Cobb at 317-234-2273
                                                                                  IDEM Calls in Risk Assessments
    October 2 – Indy. IHFA is holding its “Housing from Shelters                 900 Allen County Kids in 90 Days
     to Homeownership Application Workshop” to help potential                     Leveraging Disclosure – IKE’s Offer
     grant applicants improve their chances of getting a successful               Multi-Tasking in St. Joe County
                                                                                  Responsible Contractors
     grant. Contact Mark Young at 317-233-1812
                                                                                  Learning About the New Lead Rules
    October 2 – South Bend. Lead-safe work practices training                    New Lead Rules On-Line
     offered. Contact Kathleen Kraner at 574-471-1354.                            HUD and EPA Agree on Course
    October 6 & 7 – Indy. IHFA is hosting the Annual                             Lead Supervisor – Why License?
                                                                                  Disclosing Addresses Under HIPAA
     Affordable Housing conference at the convention center.
                                                                                  Grant Opportunities
     Check out www.in.gov/ihfa/news/conf/2003/agenda.htm.                         Indy’s Problem Landlords Identified
    October 9 to 11 – Evansville. The City of Evansville will be                 Indy’s Citizen’s Healthy Homes Initiative
     holding its 2003 Regional Neighborhood Network conference.                   AECLP Becomes AFHH
                                                                                  Asthma and Healthy Homes
     Contact 812-426-7823.
                                                                                  News from Outside Indiana
    October 15 & 16 – 2003 Indiana Lead-Safe and Healthy
     Homes Conference. See related article below.                              Thanks to Indiana Housing Finance Authority and
    October 28 & 29 – Indy. Lead Worker Initial course at EMI.                the Boren Foundation for making this newsletter
     Contact Joan Ketterman at 800-488-8842.                                   and the work of the Task Force possible.

    November 17 to 21 – Indy. Lead Inspector and Risk
                                                                               While IKE appreciates their support, their
     Assessor Initial courses at EMI. Contact EMI at 800-488-                  sponsorship does not imply endorsement of IKE or
     8842                                                                      the content of this webpage. IKE is wholly
    December 9 and 10 – Indy. Lead Inspector and Risk                         responsible for the content of this newsletter.

     Assessor Refresher courses at EMI. Contact EMI at 800-
                                                                               Acronyms:
     488-8842.                                                                  ISDH = Indiana State Department of Health
    December 11 – Indy. ISDH Advisory Task Force and the                       IDEM = Indiana Department of Environmental
     Lead-Safe Indiana Task Force will meet at the EMI, 5610                     Management
     Crawfordsville Road, Suite 15.                                             IHFA = Indiana Housing Finance Authority
                                                                                CDC = Centers for Disease Control and
                                                                                 Prevention
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 2

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
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 3

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 neltner@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.
 Casas Saladubles/Healthy Homes: Eleven bilingual/bicultural students worked in a Hispanic and
   African-American neighborhood in South Bend canvassing 200 homes, surveying families in both
   Spanish and English, and providing materials. Greentree Environmental Services did visual assessments
   on homes. The project identified at-risk homes which are being followed up with risk assessments for
   lead. The project culminates with an open house at Marycrest Health Center that provides bilingual
   services and programs.
 Chemistry through Service in Community: The Notre Dame class is filled. Twelve students
   participated in a risk assessment, with Greentree Environmental Services, on a student’s rental home.
   The students will be working with families with children that have lead levels of five micrograms of lead
   per deciliter of blood or more and providing both environmental and public health services to each
   groups family.
 Leadosaurus and Head Start: This ongoing project will culminate with the Halloween delivery of over
   900 "Leadosaurus" backpacks in St. Joseph and Elkhart County. This has been a learning experience for
   all involved, but with the assistance and diligence of the Health Department, South Bend Medical
   Foundation, Memorial Hospital, Head Start, and others, the diverse needs and logistical challenges of
   making sure over 900 children have had lead and hemoglobin screenings is a major step in the right
   direction. We hope they can do it yearly during enrollment.

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.
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 4

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:
 A licensed lead abatement supervisor with workers who have only had training under the OSHA Lead
    Construction Rule (29 CFR 1926.59); or
 Have all people doing the work successfully complete one of the following:
        o EPA or state accredited lead abatement worker or supervisor course; or
        o One of several lead-safe work practices courses approved by HUD.

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.
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 5

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
   City of Indianapolis Applies for $3.5 million: The City of Indianapolis applied to HUD for a $3.5
    million Lead Hazard Demonstration Grant on July 31. The grant would provide funding for three years.
    The funding would focus on old rental property and on complementing the existing weatherization
    program with more extensive lead hazard control. Good luck!
   IHFA Grant Opportunity: IHFA is again offering another round of grants to Indiana organizations.
    For lead hazard control, the best opportunity is for local units of government seeking Community
    Development Block Grant (CDBG) funds. The grants may be up to $500,000. There are several key
    restrictions:
         o The work must not be performed in entitlement communities that already receive CBDG funds
             directly from HUD;
         o A local match of 10% is required; and
         o The applicant must be a local unit of government such as a health department.

    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 Indianapolis
Indianapolis’ 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.
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 6


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:
    1. Vacant lots outnumber homes.
    2. 9.2% of the homes are boarded and vacant.
    3. Vacant buildings provide promise and blight.
    4. 191 of 446 homes had at least one obvious code violations likely to cause health hazards.
    5. 54% of homes had more than one obvious code violations likely to cause homes to be abandoned.
    6. Two-thirds of apartment buildings need help.
    7. Gentrification threatens to drive property values up and residents out.
    8. Health department makes a difference but needs to be more proactive.
    9. Contractors aggravate conditions.
    10. Funding cuts undermine neighborhood support networks.
    11. Other neighborhoods need CHHI model.

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.
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 7

Asthma and Healthy Homes
ISDH 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
   Cleveland Landlord Held Responsible: In August, a jury found a property manager responsible for a
    tenant’s childhood lead poisoning and awarded the family $100,000 in damages. While the landlord
    apparently acted quickly to address the problem after being told that the child was lead poisoned, the
    jury felt that ignorance of the problem – given the age and condition of the housing – was no excuse to
    allow a child to be poisoned.
   Tax Credit for Lead Paint Removal: Senators Clinton of New York and DeWine of Ohio are
    sponsoring legislation (S.1228) to allow for a maximum tax credit of 50% - up to $1500 - of a
    homeowner's cost of removing lead paint.
   Housing Authority of Louisville Held Responsible: In July, a jury found the Housing Authority of
    Louisville responsible for failing to adequately remedy lead-tainted soil. The jury awards $3,500,000
    to the family of a 12-year-old boy who was mildly retarded as a result of the housing authority’s
    negligence – $500,000 as compensation for injuries and $3,000,000 in punitive damages.
   State Mold Regulations: Texas, Arizona and Louisiana have laws in place regarding the performance of
    mold assessors and mold remediators. Texas also requires the adoption of building and performance
    standards to reduce mold exposure in residential construction, including measures to recognize mold,
    limit water intrusion into homes, and remediate mold. Montana adopted a mold disclosure law.
   Michigan Action Plan: Michigan Governor Jennifer Granholm issued a 33 page “Call to Action” to
    address childhood lead poisoning in the state. A full copy of the Call to Action can be downloaded at
    http://www.michigan.gov/documents/ChildLeadPoisoning2_71150_7.pdf. For more information, contact
    Paul Haan, Coordinator, Get the Lead Out! Project at gtlo@altelco.net or 616-241-3300. The report
    describes the dimensions of lead poisoning in the state and outlines a number of proposals to address
    the problem, including:
    o Redoubled efforts to increase blood lead screening of young children, particularly children enrolled
        in Medicaid.
    o Legislation to create a lead-safe housing registry and provide penalties against property owners and
        managers who knowingly fail to remedy hazards or who sell or re-rent hazardous housing.
    o Assessment and reporting on lead contaminated current or former smelters, foundries or other
        industrial sites.
    o More aggressive efforts to secure grants from federal agencies, as well as private foundations, to
        increase resources to address lead poisoning.
    o Creation of a multi-agency/multi-stakeholder task force to develop a comprehensive strategic
        action and funding plan. The task force has already started meeting and has until the end of the
        year to complete its work.
Indiana Lead-Safe & Healthy Homes Newsletter – September 2003
Page - 8

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 neltner@ikecoalition.org, 317-442-3973 or 5244
Carrollton Avenue, Indianapolis, IN 46220-3181. 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 neltner@ikecoalition.org if you
want to subscribe to either of those newsletters.
   “Sewage in Our Streams” newsletter on behalf of the Indiana Clean Water Coalition. .
 “Improving Kids’ Environment” newsletter. This newsletter deals with all issues and events in which IKE involved.




         SEE YOU AT THE 2003 INDIANA LEAD-SAFE AND HEALTHY HOMES
              CONFERENCE ON OCTOBER 15 & 16 IN INDIANAPOLIS!

  EARLY REGISTRATION BY SEPTEMBER 26. SCHOLARSHIPS ARE AVAILABLE.
 CONTACT TOM NELTNER AT NELTNER@IKECOALITION OR 317-442-3973 FOR
                        MORE INFORMATION.

				
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