Overview: A Community Approach to Childhood Lead Poisoning Prevention Ben Gramling Director of Environmental Health June 8, 2016

Sixteenth Street Community Health Centers Founded in 1969, Serving Milwaukee’s South Side Federally Qualified Community Health Center 39,440 Clients; 84% Hispanic 80% Below FPL; 19% Uninsured Primary Care (Medical & Behavioral) and Wraparound Supportive Services

Department of Environmental Health … envisions a network of public, private and nonprofit sector organizations that are working to bring about improvements in the built and natural environments of Milwaukee’s south side. These improvements represent fundamental steps towards realizing and sustaining improvements in the health and well-being of clients served by SSCHC.

Childhood Lead Poisoning Lead poisoning is the number one environmental health concern for U.S. children Children 6 years old and younger Multiple risks in the home environment

Lead Poisoning in Wisconsin 6 6 6

SSCHC EBLs - 2015 7

Lead Prevalence Rate Number of Children with EBL / Number of Tests 2014

SSCHC Funders/Partners State of Wisconsin Financial Support (General Funds) Technical Assistance & Monitoring Milwaukee Health Department Financial Support (HUD Pass-through) Nuisance Properties – Non-Voluntary Abatement Case Management Primary Prevention – Voluntary Abatement

SSCHC’s Approach Provide Coordinated Intervention and Prevention Services Bridge clinical & outreach activities Link SSCHC & partner services Maintain High Rates of Screening Top performers among Wisconsin’s providers Sustain Effective Outreach Services 1,200-1,400 Active Families served at any time

Core LOP Services Staff Capacity Staff Will: 1.0 FTE Program Coordinator 1.0 FTE Program Assistant 1.25 FTE Outreach Worker 0.75 FTE Research Staff Will: Coordinate screening of children & clinical care (7,500/6,095) Conduct an admit home visit (190) Conduct follow up home visits (425) (every 3, 6 or 12 months depending on situation) Refer properties to department’s housing specialist (59) Discharge family as/when appropriate (191)

Home Visit Description Record the demographic information of the family Conduct an environmental survey Provide parents with lead education and prevention Conduct capillary screening Set goals with the family

Housing Specialist Demonstrate Interim Controls Hepa-Vac window cleaning Duct tape Interface with Landlord Provide Technical Assistance & Linkage to Resources Maintenance plan Renovate Right class referral Grant & loan programs MHD Primary Prevention Program*

Door to Door Canvassing Identify families/children that require testing and/or follow up services & schedule return visit Target areas based on tract-level prevalence rates, housing conditions and population estimates

Backyard Garden Research The Problem: Backyard gardening is being actively encouraged in urban neighborhoods Exposure risk from residential gardening is unclear Risk of exposure is not understood by residential gardeners Soil testing capacity is limited & problematic

Thank You! Ben Gramling Director of Environmental Health Sixteenth Street Community Health Centers Milwaukee, WI www.sschc.org ben.Gramling@sschc.org 414-897-5163