USING LAW FOR HEALTHY HOMES Priscilla Keith, JD Dana Reed Wise Health and Hospital Corporation of Marion county Indianapolis, Indiana

Environmental Justice Environmental Justice “Environmental justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.” “Environmental justice is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies.” EPA Policy statement EPA Policy statement

Selected Indiana statutes Selected Indiana statutes IC Child lead poisoning screening IC Child lead poisoning screening IC Childhood Lead Poisoning IC Childhood Lead Poisoning IC Lead-Based Paint Activities IC Lead-Based Paint Activities IC General Emergency Procedures IC General Emergency Procedures

Proposed changes to Chapter Ten of HHC Ordinance An “approved water supply” may not contain hazardous levels of copper and lead. An “approved water supply” may not contain hazardous levels of copper and lead. Defines and adopts standards for determining: Defines and adopts standards for determining: Lead in dust contamination Lead in dust contamination Lead in soil and water contamination Lead in soil and water contamination Defines and adopts lead-safe work practices. Defines and adopts lead-safe work practices. Requires replacement of all pipes constructed or contains lead compounds. Requires replacement of all pipes constructed or contains lead compounds. Requires interior of housing, exterior walls and soil be free from lead and lead dust hazards. Requires interior of housing, exterior walls and soil be free from lead and lead dust hazards.

Proposed State Legislation Protecting Children from Lead Hazards Protecting Children from Lead Hazards Restrictions on Retailers of Children’s Jewelry Restrictions on Retailers of Children’s Jewelry Restrictions on Paint Retailers Restrictions on Paint Retailers

Medicaid Reimbursement Amount Reimbursements for the following: Reimbursements for the following: Blood tests to determine levels of lead Blood tests to determine levels of lead Allocation between laboratory and corporation Allocation between laboratory and corporation Case management and inspections Case management and inspections

Code Enforcement Procedures Ordinance authorizes health officers to conduct housing inspections. Ordinance authorizes health officers to conduct housing inspections. Generally, the inspectors must first obtain consent from the owner or occupant. Generally, the inspectors must first obtain consent from the owner or occupant. The health officer may make both a lead- based paint inspection and risk assessment The health officer may make both a lead- based paint inspection and risk assessment

Code Enforcement Procedures After finding a violation, a health officer will issue an administrative notice of violation to the persons responsible. After finding a violation, a health officer will issue an administrative notice of violation to the persons responsible. The written notice will include the reasons for which it is issued. The written notice will include the reasons for which it is issued. The notice will also contain an outline of remedial action to achieve compliance. The notice will also contain an outline of remedial action to achieve compliance.

Code Enforcement Procedures The notice will allow a reasonable time for the performance of any act it requires. The notice will allow a reasonable time for the performance of any act it requires. The person who receives the notice may request an administrative hearing. The person who receives the notice may request an administrative hearing. The administrative law judge shall issue a final order within 15 days of the hearing. The administrative law judge shall issue a final order within 15 days of the hearing.

Code Enforcement Procedures Either party may appeal the final order in court. Either party may appeal the final order in court. HHC may issue a bill to the property owner to recover costs incurred in bringing the property into compliance. HHC may issue a bill to the property owner to recover costs incurred in bringing the property into compliance. HHC may also bring a civil action to enforce an ordinance violation HHC may also bring a civil action to enforce an ordinance violation Any person found in violation may be fined up to $2,500 for each offense. Any person found in violation may be fined up to $2,500 for each offense.

Lead Hazard Control Grant Update 141 units under contract to receive remediation: 74 units completed, and $600,000 collected from property owners 141 units under contract to receive remediation: 74 units completed, and $600,000 collected from property owners An additional 76 units are enrolled, but not under contract An additional 76 units are enrolled, but not under contract 17 contractors working in Marion Co. have been trained in lead-safe work practices 17 contractors working in Marion Co. have been trained in lead-safe work practices Grant ends October 31, 2008 Grant ends October 31, 2008

Systematic Code Enforcement Original purpose - to focus on holistically improving the housing stock, one neighborhood at a time Original purpose - to focus on holistically improving the housing stock, one neighborhood at a time The team consisted of a social worker, community resource liaison, nurse, and health educator The team consisted of a social worker, community resource liaison, nurse, and health educator The team worked to assist families in bringing their properties into compliance The team worked to assist families in bringing their properties into compliance

Systematic Code Enforcement Current team consists of only social worker and community resource liaison Current team consists of only social worker and community resource liaison No longer working on specific neighborhoods, but county-wide No longer working on specific neighborhoods, but county-wide Referrals from adult protective services, child protective services, community development corporations Referrals from adult protective services, child protective services, community development corporations

SCE – Healthy Homes Initiative Staff from the National Center for Healthy Housing provided training for MCHD staff Staff from the National Center for Healthy Housing provided training for MCHD staff Essentials for Healthy Homes Practitioners course was very well received Essentials for Healthy Homes Practitioners course was very well received Before training, recognized the need that the program needed to be enhanced Before training, recognized the need that the program needed to be enhanced

SCE-Healthy Homes Initiative National Center for Healthy Housing provided a detailed report with recommendations after the training National Center for Healthy Housing provided a detailed report with recommendations after the training Goals of the program: Goals of the program: To implement a multi-disciplinary approach for inspecting homes To implement a multi-disciplinary approach for inspecting homes Provide cross-training for staff in environmental health and population health bureaus Provide cross-training for staff in environmental health and population health bureaus

Healthy Homes Initiative Goals continued: Goals continued: Implement a team approach for EHS and nurses based on census tract or assigned health district Implement a team approach for EHS and nurses based on census tract or assigned health district Develop a list of resources and funding opportunities Develop a list of resources and funding opportunities Immediately add another team consisting of a social worker and community resource liaison Immediately add another team consisting of a social worker and community resource liaison

Healthy Homes Initiative Conclusions Lead hazard control and elimination plays a large role in the initiative Lead hazard control and elimination plays a large role in the initiative Plan to purchase moisture meters for inspectors Plan to purchase moisture meters for inspectors Plan to construct a database for the homes that may need to be re-inspected Plan to construct a database for the homes that may need to be re-inspected Support has been given by the MCHD director Support has been given by the MCHD director