HomeMy WebLinkAbout1992-08-24 92-401 ORDERDate August 24,101992 from No. 92-401
Item/Subject: Dead NaafaN progcvan Grant
Responsible Department: Dealfh avd Welfare
Commentary:
This is a mea ($24,000) grant with the Dent of Hossom Services,
Buueau of Health nvuung from thio toms, of signature thmugh June 30,1992.
The fA -Dose of the grart is to siucate the Public shout the hazzards of
rotmental lead, follav up on children with an elevated lead level
send to mndue t prelisinaxy iwpection of musing units where such children
reside.
This item was discussed by the Murucipel Operations caalittee at tlte
Augast 181 meeting.
Attached is a packet of infouretion detailing the proposal.
e"
Managers Comments:
Y.vw��hGi�.n.�et,dou�,
d4 3
ICA cif�
IM1.44 City A,mage, --
Associated Information:
Budget APProval:
film a Dire
Legal Approval:
nay s[L
Introduced For
® passage
❑ First Reading page 1_ of.Z_
0 Referral
92-001
Aeddned to t: a annHw alPnchette, Angest 20, 1992
CITY OF BANGOR
(TIRE.) ("Mt Ao[ iZimt the.C.ity Manages. w.bkecute. a. 9 aat Agc t __..
_.._.. thtlie__M__ai_n_e, DeFu. l _ of Htaait S¢2vioes — Irad Hazzatt Pitg[m0
ByW caro ewnat W W Cie. dfBaadw:
ORDERED,
TWT the City Manager, m befialf of the City of Bangor, is hetetty
aut ize2 and directai th � a Oeant Agreetpnt with tffi Maine
Depsehrent of Hw Services, a miry of which is on file in L Office
of t City Clerk, and to take all ott +erzssai action, i l ding
eeenttion of docwents and m acts, of pnoviding
seroaces n ugh the Dead Hazzard Ptagmmm.
IN CITY COUNCIL
August 4, 1992
Pee d
ITY CL t
92-401
ORDER
Title,
Authorizing the City Manager to execute a(
Grant Agreement witM1 tM1e Maine Department
of evman Services - Lead HazardProgra
.................. .. ..m
Aumipedto
TX �_
�GM . YJMZ. ... ........
Councilmen
0@,
ele �p
nucx a.
�:�ssc:stsa
Attached is a copy of the Lexi Grant proposal which I would like W
discuss with the Municipal Operations Committee at their meeting no
August 18th.
lead poisirg. is considered a significant public healfh hazzard for
children under the age of 6 years Fila reside in housing mretzvctal
prior W t 1978 ban on lead basal paint. Since approxinately 80-
908 of Bangor's housing stock predates the ban, it is reasonable W
assure U t the lazzard W Bangor's children - particulaz'ly low income
children - is significant
in May 1991 the Maine Legislature revised the Lead Poisoning Control
Statute (Oce attacM1re t $1). The goal of the Legislature is W
'eradicate childhood lead poisoning by the year 2010 t ugh the e1Lo-
umtion of lotential sources of enviromrental lead." The OeparWent
of Human Services was naes as lead agency aml given the authority W
promulgate reglatimrs pertaining W licereure of lead inspectors and
lead aheterant personnel.
In coder W ivplarenta pregram in this time of fiscal crisis, the Bnmaau
Of Health applied for, and was awarded, a Federal Grant (sec attatlmairt d2)
W increase education and pylic awareness of the hazzard of enrvironr�mtal
lead, iscnease screenings Of children at rdst and coatuct follow up inspect
tions/inmesttgations of premises where children with lead levels of 20
zi¢egrmms or above reside. It is t intention Of the Depaxnvent to take
ervative approacb to abatement; prunotim enclosure, ennapsulation,
etc. over full scale raxrval.
TO meet the goals Of the Federal Grant, DHS is subocmracttnq with the
Cities of P Iaed and Bangor W conduct e]noattonal progra s ana follow
up visits/inspection of households where children with elevated lead
levels. reside (s attachment k3). On going„indepth imrestigation will
be the responsibility of the Division of Health Bngl ing.
In amition Tom Small sol I have been asked W serve on the Statewide
ac al Coalition. This gives Bangor a direct epportunity W participate
in folicy/rule n ting, etc. ^ a cbmse W lead; rather Tian follow•.
3\
The Faleral Grant is fox an initial 3 years wiN a lnssible 2 year
xsnesal. Hopefully, by tb ed of the grant periai we will have male
sigenficant healway in Public araxanness, screw and prevention as
Well as saa fins data e6 ut th a availability of lead free busing
stock within tlw_ City of Bags.
Total grant amount through June 30, 1993 is $24,000. This may
in=ease in svbsniure years.
33
i.TTmmSTm #1
STATE OF MAINE
LEAD POISONING CONTROL ACT
TITLE 22, MRSA SECIION 1314
INFORMATION DISTRIBUTED BY
Department of Human Services
Bureau of Health
Division of Health Engineering
Community Health Program
State House, Station #10
Augusta, Maine 04333-0010
(207)-287-5689
Revised May 1992
Maine Lead Poisoning Control Act
ChaWnalo
1. Deparmievt "kPmv^®Cmmu Ae
wvdfIDl ucl b[ ma nee immmw m.
LEADPOLSONLYGCONPROLACf
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ft
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36 BROU
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33
Maine Lead Poisoning Control AM 5A
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of
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194
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Maine Lead Poisoning Control Act
g ,N or Nor" my s¢m(rode wads
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6334 M ffID C OF RL DWPLL CARE
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at
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gum mry pmul
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mum nr o No once ma mR vawn
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nNed $I.GLO for Nati violedae a oM
m
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wa �mtlmeamam�wmamw.
a Ind abwM n vddwM+a n
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Maine Childhood Lead Poisoning Prevention Program
Revised Objectives: July, '1992 _
C. PROGRAM PLAN
GOALS AND OBJECTIVES
For the past twenty years Maine has concentrated its efforts on screening and
follow-up activities for low-income children and unfortunately only a limited
number of those children. A growing body of evidence indicates that all children
may be at risk of harmful effects of lead absorption. The estimated lead
screening penetration rate for low-income children in Maine is 5%... this is too
lar. We believe that all preschool children living in Maine should have the
opportunity to bescreenedfor lead exposureamreceive appropriate blood lead
testing and be followed up with medical and environmental treatment when needed.
The current program has been administered and carried out primarily by public
health/ community health nursing agencies. Although some private physicians and
health centers have been submitting blood samples and working with nurses for
follow-up activities, there are ou medical protocols in place. The program, to
be effective, must involve all providers of pediatric care, include business and
community leaders, and develop a plan for true primary prevention of childhood
lead Poisoning.
Maine Year 2000 Goal: To reduce the prevalence of blood lead levels' exceeding 15
ug/dL and 25 ug/dL among children ages 6 months through 5 years to no more than
20% Of the current rate and zero, respectively.
Maine Year 2010 Goal: To eradicate childhood lead poisoning (in Statute, 1992)
ENHANCE SCREENING
Long Term objective A:
By Jere 30, 1991 the Maine Bureau of Health, Department of Human Services, will
annually screen for blood lead or collect blood lead screening data on 50,000
Maine children who are five years old or younger and who are at risk for having
blood! lead levels above 10 ug, L.
Budget Period Objective A:
Establish the lead program management information system for data collection and
management by December 1, 1992. The laboratory request for testing will include
information about risk status, the type of testing (screening, retest, treatment
monitoring), and health care provider new. Data will be entered into a data
base and reported out quarterly for analysis. -
Short Tern objective A:
To increase number of Maine children screened from the estimated 0,000 to 1,000
by June 30, 1993. Subcontracted agencies will ensure the following number Of
screenings take place: Portland 120; Bangor 1,000; and, rural health clinics
100.
WORN PLAN, ACTIVITIES AND TASKS,
1. Mire Lead Program Coordinator by December 1, 1992.,
43
eio
Maine Childhood Lead Poisoning Prevention Program
Revised! Objectives: July, 1992
2. Hire the Nord Processing Operator by January 1, 1993.
3. Convene the Physician Advisory Committee by September 1, 1992 and begin work
to provide guidance to pediatric care providers.
d. Convene the Statewide Lead Coalition by October 1, 1992.
5. Hold quarterly Meetings with the Physician Advisory Committee to review
progress of educational efforts and to evaluate protocols developed by the
Maine Bureau of Health staff for blond lead screening.
6. The Health and Environmental Testing Laboratory w111 purchase and install
atomic absorption graphite furnace or comparable instrument by November 1,
1992.
T. Finalize plans for payment for blood lead screening through the Maine Medicaid
Preventive Health Program (EPSOT) and the Maine Health Program by November 15,
1992.
S. Estimated target objectives for the number of children to be screened from the
Portland area would be 300 children the second quarter, 300 children the third
quarter, and 600 children in the fourth quarter. Targets will be reviewed by
the Physician Advisory Committee.
9. Estimated target objectives for the number of children to be screened from the
Bangor area would be two hundred children the first quarter, two hundred
children in the second quarter, three hundred children the third quarter, and
three hundred children -in the fourth quarter. Targets will be revs ewed by the
Physician Advisory Calm ittee.
10. Estimated target objectives for the number of children to be screened from the
rural health canters would be one hundred children the second quarter, two
hundred children the third quarter, and four hundred children in the fourth
quarter. .Targets will be reviewed by the Physician Advisory Committee.
11. The Bureau of Health Lead Tem, under the guidance of the Physician Advisory
Committee, will develop a simplified Maine -specific Professional protocol for
screening children under 5 for lead poisoning by October 1, 1992.
12. The Maine Bureau of Health, Department of Human Services will conduct a
statewide mailing to pediatric providers including the slmpllfled screening
protocol and information about submitting blood lead samples to the State's
Health and Environmental Testing Laboratory by December 1, 1992.
13. The Morin Bureau of Health, Deparbmnt of Moran Services will meet with each
of the subcontracting Agencies (Portland City Health Department, Bangor City
Health Department and the Maitre Ambulatory Care Coalition) to develop contract
plan and finalizeobjectives by August 1, 1992.
,14. Contracts with local agencies will be completed and signed by November 1,
1992.
Maine childhood Lead Poisoning Prevention Program
Revised Objectives: July, 1992
15. By January 1, 1999 develop and implement new questions about environmental
lead exposure and blood lead screening for use in the Maine Behavioral Risk
Factor Survey.
16. By July 1, 1993 aM every year thereafter, all children, six months to six
years, attending well child clinics supported by the Maine Bureau of Health
will have been screened according to the Maine Childhood Lead Poisoning
Prevention Program protocols developed in conjunction with the Physician
Advisory Committee. -
tT. By January 1, 1996 95% of all primary care providers will offer lead screening
to their patients.
EVALUATION -
1. Coordinator will be hired for coordination and implementation of objectives by
December 1, 1992.
2. The Word Processing Operator will be hired by January 1, 1993.
3. Physician Advisory Committee will have been convened by September 1, 1992.
0. The Statewide Lead Coalition will have been convened by October 1, 1992.
5. The atomic absorption graphite furnace will be operational by November 1,
1992.
6. minutes of meetings with the Medicaid Preventive Health Program will document
plans for establishing payment. Successful billing will be accomplished by
the HETL using designated procedure codes.
1. Quarterly review of data prepared by the Health and Environmental Testing
Laboratory (HETL) to assess the number of children screened from specific
areas of the state will be done quarterly by the Lead Teem and the Physician
Advisory CCam ittee.- B. A simplified professional protocol for screening children for lead poisoning
will have been developed by October 1, 1992.
9. A statewide mailing to pediatric providers regarding lead screening will have
been conducted by December i, 1992.
10. Contracts (which include specific activities and timelines) with 'local
agencies will be signed by November 1, 1992
45
LP
Maine Childhood Lead Poisoning Prevention Program
Revised Objectives: July, 1992
Lang Term Objective S:
By June 30, 1997 the Maim Bureau of Health, Department of Human Services, in
collaboration with health care Providers will assure appropriate follow-up
cording to an established protocol for 90% of all children tested for lead
Poisoning. -
Budget Period Objective B:
By June 30, 1993 the Maine Childhood Lead Prevention Program will have 95% of all
Class IV add V and 90% of all Class III cases, 1n compliances with the medical
follow-up protocol.
$ban Term Objective B:
By October 1, 1992 a simplified protocol for follow-up of children screened for
lead poisoning will have been developed by the Maine Bureau of Health under the
guidance of the Physician Advisory Committee.
WORK PLAN, ACTIVITIES AND TASK&
1. Maine Bureau of Health staff will develop protocol and submit protocol to the
Physician Advisory Committee for review by September 1, 1992.
2. Maine Bureau of Health staff will develop a pilot project for screening and
fallow -up of children in the Bangor area by August 1, 1992.
3. Assure that proper methods of tracking children are included in the data
management system by January 1, 1993.
EVALUATION: _
1. Development of a fallow -up plan.
2. Assessment of compliance based on data from the tracking module and random
record reviews.
Long Tenn Objective C:
By June 30. 1997 the Maine Childhood Lead Poisoning Prevention Progress will
conduct initial environmental inspections in 95% of the dwelling units occupied
by newly identified and confirmed cases, according to the criteria,and within
the time frames specified, in our CDC being! Environment9l Management Protocol.
Budget Period Objective C:
By June 30, 1993 the environmental management protocol will have been fully
implemented by Maine Bureau of Health staff.
Short TOM Objective C:
By January 1, 1993 the environmental management protocol will have been developed
by the Maitre Bureau of Health Staff.
WORN PLAN ACTIVITIES ANO TASKS
1. By December 31, 1992 develop and promulgate rules regarding the standards for
licensure and certification of lead inspectors and abatement personnel.
46
Maine Childhood Lead Poisoning Prevention Program.
Revised Objectives: July, 1992
2. The Bureau of Health Lead Team will meet on a monthly basis to facilitate
Coordination Of environmental follow-up.
3. By November 1, 1992 the Maine Bureau of Health will have establlshei
guidelines for making lead inspections available on a prioritized basis to
those persons who request than, add are unable to afford a private inspection.
a. By July, 1994 identified interior lead paint hazards will be remediated in 902
of all cases under clinical management within the time frames specified under
rules established by the Department of Hunan Services.
5. By January 1, 1994 the Maine Childhood Lead Poisoning Prevention Program will
assure a comprehensive lead risk assessment, including dust, soil, and water
as well as interior and exterior paint, at 95% of the homes where a lead
environmental investigation is done after identification of a child meeting
Class Iv or V criteria.
EVALUATION:
1. Rules promulgated for licensure and certification of lead inspectors and
abatement personnel by December 31, 1992.
2. Environmental management protocol developed by January 1, 1993.
3. Link follow-up data for those children identified with elevated blood lead
levels with environmental investigations conducted, to ascertain compliance
with environmental management protocol by May 1, 1993.
4. auidelines for making lead inspections available on a prioritized basis to
those unable to afford private inspections will be developed by November 1,
1992.
Long Term Objective 0:
To assure that the Maine Childhood Lead Poisoning Prevention Program is
maintained at the termination of federal funding.
Budget Period Objective D:.
By June 30, 1993 assure that sufficient funds are obtained through the licensure
and certification program to maintain at least one one-half time position.
Short Tend Objective 0:
By January 1, 1993 centralize all blood lead testing in the State's Health and
Environmental Testing Laboratory. Fees collected will support analyzing samples -
obtained from those unable to pay.
MORN PLAN, ACTIVITIES AND TASKS
1. Revise the laboratory requisition to facilitate third party Milling and data
Collection by October 31, 1992.
Maine Childhood Lead Poisoning Prevention Program
Revised Objectives: July, 1992
2. print and distribute new laboratory requisitions to health care providers and
laboratories by December 15, 1992. -
3. By December 15, notify all pediatric care providers and laboratories the all
childhood blood lead samples will be analyzed at the State's Health and
Evlronmental Testing Laboratory effective January 1, 1993.
a. Establish a fee schedule through rule-making for blood. lead analysis by
December 31, 1992.
5. Establish a system of billing retrospectively third party payors, Medicaid,
Maternal and Child Health and for private payment for blood lead sample
analysis by December 31, 1992..
6. Bureau of Health staff will receive and process applications for licensing and
certification of environmental Inspectors and abatement contractors by January
15, 1993.
EVALUATION
1. Fees realized from analysis of childhood blood lead samples will be deposited
into a account dedicated to the HETL.
2. Fees realized free the licensing and certification of environmental inspectors
and abatement contractors will be deposited into an account dedicated to
support environmental management activities.
48
STANDARD AGREEMENT
ATTACH EAV 43 kA3
Page,4 of 12
RIDER A: SPECIFICATIONS OF WORK TO BE PERFORMED
Services to the Childhood Lead Poisoning Prevention Program (CLPPP). partially
financed through a grant from the Centers for Disease Controlwill be provided as
described in the work plan below. The Contractor shall ensure thatservices
covered under this agreement are provided and that required reports are submitted
timely.
The geographic area covered bythis agreement is
An organization chart showing the relationship of CLPPP services is attached.
ACTIVITIES/TASKS COMPLETION
DATE
I.' City housing inspectors will be certified lead
inspectors by 1/1/93. Public HealthNurse/Lead Coordinator
will be certified lead inspector by 6/30/93.
1) Two currently
ently employed housing inspectors will
attend the three day EPA Seminar at University of
Massachusetts/Amherst September 9-11, 1992.
2) Public Health Nurse/Lead Coordinator will attend
the first EPA certification seminar - offered within a
reasonable geographic distance - available after his/her
date of hire.
II. The City of Bangor Health and Welfare Department will
develop an educational and publicity program aimed at
informing medical proffessionals, service providers,
families with children and the general public about the
hazards of lead.
1) A part time (22.5 hour/week) Public Health Nurse
will be hired by 12/1/92. '
2) Establish a print and audiovisual library of
current materials regarding lead hazards, medically approved
treatments for elevated lead levels and recommended
abatement procedures.
3) Develop and coordinate a media campaign aimed at
informing the general. public about the hazard of lead and
theavailabilityof screening programs.
III. The Public Health Nurse/Lead Coordinator will establish
and staff a Local Lead Coalition whose membership will
mirror that of the Statewide Lead Coalition.
1) The PHN/Lead Coordinator will meet with the local
'AA
STANDARD AGREEMENT
Rider A: Specifications of work to be performed. cont. _
ACTIVITIES/TASKS COMPLETION
DATE (MMODVY)
representatives, on the Statewide Coalition to form a
steering committee for the Local Lead Coalition by 2/1/93.
2) The steering committee of the Local Lead Coalition
will invite prospective members to an organizational meeting
by 3/15/93. Prospective members will be chosen from the
same general categories represented on the Statewide
coalition and any others deemed appropriate.
3) The Local Coalition will meet quarterly to assist
the PHN/Lead Coordinator develop and implement a public
education campaign about lead exposure aimed at the
community and families. Assess the impact of the education
campaign through increased Screenings.
IV. The PHN/Coordinator will conduct a follow up visit to
all households containing children reported to haveelevated
lead levels.
1) Visite will be scheduled to households containing
children with lead levels of 20 or above.
2) Information regarding lead hazards, treatment and
accepted abatement procedures will be given at the time of
the fallow up visit.
3) Visite will be made to other households in the
building who may have children of pregnant women in danger
of lead exposure.
building who may have children or pregnant women in danger
of lead exposure.
9) Referrals to primary care provider will be made as
appropriate.
5) The City of Bangor Housing Inspectors will conduct
preliminary lead inspections in housing where children with
lead levels of 20 or above reside.
6) When the City of Bangor Housing Inspectors identify
lead hazards on a premises areferral will be made to the
Division of Health Engineering for investigation and follow
up.,
L6
STANDARD
AGREEMENT
page 5
of
U
Rider A:
Specifications
of
work
to
be
Performed,
cont.
EVALUATION ME NODS
I. 1) Housing inspectors will be certified as lead
inspectors by 1/1/93.
2) Public Health Nurse/Lead Coordinator will be
certified as a lead inspector by 6/30/93.
II.
1) A part time Public Health Nurse /Lead Coordinator
will be hired by 12/1/92.
2) By 6/30/92, The City of Bangor will house a library
containing the latest print and audiovisual material
available -on the hazards of lead.
3)a) A press release will be issued announcing
ing the
certification of the housing inspectors as n leadinspectors
b) A press release will be issued announcing the
hiring of the PVN/Lead Coordinator .
c) Monthly public service announcements will he sent
to the television stations, radiostations and print media
announcing the locations and times that screening is
available.
d) State and local government to proclaim a "Lead
Awareness Week".
e) Coordinate/conduct three radio and television
interviews explaining the hazard of lead, screening and.
abatement.
f) The number of children screened during the 12
months will increase by 1000. _
IIT. 1) Steering committee to Local Lead Coalition will
LAL-Q
STANDARD
AGREEMENT
-
Rider A:
Specifications
of
work
to
be
performed,
cont. _
ACTIVITIES/TASNS - COMPLETION
t D )
meet by 2/l/93.
2) An organizational meeting of the Local Lead
Coalition will meet by 3/15/93.
3) The Local Lead Coalitionwillhave one regular
quarterly meeting prior to 6/30/93. -
IV 1) The PUN/Lead Coordinator will make follow up visits
to 95% of households containing children with lead levels of
20 or above.'
,2) The housing inspectors will conduct lead
inspections o£-95% of units occupied by families with
children who havehadlead levels of 20 or above.
'3) Referrals will be made to the Division of Health
Engineering for follow up investigation of all premises
where lead hazards are identified.
I