Childhood Lead Poisoning Prevention Program

State: PA Type: Model Practice Year: 2007

The Childhood Lead Poisoning Prevention Program, through the Lead Abatement Strike Team (LAST), coordinates activities across several City Departments to eliminate childhood lead poisoning as a public health concern. The City has a coordinated strategy for the elimination of childhood lead poisoning, with several City Departments providing resources.
Despite great success in the prevention of lead poisoning over the past 10 years, Philadelphia continues to have one of the highest prevalence rates for children in the nation. In 1991, over 80% of the children tested had elevated lead levels. Last year that rate had dropped to 8.5%, however this rate translates to over 2,500 children. The Health Department had a backlog of 1,400 homes that contained lead hazards that had made a child lead-poisoned, and lead hazards remained. There was no enforcement system, and no ability to assist families with lead hazard control. Recognizing that there were City agencies that had expertise in dealing with many of these roadblocks, the Health Commissioner contacted them for their assistance - forming LAST - the Lead Abatement Strike Team. The group continues to meet twice a month - once for policy-level Department Managers, and once for the front-line implementation staff. Challenges that arise are solved at these meetings. Many "health" issues, especially in the field of Environmental Health, overlap agencies and disciplines. Environmental Health issues often involve housing agencies, and often require code enforcement actions. Health Departments often do not have the expertise in housing, relocation, or other issues to be successful. Often these different agencies do not talk to each other, and worry about guarding their "kindgoms". This coordinated effort allowed brainstorming to solve the existing problems. Often one agency already had a process for dealing with a similar problem. The process was then modified to work in the Public Health field. For example, the Office of Supportive Housing maintained properties throughout the City to be used by families in cases of emergency, such as when their home was destroyed by fire. Those properties often were not used, and it was decided to make them available to Health Department clients while their homes received lead hazard control services. The Law Department had experience with utilizing a judge to hear specific code enforcement violations, and worked with the Court system to establish "Lead Court". This coordination of efforts can be replicated to address many health and social problems, but it needs strong oversight to succeed. Our project succeeded in great part because it was coordinated by the Managing Director, who is second (in command) only to the Mayor, therefore he could make everyone "play nice".
Agency Community RolesThe Health Department coordinated the establishment of the team, and provided the meeting site and support. The other agencies involved included the City’s Law Department; the Department of Licenses and Inspections; the Office of Supportive housing; the Office of Housing and Community Development; the Courts; the Department of Human Services; and the Managing Director’s Office.  Costs and ExpendituresThis project was suggested by the Health Commissioner, approved by the Mayor, and coordinated through the Managing Director`s Office. Staff time to attend the monthly meetings was the only cost. ImplementationOver the past 5 years, this coordinated effort has resulted in the following: The establishment of "Lead Court" - a judge who hears cases involving Health Department violation notices for lead hazards twice a week. This has tripled compliance with the Health Department Orders - making hundreds of properties "lead-safe" each year. The Office of Supportive Housing provided 11 "safe" houses for free relocation of families while their homes are being made "lead-safe". The City Housing agencies now prioritize families with children with elevated lead levels for free basic system repairs (so that the lead work can proceed). The City Office of Licenses & Inspections revokes rental licenses of landlords in violation - landlord can not collect rent or evict tenant. The establishment of a contractor pool to remediate lead hazards. LAST assisted the City to be designated as a "Healthy Homes City" by CDC/HUD/EPA, and to receive lead hazard control grants from HUD for over $12 million
The goal of the practice is the coordination of efforts to eliminate childhood lead poisoning. Objective 1: Eliminate backlog of lead violation houses.  Performance Measures: Number of units removed from backlog of the total of 1,400.  Feedback: Data updated after new information obtained as a result of Inspection or lead Court action.  Outcome: Backlog reduced to 275. Objective 2: Establishment of Enforcement Process.  Performance Measures: Establishment of Lead Court.  Outcome: Lead Court began 11/02. Objective 3: Establishment of assistance for lead hazard control.  Performance Measures: Relocation ability; funds for lead work; contractors to do work.  Feedback: Health Department - updated every day. All of these processes are constantly being updated and modified as concerns arose.
The team has continued to meet for the past 5 years. As no funds are needed to attend the meetings (other than staff time), it is easily sustainable.