to eliminate childhood lead poisoning in state of michigan计划消除儿童铅中毒在密歇根州课件

Healthy Homes SectionHealthy Homes Section PLAN TO ELIMINATE PLAN TO ELIMINATE CHILDHOOD LEAD CHILDHOOD LEAD POISONING IN POISONING IN MICHIGANMICHIGAN UPDATEUPDATE n n Efforts in Michigan Efforts in Michigan n n Decreased childhood EBL cases in both severity and numericallyDecreased childhood EBL cases in both severity and numerically n n Increased number of children tested and reported to MDCHIncreased number of children tested and reported to MDCH n n Positive trend causes - possible Epidemiological surveyPositive trend causes - possible Epidemiological survey n n Current prominent initiatives Current prominent initiatives n n National and state levelNational and state level n n Latest efforts to reduce exposures to leadLatest efforts to reduce exposures to lead over a short time frameover a short time frame n n Future workFuture work n n Eliminate childhood lead poisoning in our state over next two yearsEliminate childhood lead poisoning in our state over next two years n n Foster this change as a state and individual areas of responsibility and Foster this change as a state and individual areas of responsibility and expertise. expertise. n n Steps toward a national and international vision to provide our children Steps toward a national and international vision to provide our children with the ability to live, learn and prosperwith the ability to live, learn and prosper INITIATIVESINITIATIVES n n Outreach/EducationOutreach/Education n n Federal Initiatives Federal Initiatives n n HousingHousing n n Health Health n n FundingFunding OUTREACH available training about lead hazards and lead poisoning; n n hand-washing practices;hand-washing practices; n n HEPA filters for vacuum cleaners;HEPA filters for vacuum cleaners; n n lead safe wet-cleaning practices; andlead safe wet-cleaning practices; and n n pamphlets and other resources about lead-based paint hazards. pamphlets and other resources about lead-based paint hazards. ( (/documents/dhs/Home_TA_manual_9/documents/dhs/Home_TA_manual_9 _06_173064_7.pdf_06_173064_7.pdf ). ). Licensing Rules for Family and Licensing Rules for Family and Group Child Care HomesGroup Child Care Homes Next stepsNext steps n n Review by the State Office of Administrative Review by the State Office of Administrative Hearings and Rules (SOAHR).Hearings and Rules (SOAHR). n n Public hearings - Fall of 2008.Public hearings - Fall of 2008. n n Plans to have the new rules in place early in Plans to have the new rules in place early in 2009. 2009. n n Information about the public hearings will be Information about the public hearings will be forwarded to the Lead Commission, Lead forwarded to the Lead Commission, Lead Advisory Committee, and other interested Advisory Committee, and other interested parties so that they can support the inclusion of parties so that they can support the inclusion of these new rules in the final package.these new rules in the final package. HEALTHHEALTH n n Assessment and CareAssessment and Care n n Early On Redesign ProcessEarly On Redesign Process Assessment and CareAssessment and Care EBLEBL n n In 2003, the number of children In 2003, the number of children with an EBL greater than with an EBL greater than 10ug/dL was 3,141 (3.2% of 10ug/dL was 3,141 (3.2% of those tested). In 2007, that those tested). In 2007, that number dropped to 2,031 number dropped to 2,031 (1.4% of those tested)(1.4% of those tested) n n More than 50% More than 50% decrease, even though decrease, even though more children were tested.more children were tested. n n This pattern persists during this This pattern persists during this period for:period for: n n 1- and 2-year olds1- and 2-year olds n n Children insured by Children insured by Medicaid Medicaid n n Various ranges of elevated Various ranges of elevated levels (10 to 14ug/dL, 15 to levels (10 to 14ug/dL, 15 to 19ug/dL, 20ug/dL and up). 19ug/dL, 20ug/dL and up). n n Testing in some of the target Testing in some of the target communities has leveled. communities has leveled. n n From 2006 to 2007, testing From 2006 to 2007, testing among 1- and 2-year olds in the among 1- and 2-year olds in the 13 target communities together 13 target communities together declined slightly. declined slightly. n n The greatest increase was The greatest increase was in the city of Lansing due mainly in the city of Lansing due mainly to testing in WIC clinics.to testing in WIC clinics. Progress of the Task Force and the publication of its Progress of the Task Force and the publication of its final reportfinal report TestingTesting In 2003, there were 100,181 In 2003, there were 100,181 children tested. In 2007, there children tested. In 2007, there were 149,445 children testedwere 149,445 children tested 50% increase.50% increase. Assessment and CareAssessment and Care n n A new version of the A new version of the Statewide Screening/Testing Statewide Screening/Testing Plan has been drafted, Plan has been drafted, shifting the geographic focus shifting the geographic focus from ZIP codes to the now from ZIP codes to the now 14 Target Communities. 14 Target Communities. n n Dearborn was added Dearborn was added n n Muskegon target Muskegon target community expanded to community expanded to include Muskegon Heights.include Muskegon Heights. n n 2008 goal for each target 2008 goal for each target communitycommunity : : n n 20% increase in 20% increase in testing among 1- and 2-testing among 1- and 2- year olds over 2007year olds over 2007 . . n n In 2007, while the statewide In 2007, while the statewide rate of EBL children identified rate of EBL children identified was 1.4%, smaller areas within was 1.4%, smaller areas within the state showed much higher the state showed much higher rates.rates. n n Detroit had a rate of Detroit had a rate of 3.5%, 3.5%, n n Benton Harbor was at Benton Harbor was at 5.3%5.3% n n Highland Park was at Highland Park was at 10.4% 10.4% n n One Detroit ZIP code One Detroit ZIP code was over 10%, while ZIP was over 10%, while ZIP codes from several cities codes from several cities around the state were over around the state were over 5.0%. 5.0%. n n 27 different Census 27 different Census Block Groups, from Detroit, Block Groups, from Detroit, Flint, Grand Rapids, Highland Flint, Grand Rapids, Highland Park and Muskegon, with EBL Park and Muskegon, with EBL rates over 20% (minimum 10 rates over 20% (minimum 10 children tested). children tested). Early On Redesign ProcessEarly On Redesign Process Recommendations:Recommendations: n n Reviewing eligibility criteria based Reviewing eligibility criteria based upon:upon: n n 1) a developmental delay, 1) a developmental delay, and/orand/or n n 2) a diagnosed physical or 2) a diagnosed physical or mental condition that has a high mental condition that has a high probability of resulting in probability of resulting in developmental delay. developmental delay. n n Criteria for eligibility related to lead Criteria for eligibility related to lead poisoning should be clarified to include poisoning should be clarified to include the blood lead level at which a child the blood lead level at which a child would be eligible for would be eligible for Early OnEarly On . . n n “Lead blood lead level at or “Lead blood lead level at or above 10 micrograms per deciliter ( above 10 micrograms per deciliter ( 10 10 g/dLg/dL)”.)”. n n Michigan Department of Michigan Department of Education held public Education held public hearings related to hearings related to eligibility criteria in eligibility criteria in November 2007. November 2007. n n Recommendations are Recommendations are being finalized.being finalized. n n Approval from the U.S. Approval from the U.S. Department of Education, Department of Education, Office of Special Office of Special Education Programs, has Education Programs, has been sought. been sought. n n November 2004, November 2004, Early OnEarly On redesign - resolve redesign - resolve issues for the current Part C systemissues for the current Part C system FUNDINGFUNDING n n Healthy Michigan FundsHealthy Michigan Funds n n DEQ Bond ProposalDEQ Bond Proposal n n KresgeKresge Foundation Proposal Foundation Proposal Healthy Michigan FundsHealthy Michigan Funds MDCH has been awarded $1,000,000 per year for the past MDCH has been awarded $1,000,000 per year for the past three years for lead poisoning prevention activities. three years for lead poisoning prevention activities. n n Allocation of funds: Allocation of funds: n n Lead testingLead testing n n Case management and follow-up of childrenCase management and follow-up of children n n Abatement of lead hazards in homesAbatement of lead hazards in homes n n Lead Ombudsman position, Lead Ombudsman position, n n Lead Safe Housing Registry, Lead Safe Housing Registry, n n Statewide Media CampaignStatewide Media Campaign n n Funding for lead advocacy groups. Funding for lead advocacy groups. n n Funding for fiscal year 2009 has been secured Funding for fiscal year 2009 has been secured DEQ Bond ProposalDEQ Bond Proposal n n Approximately eight years ago, the Department Approximately eight years ago, the Department of Environmental Quality (DEQ) issued a bond of Environmental Quality (DEQ) issued a bond proposal, the Clean Michigan Initiative. proposal, the Clean Michigan Initiative. n n Clean abandoned industrial sites for future Clean abandoned industrial sites for future reuse, improve parks and harbors and for other reuse, improve parks and harbors and for other environmental improvement and maintenance environmental improvement and maintenance projects across the state. projects across the state. TABLE I ItemTotal Cost Lead Hazard Control Costs Abatement contractors Equipment (XRF lead paint analyzers) Regional Field Consultants $4,565,000 Relocation of Families$100,000 Laboratory Analysis$185,000 Program Oversight$150,000 Total Costs$5,000,000 MDCH was the recipient of Clean Michigan Initiative MDCH was the recipient of Clean Michigan Initiative Bond funding for in fiscal year 2000 through 2004. Bond funding for in fiscal year 2000 through 2004. The funds were allocated as follows:The funds were allocated as follows: DEQ Bond ProposalDEQ Bond Proposal n n The funds were used statewide to abate homes with lead poisoned The funds were used statewide to abate homes with lead poisoned children residing there. children residing there. n n Highest risk areas:Highest risk areas: n n Berrien, Calhoun, Genesee, Ingham, Kent, Saginaw and Wayne Counties. Berrien, Calhoun, Genesee, Ingham, Kent, Saginaw and Wayne Counties. n n Many have developed successful local lead coalitions and have directly Many have developed successful local lead coalitions and have directly received lead hazard control funds from HUD. received lead hazard control funds from HUD. n n The Clean Michigan Initiative created 326 lead-safe homes. Using The Clean Michigan Initiative created 326 lead-safe homes. Using an estimate of 3 children per household at $45,360 per child, the an estimate of 3 children per household at $45,360 per child, the related savings to the State for health and social services equals related savings to the State for health and social services equals $44,362,080. $44,362,080. n n House Bills 6227 and 6228: request a ballot issue by the voters to House Bills 6227 and 6228: request a ballot issue by the voters to request a Clean Michigan II bond in the amount not to exceed request a Clean Michigan II bond in the amount not to exceed $1,300,000,000. $1,300,000,000. n n Allocate $20,000,000 for the abatement of lead hazards. Allocate $20,000,000 for the abatement of lead hazards. n n Information by the media suggests that these bonds will not be put Information by the m