HEALTH AND HOUSING HEALTH AND HOUSING Collaboration at Collaboration at LASTLAST::
The LEAD ABATEMENT STRIKE TEAM
Philadelphia Department of Public Health
Carla Campbell, MD, MS; Robert Himmelsbach, BA; Peter Palermo, MS; and
Richard Tobin, MS, MPA
Pre-Collaboration:Pre-Collaboration:Extent of the ProblemExtent of the Problem
Housing in Philadelphia:
590,071 occupied units^
92% built pre-1978; 72% pre-1960^
57% of pre-1978 units (310,000) occupied by low-income residents*
60% of pre-1960 units (250,000) occupied by low-income residents*
^ 2000 Census * 1990 Census
Philadelphia Children Tested with Confirmed Blood Lead Level 10
g/dLYear 1995 1997 1999 2001
Total Tested 30,183 33,587 31,498 46,367
Total > 10 g/dL 9,554 9,652 5,898 5,395
% > 10 g/dL 32 % 29 % 19 % 12 %
CLPPP Functions:CLPPP Functions:Pre - LASTPre - LAST
Medical Case ManagementInspectionIssuance of Orders to Remediate Lead
HazardsRe-InspectionNo Further Action if Property Owner
Un- Responsive
Problems With Enforcement Problems With Enforcement Pre - LASTPre - LAST
Court-ordered lead hazard control (LHC) to be done by City without prioritization or resources
No resources for BSR (basic system repair) and resident relocation, often prerequisite to LHC
Fear of creating more homelessness and property abandonment
Backlog accumulated of 1400 properties with lead hazards
New cases continued to add to backlog (about 768 from 4/1/2002-10/23/2003)
CLPPP Functions:CLPPP Functions:Post - LASTPost - LAST
Medical Case ManagementInspectionIssuance of Orders to Remediate
Lead HazardsRe-Inspection
CLPPP Functions:CLPPP Functions:Post - LASTPost - LAST
Property Owner Responsive:– Visual and DW Compliance and Clearance by
Owner or City-Directed LHC
Property Owner NOT Responsive:– LEAD COURT PROCESS– LHC BY OWNER OR CITY-INITIATED– VISUAL AND DW CLEARANCE
Lead Abatement Strike Team: Lead Abatement Strike Team: CreationCreation
Strong community advocacy for increased enforcement and funding for LHC
Concern about the large backlog of casesIncreased interest in problem from City
Council members and Health Commissioner
Commitment for increased funding ($ 1.5 million) and activity around this issue
Lead Abatement Strike Team: Lead Abatement Strike Team: OrganizationOrganization
Partner Agencies meet Bimonthly– Policy Meetings
Decisions made about New Policies, Programs, and Direction of Group
– Program Operations Meetings Review Process to Accomplish Goals, address
obstacles and GET WORK DONE
MDO Office Coordinates the Collaboration
Lead Abatement Strike Team: Lead Abatement Strike Team: CollaborationCollaboration
ALPHABET SOUP OF INVOLVED AGENCIES PDPH—HEALTH DEPT. OHCD—HOUSING & COMM. DEVELOP. PHDC– PHILA. HOUSING DEV. CORP. PHA– PHILA. HOUSING AUTHORITY OESS/OAS—EMERGENCY SERVICES AND
SHELTERS DHS—DEPT. OF HUMAN SERVICES L & I—LICENSES AND INSPECTIONS CITY LAW DEPARTMENT
LAST Policy GroupLAST Policy Group
Why Have Collaboration ?Why Have Collaboration ? Some goals can’t be accomplished without it
– EX: Basic System repair work (OHCD, PHDC) preceding lead remediation work (PDPH)
– Resident relocation (OESS)
Pooling of resources from different agencies Sharing of expertise, knowledge of staff from
different agencies Look at problem from different perspectives Landlords can’t play one agency against the other
Philadelphia Lead CourtPhiladelphia Lead Court
Philadelphia Lead CourtPhiladelphia Lead Court
Created in 11/02 for code enforcement of both backlog and new cases
Court scheduled for three sessions a week, typically 25 cases/session
Deputy City Solicitor (DCS) and the CLPPP Program Manager represent the City
Defendant interview before start of court, we try and set agreements of when they will get the work done
This special court is one of the most efficient/effective courts in the City
Lead Risk Assessment (RA)Lead Risk Assessment (RA)
Always triggered by presence of a child with an EBL
Performed by staff who are PA-Certified Lead Risk Assessors
Full set of surface-by-surface readingsNote condition of surfaces
– Paint intact or defective?– Surface easy-to-clean?
Violation NoticesViolation Notices
PDPH issues Orders to the property owner to Remediate the lead hazards within 10 days.
Owner required– remediate deteriorated lead paint– make all surfaces smooth, tight, and easy-to-clean
Ownership determined by:– resident interview– electronic record search of Phila. Water Dept. and
L & I databases
RA Follow-UpRA Follow-UpNon ComplianceNon Compliance
Inspected 10 days after OL; if non-compliant: No-compliance letter, which includes notification
of additional legal action:– PDPH may remediate hazard and bill owner– Lead Court
L & I notified of Violation – owner rental license revoked:
– Tenant can stop rent payment– Landlord cannot evict tenant
Copy pertinent case information sent to the Law Department
Law ComplaintLaw Complaint
Due ProcessDue Process
Complaint filed with the Court Administration; a hearing date is set
Complaint (hand) delivered to owner Owner ordered to appear in court or face
significant fines Complaint contains copies of the CLPPP’s
original order letter, no compliance letter, and other official letters, eliminating the “I never got it” argument
Lead Court (old)Lead Court (old)
Defendant InterviewDefendant Interview
Lead CourtLead Court
Court Order Form (McJustice) – all usual court decisions pre-printed
Solicitor requests by numberJudge checks appropriate box, enters
next court date specified and signs order.Clerk date stamps document, copy is
made in court and given to the defendant with explanation
Lead CourtLead Court
Solicitor asks the court for certain set judgments and usually 30, 45, 60 or 90 days to complete the work.
Provided work is continuing, each new court appearance may generate another order to “keep up the good work” and another 1, 2 or 3 month extension.
Length of time given dependent on rate of work, BLLs of and presence of children, etc.
Status of Lead Court CasesFor the period 11/5/2002 thru 11/5/2003
1,821 Cases logged by Law Dept. to be processed for court filing.
1,460 Cases filed with the court (includes cases heard & re-listed)
1,406 Cases scheduled for hearings
1,274 Cases heard in court (includes cases heard & re-listed)
752 cases ended through court action
489 have been brought into compliance
93 have been found vacant and referred to Licenses and Inspections
165 have been given to the Health Department for LHC
5 ended for other reasons
Therefore 522 cases are still in the legal process (“returning for status”)
Continuing Evaluation of Lead Continuing Evaluation of Lead Court Dust/Blood ResultsCourt Dust/Blood Results
Ongoing analyses of BLL and dust lead levels post LHC Properties repaired by the Health Department experienced
30% fewer failures in post-repair lead dust loading tests than properties repaired by their owners.
Among failed areas, the mean dust sample test results in owner-repaired homes exceed the EPA standard by significantly more than in city-repaired homes.
Preliminary BLL analyses show that in children aged 25-36 months living in properties that have come into compliance through Lead Court, post-hazard-control blood lead levels decrease less in residents of owner-repaired properties than in residents of CLPPP-repaired properties.
LAST InitiativeLAST InitiativeLead Hazard ControlLead Hazard Control
LHC Barriers (Pre-LAST)LHC Barriers (Pre-LAST)
$$$BSRRelocationCertified Lead Abatement ContractorsProtocols and InfrastructureDangerous Properties
LAST LHC Infrastructure LAST LHC Infrastructure
$ 1.5 million for LHC– Six PA-certified lead abatement contractors
under contract with CLPPP for LHC– Two CLPPP LHC crews– BSR through PHA & PHDC
Relocation (by OESS) – 11 “Safe” housesL & I Inspection of Dangerous Properties
ClientsClients
Court-ordered (166 since 11/02) Pre-Court Owner-occupied CLPPP EBL
cases at time of non-compliance re-inspection (300 / year)
Grant Applicants (100+)
Protocol – ContractorProtocol – Contractor
PA-CertifiedHave multiple PA-certified crewsAgreed to a set price listHave adequate insurancePaid after CLPPP RA OK and Dust
Wipe TestNot paid for additional cleaning if dust
wipes fail clearance
Protocol – Work EvaluationProtocol – Work Evaluation Property evaluated by CLPPP:
– Surfaces / areas / fixtures measured– Treatment determined for each surface / area /
fixture Written Work Specification Report:
– List of specific treatment for each surface / area / fixture– Cost for each treatment
Basic System Repairs completed prior to work Relocation Coordinator notified if relocation
needed Case assigned to next available Contractor, or
CLPPP Crew
Lead Hazard Control WorkLead Hazard Control Work
Typical work:– Surface Paint Stabilization– Replace Windows and Doors– Luan / vinyl tile floors
Complete in 2 weeksMust pass Dust Clearance (by CLPPP)Typical costs for LHC: $ 6,000 - $ 16,000
LAST AccomplishmentsLAST Accomplishments 2001 – 159 Properties received LHC work
– 131 by Owner– 28 by City crew
----------------- (LAST Initiative started 4/1/2002) ----------------- 2002 – 332 Properties received LHC work
– 232 by Owner– 38 by City crews– 62 by CLPPP Contractor
2003 – 510 Properties received LHC work– 395 by Owner– 19 by City crews– 96 by CLPPP Contractor
Total LAST Tally : 819 properties serving 1118 children in 18 month period (340% increase)
Why Did This Collaboration Why Did This Collaboration Work ?Work ?
Strong support from Mayor and Health Commissioner
Managing Director’s Office mandate Different agencies within city government
urged to use 3 Cs:– Communication– Collaboration– Cooperation
Staff Dedication
Benefits of LAST ProcessBenefits of LAST Process
Much improved enforcementDramatic increase in properties receiving
lead hazard controlFor every City dollar spent $2.50 worth
of LHC achieved by private home ownersInfrastructure ready for Successful
Grant Applications and Primary Prevention
For More Information:For More Information:Philadelphia Department of Public HealthChildhood Lead Poisoning Prevention Program2100 W. Girard AvenuePNH - Bldg #3Philadelphia, PA 19130-1400Phone: 215-685-2788 Fax: 215-685-2978
Carla.Campbell @ Phila.govRobert.Himmelsbach @ Phila.govPeter.Palermo @ Phila.gov