FLINT LEAD FREEDATA TRENDS & MULTI-SECTOR COLLABORATION 2021 REPORT FLINT LEAD FREE | 2021 REPORT TABLE OF CONTENTS Introduction ................................................................................................ 3-5 Lead in the Environment: Identification & Removal • Water Lead Testing Results ............................................................... 6 • Pipe Replacement Program .............................................................. 6 • Flint Service Line Data Sharing ........................................................ 7 • Land Bank Demolitions....................................................................... 7 • Habitat Lead Interventions ................................................................ 8 • Lead Safe Home Program .................................................................. 9-12 • Workforce Development .................................................................... 12 Lead Risk Screening • The Flint Registry ................................................................................... 14 • OB/GYN Lead Risk Screening ............................................................ 14-15 • Community Education ....................................................................... 15 • Blood Lead Level Surveillance .......................................................... 16 Economics and Next Steps • Preliminary Economic Analysis ........................................................ 19 • Challenges & New Opportunities ................................................... 19 Conclusion .................................................................................................... 21 Photo by Ebony Stith/ Michigan State University 1 INTRODUCTION FLINT LEAD FREE | 2021 REPORT BACKGROUND ON FLINT LEAD FREE Founded in 2017, Flint Lead Free is comprised of a di- Mission verse group of public, private, and non-profit members, stakeholders, and partners including residents, property To eliminate lead exposure in Flint, MI by 2022. managers, housing organizations, legal services, com- Vision munity organizations, foundations, and city/county/state government with the mission to eliminate lead exposure Through tracking and reporting on environmental lead in Flint by 2022. Flint Lead Free serves as a clearinghouse risks, blood lead levels, environmental assessments, and of lead-related programming, education, and training for interventions and by providing a clearinghouse of lead-re- a variety of audiences such as residents, outreach work- lated programming and education/training, Flint, MI will ers, home visitors, construction workers, and Flint Registry be a model lead-free city through the collaboration of com- staff. The program’s primary prevention and data-driven munity, agencies, and nonprofit groups. focus seeks to identify lead risks and service gaps, strate- gically align resources, and determine cost-effectiveness, Leadership & Flint Registry return on investment, and translatability of local lead elim- A workgroup of the Flint Registry, Flint Lead Free is co- ination. chaired by Jenny LaChance, associate director of MSU-Hur- Primary prevention refers to the elimination of lead expo- ley Pediatric Public Health Initiative, and Lydia Starrs, Pro- sure before a child is poisoned. Because there is no safe gram Offer at the Community Foundation of Greater Flint. level of lead exposure and no available treatment, prima- With grant support to Michigan State University from the ry prevention is the recommended intervention and con- Centers for Disease Control and Prevention’s (CDC) Na- tributes most significantly to lifetime savings on societal, tional Center for Environmental Health (NCEH) and Lead healthcare, and education costs. Poisoning Prevention and Environmental Health Tracking Flint is uniquely positioned to eliminate lead exposure Branch, the Flint Registry contributes to lead elimination because of a confluence of programs that include lead efforts by enrolling individuals exposed to the lead-con- service line removal, lead fixture replacement, primary taminated Flint water, screening for ongoing environmen- prevention and enhanced elevated blood lead level home tal lead exposure via a survey of environmental risks, and investigation and abatement, water testing, as well as connecting individuals to lead-mitigating services. community-wide engagement and lead awareness. Photo by Ebony Stith/ Michigan State University 3 FLINT LEAD FREE | 2021 REPORT Photo by Ebony Stith / Michigan State University Flint Lead Free Members Flint Lead Free Report Flint Lead Free is a multidisciplinary group of partners Flint Lead Free creates a periodic report that highlights from local, state, and national organizations. This diverse lead-related trends emphasizing primary prevention ef- group of partners convenes regularly for strategic con- forts currently underway in the City of Flint. As Flint grows versations related to efforts to eliminate lead exposure in local capacity to increase primary prevention efforts, Flint Flint, share best practices, develop new partnerships and Lead Free tracks, monitors, and reports data from pro- initiatives, and provide feedback to the Flint Registry. grams and services to reflect both progress and challeng- es and to drive programming. g Altarum It is our hope that this 2021 report will build on the last Flint g Center for Community Progress Lead Free report released in 2018 (https://www.flintregis- g City of Flint try.org/flint-lead-free/) and reflect the widespread com- g Community Foundation of Greater Flint munity efforts to reduce lead exposure, share progress g Flint Registry made from new investments and strategic partnerships, g Flint residents/parents demonstrate the positive impact of lead elimination, and g Genesee County Habitat for Humanity highlight the amazing work of partners. g Genesee County Health Department g Genesee County Land Bank This report is not inclusive of all lead-related activities g Genesee Health System currently taking place in Flint, and due to the time lag of g Greater Flint Health Coalition, Elevated Blood Lead collecting complete data, predominantly reflects trended Level Nurse Case Management Program information up to the end of 2019. g Legal Services of Eastern Michigan By continually engaging partners, Flint Lead Free is mak- g Local Initiatives Support Corporation ing intentional connections to strengthen collaboration, g Michigan Department of Health and Human Services, generate greater transparency, and increase access to ser- Lead Safe Homes Program & Child Lead Poisoning vices and information. Prevention Program g Michigan State University Institute for Health Policy g Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative 4 LEAD IN THE ENVIRONMENT: IDENTIFICATION & REMOVAL FLINT LEAD FREE | 2021 REPORT Flint Lead in Water Levels Recognizing no safe level of lead, the Environmental Protection Agency’s Maximum Contaminant Level Goal for lead in water is set at a non-enforceable 0 ppb. The non-health-based action level for a water system is 15 ppb, and the action level for bottled water as set by the Food and Drug Administration is 5 ppb. Flint undergoes Lead and Copper Rule (LCR) compli- ance testing during six-month intervals. Below figure from Michigan Department of Environment, Great Lakes, and Energy notes Flint’s LCR monitoring results from 2016 to 2019. Beginning in 2019, LCR monitoring was performed under the strengthened Michigan LCR rule which requires a 5th liter sample to better detect the potential contribution of lead release from lead service lines. More information at www.michigan.gov/ flintwater and current LCR results at www.michigan. gov/mileadsafe. The data below reflect the total number of residential water kit distribution, reduction in locations for test kit pick-up, and tests with lead results equal to or above 10 parts per billion, no ongoing communication campaign to encourage test- consistent with the previous Flint Lead Free report. The results ing water, the overall number of residential water tests have are from resident sampling kits distributed by the City of Flint. steadily dropped. All results are posted online by the Michigan With a dramatic reduction of resources dedicated to water test Department of Environment, Great Lakes, and Energy. Calendar Year 2013 2014 2015 2016 2017 2018 2019 Number tested 672 25,604 4,482 1,337 431 Number ≥10 ppb 77 2,948 267 33 13 Percent ≥10 ppb 11.5 11.5 6.0 2.4 3.0 Flint Lead Service Line Replacements excavations at replacement eligible homes and approximately 9,695 lead or galvanized steel service lines replaced. According As a result of a 2017 settlement agreement, Flint began an effort to the city, 172 residents have expressly declined to have their to replace service lines damaged during the Flint water crisis. service lines inspected or replaced, and 780 residents have The mission of the program is to remove and replace lead and not responded to the City’s request for permission to conduct galvanized steel service lines. Per the settlement agreement, a service line inspection or replacement. The City estimates the pipe replacement program was to be completed by ear- that about 4,400 service lines at replacement eligible homes ly 2020. Flint residents must opt-in to the service line replace- remain to be excavated. As the residential pipe replacement ment program by completing a form and providing consent concludes, the City of Flint and local crews are gearing up for for contractors