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RenewingOurPledge:
APathtoEndingLeadPoisoningofBuffalo’s
MostVulnerableCitizens
Preparedfor:
CityofBuffalo
CommunityFoundationforGreaterBuffalo
HealthFoundationforWesternandCentralNewYork
PeterandElizabethC.TowerFoundation
RalphC.Wilson,Jr.Foundation
TheJohnR.OisheiFoundation
UnitedWayofBuffaloandErieCounty
Preparedby:
KentGardner,Ph.D.
ProjectDirector
©CGRInc.2017–AllRightsReserved
i
Acknowledgements
Thisreportwouldnothavebeenpossiblewithoutastrongcrosssectorcollaboration
committedtosafeguardingthehealthandsuccessofBuffalo’schildren.The
CommunityFoundationforGreaterBuffaloplayedtheroleofcentralcoordination
conveningandfacilitatingtheworkofpartnersthroughthepersistenceandwisdom
ofitsstaff,VicePresident,CommunityImpactCaraMatteliano,andDirector,
CommunityImpactKatiePieri.TheCityofBuffaloofferedtheleadershipofAssistant
DirectoroftheDepartmentofPermitsandInspections,LouPetrucci,andAssistant
CorporationCouncilAnnaFalicov,whodrewuponextensiveexperienceinhousing
andcodeenforcement.ErieCountyprovidedtheexpertiseofDeputyDirectorof
EnvironmentalHealthMelanieDesiderio,SeniorPublicHealthSanitarianTom
Muscarella,andPolicyDirectorBenjaminSwanekamp,whocontributedtheirdeep
knowledgeofpublichealth,policy,andleadpoisoning.
TheWesternNewYork(WNY)CoalitiontoPreventLeadPoisoningservedasthe
project’ssteeringcommittee.Withover100membersfromacrossthecommunity,
theirideasandadvicearegratefullyacknowledged.
ThePartnershipforthePublicGood,ledbyExecutiveDirectorSamMagavern,
providedinvaluablesupportincludingacompilationofpossiblepolicyalternativesand
leadershipofcommunityengagementefforts,includingatownhallandinterviews
withstakeholders.JessicaGilbert,ResearchAssociate,supportedMr.Magavern.
StaffTeam
KatrinaKorfmacher,Ph.D.,AssociateProfessor,CenterforCommunityHealth,
departmentsofEnvironmentalMedicine&PublicHealthScience,Universityof
Rochester,providedcriticalguidanceasaprojectconsultant.Herrichstoreof
knowledgeonleadpoisoningandpracticalexperiencewithleadpoisoning
policymakingincitiesacrosstheUnitedStateswasinvaluable.
ContributingCGRstaffincludesDonnaHarris,AmeliaRickard,DavidTernerandKate
Bell.
ii
TableofContents
ExecutiveSummary....................................................................................................................iv
Recommendations................................................................................................................................v
CalltoAction........................................................................................................................................vii
LeadPoisoning:History&Consequences............................................................................1
MajorSources.........................................................................................................................................2
SteppingupforOurChildren...................................................................................................6
PreventionStrategy.............................................................................................................................9
SummaryofCurrentLocalInitiatives........................................................................................10
DemographicsandData..........................................................................................................14
Testing.....................................................................................................................................................14
ComparativeLeadPoisoningStatisticsinNYS......................................................................16
HousingCharacteristics&LeadContamination...............................................................17
RentalProperties.................................................................................................................................20
Poverty....................................................................................................................................................21
PracticalPoliciesforReducingLeadPoisoning...............................................................24
AFrameworkforChange................................................................................................................24
ProtectingOccupantsofRentalHousing.................................................................................28
CertificateofOccupancyforAllResidentialHousing.........................................................33
EnforceLeadsafeworkpractices...............................................................................................35
TenantsReceivingAssistance.......................................................................................................39
LowerStatutoryStandardforEBLL.............................................................................................40
PublicEducation.................................................................................................................................41
ResourcesforLeadRemediationandIncreasedEnforcement......................................44
Conclusion:CalltoAction......................................................................................................47
Appendix(onlineonly:Seehttp://www.cfgb.org/leadactionplan).........................49
ChecklistofRecommendedPolicyChange............................................................................49
LeadInterviews:Themes................................................................................................................51
DetailedTables....................................................................................................................................54
Analysis:ElevatedBloodLeadLevelReferrals.....................................................................56
iii
ErieCountyPrograms..............................................................................................................58
CaseStudies:Preventingleadpoisoninginselectedcities..........................................59
SecondaryPrevention.......................................................................................................................60
PrimaryPreventionPolicy...............................................................................................................60
MakingSenseofComparativeStatistics...................................................................................61
CaseStudySummary........................................................................................................................62
Detroit......................................................................................................................................................69
Philadelphia...........................................................................................................................................71
SanDiego...............................................................................................................................................73
WashingtonD.C...................................................................................................................................76
Burlington..............................................................................................................................................78
Chicago...................................................................................................................................................80
Toledo......................................................................................................................................................82
Baltimore................................................................................................................................................84
GrandRapids.........................................................................................................................................87
Rochester...............................................................................................................................................90
iv
ExecutiveSummary
Whileleadispotentiallyharmfultoindividualsatanyage,itisespeciallydangerousfor
childrenundertheageofsix.TheCentersforDiseaseControlreportsthat“thereisno
knownbloodleadlevelforchildrenwithoutsomelevelofriskforsomeoftheadverse
neurologicaleffectsofleadinchildren.”
*
Leadpoisoningcausespermanentdamage
includinglossofI.Q.,developmentaldelays,learningdisabilities,memoryloss,hearing
loss,attentiondeficits,hyperactivity,andbehavioraldisorders.Inextremecases,lead
exposurecanresultinorganfailureanddeath.Thegoodnewsisthatleadpoisoningis
preventableanderadicatingleadfromourcommunityispossible.
Preventionrequirescollaborationoneverylevel.WhilethetragedyinFlint,MIhas
vaulteddangerousleadexposuretothefrontofnationalconsciousness,citiesacross
thecountryhaverenewedtheireffortstoaddressleadhazards.TheCityofBuffaloand
ErieCountyhavemovedtogethertopreventleadpoisoningwithagreatsenseof
purpose.Overthepasttwoyears,CityandCountygovernmentshaveundertaken
aggressiveactiontotacklethecomplexissueofleadhazardsthroughpolicychange
andincreasedresources.Theircollaborativeeffortshaveincreasedenforcement,
educationandfundingandhavesupportedshareddataandaligneddecision making.
Philanthropy,ledbytheCommunityFoundationforGreaterBuffalo,hasincreased
fundingandadvocacyeffortsandconvenedpartnersacrosstheregion.This
communityhasdemonstratedareadinessforaddressingleadheadon.
Thisreportprovidesacomprehensiveassessmentofleadpoisoningdatafor
communitystakeholders,decisionmakers,andfunders.Theassessmentwasadvised
bytheWNYCoalitiontoPreventLeadPoisoningandinformedbykeystafffromthe
CityofBuffaloDepartmentofPermitsandInspectionsandCorporationCounsel,the
ErieCountyDepartmentofHealth(ECDOH),andinterviewsconductedwithofficials,
tenants,landlords,homeowners,nonprofitstaff,communityleaders,andother
stakeholdersinErieCounty.
Thereportisintendedtodevelopacommonunderstandingofthelandscapeforlead
exposureandmakestrategicrecommendationsleadingtoahighimpact,
collaborativecommunitystrategytoeliminateleadpoisoninginBuffaloandErie
County.Forthefirsttime,CityhousingdataandCountyhealthdatahavebeenjoined
foraclearpictureofthelocationandtypeofhousingmostlikelytopoisonour
children.Thefocusofthisplanisprimaryprevention,addressingthesourcesoflead
hazardsbeforechildrencanbeexposed.

*
Agen
cyforToxicSubstancesandDiseaseRegistry.See
https://www.atsdr.cdc.gov/csem/csem.asp?csem=34&po=10
v
Majorfindingsinclude:
ErieCountyhasoneofthehighestbloodleadtestingratesinNewYorkStatewith
61%ofchildrenbornin2012testedtwicebyage36months.
LeadpoisoningratesinErieCountyhaveplateauedinrecentyears.
ThemajorityofchildrenwithElevatedBloodLeadLevels(EBLLs)liveinCityof
Buffalosinglefamilyhomesanddoublesownedbyover1,200differentproperty
owners.
Over80%ofthepropertieswherechildrenareleadpoisonedarerentalproperties.
Leadpoisoningismorefrequentlyfoundinlowincomeneighborhoods,butwhen
leadpoisoningoccurs,theaveragebloodleadlevel(BLL)issimilaracrossall
neighborhoodsandincomelevels.
Despitecollectiveprogressinreducingleadpoisoning,theErieCountyDepartment
ofHealthreportsthatin2017therewere290newcasesofbloodlevelelevationsof
10μg/dLorhigherand466withbloodleadlevelsof59μg/dL(countywide).
Heightenedawarenessandimprovedpolicyhavemadeadifferenceinreducing
leadpoisoninginpeercities,andexamplesoftheirworkareincludedthroughout
thisreport.
Recommendations
Basedonananalysisofdataandreviewofbestpracticesacrossthecountry,
recommendedactionsdesignedtoradicallyreducechildhoodleadpoisoning,include
thefollowing:
Requireownersofallrentalhousingtopassaninteriorinspectionfordeteriorated
(e.g.peelingandflaking)painteverythreeyearsafteraninitialsixyearphasein
periodforsinglesanddoubles.TheCitywillissuecertificatesofcompliancewhich
mustbepostedinrentalunits.
RequireCertificatesofOccupancyforallresidentialhousingatthepointofsale.
AddachippingandpeelingpaintassessmentonDepartmentofSocialServices
pretenancyinspectionform.RequireanErieCountyDepartmentofHealth
inspectionofrentalpropertiesforrentalassistanceclientswithchildrentwoyears
ofageandyoungerpriortotheapprovalofasecurityagreement.
Encouragenonprofitagenciesthatplaceclientsinprivatelyownedhousingto
secureproofofleadclearanceinspectionforallpropertiesinwhichtheirclientsare
placed.
vi
SeekaccessforresidentialinteriorswherevertheCityorCountyinspectsand
identifiesdeterioratedpaintonresidentialexteriorsoridentifiesachildwithan
EBLL.Accessmaybegrantedbytenantsorpropertyowners,ormandatedby
HousingCourtifnecessary.
Increasethefinancialresourcesforleadremediationthroughanexpandedmenuof
publicandprivategrants,lowinterestloans,andfinancingtoensureproperty
ownershaveaccesstocapitaltomakeallpropertiesleadsafe.
SeekapprovalforMedicaidfundedleadremediationinthepropertiesofEBLL
childrenunderage6whoareenrolledinMedicaid/CHIP.
Requiregroundcoverforsoiltoensurethatchildrenareprotectedfromlead
exposurefromvacantlots,demolitionsites,etc.(bothresidentialandcommercial).
IncreaseleadsafeworkpracticecomplianceandensurethattheCityandCounty
haveresourcesandappropriatelegalauthoritytoenforcecompliance.
UrgeNewYorkStatetotakeanumberofactionsthatwouldreduceleadpoisoning
locallyandstatewideby:
Aligningthestatecurrent‘actionlevels’forEBLLcasemanagementof10μg/dL
and15μg/dLforenvironmentalinvestigationwiththeCDCstandardof5μg/dL
forcasemanagementand10μg/dLforenvironmentalinvestigationand
providingtheappropriateresourcestolocalgovernmentstodoso.
Grantingschoolnursesacrossthestateaccesstochildren’sbloodleadtest
results.
ImprovingstateenforcementofleadsafeworkpracticesbypetitioningtheEPA
fordelegatedauthoritytoassumeresponsibilityforadministrationand
enforcementofEPA’sRenovation,RepairandPaintingProgram(RRP).
Addressingleadhazardsthroughprogramsthatsupportwindowreplacementto
improveenergyefficiencyand/orhistoricpreservationthroughtheGovernor’s
callfor“HealthAcrossallPolicies.”
AdoptingproposedlanguageincludedintheGovernor’sBudgetProposal
addressingleadinspectionsbymunicipalcodeenforcementindesignatedareas
ofhighriskforleadpoisoningandpresumptionofleadinpre1978housing
*
.

*
T
heproposedlawaddsapresumptionthatallbuildingsbuiltbefore1978containleadbasedpaint,
requiresthatthepaintnotbedeteriorated,andthatperiodicinspectionsbeconductedtoenforcethe
law,specificallythatin“highriskareas”(asdeterminedbytheCommissionerofHealth),“localcode
enforcementofficersconductinspectionsofresidentialrentalpropertyperiodicallyandatspecified
timesincluding,butnotlimitedto,aspartofanapplicationforacertificateofoccupancy,arenewalofa
certificateofoccupancy,orbaseduponthefilingofacomplaint.Suchinspectionsshallincludeata
minimumavisualassessmentfordeterioratedpaintandbaresoilpresentwithinthedriplineofthe
vii
IncreaseleadpoisoningpreventioneducationeffortsfromtheCity,County,
medicalcommunity,BuffaloPublicSchools,andnonprofitorganizationstoreach
vulnerablepopulationswithemphasisoninpersonoutreachinhighrisk,under
resourcedneighborhoods.
Takestepstoensurethatallchildrenreceiveleadscreeningsatagesoneandtwo,
asrequiredinNYSPublicHealthlaw.
EstablishlegalauthorityfortheCityandCountytosharedataonspecificlead
poisoningcases.
CalltoAction
Reducingleadpoisoningcannotbeaccomplishedbyanyoneplayer.Tobesuccessful,
thiscommunitymustmakeleadpoisoningahighprioritybyassemblingarespected
Lead SafeTaskForcefromtheCityofBuffalo,ErieCountygovernment,theBuffalo
PublicSchools,themedicalcommunity,nonprofitleaders,philanthropy,and
residents.Thisteammustbeprovidedwithstafftoensurethattherecommendations
areimplemented,monitoredandreportedtothecommunityonabiannualbasis.
Inthelasttwoyears,reducingleadpoisoninghastakenonasenseofurgency.With
theregion’sincreasedpublicandprivateinvestmentineconomicdevelopmentand
housinginBuffaloandErieCounty,allresidentsshouldbepositionedtorealizetheir
fullpotential.ChildrenhavemoreeducationalopportunitiesthaneverbeforewithSay
YestoEducationandExcelsiorscholarships.Eliminatingleadpoisoningenables
childrentobehealthyandreadytolearnfromthedaytheyfirststartschool.Itisvital
toourchildren’sfutureandourcollectivesuccessthatourchildrenareprotectedfrom
leadpoisoning.
Regardlessofrace,ethnicity,orsocioeconomicstatus,allchildrenshouldhavethe
opportunitytoliveinhomesthatarehealthy,safe,energyefficient,andsustainable.
Withthisfundamentalpremise,itistimeforourregiontostrengthenitsresolveto
eliminateleadpoisoningaltogether.Thiscomprehensivestudyonleadpoisoning
shouldserveasaroadmaptostrategicallymarshaltheresources,policies,and
practicesneededtosafeguardallchildrenfromleadexposure.

building.”Thelawalsoestablishesstandardsforclearanceofpropertiesfoundtobeinviolation.See
https://www.budget.ny.gov/pubs/archive/fy19/exec/fy19artVIIs/HMHArticleVII.pdf.
1
LeadPoisoning:History&
Consequences
Asleadhasmanyusefulqualitiesandiseasilymined,shaped,andrefined,ithasbeen
usedthroughoutrecordedhistory.SinceRomantimes,leadhasbeenusedtomake
pipesandcarrydrinkingwater.Leadadditivesincreasedtheoctaneratingofgasoline
untiltheEPAbegantophasethemoutofgasolinein1973.Theleadacidbatterystill
remainsnearlyubiquitousinconventionalautomobiles.
Mostimportanttothisstudy,leadimprovesdurabilityandwashabilityinpaint,andit
hasbeenwidelyused.Yetwhiletheconsequencesofleadpoisoningfrompaintwere
firstobservedearlyinthe20
th
century,itwasonlybannedforconsumerusebythe
U.S.ConsumerProductSafetyCommissionin1978(althoughitsuseininteriorpaint
wassubjecttoavoluntarybanbytheindustryin1955).
*

Theconsequencesofleadpoisoningarenowwelldocumented.Leadaffectsbrain
developmentwithimpactsoncognitivefunctionandbehavior,leadingtolower
educationalattainmentandantisocialbehaviors.Somesocialscientistshave
documentedanassociationbetweenleadexposureandcrime
†
.Childrenare
particularlyvulnerabletotheeffectsoflead.TheInstituteforHealthMetricsand
Evaluation(IHME)hasestimatedthat“basedon2015data,leadexposureaccounted
for494,550deathsandlossof9.3milliondisabilityadjustedlifeyearsduetolong
termeffectsonhealth.”
‡
Theconsequencesofleadtoxicityhavebeenwidelyandthoroughlystudied,A
compilationofthese,combinedwithreferencestotheresearchstudiessupporting
thesefindings,hasbeenpublishedbytheCentersforDiseaseControl’sAgencyfor
ToxicSubstances&DiseaseRegistry
§
.

*
http://www.leadlawsuits.com/history/historyoftheuseofleadpaint/
†
Doleac,Jennifer.“Newevidencethatleadexposureincreasescrime,”BrookingsInstitution,June1,
2017.Seewww.goo.gl/oWf7tH.
‡
Leadexposurenotonlyshortenslife,butalsoreducesthequalityofhealthduringlife.“Disability
adjustedlifeyears”isacommonlyusedmeasurethatcapturesqualityofhealth,notsimplyquantity.
Seehttp://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/formoreinformation.
StatisticfromtheWorldHealthOrganization:http://www.who.int/mediacentre/factsheets/fs379/en/
§
Seehttps://www.atsdr.cdc.gov/csem/csem.asp?csem=34&po=10
2
MajorSources
Policyactionscan
minimizeleadexposure
fromthreeprincipal
sources:paint—bothdust
andchips,residentialsoil,
andmunicipalwater.
Othersourcesoflead
includetoysandother
consumerproducts,
includinghomeremedies
andfoodimportedfrom
nationswithlessrigorous
standardsthantheUnited
States.ThisissuehasemergedinimmigrantandrefugeecommunitieshereinBuffalo
andhasbeenafocusofconcerninbordercities,asnotedbyoursourcesinSan
Diego.
Paint
TheCentersforDiseaseControl(CDC)affirmsthatthemostcommonandmost
serioussourceofleadpoisoningishouseholdpaint.
Achild'senvironmentisfulloflead.Childrenareexposedtoleadfrom
differentsources(suchaspaint,gasoline,solder,andconsumerproducts)
andthroughdifferentpathways(suchasair,food,water,dust,andsoil).
Althoughthereareseveralexposuresources,leadbasedpaintisthemost
widespreadanddangeroushighdosesourceofleadexposureforyoung
children.
*
Leadbasedpaintrepresentsachallengingpublichealthproblemasitaddressesthe
balancebetweentheobligationofgovernmenttoprotectpublichealth(particularly
thehealthofourmostvulnerableresidents)andtherightsofpropertyowners.Where
thereisevidenceofharm,e.g.achildidentifiedwithEBLL,thepowersandobligations
ofthepublichealthsystemareclear.Thefocusofthisplanisprimaryprevention,
addressingthesourcesofleadhazardsbeforechildrencanbeexposed,stopping
theleadpoisoning.

*
CentersforDiseaseControl,https://www.cdc.gov/nceh/lead/parents.htm
3
TheCDCalsoremindsusthatitisthedeteriorationofleadpaintthatcreatesthe
hazardforchildren.
Allhousesbuiltbefore1978arelikelytocontainsomeleadbasedpaint.
However,itisthedeteriorationofthispaintthatcausesaproblem.
Approximately24millionhousingunitshavedeterioratedleadedpaintand
elevatedlevelsofleadcontaminatedhousedust.Morethan4millionof
thesedwellingsarehomestooneormoreyoungchildren.
*
Since93%ofBuffalohomeswerebuiltbefore1978,leadpaintpresentsaclearand
presentdangertochildreninthiscommunity.
Soil
Leadinsoilcanpoisonyoungchildrenthroughdirectcontactandingestionof
contaminatedsoil.Themostcommonsourceofleadcontaminationinresidentialsoil
isdeterioratedpaintontheexteriorofhomes,exacerbatedbydeferredmaintenance
andtheunprotectedscrapingandsandingthatcanprecederepainting.Althoughnow
largelyremoved,leadingasolinealsocontributedtosoilcontamination,particularly
nearbusyroadwaysandindustrialsites.
CityordinancesandtheErieCountySanitaryCodeaddressthisriskfactorby
identifyingdeterioratedpaintasacodeviolationandbyrequiringleadsafework
practicesforremediation,consistentwiththeEPA’sRenovation,RepairandPainting
Rule(RRP).
†
Inaddition,theCity’sUnifiedDevelopmentOrdinance(commonlyreferred
toasthe“GreenCode”)currentlyrequiresthatallnonpavedandnonbuiltsurfaces
consistofvegetationorappropriategroundcover.
‡
Water
TheFlintcrisistriggeredarenewedfocusonleadcontaminationindrinkingwaterand
promptedwidespreadattentiontoleadlevelsinpublicwaterdistributionsystems,
includingwatercontaminationatfacilitiesfrequentedbychildren,especiallyschools,
aswellashouseholdwatercontamination“atthetap.”
TheBuffaloPublicSchoolshascollectednearly6,000watersamplesfrom63locations
atpublicschools.Thetestingfoundthat308outletshadwaterleadlevelsabovethe

*
CentersforDiseaseControlhttps://www.cdc.gov/nceh/lead/tips.htm
†
Seehttps://www.epa.gov/lead/renovationrepairandpaintingprogram.
‡
BuffaloUnifiedDevelopmentOrdinance7.1.2(A).
4
federalactionlevelof15partsperbillion,33ofwhicharetypicallyusedfordrinkingor
foodpreparation.Specifictestresultsarepostedonlineandremediationisongoing.
*

LeadlevelsinBuffalo’shouseholddrinkingwateraregenerallyfarbelowthefederal
actionlevelof15partsperbillion,andfarbelowthelevelsfoundinFlintin2015,
whereleadlevelswereregularlyfoundat31partsperbillion,andinmanyinstances
significantlyhigher.
†

Nevertheless,thepresenceofleadinBuffalo’swatermaybeacontributingsourceof
leadpoisoningininfantsandchildren.BuffaloWater,whichmanagestheCityof
Buffalo’swatersystem,hasimplementedacomprehensiveprogramtoreduceor
eliminateleadindrinkingwaterthrougha“sourcetotap”approach.
The“sourcetotap”approachbeginswithwaterinitiallydrawnfromLakeEriebeing
treatedandleavingtheBuffalowatertreatmentplantwithnondetectablelevelsof
lead.Since1995,BuffaloWaterhasutilizedcorrosioncontrolmeasuresthatprevent
leadfromleachingfromleadpipesintothedrinkingwater.Leadservicelinesand
householdplumbingmaterialscontaininglead,however,stillposeaconcernandcan
releaseleadfromthepipesintodrinkingwater.
Toaddressthisconcern,BuffaloWaterhasimplementedaproactiveapproachto
testingandensuringleadlevelsatthetaplevelareminimalornondetectable.The
EnvironmentalProtectionAgencyrequiresthatBuffaloWatertestfifty(50)residential
tapsevery3years,utilizinganactionlevelof15partsperbillion.In2016,MayorByron
W.Brownestablishedamorestringentandrigorousprotocolwhichrequiresannual
testingofadditionalhouseholds,setsanactionlevelof5partsperbillion,andmakes
yearroundwatertestingfreeandavailabletoanyresidentwhorequeststesting
throughtheCity’s311CallandResolutionCenter.
‡

*
Seehttp://www.buffaloschools.org/plantservices.cfm?subpage=124724
†
U.S.EnvironmentalProtectionAgency,seehttp://flintwaterstudy.org/wp
content/uploads/2015/11/MiguelsMemo.pdf
‡
Seehttp://www.buffalowater.org/2016LeadTestingResults/SAFEDrinkingWaterBuffaloNY
5
In2016and2017,BuffaloWatertestedatotalof566householdtaps,withnosingle
tapexceeding15partsperbillion.Forthose
householdswithtestresultsatorabove5parts
perbillion,BuffaloWaterreplacedthe
customers’leadservicelineandmonitoredthe
resultstoensurereductionintheleadlevels.
Duringthisperiod,BuffaloWaterreplaced13
servicelineswhereinitialtestingexceeded5
partsperbillion.BuffaloWateralsotestedtapsat
daycarefacilitieslocatedincityownedbuildings
forleadcontamination.
InMarch2017,BuffaloWaterestablisheda
$300,000stateoftheart“PipeLoop”laboratory,
partneringwiththeUniversityatBuffalo,to
ensureoptimalcorrosioncontroltreatment
techniques(seeadjacentphoto).
InJuly2017,BuffaloWaterlaunchedaninitiativetoconductmoreindepthwater
testingatthehouseholdtaplevel.Thisinitiativemorecomprehensivelyevaluates
corrosionofleadservicelinesandpotentialelevatedleadlevelsthatcouldadversely
impactCityresidents.Inaddition,incollaborationwithVirginiaTechandUniversityat
Buffalo,BuffaloWaterisconductinganadvancedlaboratoryanalysisofharvestedlead
servicelinestofurtherguidetheoptimizationofcorrosioncontroltreatment.Finally,
inAugust2017,BuffaloWaterengagedinacomprehensivesurveyofalldrinkingwater
plumbingfixturesincityownedbuildingstoevaluatepossiblewaterqualityconcerns.
BuffaloWaterconvenedaWaterQualityWorkingGroupwhichwillcontinueto
overseetheseinitiativesandimplementnewprograms,includingeffortstomove
towardsfullleadservicelinereplacementthroughouttheCity.
6
SteppingupforOurChildren
TheNewYorkStateDepartmentofHealth(NYSDOH)hasidentifiedzipcodesstatewide
as‘Communities of Concern’thathavethehighestincidenceofconfirmedelevated
bloodleadlevels(EBLLs).InErieCounty,thesehighriskzipcodesinclude:14201,14207,
14208, 14209, 14210, 14211, 14212,
14213,and14215showninFigure1.
Historically,eachyear,theincidence
of confirmed children with EBLLs
identified in these highrisk areas is
more than double the overall
incidencerateinErieCountyshown
inFigure2.Childreninthesezipcodes
are at highest risk of becoming lead
poisoned.
New York State has consistently
rankedhighonriskfactorslinkedwith
lead poisoning, including a
deteriorated,olderhousingstockand
manyyoungchildrenlivingbelowthe
povertylevel.InBuffaloalone,53.9%
of youth live in poverty. These
hazards are disproportionately
experienced by children of color.
While the incidence rates have
decreasedovertime,ErieCountyhas
historicallyhadhigherincidencerates
comparedtoallofNewYorkStatedue
to these high risk factors, excluding
NewYorkCity.
Figure1HighRiskZipCodesinErieCounty
7
Figure2showsallnewcasesofbloodleadlevelstestsrecordingover10μg/dLfrom
2013through2017
*
.
ThetotalnumberofEBLLtestsisonlyoneconsideration.Anincreaseinthetotal
numberofchildrentestedwouldbeexpectedtoincreasethenumberofEBLLs
identified.AccordingtodatareleasedbyNYSDepartmentofHealth,theshareofErie
CountychildrentestedwithanEBLLof10μg/dLdeclinedthrough2011,thentrended
upwardsince.Thesametrend—includinganunexplainedspikein2013—isobservedat
thestatelevel.ErieCounty’srateispersistentlyhigherthanthestate’s.SeeFigure3.
TheprincipalsourceofleadcontaminationinBuffaloisleadbasedpaintinhomes
constructedbefore1978.Withahousingstockthatisoneofthenation’soldest,
Buffalohasover120,000housingunitsbuiltbefore1980(theclosestyearto1978
reportedbytheCensusBureau),allofwhichmaycontainleadbasedpaint.Moreover,
Buffaloisalsounusualintheheavypredominanceofsmaller,woodframebuildingsas
opposedtobuildingtypessuchasbrickapartmentbuildings.Asaconsequence,Figure
4showsBuffalohasamongthehighestrateofatriskhousinginthenationand
certainlythehighestamongourcomparisoncities.Whilemanyofthesehomesdonot
haveexposedleadhazards,manyhomesinunderresourcedneighborhoodshave
significantdeferredmaintenance,creatingacuteleadhazards.

*
Thebulkofthisreportisbasedonadetailedanalysisofallreferralsof15μg/dLorhigher,matchedto
propertyaddressfortheyears20092016.The2017figureswerejustcompiledandreleasedbytheErie
CountyDepartmentofHealthjustasthisreportwasbeingfinalized.
Figure2NewEBLLforErieCounty(>10μg/dL)
8
AcrossthenationandhereinErieCountyandtheCityofBuffalo,childreninpoverty
payaterriblepricefromleadcontaminationastheirdevelopingbrainsareparticularly
vulnerabletothistoxicmetal.Leadpoisoningcontributestothepersistenceofurban
povertyand,asadisproportionateshareoftheregion’speopleofcolorresidein
centralcitiesandinnerringcommunities,italsoservestoperpetuatehealthand
incomedisparitiesbyraceandethnicity.Childrenfromneighborhoodsofcolorare
twelvetimesaslikelyaschildrenfrompredominatelywhiteneighborhoodstobe
diagnosedwithEBLLs.
*†


*
Percentageofchildrenbornin2012withatleasttwoleadscreeningsby36months
†
UniversityatBuffaloRegionalInstitute,StateUniversityofNewYorkatBuffalo,SchoolofArchitecture
andPlanning,andMakeCommunities.2016.“TheRacialEquityDividend:Buffalo’sGreatOpportunity.”
Figure3
ShareofChildrenTestedwithEBLL(≥10μg/dL)
9
Becauseleadpoisoningispreventablebymeasuresthatminimizeleadexposure,
communitiesacrossthenation,includingErieCountyandtheCityofBuffalo,have
takenonthechallengeofleadpoisoningprevention.TheWesternNewYorkCoalition
toPreventLeadPoisoningadvisedthisreport.ConvenedbytheCommunity
FoundationforGreaterBuffalo,theLeadCoalitionservesacriticalroleinbringing
togetherdisparatepartnersonaregularbasistostrategicallyaffectcrosssector,
inclusive,systemslevelchange.
PreventionStrategy
Preventionstrategiesaredescribedaseither“primary”or“secondary.”
Primarypreventionaddressesconditionsthatcouldleadtopoisoningifadwelling
wereoccupiedbyavulnerableindividual,particularlychildren.
InlongestablishedcitieslikeBuffalo,thepropertiestargetedbyaprimary
preventionstrategywillbethosebuiltbeforethenationalprohibitionofleadin
paint,thusdwellingsbuiltbefore1978.Asmanypaintmanufacturersbegan
phasingouttheuseofleadmuchearlier,particularlyininteriorpaints,therisk
riseswiththeageoftheproperty.
Althoughtheriskposedbyleadladendustissignificantinsomedwellings,the
mostseriousproblemsoccurindwellingswithdeterioratedpaint.Asgood
Figure4ShareofAtRiskHousingbyComparisonCity
10
maintenancecanbecostly,communitiesinpovertyaremorelikelyto
experienceaproblemwithlead.
Secondarypreventionreferstothesetofinterventionsthataretriggeredbyan
elevatedbloodleadtest.Oncealeadhazardissuspected,thepublichealth
authoritiesareempoweredtoidentifythesourceofcontaminationandtakesteps
tocorrectit.
Policyandpracticeaddressingsecondaryprevention—theresponsetoaprovencase
ofleadpoisoning—arewellestablishedinBuffaloandErieCounty.
SummaryofCurrentLocalInitiatives
StatePrograms
NewYork’sStrategicPlanforleadpoisoningreduction,titledEliminatingChildhood
LeadPoisoninginNewYorkStateby2010wascompletedin2004.
*

In2007,theNYSlegislaturepassed,andthegovernorsignedintolaw,a
programtocurtailchildhoodleadpoisoningdramatically(PHL1370a[3]).The
ChildhoodLeadPoisoningPrimaryPreventionProgram(CLPPPP)authorized
healthdepartmentstogainaccesstohighriskhomesforthepurposesof
educationandinspection.Thisrepresentedasignificantpolicyshift,since
previouslyhealthdepartmentscouldonlygainaccesstoahomeifachildhad
alreadybeendiagnosedwithanelevatedbloodleadlevel.
†
Theprogramisacollaborationwithcounties,includingErie,andprovidestechnical
assistanceandgrantstosupportlocalremediationandpolicydevelopment.CLPPPPis
currentlyfundedat$10millionannually.Thisisanincreasefrom$7.7millionbudgeted
inFY200910.
ThemostrecentprogressreportfortheCLPPPPisforNYSFY1415.
‡
Itreportsthat:
SincetheCLPPPP’sinception,granteeshavevisitedandinspectedtheinteriors
ofalmost38,000homes,identifiedconfirmedorpotentialleadhazardsin
12,840,andhavecleared(deemedleadsafe)75.6%(9,703)oftheunits.Asa
result,over11,020childrenwhowerepreviouslylivinginhomeswith

*
Seehttps://www.health.ny.gov/environmental/lead/exposure/childhood/finalplantoc.htm
†
Seehttp://www.nchh.org/Portals/0/Contents/NYSDOH_Yr8_SummaryReport_Final.pdf
‡
Seehttp://www.nchh.org/Program/NewYorkStateCLPPPProgram.aspxforprogressreports.
11
confirmedorpotentialleadhazardsarenowatagreatlyreducedriskforlead
poisoning...
ErieCountyconductedpostremediationfollowupandevaluationon391
housingunitswhereleadhazardcontrolwascompletedbetween2010and
2013.Eightyfourpercentofthehousingunitexteriorsremediatedwerefound
tobemaintainedandingoodconditionuponreinspection.
*
CountyPrograms
In2007,ErieCountyjoinedNewYorkStateDepartmentofHealth(NYSDOH)in
launchinganinnovativepilotprogramfocusedontheprimarypreventionoflead
poisoning.ThegoaloftheChildhoodLeadPoisoningPrimaryPreventionProgram
(CLPPP)wastodevelopinterventions,whichwouldeliminateorreducelead
poisoninghazardsbeforechildrenwereexposed.
TheErieCountyDepartmentofHealth(ECDOH)implementedathreepartprimary
preventionstrategy.First,ECDOHutilizedtheabilitygrantedtolocalhealth
departmentsbyNYSDOH,todeclare‘highrisk’areasinthe“communityofconcern”
zipcodes.Previously,thishadonlybeenattemptedforindividualproperties,which
ECDOHexpandedtoentirestreetsorcensustracts.Withinthedeclaredhighriskareas,
theexteriorsofallstructuresweretestedforleadandpropertyownerswererequired
tomakerepairs.Between2007and2015,over7,500unitswereassessed.4,846were
identifiedwithconfirmedexteriorhazardsand4,214(87%)wereclearedofhazards.
Second,ECDOHprovidespropertyownersundernoticewiththeknowledgeand
materialsneededtocorrecthazardsinaleadsafemanner.ECDOHsoughtand
receivedcertificationtoteachtheEPARenovation,RepairandPainting(RRP)course,
whichtrainspeopletoaddressleadhazardssafelywhenrenovating,repairingor
painting.Since2010,ECDOHhastrainedover1,600peopleasRRPRenovators,
includingBuildingInspectorsfromcommunitiesallovertheCounty.Finally,in2010
theErieCountySanitaryCodewasupdatedtoincluderequirementsforleadsafework
practicesandthepresumptionofleadinpre1978housing.
InFebruaryof2016,ErieCountyExecutiveMarkPoloncarzannouncedplansfora
“LeadPoisoningPrimaryPreventionInitiative”.ThisInitiativebuildsuponandexpands
thescopeoftheECDOHprimarypreventionactivitiestotheentireCounty.The
CountyExecutivepledged$750,000peryearforfiveyears.AsaresulttheCounty:
LoweredthethresholdforEBLLsfrom10microgramsperdeciliter(μg/dl)to5
μg/dL,aligningErieCountywiththeCenterforDiseaseControl(CDC)standard.

*
Seehttp://www.nchh.org/Portals/0/Contents/NYSDOH_Yr8_SummaryReport_Final.pdf
12
HiredafulltimeRegisteredNursetoprovidemedicalcasemanagementofchildren
withEBLLsof59μg/dL.
Providesenvironmentalinterventionforchildrenwithlowerbloodleadlevel
elevationsstilldeemedharmfulat1014μg/dLand59μg/dL
*
.
Hiredadditionalinspectionandprofessionalstafftoincorporateleadpoisoning
preventioninalloftheCounty’shousingbasedprograms.
Createda“WindowFund”forawindowreplacementprogramtoassisthomeand
propertyownerswithmakingErieCountyhomesleadsafe.
ProvidedmatchingfundsforathreeyearHUDLeadHazardReduction
Demonstrationgranttosupportefficient,costeffectiveleadhazardreduction
activitiesinprivatelyownedhomesinErieCountythatareoccupiedand
frequentedbychildrenundertheageofsix.Recruitmentisfocused,butnotlimited
to,theCitiesofBuffaloandLackawanna.
CityPrograms
InMay2016,MayorByronW.Brownunveiledamultiprongedinitiative,“TheCityof
BuffaloLeadHazardControlProgram–Legislate,Collaborate,Educateand
Remediate.”ThisinitiativetoreduceBuffaloresidents’exposuretohazardsfromlead
includesproceduralchangesandkeyamendmentstotheCityCodeandnewresource
allocation,includingadedicatedcallinlinethroughthe311CallandResolution
Center.TheMayoralsoexpandedandstrengthenedtheCity’sprotocolwithrespectto
concernsaboutthepresenceofleadindrinkingwater.Asaresult,theCity,in2016
and2017:
Significantlyincreasedenforcementofexistingbuildingcodes,particularlyaround
exteriorchippingandflakingpaint,byinspecting,andcitingwhereappropriate,
over5,000residencesinzipcodeswiththehighestconcentrationofchildrenwith
EBLLsasdefinedbytheECDOH.
Requiredalllandlordsofnonowneroccupiedsinglesanddoublesconstructed
priorto1978toprovidea“LeadPaintNoticeForm”totenantsexplainingthe
likelihoodofthepresenceofleadpaint,andencouragingtenantstocall311with
concerns.
RequiredlandlordsandpropertymanagerstocomplywiththeEnvironmental
ProtectionAgency’s(EPA)“Renovation,RepairandPainting”(RRP)programthat

*
AlthoughNYSlawonlyrequiresinterventionforelevationsof15μg/dLorhigher,ErieCountybegan
respondingtoelevationsat10μg/dLinApril,2017.
13
reducesleadcontaminationfromrepairandrenovation,includingsubmissionof
RRPcertificationbyallregisteredpropertymanagers.
Loweredthe“actionlevel”forpresenceofleadindrinkingwaterfrom15partsper
billionto5partsperbillion.
Establisheda311calllinefortenantsandhomeownersconcernedwithlead
poisoning,andrevampedtheCitywebsitewithadditionalresourcesand
informationonleadhazards.
Encouragedresidentstocall311forfreewatertestingaspartofanexpanded
testinginitiative.
TesteddrinkingwaterinallCityofBuffaloowneddaycarefacilitiesandsurveyed
fixturesinallCityofBuffaloownedbuildingsaccessibletothepublic.
Activelycollaboratedwiththe(ECDOH)andtheWesternNewYorkCoalitionto
PreventLeadPoisoningtopublicize311andcontinuetodevelopa
comprehensiveleadpoisoningpreventionplan.
CollaboratedwiththeWesternNewYorkCoalitiontoPreventLeadPoisoningto
engageinwidespreadpubliceducationthroughbillboardsandanewwebsite,
WipeOutLead.com.
WorkedwiththeBuffaloPublicSchoolstodevelopleadawarenessmaterialsin
eightlanguagesanddistributedover250,000flyersaboutleadbasedpainthazards
toparents.
Providedfinancialsupportforthisstudy.
BoththeCityandtheCountyhaveimprovedtheircoordinationinrecentyears,
includingcofundingacampaigntoimproveleadawareness.TheCity’sDepartment
ofPermitsandInspectionsisresponsibleforensuringthesafetyofhousingconditions.
TheECDOHisresponsibleforprotectingthehealthofresidents.Toensureleadsafe
housingandhealthychildren,thesetwogovernmentagenciesmusthaveaclose
workingrelationshiptocoordinateappropriateaction.Thisstudydemonstratesanew
commitmenttocollaborationasCityhousingandCountyhealthdatahavebeen
combinedforthisanalysis.
Allofthisactivitysignifiesprogress,butdefeatingleadpoisoningwillrequiremuch
morefromlocalgovernmentandtheentirecommunity.AstheCity,County,
philanthropy,nonprofitsandcommunityleadersrenewedtheircommitmentto
eliminatingleadpoisoningin2016,theiractionsrepresentthefirststepsonthe
journey.Thisreportisintendedtosharpentheircollectiveeffortstoprotectchildren
fromthedevastatingeffectsofleadpoisoningandwasdesignedto:
14
UndertakeacomprehensivereviewofCityofBuffaloandErieCountypolicies
affectingtheriskofpoisoningfromleadbasedpaint;
Addressgapsinexistingpoliciesandprograms;
Comparepoliciesandprogramsinplaceherewiththosebestpracticesestablished
elsewhere;and
Recommendasetofachievable,datadrivenpolicyreformsandevidencedbased
preventionprogramsthatwillhelpthecommunitytakethenextstepstoward
eliminatingthescourgeofleadcontamination.
DemographicsandData
Testing
Bloodleadlevelscreeningofchildrenisanimportantpartofaleadpoisoning
controlstrategy.
NYSDepartmentofHealthregulationsrequireuniversalscreeningforleadpoisoning
ofchildrenundersixyearsold.PrimaryCarephysiciansarerequiredtotestchildrenat
ageoneandagetwo
*
.Complianceischallenging,particularlyamongfamilieswithout
aregularconnectiontothehealthcaresystem.Aneffectiveleadpoisoningstrategy
mustensurethatthisregulationisfollowed.
Laboratoriesandhealthcareproviderswhoprovidetestingatpointofcareare
obligatedtoreporttestresultstotheNYSDepartmentofHealth.Althoughallresults
aretobereportedbyregulation,someprovidersappeartosubmitresultsonlywhen
anEBLLisdetected.
Thevariabilityintestingratessuggeststhatmuchremainstobedonetoensure
compliancewithstatelawgoverningscreening.Althoughprimarypreventionisthe
focusofthisplan,effectivescreeningwillensurethatchildrenwhoarepoisoned
receivetimelytreatment.

*
NYSDepartmentofHealth.Seehttps://www.health.ny.gov/regulations/nycrr/title_10/part_67/index.htm
15
PolicyinAction:LeadHazardTesting
Philadelphiareportsthat88%ofchildrenbornin2012werescreenedfor
leadpoisoningbeforeage3.Inothercitiesthetestingrateiswellunder
halfthatrateorcanonlyberoughlyestimated.Philadelphiaattributesthis
remarkableachievementtoveryaggressivemonintoringofscreening
ratesforallphysicianswithatleast10childrenintheirpractices:“PDPH
[PhiladelphiaDeptofPublicHealth]hasidentifiedbloodleadscreening
ratesforallphysicianpracticesthatserveatleast10children,andhas
startedsendingmessagestothosepracticesnotifyingthemoftheir
screeningrates.Themessagesalsoincludeinformationonchildrenthat
PDPHdoesnothavescreeningresultsfor,sothatproviderscanreachout
tothosefamiliesandaskthemtocomeinforscreening.
*
Testingratesacrossthestateandthecountryvaryconsiderably.
ErieCounty’stestingratehasbeenhigherthanthatofotherNYScountiesinmost
reportedyears.Figure5showstestingratesbycomparisoncounty.
ComparisonsforscreeningandEBLLsareconnectedbutcompromisedbythefact
thattheEBLLrateamongtestedchildrenwilldependonboththetestingrateandthe
county’sunderlyingriskprofile(includingtheageofthehousingstock,relative
povertyandtheowneroccupied/rentalhousingproportion).Unlessnearlyallchildren
arebeingtestedorthechildrentestedareselectedrandomly—neitherofwhich
appearstobetrue—thenthecharacteristicsofthetestedgroupwillhaveasystematic
impactontheEBLLrate.IfErieCountyistestingahighershareof“atrisk”children
than,sayOrangeCounty,thenthereportedEBLLrateforEriewouldnotbedirectly
comparablewiththatforOrange.Moreover,alowerscreeningrateforOrangeCounty
maymeanthatkidswithEBLLsaren’tgettingfound,suggestingthattheactualEBLL
ratetheremaybehigherthanreported.Thetestingratematters,asdoesthe
technologyusedtoconductthetests.

*
Seehttp://www.phila.gov/health/pdfs/Phila_Lead_Disclosure_and_Certification_Law_12_21_11.pdf
16
ECDOHhasaggressivelysoughttoincreasetestingratesforchildrenatboth1and2
yearsofage.Regularoutreachandcontinuingcommunicationwithlargepediatric
practicesismaintainedbymedicalstaff.Everymonthhundredsof“Reminder”letters
aresenttofamilieswithchildrenturningtwotourgethemtogettheirchildscreened.
Theimportanceofscreeningisstressedatalloutreacheventsandduringhomevisits
withfamilies.Anychildundersixidentifiedduringhousingbasedactivitiesforanyof
ECDOH’sprogramsgeneratesaninhousereferraltotheLeadProgramtoverifythat
thechildisuptodateonrequiredscreening.Leadprogramstaffwillfollowupand
makesurethechildisscreened.Childrenwithoutprimarycareorhealthinsuranceare
alsoidentifiedandfamiliesdirectedtoboth.
ComparativeLeadPoisoningStatisticsinNYS
TheNYSDepartmentofHealthcompilesandreportsEBLLstatisticsbyzipcodeand
county.Thewayinwhichthisdataiscollectedandreportedmakesmeaningful
comparisonacrosscountiesproblematicforseveralreasonsincludingthescreening
issuesdescribedabove.Inaddition,thestatethresholdforactionis10μg/dL,while
somecounties(includingErieCounty)haverecentlyreducedthethresholdto5μg/dL.
AlthoughNYShasbegunreleasingstatisticsfortestsshowing510μg/dL,statefigures
inthisreportremainbasedonthethresholdlevelof10μg/dL,
Figure5TestingRateTrendsforComparableNYSCounties
17
ErieCounty’srateofchildrenwithEBLL(atthe10μg/dLthreshold)per1000children
testedhasbeenconsistentlyhigherthancomparablecounties(definedascounties
outsideNYCwithsubstantialEBLLreferrals).
Statefigures,combinedwiththeCGRanalysisofindividualdatapointsforErieCounty,
suggestthattheprobleminBuffalohaschangedlittlesince2008.Thesamecanalso
besaidforsomeotherNYScounties;theEBLLrateinOnondaga,forexample,is
secondhighestandhasincreasedmarkedlysince2011.
HousingCharacteristics&Lead
Contamination
Aneffectiveleadpoisoningpreventionpolicyshouldtargettheneighborhoods,
buildingandtenurecategoriesmostlikelytoendangerchildren.Forthepurposeof
identifyingthehighriskdwellings,theCityofBuffalo’spropertydatabasewasmatched
Figure6EBLLRatesforComparableCounties
18
againsttheEBLLrecordsunderthejurisdictionoftheECDOHforcasesof15μg/dL
andover(thestatemandatedinterventionthreshold).Astheresidentialaddressofan
individualwithanEBLLiscoveredbythefederalHealthInsurancePortabilityand
AccountabilityAct(HIPAA)law,CGRenteredintoaBusinessAssociateAgreement
withtheECDOH,permittingaccesstotheHIPAAprotecteddata.Adescriptionofthe
datamanagementandanalysisprocessplusdetailedtablesappearintheAppendix.
Figure7showsthenumberofEBLLreferralsof15μg/dLorhigherovertimeandthe
typesofpropertywheretheyoccurred.ThenumberofchildrenwithEBLLshas
changedlittlefrom2008to2016withtheexceptionofspikesin2009and2010.Thisis
contrarytotheexperienceofmanycitiesdiscussedintheCaseStudyfoundinthe
appendix.ErieCounty’srateofleadpoisoninghasnotimproved.
BycombiningCityandCountydata,theanalysisshowsthatthemajorityoflead
poisoningisoccurringinoneandtwofamilyhomes,andlessfrequentlyinmultiunit
dwellingswiththreeormoreunits.Roughlyhalfofreferralsareassociatedwith
doubles,typicallywithanupperandlowerunitinBuffalo.Doubles,whichrepresenta
largeportionofBuffalohousing,arenotcoveredbythecity’srentalregistration
requirementifoneoftheunitsisoccupiedbytheowner.
Figure7EBLLReferralsbyPropertyClass(15μg/dL+)
19
Figure8EBLLRatesbyHousingTenure(15μg/dL+)
Figure8showsthatmostEBLLreferralscomefromrentals,withonlyapproximately
20%ofreferralsapparentlyassociatedwithowneroccupieddwellings.80%ofthe
EBLLreferralsarefromaddressesthatareprobablerentals.Forthisreason,primary
preventioneffortshavebeendirectedatthoseproperties.However,additionalpolicies
needtobeputinplacetoaddressthe20%ofpropertiesthatareowneroccupied.
Notethatsomelandlordsmayfalselyclaimtoliveinadoubletoavoidtherental
registrationrequirement,asitisnotrequiredforowneroccupiedunits.
Figure9combinesdataonthetypeandownershipoftheproperty,clearlyshowing
thatrentaldoublesareresponsibleforthevastmajorityofEBLLreferrals.Ownersof
buildingswith4ormoreunits(assessmentclassification411)appeartobemaintaining
theirpropertiestominimizetheleadhazard.Overthenineyearreportingperiod,only
73EBLLreferralswerereceivedforchildrenlivinginapartmentbuildings.
20
Figure9EBLLReferralsbyBuildingCharacteristic(15μg/dL+)
RentalProperties
TheproblemwithEBLLreferralsisdiffused,thusmoredifficulttoaddress.Insteadofa
fewownersormanagerswhoeachhaveresponsibilityforalargenumberofrental
properties,thenumberofownerscontrollingmultiplepropertiesisrelativelylow.In
otherwords,theproblemiswidespreadandnottheresultofjustafew“badactors”.
Onlytwoownersareassociatedwithmorethan10referralsatthislevel.The
distributionappearsinFigure10below.
21
Figure10NumberofReferralsperOwner(15μg/dL+)
Thedatapointsshowthatfewindividualpropertiesare“repeatoffenders.”Fortytwo
addresseshave4ormorereferrals,butmanyofthesereferralsareclusteredaround
thesamedate,suggestingasingleincidentwithmultiplechildrenorrepeatedtesting.
Poverty
Themapsonthefollowingpagesillustratetherelationshipbetweenhousehold
povertyandEBLLreferrals.TheshadedshapesonthemaparetheU.S.Census
Bureau’s“censusblockgroups.”Theshadingshowsmedianhouseholdincome—the
shadingisdeeperwheremedianhouseholdincomeishigher.
Inthefirstmap(Figure11),thedotsplacedineachoftheshapesrepresentsthe
numberofEBLLreferralstoErieCountyfrom20092016.Largerdotsindicatemore
referrals.Alargedotinalightlyshadedareaindicatesmorereferralsandlower
householdincome.AstheCensusBureaudesignstheblockgroupstocontainroughly
thesamepopulation,thesizeofthedotapproximatestheshareofchildrentested
whowerefoundtobeleadpoisoned.
ItisexpectedthathigherEBLLrateswouldbeobservedincensusblockgroupswith
lowermedianhouseholdincome(MHI).Thisisclearlyapparentinthemapfollowing.
*


*
Instatisticalterms,thisassociationbetweenhouseholdincomeandEBLLfrequencycanbemeasured
withthe“correlationcoefficient.”Acorrelationcoefficientof1.0is“perfect”correlation,i.e.thatan
increaseinoneoftheobservedvariablesisassociatedwithexactlythesameincreaseintheother.Ifthe
correlationcoefficientisequalto1.0,thenanincreaseinonevariableisassociatedwithexactlythe
samedecreaseintheother.InthiscasewewouldexpecthigherEBLLtobeassociatedwithlowerMHI.
22

Infact,thecorrelationcoefficientis0.41,whichcanbeinterpretedassayingthatanincreaseof100%
inEBLLrateisassociatedwitha41%decreaseinMHI.Thisisconsideredastrongnegativecorrelation.
inLowIncomeAreas20082016
Figure11MapofEBLLFrequencybyCensusBlockGroup(15μg/dL+)
23
AverageEBLLisSimilarAcrossCensusBlock
Groups20082016
Figure12MapofAverageEBLLover15μg/dLbyBlockGroup
24
Inthesecondmap(Figure12),thedotsrepresenttheaverageoftheEBLLlevel
reportedforresidenceswithinthecensusblockgroup.Itmightalsobeexpectedthat
theaverageEBLLlevelmightalsobehigherinlowerMHIneighborhoods,butthisis
notthecase.Inotherwords,childreninlowerincomeneighborhoodsaremuchmore
likelytogetleadpoisoning.But,forchildrenwithleadpoisoning,theseverityofthat
poisoningdoesnotseemtovarywithincome.
AninteractivemapthatdisplaysthenumberofEBLLreferrals,averageBLL,and
medianhouseholdincomeforeveryCensusBlockGroupintheCityofBuffaloishere:
http://arcg.is/1vjfPT0
PracticalPoliciesforReducingLead
Poisoning
AFrameworkforChange
Policyandpracticeaddressingsecondaryprevention—theresponsetoaprovencase
ofleadpoisoning—arewellestablishedinBuffaloandErieCounty(seeappendicesfor
outlineofcurrentprograms).Thegoalofthisstudyistoidentifystrategiestoreduce
theincidenceofleadpoisoning,i.e.primaryprevention.Thefollowing
recommendationsweredevelopedcollaborativelywithkeystafffromtheCityof
Buffalo,ErieCountyandtheCommunityFoundationforGreaterBuffalo,facilitatedby
theconsultantteamofCenterforGovernmentalResearch(CGR)andPartnershipfor
thePublicGood(PPG),andadvisedbytheWNYCoalitiontoPreventLeadPoisoning.
Additionally,researchintobestpracticesfoundinpeercitieswasusedtoinformpolicy
recommendations;interviewsconductedwithofficials,tenants,landlords,
homeowners,nonprofitstaff,communityleaders,andotherstakeholdersinErie
Countyhelpedinformrecommendations.AlthoughCityandCountystaffhelped
informtheserecommendations,theyhavenotyetbeenconsideredandadoptedby
theCityofBuffaloMayorandCommonCounciloftheCityortheErieCounty
Executive,ErieCountyLegislature,andtheErieCountyBoardofHealth.
Publicdebateanddiscussionwillfollowthereleaseofthisreportandwilllikelyresult
inchangesandmodificationstothepoliciesproposed.Moreover,thisreportdoesnot
includespecificlegallanguageforconsiderationbytheBuffaloCommonCouncilor
theErieCountyLegislature,nordoesthereportincludethedetailedregulatory
languagerequiredtoimplementproposednewpolicies.
25
PresumptionofLeadinPre1978Housing/Leadsafework
practices
Thepolicydiscussionwasframedaroundtheideaofthepresumptionofleadinpre
1978housingandrequiringleadsafeworkpracticesforallworkwhichmaydisturb
paintedsurfaces.
LeadSafe,notLeadFree
Whenadwellingisdeclared“leadsafe,”itisdeemedtoposelittleornoriskto
inhabitantsdespitethelikelihoodthatleadbasedpaintremainsinplace.Adwellingis
declared“leadfree”whenremediationhasremovedallleadcontainingmaterial.
Bringingadwellingtoleadsafestatusinvolvestheapplicationof“interimcontrols,”
principallystabilizingdeterioratedpaintthroughpartialremovalandrepainting,
cleaningofleadcontainingdust,andaddinggroundcovertocontaminatedsoils.
*

Awarenessoftheissuenationwidepromptedaninformativereviewofthelead
poisoningproblemandfederalpolicyresponsebytheHealthImpactProjectofthe
RobertWoodJohnsonFoundationandthePewCharitableTrusts.Thereportwas
publishedinAugust,2017.
†
Thereareanumberofotherreportsthathavecontributed
toourknowledgeoftheproblemandapproachestoaddressit,includingtheGreen
andHealthyHomesInitiative’sStrategicPlantoEliminateChildhoodLeadPoisoning,
‡
FindItFundItFixItPolicyRecommendations
§
fromtheNationalCenterforHealthy
HousingandtheEarthjusticePlanofActiontoPreventChildhoodLeadExposure
**
.
TheCostofRemediation
Thesedeliberationswereinformedbyanacuteawarenessoftheirpotentialcostto
buildingownersandtaxpayers.Inaworldofunlimitedresources,thecommunity
wouldseekpoliciestomakehomesleadfree,notsimplyleadsafe.Theoverwhelming
numberofdwellingslikelytocontainleadpaintmakeseliminationunaffordable,with
93%ofallhousingunitsinBuffalobuiltbefore1980(abanonleadinpaintcameinto
forcein1978).TheAmericanCommunitySurveyestimatesthatthereare
approximately64,300rentalunitsinBuffalo,mostofwhichwerebuiltbeforelead
paintwasbanned.TheECDOHestimatesthatthecostofremediationthatincludes
replacing“frictionsurfaces”—e.g.selectedwindowsanddoors,averages$9,000to

*
NationalCenteronHealthyHousing.Seehttp://www.nchh.org/1012/html/interim_controls.htm
†
Seehttp://www.pewtrusts.org/~/media/assets/2017/08/hip_childhood_lead_poisoning_report.pdf
‡
Seehttp://www.greenandhealthyhomes.org/sites/default/files/GHHIBlueprintforActionFinal.pdf
§
Seehttp://www.nchh.org/Portals/0/Contents/FFFActionDriveTransitionDocument_Admin
Version.pdf
**
See
https://earthjustice.org/sites/default/files/files/President's%20Task%20Force%20Letter%20FINAL.pdf
26
$11,000perunit,basedonunitsrenovatedaspartoftheCounty’sHUDfundedLead
BasedPaintHazardControlgrants.TheseprojectsweresubjecttoHUDguidelines,
whichrequirecertifiedLeadAbatementcontractors,ratherthanRRPcertification,
whichincreasesthecost.IflimitedtorenteddwellingsintheCity,thebillforsucha
programcouldtotalover$400million.Evenatthiscost,manydwellingunitswould
stillnotbeleadfree,althoughfrictionsurfacereplacementprovidesgreaterassurance
ofcontainment.
Defeatingleadpoisoningwillrequireresourcesacrossthecommunityincode
enforcement,leadremediation,increasedprivateandpublicsectorinvestment,and
communityengagement.Therecommendationsin
thisreporthavemadeeveryefforttoarriveatpolicies
thatwillachievemeaningful,butaffordable,reductions
inleadpoisoning.Thecostofremediatingleadper
homerangesfromafewhundreddollarstothousands,
dependingonthescopeofwork.GiventheageofBuffalo’shousingstock,theneedis
significant,andwillrequireconsistentresourcesfortheforeseeablefuture.
Currentresourcesforleadremediationcomefrombothpublicandprivatefunding.
TheECDOHhasledthechargeonpublicfundingforleadremediation,winning
regularleadgrantsfromHUD’sOfficeofLeadHazardControlandHealthyHomes,
includingtheLeadHazardReductionDemonstrationgrant.Italsoreceivessupport
fromNYS’sDepartmentofHealthfortheirChildhoodLeadPoisoningPrimary
PreventionProgramtovisithomesforeducationandenforcement.Aspartofthe
CountyExecutive’sLeadPoisoningPrimaryPreventionInitiative,theCountyalsohas
moneysetasideforawindowreplacementprogramthatassistspropertyownersand
homeownerswithreducingleadhazards.
Inaddition,leadremediationiscoveredbyahostofgrantsfromstateandfederal
sourcestotheCityofBuffaloandcommunitybasedorganizationsforresidential
rehab,energyretrofits,andweatherizationthatultimatelyaddressleadhazardsinthe
courseoftheirwork.TheCityrecentlygeneratedadditionalfundsforleadcontrol
measuresthroughanincreaseintherentalregistrationfee.TheCityofBuffaloalso
offersa50/50RehabLoanProgramforonehalfoftherehabandrepaircosts(upto
$25,000)forcoderelatedrepairsandleadbasedpainthazardreductiontopurchasers
andnewownersinexistingoneandtwofamilyhomes.
In2010,theNYSAttorneyGeneral’sOfficeawardedtheCommunityFoundationfor
GreaterBuffalo$2milliontoestablishtheGreen&HealthyHomesInitiativeBuffalo
andfundhomeinterventionsandleadremediationefforts.In2014,NYSAttorney
General’sofficeawardedtheCommunityFoundation$166,000fortheNewAmericans
Projectforoutreachtoimmigrantsandrefugees.AttorneyGeneralSchneiderman
“Thebiggestdaytodayissue
isthelackoffunding.”
JudgeCarney,Housing
27
investedanadditional$346,825in2016tobeusedforleadremediationwitha
preferenceforwindowreplacement.
Rochester’sexperienceindicatesthatwhilesomeviolationsarecostlytoremedy,
manyarenot.WhileBuffaloandRochesterhavedifferenthousingstocks,thereare
enoughsimilaritiesbetweenthetwotowarrantacomparativeapproach.Asurveyof
RochesterlandlordsconductedbyCGRaftertheprogramhadbeeninplacefor
severalyearsfoundthefollowing
*
:
Onethirdofrespondentsdidnotspendanymoneyonrepairsinpreparingforor
respondingtoaninspection,37%spentbetween$1and$1,000,andtheremaining
30%spentmorethan$1,000,withwindowreplacementscontributingtohigher
costsforsomelandlords.
Ofthoserespondentswhoreportedspendingmoneyonrepairs,theaverage
amountwas$2,618,withthemediancostabout$950.Lessthanhalfofthese
landlordsreplacedwindows;morethanthreequartersrepairedorpainted
windows.
Amajorityofrespondentsreporteddoingtheirownleadrepairwork,which
promptedthestudyteamtorecommendthecitycontinueitseffortstoeducate
andtrainworkerssotheydon’tinadvertentlycreatenewhazards.
Theaveragecostofclearingasingleviolation(morethanoneviolationcanbe
cited)wasabout$150.Duringthestudyperiod,landlordscouldapplyfora$100
granttohelpdefraythiscost.(Note:“Thirdpartyclearance”referstoaninspection
afterremediationthatisconductedbyaprivatefirm,nottheCityofRochester.
Thesefirmsareroutinelyauditedbythecityofficials.)
It’simportanttonotethatthissurveyoccurredafterRochester’sleadpolicyhadbeen
inplaceseveralyears,andthelowcoststoclearinspectionmightreflectthefactthat
manylandlordshadalreadyremediedthelarger,moreegregiousandcostlyviolations
topasstheinitialinspection.Nevertheless,thecostofmakingthesehomesleadsafe
isaffordable.Thewelfareofourchildrendemandsnothingless.Properly
maintainedandmonitored,socalled“interimcontrols”thatachieveleadsafety
withoutleadremovalhavebeenproventobeeffective
†
andarecriticaltoaddressing

*
Boyce,Sarah,etal,“AnEvaluationofRochester’sLeadLaw:20062008”CenterforGovernmental
Research,December2008.Seewww.goo.gl/k2m6e1
†
"Adjustedfloorandsilldustleadgeometricmeandustleadloadingsdeclinedatleast85%frompre
interventionto12yearsaftertheinterventionforhomeswithallreplacementwindows,somewindows
28
leadhazardsinalargernumberofpropertiesduetothelackoffinancialresourcesin
manyinstancesforownerstoconductfullleadabatementoftheirproperty.
TheRoleofEnforcement
Enforcementofhousingandsanitarycodesarevitaltotheprimarypreventionoflead
poisoning.Strongpolicyiscriticalbutwillnotbesuccessfulifitisnotimplemented.It
cannotbeemphasizedenoughthatitisnotenoughtopassanordinanceifthat
ordinanceisnotgoingtobeenforced.Thisthemeappearsrepeatedlyinthecase
studies.
ProtectingOccupantsofRentalHousing
CityofBuffaloRentalRegistry
Eightypercentofleadpoisoningoccursinrental
propertiesintheCityofBuffalo,sowhenfocusing
primarypreventionactivities,nothingismore
importantthantheleadsafeconditionand
maintenanceofrentalhousing.
ThreesectionsoftheBuffaloCityCode
specificallyaddressthemaintenanceand
registrationofrentalhousing.Theselawscanbe
foundinChapter264,theRentalDwellingUnit
Registration;Chapter265,detailingrequirements
forcertainindividualswhomustregisteras
“PropertyManagers,”andChapter261,which
outlinesspecificpracticesforleadsaferenovations.
AneffectivemechanismforreducingleadexposureinBuffalo’srentalunitsisto
improveupontheCity’sRentalRegistrationprogram,whichbeganin2005.Itwas
revisedin2016toincludeleadpainthazardsafetymeasures,andfeeswereraisedin
February2018.Theprogramcurrentlyrequirestheregistrationofallnonowner
occupiedsingleandtwofamilyhomesandapaymentofasmallfirstyearfee$20
dollarsforsingleunitrentalsand$40fordoubles.
*
Theownerisrequiredtopayan

replacedandnowindowsreplaced.”Windowreplacementwasfoundtobemoreeffective,butinterim
controlsstillreducedleadlevelsdramaticallywithoutreplacement.Dixonetal.Windowreplacement
andresidentialleadhazardcontrol12yearslater.EnvironmentalResearch113:1420(February2012).
https://www.sciencedirect.com/science/article/pii/S0013935112000618
*
RentalpropertieswiththreeormoreunitsinthesamebuildingdonotfallundertheRental
RegistrationprogrambutareinsteadsubjecttotheCity’sMultipleDwellingsLaw,whichrequires
ownerstoobtainaCertificateofOccupancypriortorentingunits,discussedinfra.
“Whenthereisaserious
problem,tenantsusuallymove
outimmediately,beforethe
inspectorscome.Butoncethey
moveout,theinspectionis
cancelled,thecaseisdropped,
andnewtenantsmovein.We
needawaytoeitherexpedite
inspectionsorensurethatthe
inspectorsstillcomeevenifthe
tenantshavemovedout.”
29
annualrenewalfeethereafterof$25forsingleunitrentalsand$50fortwounit
rentals.WhilethelawcurrentlyallowstheCityofBuffalotoinspectinteriorswhere
leadpainthazardsaresuspectedandfinelandlordswithdeterioratedpaint(which,in
olderhomesispresumedtocontainleadbasedpaint);itdoesnotrequirean
inspectionasaconditionofregistration.Additionally,theCityofBuffaloDepartment
ofPermitsandInspectionshasbeenconductingsystematicinspectionsofresidential
exteriors,issuingcitationsandticketsfordwellingswithchippingandpeelingpaint.
*
PresentlytheRentalRegistrationlawcontainsthefollowingprovisions:
ARentalRegistrationfeeisrequiredtorentsingleanddoubleunits.
TheRentalRegistrationfeeexemptsowneroccupiedunits.
TheRentalRegistrationmustberenewedannually.
OwnerssubjecttotheRentalRegistrationfeeandwhosepropertieswerebuilt
before1978mustcertifythattheyareawaretheirpropertiesmaycontainleadand
areawarethattheymustutilizeleadsafemethodswhenengaginginany
renovationorrepair.
Ownersmustprovidetenantswitha“LeadPaintNoticeForm”whichexplainslead
basedpainthazardsandencouragestenantstocall311withconcernsand
submitanattestationthatsuchformwasreceivedandsignedbythetenant.The
attestationmustbefiledwiththeCitytorenewtheregistrationfee.
Ownersofdwellingsfoundtocontainleadhazardsmustremediatethehazardand
maybesubjecttofines,butaninspectionisnotrequired.TheDepartmentof
PermitsandInspectionsmayrevoketheRentalRegistrationcertificateifthe
remediationisnotperformed.
Buildingownerswhenseekingpermitsforrenovationmustcertifythatthe
companyandindividualsperformingtheworkareRRPcertifiedbytheEPA.
RecommendedChanges
WhenrenewingRentalRegistrationinthefuture,ownersofrentalhousingsubject
totheRentalRegistrationrequirement—i.e.ownersofsingleandtwofamilyhomes
(“doubles”)forrentshouldberequiredtoobtainevidenceofhavingpasseda
leadinspectionfordeterioratedpaint.TheCity’sDepartmentofPermitand
InspectionServicesshouldissuecertificatesofcompliancewhichmustbe

https://www.epa.gov/enforcement/fy2016enforcementactionsleadrenovationrepairand
paintingrulerrp
*
Of5,200inspectionscompletedrecentlybytheDepartmentofPermitsandInspections,11%were
citedfordeterioratingexteriorpaint.
30
conspicuouslypostedinrentalunits.Therecommendationisconsistentwith
practicesinRochester,Detroit,ToledoandBaltimore,whichalsohavearental
registrythatrequireaninspectionpriortooccupancy.Itisalsoconsistentwitha
recommendationfoundintherecentlyreleasedCityofBuffaloHousing
OpportunityStudy.
Approximately39%ofallhousingintheCityofBuffaloconsistsofdoubles.Ifthe
owneroccupiesoneofthetwounits,theentiredwellingisexemptfromRental
Registration.WerecommendtheBuffaloCommonCouncilbringtheseunits
underthepurviewofRentalRegistrationrequirement.Werethistooccur,the
samedeterioratedpaintinspectionrequirementwouldapplytotherentedunitin
theowneroccupieddouble.Theunitoccupiedbytheownerwouldcontinueto
beexemptfromtheinspectionrequirement.Basedonguidelinesestablishedby
theDepartmentofPermitsandInspections,theotherunitwillalsobeexemptif
occupiedbyafamilymember.DetroitandSanDiegopresentlyrequireallrental
units,includingoneandtwofamilyhomestobeincludedontherentalregistry,
regardlessofwhetheroneunitisoccupiedbytheownerornot.
Phasing
Giventhelargenumberofdwellingsinvolved,aphaseinprocessisrecommended
toscaleuptocaptureallrentalhousingwithinasixyearperiod.
ThephaseinscheduleshouldbebasedongeographicconcentrationofEBLL
referrals,thusputtingthecensusblockgroupsatgreatestriskintheearlyyearsof
theprogram.
CityofBuffaloStaffingforInspections
TheCityofBuffaloDepartmentofPermitandInspectionServicesand/oraprivate
firmornonprofitorganizationshouldbeempoweredtoconducttheinspections.
FeeschargedbytheCityofBuffaloshouldbesettocovertheCity’scostsof
increasedinspectionsandtoencouragetheexpansionofprivateinspection
services.
TheDepartmentofPermitandInspectionServicesshouldestablishstandardsfor
compliancewiththeCity’sordinancegoverningdeterioratedpaintanddevelop
guidelinesforprivateinspectionservicesbycompaniesthatareaccreditedand
unrelatedtotherentalpropertyowner,includingaccreditationstandardsforthird
partyinspectors,propertycertificationinspectionprotocols,andthetraining
requirementsofworkers.
Asthesenewinspectionswillcreateanewmarketfortheprivatesector,SUNYErie
orothertrainingprovidersshouldexplorethecreationofatrainingprogramfor
31
Cityresidentswhowishtobecertifiedtoinspectcovereddwellingsortoprovide
leadhazardreductionservices.NOTE:TheErieCountyactionplantitledInitiatives
foraSmartEconomy2.0includesatsection4.5.8.btheideaoftrainingveteransto
doleadremediationwork.
Anythirdpartyinspectionsystemthatisdevelopedtomeettheproperty
certificationstandardsshouldbeaccompaniedbyspecialmeasuresthatareputin
placetoprotectagainstfraudulentthirdpartycertifications,includingrandom
auditsofthirdpartyfirms,sitespotchecksanddebarmentoffirmsfoundtohave
issuedfraudulentreports.Arobustauditprocesswillbenecessarytoensure
complianceandtoprotecttheintegrityofthethirdpartysystem.
LeadClearanceRenewals
ThefirstinspectioncertificateobtainedaspartoftheRentalRegistrationrenewal
willexpireinsixyears.
Renewalsoftheinspectioncertificate(aftertheinitialsixyearphasein)willexpire
everythreeyears.
Violations
Ownersofdwellingsthatfailaninspectionfordeterioratedpaintshouldbe
requiredtosubmitproofthattheyorthepersonperformingrepairsiscertifiedor
hasattendedanRRPcertificationtrainingprogram(ifnotalreadycertified)before
beginningrepairs,asrequiredbyfederallawunderEPAregulations.
Asecondinspectionshouldberequiredaftertheworkhasbeencompletedand
additionalremediationandinspectionsconducteduntilcertificationisobtained.
Noncompliance
Landlordswhofailtorenewtheirrentalregistrationaccordingtotheproposed
regulationsshouldbesubjecttograduatedfinesperascheduletobedeveloped
andenforcedbytheDepartmentofPermitandInspectionServicesaswellasan
automaticinteriorinspection.
PersistentviolatorsshouldbereferredtoHousingCourt.AstheCityandCounty
bringcasestoHousingCourt,itisrecommendedtheyexplorealloptionsatthe
disposalofthecourttomitigateanyunnecessarydisplacement.
IncaseswhereoccupancyisdeemedunsafeutilizingestablishedNYSBuildingand
FireCode,landlordsshouldberequiredtoprovidetemporaryhousingtotenants
duringrepairandrenovation.
Inaddition,theNewYorkStateOfficeoftheAttorneyGeneral(NYSOAG)hastaken
anactiveroleinenforcement.TheNYSOAG’sofficehasinvestigatedandreached
32
settlementsinnumerouscasesacrossthecityofBuffaloagainstlandlordswitha
historyofpropertyviolations,includingleadbasedpainthazards.Maintainingopen
communicationwiththeNYSOAG’sOffice,ECDOH,theCityofBuffaloandtheU.S.
DepartmentofHousingandUrbanDevelopment(HUD)shouldcontinueinorder
toprosecutelandlordsinviolationandbringpropertiesuptocode.
PolicyinAction:RentalInspectioninRochester
AkeytoprimarypreventioninRochesterisgainingaccesstotheinterior
ofunitsfortestingandrequiringavisualexteriorandinteriorinspection
forpossibleleadsources.ReportedEBLLscreeningresultsareusedto
identify“highrisk”housingbyZIPcode,whichrequiresfurtherpassing(or
clearance)requirementswithadustwipe,regardlessofvisualinspection
results.Inspectionsarecarriedoutbycitycertifiedriskassessorsorathird
partyleadbasedpaintinspector(certifiedbytheEPA’sRRPstandards),the
latterofwhicharesubjecttorandomizedauditstoensureconsistencyin
compliance.
“Allinspections,including,butnotlimitedto,inspectionsperformedas
partofanapplicationforacertificateofoccupancy...,arenewalofa
certificateofoccupancy,orbaseduponthefilingofacomplaint,shall
includeavisualassessmentfordeterioratedpaintandbaresoilviolations.
Withrespecttounitsinstructurescontainingfiveorfewerunitsand
locatedinthehighriskareaidentifiedbytheMayorortheMayor's
designee,whenthevisualassessmentidentifiesnointeriordeteriorated
paintviolation,theownershallcausedustsamplestobetakenand
certifiedtestresultstobeobtained...”
*

*
Seehttp://www.cityofrochester.gov/article.aspx?id=8589939520.
33
CertificateofOccupancyforAllResidential
Housing
TheCityofBuffalorequiresthatcertainproperty
ownersobtainCertificatesofOccupancy.Toobtain
acertificate,theownermustsubmitanapplication
andagreetoa“finalinspection”conductedbythe
City.Theinspectionrequirescompliancewithall
NewYorkStateBuildingCodesandlocal
ordinancestoensurehealthandsafety,including
remediationofdeterioratedinteriorandexterior
paint.Iftheapplicantdoesnotpasstheinspection
duetoleadhazards,theprovisionsofChapter129
3(F)areapplied.PursuanttoChapter1293(F),afullremediationmustoccurbefore
theCertificateofOccupancyisissuedandthepropertyiseligibleforoccupancy.
FailuretopassthatinspectionwillresultinrevocationoftheCertificate.Moreover,
leadbasedpaintviolationsaresubjecttofines,includinga$105fineforchippingand
peelingpainteitherontheexteriororinterioroftheresidence.
UndercurrentStatelaw,onlyownersofbuildingswiththreeunitsormoreare
requiredtoobtainaCertificateofOccupancyandmustrenewtheCertificateevery
threeyears.Thispolicyisonefactorinfluencingthelowrateofleadpoisoningamong
apartmentbuildings:Overthenineyearreportingperiodcoveredbythisstudy,only
73EBLLreferralswerereceivedforchildrenlivinginapartmentbuildings.
*
Although
someownersofsinglesanddoublesrequestCertificatesofOccupancydueto
requirementsoffinancialinstitutionsatthepointofsale,theCityofBuffalodoesnot
currentlyrequireone.ItisrecommendthattheCityofBuffalophaseinsucha
requirementatpointofsale.
Recommendations
ACertificateofOccupancyshouldberequiredforallpropertiesatthetimeof
sale.Basedonsalesofresidentialpropertiesof4unitsorlessfrom20142016,this
provisionwouldaffectabout1,900propertieseachyear.
Recognizingthatsomesellerswilllackthefinancialresourcestocorrect
deficiencies,itisrecommendedthatsellersbepermittedtosellpropertieswitha
conditionalCertificateofOccupancy,assumingtherearenoimmediatethreatsto

*
ACertificateofOccupancyisalsoneededtobuild,addto,oralteranybuildingthatwillbeoccupied.
Notably,thisprovisionexcludes“enlargementsorextensionsofoneandtwofamilydwellingswhere
theoriginalfloorareaisnotincreasedbymorethan25%”thereforelimitingtherequirementtoonly
newbuildingandbuildingsthatareaddingsignificantlytotheoriginalfloorplan.
“Wedidn’twanttocallthe
countytohaveourhometested
forleadbecauseweknewwe
hadotherhousingviolationsand
didn’twanttogetcitedforthem,
aswell.Wecouldn’taffordtofix
everythingatthesametime.”
Homeowner
34
lifeorsafety.Thebuyerwillberequiredtohavethepropertyinspectedwithinsix
monthsoftakingpossessionorhavetheCertificaterevoked.Nopropertymaybe
grantedasecondconsecutiveconditionalcertificateofoccupancy.
Enforcementprocedures,includingagraduatedscheduleoffines,ifdeemed
appropriate,shouldbedevelopedbytheDepartmentofPermitandInspection
Services.Currentfinesremainunchangedsincetheoriginalenablinglegislation.
35
EnforceLeadsafeworkpractices
Althoughtheforegoinghasfocusedattentionon
homeinteriors,theriskofleadpoisoningfrom
exteriorsourcesissignificant.In2004,ErieCounty
compiledhistoricalinspectiondatafromhousing
unitsoccupiedbyachildwithaconfirmedEBLL
of20μg/dLorhighertoidentifythebuilding
componentsmostoftenassociatedwithlead
poisoning.Thedataindicatesthatbyalarge
margin,exteriorcomponentsaresignificant
contributorstoleadpoisoningandalsoareclosely
correlatedwithinteriorhazards.
Commonsourcesofleadinhousingunitswherechildrenarepoisonedarewindows,
doors,sidingandporches.Thiscontributestoaseasonalriseofleadpoisoningratesin
thesummer,aswindowsgetopenedandclosed,leaddustblowsinsidefromexteriors,
andleaddustfromsoilandporchesgetstrackedintohomes(seeFigure13).Givenits
durability,leadbasedpaintwasmorecommonlyusedonexteriorsurfacesthan
interiorandwasphasedoutofexterioruseslaterthanininteriorapplications.
Themostcommonsourceofleadcontaminationinresidentialsoilisdeteriorated
paintontheexteriorofhomes,oftenexacerbatedbydeferredmaintenanceandthe
useofunsafeworkpracticesthatcanprecedepainting.Currently,theErieCounty
SanitaryCoderequiresleadsafeworkpracticesforremediationofpre1978housing.
Cityordinancesaddressthissourcebyidentifyingdeterioratedpaintascodeviolations
andbyrequiringleadsafeworkpracticesforremediation,consistentwiththeEPA’s
Renovation,RepairandPaintingRule(RRP).NeithertheCitynortheCountycan
directlyenforcetheEPA’sRRPRule.Contractorsarerequiredtobeincompliancewith
theEPA’sRRPRule.However,thereisconsiderablestrainontheEPA’sresourcesfor
outreachandenforcement,resultinginonly123enforcementactionsacrossthe
countryduringfiscalyear2016,withonly3inNewYorkState.
*


*
Seehttps://www.epa.gov/enforcement/fy2016enforcementactionsleadrenovationrepairand
paintingrulerrp
“Mygrandsonwasrecently
diagnosedwithleadpoisoning.I
thinkthemostlikelysourcewas
hisgrandmother’shouse,who
oftenbabysitshim.Shewas
doingrenovationsonherown
andhiringpeoplesheknows,so
hewasexposedtoalotofdust
there.”
Buffaloresident
36
Finally,thereisademonstratedcorrelationbetweentheconditionofexteriorpaint
andinteriorpaint.Whenahomehasdeterioratingexteriorpaint,thehomeismore
likelytohavedeterioratedpaintintheinterior
*
.
Recommendations
Oneofthekeythemescomingoutofthepeercitiesreviewistheimportanceof
enforcement.TheabilitytoenforceRRPandleadsafeworkpracticesiskeyfor
boththeCityandtheCounty.Withlimitedresourcesforlocalenforcementanda
shiftinemphasisattheEnvironmentalProtectionAgency,itisrecommended,with
thesupportoftheWesternNewYorkCoalitiontoPreventLeadPoisoning,that
NYSassumeresponsibilityforadministrationandenforcementoftheRRP

*
Thisisconfirmedbyapooledanalysisofadozenstudies.SeeLanphear,etal,“TheContributionof
LeadContaminatedHouseDustandResidentialSoiltoChildren’sBloodLeadLevels”,ENVIRONMENTAL
RESEARCH,SECTIONA79,51—68(1998)ARTICLENO.ER983859
Figure13SourceofLeadContaminationinHomes
37
program.AccordingtotheEPAwebsite,14Statesand1TribeintheU.S.have
adoptedtheEPALeadAbatementProgramandenforcementofRRP.
TheECDOHandDepartmentofPermitsandInspectionsshouldseekthe
permissionofownerstoinspectadwelling’sinteriorwhentheexteriorpaintshows
signsofneglect.Iftheownerrefuses,theDepartmentshouldseekaninspection
orderfromHousingCourt.ThisrecommendationalignswithstatutesinToledo,
WashingtonD.CandSanDiegothatgrantcityadministrationbroadlatitudeto
conductinspectionswhentheappearanceofastructurewarrantsinvestigation.
TheDepartmentofPermitsandInspectionsshouldbeempoweredtoissue
citationswhencontractorsarefoundtobeignoringleadsafeworkpracticesand
developasetofgraduatedfinestoensurecompliance.Thisrecommendationisin
linewithbestpracticesseeninBurlington,VTandGrandRapids,MI.
ErieCountyshouldamendtheSanitaryCodetostrengthenenforcementoflead
safeworkpracticesincludingStopWorkOrders,stipulationsandfines.
Buildingpermitsforrepairandrenovationshouldbeissuedonlyiftheapplicant
providesproofthatworkersareEPAcertifiedRRPworkers.Asimpleattestation
shouldnolongerbedeemedsufficient.ForNewYorkStateexamples,boththe
VillageofBrockportandTownofIrondequoitinMonroeCountyrequiresuch
proof.
Developadditionalleadworkerandsupervisortrainingtoincreaseleadcontractor
capacityincludinggreenjobtrainingprogramsthatprovidefreetrainingand
accreditationfeessupporttounemployed,underemployedandreentryresidents
inatriskcommunitiesinthecity.
AddressSoil
Leadinsoilcanpoisonchildrenthroughdirect
contactandingestionofcontaminatedsoil.In
additiontothedeterioratedpaintresultingfrom
deferredmaintenanceandtheuseofunsafework
practices,industrialusesoftenleftcontaminated
soilaswell.Uncoveredsoilcanbeasourceof
leadcontaminationforyoungchildren.Presently,
thebuildingcoderequiresthatgroundcoverbein
place.Inregardtoothersourcesofleadoutdoors,housingdemolitionmayboth
disturbcontaminatedsoilandproducedustthatisleadcontaminated.Lastly,
abandonedindustrialsitescanbesourcesofcontamination.Soiltestingcanbeseen
asabestpracticeinChicago,Illinois.
“Leadinthesoilisabigproblem
inthesummer.Thewindblows
itaround,andthenpeopletrack
it(andtheleadinit)intothe
house.”
LeadPreventionSpecialist
38
Recommendations
InspectorsfromtheDepartmentofPermitsandInspectionsshouldbeempowered
tocitepropertyownerswhenthegroundcoverhasbeendisturbedandapplya
graduatedseriesoffinestoachievethisgoal.
Inadditiontocomplyingwithleadsafepracticesduringthedemolition,theCity’s
demolitionspecificationshould,consistentwiththeGreenCoderequirement,
specifythatsitesofhomesthathavebeenremovedshouldbeseededwith
grassorothervegetationassoonaspossibleafterthedemolitionhasbeen
completed.TheCityshouldincludethecostofseedinginthedemolition,
especiallyasthenumberofdemolitionshasdecreased.
PolicyinAction:EPARemovesSoilinChicagoNeighborhood
ContaminatedbyIndustrialSources
*
Chicago’slongindustrialhistoryhasleftatoxiclegacythatincludes
contaminationofresidentialsoilswithlead.Ascleanuphasproceeded,
additionalsiteshavebeendiscoveredandremediatedorscheduledfor
remediation.
In2013theU.S.EPA,inpartnershipwiththeCityofChicago,
completedcleanupoftheformerLoewenthalMetalssiteand
adjacentproperties.
TheBurlingtonNorthernSantaFe(BNSF)railroadiscooperating
withEPAonadditionallandsitownsneartheLoewenthalsite.
U.S.EPAhasalsobeencoordinatingtheremediationoflead
contaminationinthenearbyPilsenneighborhood,theprobable
resultofactivitiesbyH.Kramer&Co.Cleanupofthe580acresite
consistedofexcavatingcontaminateddirtintheyardsandgardens
ofhomeswithleadinsurfacesoilgreaterthan400partsleadper
millionpartssoil.AsofSeptember30,2017,yardsat15properties
wereexcavated,filledinwithcleansoilandrestored.

*
Seehttps://www.epa.gov/il/environmentalissueschicagoslittlevillagepilsenneighborhoods
39
TenantsReceiving
Assistance
Giventhedataavailable,80%ofpoisoningoccurs
inrentalproperties,sowhenfocusingprimary
preventionactivities,itisimperativetostrengthen
effortsmadewhentheCountyoranonprofit
agencyishelpingtopayforortoplaceafamilyin
rentalhousing.
Recommendations
IncaseswheretheErieCountyDepartmentofSocialServicesisguaranteeinga
securitydepositforaclientwithachildtwoyearsofageoryounger,itshould
triggeramoveininspectionbyaCountySanitariantoinspectforhazardsand
conditionsconducivetoleadpoisoning,includingtheconditionofallpainted
surfacesinpre1978housing.DepartmentofSocialServicespreinspection
documentsshouldincludeareviewofchippingandpeelingpaint.
Nonprofitagenciesthatplacepeopleintorentalhousing,suchasrefugee
settlementagenciesandsupportiveandtransitionalhousingproviders,should
ensurethataleadclearanceforthoseunitshasbeenobtainedpursuanttothe
requirementsoftheRentalRegistrationcertificate.
“Theydon’tcondemnthe
property,sonewtenantsmove
in.Moststaywithout
complainingbecausethebad
conditionsarestillastepup
fromthelastplacetheywere
living.”
Communityorganizer,Buffalo
40
PolicyinAction:VermontEssentialMaintenancePractices(EMP)Law
*
AllrentalpropertiesinVermontthatwerebuiltbefore1978arerequiredto
complywiththislaw,whichwaspassedin1996andupdatedin2008.It
requiresthatpropertyownersperformEssentialMaintenancePractices
annually:
Inspecttheinteriorandexterioroftheproperty,includingout
buildings.
Identifyareaswherepaintisinpoorcondition,andpromptlyfixit
usingleadsafeworkpractices.
Verifytheinstallationofcoilstockinsertsinwindowwells.
Removeanyvisiblepaintchipsonthegroundoutsidethebuilding.
Performaspecializedcleaningincommonareasandattenant
turnover;useaHEPAvacuumtoremoveleaddust.
Takeprecautionswheneverremodelingtopreventthespreadof
leaddust.
SignaComplianceStatementcertifyingthatEMP’shavebeendone
andprovideacopytoyourtenants,insurancecarrierandVT
DepartmentofHealthatleastevery365days.
LowerStatutoryStandardforEBLL
Nosafebloodleadlevelinchildrenhasbeenidentified.Evenlowlevelsofleadin
bloodhavebeenshowntoaffectIQ,abilitytopayattention,andacademic
achievement.Effectsofleadexposurecannotbecorrected.Until2012,childrenwere
identifiedashavingabloodlead“levelofconcern”ifthetestresultis10ormoreμg/dL
ofleadinblood.TheCenterforDiseaseControl(CDC)isnolongerusingtheterm
“levelofconcern”andisinsteadusingthereferencevaluetoidentifychildrenwho
havebeenexposedtoleadandrequirecasemanagement.Expertsnowusea
referencelevelof5μg/dLtoidentifychildrenwithEBLL.Priorto2012,bloodlevels
below10μg/dLmayormaynothavebeenreportedtoparents.Thenewlowervalue
meansthatmorechildrenwilllikelybeidentifiedashavingleadexposure,allowing
parents,doctors,publichealthofficials,andcommunitiestotakeactionearlierto
reducethechild’sfutureexposuretolead.
Presently,NewYorkStateuses10μg/dLasthestatutorystandardforEBLL.WhileErie
Countyhasproactivelyloweredtheiractionlevelformedicalfollowupto5μg/dL,the

*
See
http://www.healthvermont.gov/sites/default/files/documents/pdf/ENV_AL_RentalPropertyOwnerFactShe
etFinal6.9.08PDF.pdf
41
restoftheStatehasnotfollowedsuit.NewYorkStateshouldlowerthedefinitionof
EBLLsinthePublicHealthLawto5μg/dLasrecommendedbytheCDC,acrossthe
state.Additionally,NYSDepartmentofHealth(DOH)uses15μg/dLasan
environmentalactionlevel.WerecommendthatNYSDOHlowertheenvironmental
actionlevelto10μg/dL.
Whileloweringtheactionlevelforenvironmentalinterventioninthestateandincities
suchasBuffaloisnotprimaryprevention,itwillpreventhigherlevelleadpoisonings
andthepossiblepoisoningofsiblingsinthesamehome.StatessuchasMaryland,
Maine,Michigan,Nebraska,NewHampshire,NewJersey,OregonandNorthCarolina,
havealreadyloweredtheiractionlevelto5μg/dLforbothmedicalcasemanagement
andenvironmentalinvestigation.Whileimprovedleadtestingandscreeningratesare
animportantcomponentofapreventionstrategy,theyareineffectiveifthecity,
countyandstatedonotfollowupwiththeappropriateenvironmentalinvestigation,
enforcementandinterventiontreatmentsystemstoreduceknownleadhazardsin
homesofchildrenidentifiedasbeingatthemostrisk.Inadditiontoloweringthe
statutorystandard,NYSshouldalsoprovidethenecessaryresourcestolocal
governmentstoimplementthelowerstandard.
PublicEducation
EmpoweringFamilies
Effectivepubliceducationisthebedrockof
publichealthasitempowerscitizensto
advocatefortheneedsoftheirfamiliesand
neighbors.InOctober2016,theCityofBuffalo
developedleadeducationflyersin8
languages,ofwhichover250,000havebeen
distributed.MayorBrownandSuperintendent
Dr.KrinerCashannounceddirectmailingsto
all18,000+BuffaloPublicSchoolfamilies
targetedbylanguageinDecember2016.
Effortssuchastheseleadflyersareagreat
starttoengagethecommunityatlarge.
Additionally,NeighborhoodLegalServicesandLegalAidprovideassistanceand
educationtotenantsregardingtheirrights.LeadpoisoningeducationbytheCity,
County,medicalcommunity,andnonprofitcommunityshouldbetargeted,
interactive,specificandpractical.
GiventheattentionplacedonthisbytheFlintexperience,therearemanycitiesand
statesplacinganewemphasisonleadpoisoningandhealthyhousing.States,
“Ourneighborstoldusthatas
longasmysondidn'teatpaint
chips,hewouldbefine.Butthen
afingerpricktestsaidthathe
hadanEBLLof5.5.Onlythen
didtheCountycomeouttotest
ourhouseandgiveuslead
information,whichtoldusthatit
wasthedustinthehouse,not
paintchips”
ResidentonBuffalo’sEastSide.
42
includingNewYork
*
,havedevelopedabroadsetofmaterialsaimedatresident
education.MinneapolispartneredwiththeStateofMinnesotatocreateavideoon
leadsafetyinEnglish,Hmong,Khmer(Cambodian),Lao,Vietnamese,Somaliand
Spanish
†
.TheStateofMichiganhasaquiteextensivesetofmaterialsavailable.
‡
The
challengeislikelymoreaboutstaffingandpersistencethanthespecificapproach.To
underscorethefindingsofthisstudy’sdataanalysis,theneedforbettereducation
mustfocusonsoloownersandindividualfamilies.
TargetedandInteractive.Inpersoncommunicationwiththemostvulnerable
populations,lowincomerentersinhighpovertyneighborhoodsandNew
Americans,shouldbeacentralfocusofpubliceducationefforts.Community
healthworkersfromtheimpactedcommunitiesshouldbehiredtovisitschools,
placesofworship,blockclubs,neighborhoodevents,etc.andtalktopeopleabout
prevention.Separateeducationcampaignswithdifferentmessagingshouldbe
addressedtolandlords,homeowners,doityourselfrenovators,andprofessional
renovators.Supportforlegalserviceseducatingtenantsontheirrights,especially
asenforcementincreases,shouldbeinplace.Allhelpingprofessionalswhovisit
homesshouldbehighlytrainedinleadissues.
Specific.Theeducationshouldbefocusedonthekeysourcesoflead
contamination,includingdeterioratedpaintandleaddustfrom“frictionsurfaces”
(windows,doors,porches,andsiding)anddustcreatedfromremediationand
renovation.
Practical.Residentsshouldbeprovidedpracticalguidanceonhowtoprevent
poisoning,includingaccesstoinformation,tipsonhowtorequestrepairsfrom
landlords,whotocallforinspections,howtoaccesslocalgrantandloanresources
forleadhazardreductionandhousingrehabilitation,theimportanceofleaddust
controlinthehome,etc.
Forexample,alinkontheCity’s“ReportCodeViolations”websitelinkshould
indicatethatcallstoeithertheCityortheECDOHwillpromptaninvestigationofa
renovationsitethatisoutofcompliancewithleadsafeworkpractices.

*
Seehttp://www.nyshcr.org/AboutUs/Lead/
†
Seehttp://www.health.state.mn.us/divs/eh/lead/fs/index.html.
‡
Seehttp://www.michigan.gov/mdhhs/0,5885,733971550_2955_298319488,00.html
43
SupportingScreeningbyHealthCareProfessionals
Primarycareprovidersarecriticalcontributorstothe
treatmentandassessmentofleadpoisoning.TheCity
andCountyreportahighlevelofcooperationbythese
professionalswhenbloodleadleveltestsrevealthata
childhasbeenpoisoned.
Bothprimarycareprovidersandlaboratoriesneedto
bereminded,however,thatallbloodleadleveltest
resultsmustbereportedtoNewYorkStatetoensure
accuratefiguresontheproportionofchildrenwith
elevatedlevels
*
.
Notonlyisahighrateofscreeningcriticalforstatisticalpurposes,butitwillalso
ensurethatallcasesofleadpoisoningareidentified,affectedchildrenaretreated,and
contaminateddwellingsareremediated.Recommendationstoassistinincreasingtest
ratesincludethefollowing:
HelpMeGrowNewYorkisafreeresourceconnectingfamiliestocommunity
resourcesandchilddevelopmentinformation.Itisrecommendedthatbloodlevel
screeningquestionsandleadpoisoningprimaryandsecondaryprevention
educationalinformationbeintegratedintotheirscreeningsandcarecoordination.
SayYesMobileHealthClinicsshouldofferleadscreeningforcurrentBuffaloPublic
Schoolstudentsandtheiryoungersiblingsatcommunityschools.(NOTE:Pre
schoolchildrenareatmuchgreaterriskfromleadcontamination.Testingof
schoolagedchildrencanhelpidentifyunsafehousingconditionsforyounger
siblings.)
Since2009,the
NewYorkStateImmunizationInformationSystem(
NYSIIS)has
includedchildren'sbloodleadtestresultsinadditiontotheirimmunization
information.Healthcareprovidersandschoolscaneasilyaccessimmunization
informationfromNYSIIS;howeverschoolsoutsideofNewYorkCity(whichhasits
ownseparateimmunizationinformationsystem)cannotviewstudents'bloodlead
levels(BLLs).AllschoolsinNewYorkStateneedaccesstothisinformationwhichis
necessarytohelpschoolsidentifychildrenwithahistoryofleadpoisoningand
carefullymonitortheireducationalprogressasrecommendedbytheCDC.NYS
shouldgrantschoolnursesacrossthestateaccesstochildren’sbloodleadtest

*
See
https://www.health.ny.gov/environmental/lead/health_care_providers/blood_lead_testing_reporting_gui
dance.htm
“Mysonis4andalways
getshisannualcheckup,
buthehasneverbeen
testedforlead…Arethere
waystoholddoctors
accountablefortesting
lead?
Residenton
Buffalo’sWestSide
44
resultsinNYSIIS.Withoutaccesstothisdatastudentscannotbeappropriately
evaluatedforbeneficialeducationalservices.Additionally,thiswillallowschoolsto
workwithparentsofchildrenwhohavenotbeentestedtoworkwiththeSayYes
MobileHealthClinicsorcontacttheirprimarycareprovider.
ResourcesforLeadRemediationand
IncreasedEnforcement
TheCity’sHousingOpportunityStrategyreleasedin2017clearlyshowsthathousing
issuesinBuffaloarerelatedtotheintersectionofhousingconditionandincome
constraints.Manypropertyownersinthehighriskzipcodescannotaffordto
remediateleadhazards.Repairsthatexceedthefinancialcapacityoftheproperty
ownersisaconcernthatneedstobeaddressed,particularlyasincreasedenforcement
isphasedin.
Publicfunders,financialinstitutionsandphilanthropyshouldworktogethertodevelop
acomprehensiveprogramofgrants,lowinterestloans,andotherfinancingtoassist
propertyownerswhoneedassistanceinmakingtheirpropertiesleadsafe.Knowing
thelimitedresourcescurrentlyavailabletoaddressaproblemofthismagnitude,many
innovative,longtermcollaborativeeffortswillberequired.Othercitieshavecreatively
supportedthiswork,suchas:
TheCityofRochesterhasaWindowsReplacementProgram,withHUDincome
guidelines.Upto$5,000isprovidedtoownersofsinglefamilyowneroccupiedor
rentalresidentialpropertiesforwindowssoleadhazardsinoldwindowwellsare
removed.
InMilwaukee,aregionalbankhasestablishedaTargetAreaHomeImprovement
Programthatmakesloansofupto$6,000perunitasamatchtoexistinggrant
funds.
TheOmahaHealthyKidsAlliancealsoworkswithbankstoprovidelowinterest
loansforleadremediationupto$10,000.
NewYorkStatecanlooktootherstates,suchasMassachusetts,tomodeltaxcredit
programstohelphomeownerspayforremediatingleadhazards.
Otherwaysofdeployingassetscurrentlyinplaceinclude:
DedicatingaportionofCommunityDevelopmentBlockGrant(CDGB)andHOME
fundstoleadhazardremediation,aspermittedunderprogramregulations.
UsingHousingCourtfinesforbuildingcodeviolationstosupportenforcementand
remediation.
45
Assemblingapooledfundofpublic,privateandphilanthropicfundstoleverage
andmatchnewopportunitiesastheyemerge.
ScalinguptheGreen&HealthyHomesInitiativetobraidvariousfundingstreams
toensurethatleadremediationisconductedasapartofhomerepair,rehab,and
weatherizationandthatinnovativefundingstreamsaredevelopedtomeetthe
demandforgrantservices.
Remediatinginrempropertiesandprovidingpurchaseincentivesforfamilieswith
youngchildren,astheCityorBuffaloNiagaraLandImprovementCorporationtake
titleofproperties.
CreatingarevolvingfundfortheHousingCourtreceiver(currentlyMattUrban
Center),whichtakescontroloverpropertieswhenlandlordsdonotremediatelead
sothereceivercanmakerepairsimmediatelyandrepaythefundasitcollects
rents.
Reallocatingfundspreviouslyusedfordemolitiontoleadremediationastheneed
fordemolitionsdeclines.
Workwithfinancialinstitutionstoprovidefavorablefinancingforleadremediation
throughtheirCommunityReinvestmentActobligations.
RequestingNYSOfficeoftheAttorneyGeneraltocontinuetosupportlead
remediationthroughallocationofsettlementfunds.
WorkingwithNYSMedicaidtoenablephysicianstorecommendleadinspection
andremediationasanallowableexpenseforMedicaidrecipientswhoareidentified
withEBLLsof5μg/dlorhigher.
Encouragingthestatetoaddressleadhazardsthroughprogramsthatsupport
windowreplacementwhereallowabletoimproveenergyefficiency(principally
throughtheWeatherizationAssistanceProgramandNYSEnergyResearchand
DevelopmentAuthority’sHomeEnergyEfficiencyPrograms
*
)ortosupporthistoric
preservationthroughwindowrepair.Bothprogramscouldaddresswindows,a
majorsourceofleadhazardsbyapplyingtheGovernor’scallfor“HealthAcrossall
Policies.”
Encouragingthestatetoprovidetaxabatementrelatedtotheremovalofleaded
paint.

*
https://www.nyserda.ny.gov/AllPrograms/HomeandResidents
46
PolicyinAction:FinancingLeadPaintHazardControl
FromPewTrusts“10PoliciestoPreventandRespondtoChildhoodLead
Exposure”
Massachusetts’leadlaw,enactedin1971,isoneoftheoldestinthe
countryandrequiresthatanypropertybuiltbefore1978andoccupiedby
achildunder6be“deleaded”byremovingorcoveringleadpainthazards.
Thestatealsoprohibitspropertyownersfromdiscriminatingagainst
familieswithyoungchildrenwhenrentingorselling.Tohelp
homeownerspayforremediatingleadhazards,includingreplacementof
windows,Massachusettsoffersincometaxcreditsof$500and$1,500,
dependingonaproperty’sneeds,andadministersaseriesofloan
programstosupportcompliancewiththelaw.Massachusettsimposes
surchargesof$25to$100ontheannualfeesofcertainprofessional
licenses,includingforrealestatebrokers,propertyandcasualtyinsurance
agents,mortgagebrokersandlenders,smallloanagencies,and
individualswhoperformleadinspections.Thecollectedrevenue,roughly
$2.5millionannually,isdepositedintotheLeadPaintEducationand
TrainingTrustAccountforusebythestate’sDepartmentofPublicHealth.
In2016,testingfoundthatofmorethan175,000Massachusettschildren
tested,just686underage6hadbloodleadlevelsof10mcg/dLorgreater,
comparedwith3,095ofabout194,000childrentestedin2001,theearliest
dateforwhichdataareavailableonline.
*

*
Seehttp://www.pewtrusts.org/~/media/assets/2017/08/hip_childhood_lead_poisoning_report.pdf.
47
Conclusion:CalltoAction
LeadSafeTaskForceofBuffaloandErieCounty
Leadpoisoninghashadawellestablishedfootholdinthisandmanycommunitiesfor
overacentury.Eliminatingitwillrequireaveryseriouscommitmentacrossallsectors
tomountaneffortthatisstrategic,consistent,andaccountable.Protectingour
childrenfromleadpoisoningwillrequireresources,infrastructure,disciplinedplanning
andimplementation.
Tobesuccessful,thiscommunitymustmakeleadpoisoningahighpriorityby
assemblingarespectedLeadSafeTaskForcemodeledontheoperatingcommitteefor
thesuccessfulSayYespartnership.Representationfromthemajorplayersmust
include:theCityofBuffalo,ErieCountygovernment,theBuffaloPublicSchools,the
medicalcommunity,nonprofitleaders,philanthropy,propertyowners,parents,and
theWNYCoalitiontoPreventLeadPoisoning.ThisTaskForceshouldbechargedwith
prioritizingtherecommendationsofthisreport,buildingathoughtfulplanforpolicy
changewithanemphasisonprimaryprevention,andensuringthatthecommunityis
engagedinpreventingleadpoisoningoverthelongterm.Achecklistsummarizing
recommendationsforpolicychangeisincludedintheappendix.TheTaskForce
shouldalsobechargedwithdevelopingafinancialtoolboxtosecureanddeploy
fundsforremediationwheretheyaremostneeded.
TheTaskForcemustbeprovidedwithadequatestafftoensurethatthe
recommendationsareimplemented,monitoredandreportedtothecommunityona
biannualbasis.TheTaskForcemustbefocusedonshareddecisionmakingand
sharedaccountabilitytoourchildren.Towardthatend,itisrecommendedthatthe
lawdepartmentsoftheCityandCountydevelopanagreementthatwillpermitthe
CountyDepartmentofHealthtoshareinformationonspecificEBLLcaseswiththe
City’sDepartmentofPermitsandInspectionsandanyCityandCountyleadgrant
program.Datasharingisvitaltoacoordinatedefforttoremediatethemostatrisk
housingandisallowedbyaprovisionofthefederalHealthInsurancePortabilityand
AccountabilityActof1996(HIPAA)thatpermitsthesharingofprotecteddatathrough
a“businessassociate”agreement.Finally,theTaskForceshouldcoordinatewiththe
BuffaloWaterQualityWorkingGrouptoensurecontinuedscrutinyofdrinkingwater
distributionlines.
Becauseleadcontaminationissoprevalent,preventingleadpoisoningrequiresa
multifacetedstrategywithaccountability.Thus,thecreationofaLeadSafeTask
Forceshouldbetreatedwithasenseofpurposeandurgencyandresourced
48
adequatelytomovethisagendaforward.Leadpoisoningwillnotbeeliminated
overnight,butitcanbeaccomplishedwiththededicatedactionacrossallsectors.
4
9
Appendix(onlineonly:See
http://www.cfgb.org/leadactionplan)
C
hecklistofRecommendedPolicyChange
TheCityofBuffaloandErieCountylocallawswillrequireamendmentifthese
recommendationsaretobeimplemented.TheLeadSafeTaskForcewillbeaskedto
setanaggressivetimeframefortheimplementationofthefollowing
recommendations.
CityofBuffalo
RequirealllandlordssubjecttotheRentalRegistrationrequirementtoobtainalead
paintclearanceinspectionasaconditionofmaintainingtheirRentalRegistration
certificate.
Ifapropertyfailstopasstheleadclearanceinspection,requirethatlandlords
remediatethehazardutilizingRRPcertifiedworker(s)toensurenoadditional
hazardsaregeneratedintheremediationprocess.
Provideforaseriesofincreasingfinesandpenaltiesforlandlordswhorefuseto
complywiththeleadclearancerequirement.
ExpandtheRentalRegistrationrequirementtoincluderentalunitsthatarewithin
owneroccupiedstructures.
RequirethatsellersobtainaCertificateofOccupancy,whichincludesaleadbased
paintinspection,whensellingresidentialhousing.
Review,reviseandpossiblyeliminateCityCodeChapter261LeadBasedPaint
AbatementandsectionsoftheChapter1131VacantorDamagedBuildingsto
reflectchangesinacceptedleadbasedpaintremediation.
Requirethatcontractorsandownerspullingpermitsforrenovationsprovide
currentcopiesoftheirRRPcertificationinsteadofacheckbox.
Requiredemolitioncontractorstoprovideforgroundcoverwhendemolishing
property.Includeamaintenanceplantoavoidovergrownand/orineffectivecover.
EmpowertheDepartmentofPermitsandInspectiontoissuecitationswhen
contractorsfailtoutilizeleadsafeworkpractices.
EmpowertheDepartmentofPermitsandInspectionstorequestaninterior
inspectionofanyhomewhoseexteriorhaschippingandpeelingleadbasedpaint.
5
0
Wherethereisadditionalreasontosuspecthazardousinteriorconditionsand
refusaltocomply,consideraCourtOrder.
EstablishlegalauthorityfortheCityandCountytosharedataonspecificlead
poisoningcases.
ErieCounty
AmendtheErieCountySanitaryCodetoprohibitreoccupancyofadwelling
foundtobeinviolationofthesanitarycodewithoutaninspectionthatconfirms
thattheviolationhasbeencorrected.
AmendtheErieCountySanitaryCodetostrengthenenforcementofleadsafework
practicesincludingStopWorkOrders,stipulationsandfines
IncaseswheretheErieCountyDepartmentofSocialServicesisguaranteeinga
securitydepositforaclientwithachildtwoyearsofageoryounger,itshould
triggeramoveininspectionbyaCountySanitariantoinspectforhazardsand
conditionsconducivetoleadpoisoning,includingtheconditionofallpainted
surfacesinpre1978housing.DepartmentofSocialServicespreinspection
documentsshouldincludeareviewofchippingandpeelingpaint.Thiswouldbea
requirementofpropertiesnotjustintheCityofBuffalo,wherethereport
recommendsacertificateofcompliance,butacrosstheCounty.Requiringmovein
inspectionsinrentalpropertiesiscurrentlyaprerequisiteinBurlington,VT;Detroit,
MI;SanDiego,CA;GrandRapids,MI;andtheStateofMarylandwithvarying
inspectionrequirements.Bymakingtheinspectionandcertificateofoccupancya
requirement,theDepartmentofSocialServiceswillhavetheabilitytowithhold
rentalpaymenttolandlordsnotincompliance,asisdoneinRochester,NY.
NewYorkState
NewYorkStateshouldassumeresponsibilityforadministrationandenforcement
ofEPA’sRenovation,RepairandPaintingProgram(RRP).
NewYorkStateshouldlowerthe‘environmentalactionlevel’forEBLLcase
managementfrom15μg/dLto10μg/dL.
NewYorkStateshouldadoptproposedlanguageincludedintheGovernor’s
Budgetproposaladdressingleadinspectionsbymunicipalcodeenforcementin
5
1
designatedareasofhighriskforleadpoisoningandpresumptionofleadinpre
1978housing
*
.
NewYorkStateshouldgrantschoolnursesacrossthestateaccesstochildren’s
bloodleadtestresultsinNYSIIS.
NewYorkStateshouldaddressleadhazardsthroughprogramsthatsupport
windowreplacementtoimproveenergyefficiencyand/orhistoricpreservation
throughtheGovernor’scallfor“HealthAcrossallPolicies.”
LeadInterviews:Themes
†
Aseriesofinterviewsregardingleadpoisoningandpreventionwereconductedwith
officials,tenants,landlords,homeowners,nonprofitstaff,communityleaders,and
otherstakeholdersinErieCountythroughoutthespringof2017,andaleadtownhall
washeldonJune8,2017.Belowwesummarizesomekeypointsfromthose
conversations.
Fortenants,thethreatofleadpoisoningisoftenpartofaclusterofotherhousing,
health,andlifechallenges–particularlyfortenantslivinginconcentratedpoverty
inold,badlymaintainedhousingstock.Concernaboutchippedorflakingpaint
mightbeovershadowedbyleakingroofs,watershutoffs,thepresenceofblack
mold,rodentinfestations,orotherproblemsthatneedimmediateattention.
Tenantsmaynotcomplainaboutbadhousingconditionsforfearofaretaliatory
evictionorforfearthatcityorcountyinspectionactivitymightgetthetenants
themselvesintrouble.
AnunusuallylargeportionofBuffalorentalpropertiesbelongtosmallscale
ownerswithlimitedresources.Theseownersoftenworkontheproperties
themselvesorthroughinformalarrangementsandoftenlacktheproperleadsafety
training.Inmanycasestheyaredealingwithmultiplerepairproblemsandsmall
amountsofcapital.Unsaferenovationswithrentersonthepremisesseem
common,andmanylandlordsseemunawareofthefreeandlowcosttrainings

*
Theproposedlawaddsapresumptionthatallbuildingsbuiltbefore1978containleadbasedpaint,
requiresthatthepaintnotbedeteriorated,andthatperiodicinspectionsbeconductedtoenforcethe
law,specificallythatin“highriskareas”(asdeterminedbytheCommissionerofHealth),“localcode
enforcementofficersconductinspectionsofresidentialrentalpropertyperiodicallyandatspecified
timesincluding,butnotlimitedto,aspartofanapplicationforacertificateofoccupancy,arenewalofa
certificateofoccupancy,orbaseduponthefilingofacomplaint.Suchinspectionsshallincludeata
minimumavisualassessmentfordeterioratedpaintandbaresoilpresentwithinthedriplineofthe
building.”Thelawalsoestablishesstandardsforclearanceofpropertiesfoundtobeinviolation.See
https://www.budget.ny.gov/pubs/archive/fy19/exec/fy19artVIIs/HMHArticleVII.pdf.
†
In
terviewswereconductedandsummarizedbythePartnershipforthePublicGood
5
2
providedbytheCounty.Also,asignificantnumberofownersliveoutsidethearea,
makingcommunicationandenforcementdifficult.
Forhomeownerswithaleadpoisonedchild,gettingrepairsdonecanbedaunting.
Aninspectormayfindmultipleproblemsthatneedtobeaddressedinadditionto
theleadpaint.TheCountydoesnotprovidearecommendedlistofcontractors,
andfindinganhonest,properlytrainedcontractorcanbedifficult.Buffalohasmany
lowincomehomeowners,andHousingCourthasabacklogofcaseswherethe
ownersimplydoesnothavetheresourcestomakethenecessaryrepairs,andthere
isnofundingstreamavailabletohelp.Inaddition,parentsmayfeelguiltyand
scaredandbeunwillingtotalkaboutleadpoisoning.
Thereisashortageoffullyqualifiedcontractors.Accordingtoaprogram
coordinatoratBelmontHousing,“MostcontractorshaveRRPcertificates,butthey
don’twanttotakethenextstepandbecomeLeadAbatementCertified.They
almostseemtobeafraidoftheresponsibilityofit,andtherearen’tmanyincentives
toconvincethemtotakethatnextstep.”Also,currently,whencontractorsor
ownerspullpermitsfromtheCityofBuffaloforworkthatwilldisturbpaint,theCity
requiresthemtocheckaboxthattheyareRRPcertified,butitdoesnotrequire
proof;anditrarelychecksonworkinprogresstoseethatitisbeingdoneinalead
safemanner.
Therearemanychallengesinenforcingexistinghousinglaws.Somequestionthe
prioritiesofCityhousinginspectors,whospendmuchoftheirtimeonexterior
housingviolationsthathavelessimpactonhealthandsafetythanlead.Others
worrythattenantshavelimitedoptionstoforcelandlordstomakerepairs(unlike
somestates,NewYorklacksaneasywayfortenantstobringnoncomplying
landlordstocourt),andthattenantsareoftenadvisedsimplytomove–leavingthe
repairproblemsforthenexttenanttodealwith.CityandCountyleadcasesin
HousingCourtaretypicallyhandledbyinspectors,ratherthanattorneys.Fines
oftengouncollected.
Educationaleffortsaroundleadpoisoningmaybesomewhatoutdatedor
ineffective,particularlywhenitcomestowarningparentsaboutthedangersoflead
dust.Asoneparentsaid,“Iknewthatmywindowshadleadpaintonthem,butI
wasn’tworriedbecauseIthoughtmysoncouldonlybeleadpoisonedifheatethe
paintchipsandIknewIwouldneverlethimdothat.Ididn’tknowitcamefrom
dust,too.Andnowmysonhasleadpoisoning.”Manyrentalownersdonotcomply
withtheirlegaldutytowarnofpotentialleadhazardsanddistributetheEPA
booklet,andmanytenantshavelanguagebarriers.Educationalmaterialsoftendo
notclearlyexplaintherelativedangersofdifferentleadpoisoningsourcesandthe
simplestwaystodecreasethosedangers.
5
3
Fundinggapspreventsomeleadremediationandpreventionworkfromtaking
place.Gapsexistwhenthereareother,nonleadrelatedhousingcodeviolations
thatmustbeaddressed,orthereisnoleadpoisonedchildcurrentlyinthehome.
Weatherizationprogramsprioritizeenergyefficiencywithoutincludinghealth
impactsfromlead,andsotheyrarelyincludewindowreplacement.TheGreen&
HealthyHomesInitiative(GHHI)wasveryhelpfulinallowingamoreholistic
approachtorepairs,whenitwasoperating,butitsfundingranout.Whilenew
fundinghasbeenidentifiedtoreinvigorateGHHI,itisforatargetedgeographic
regionandsustainablefundinghasyettobeidentified.
54
DetailedTables
EBLLReferrals,ErieCounty,NY
2013 2014 2015 2016 2017
EBLLRange
(μg/dL) All New
All New
All New
All New All New
City1014 444
168 357
146 361 150 442
165 394
164
City1519 194
38 186
48 184
58 171 44 175 49
City20+ 197 45 172
45 225
65 204
50 192 55
Suburbs1014 57 17 44 8 46 12 50 22 50 12
Suburbs1519 23 5 10 6 19 6 13 2 17 2
Suburbs20+ 16 2 16 2 16 4 19 2 22 8
Total 931 275 785
255 851
295 899
285 850
290
Source:ErieCountyDepartmentofHealth
Newlyreleaseddatashowthat466childrenweretestedin2017withbloodleadlevels
of59μg/dL.
EBLLbyHousingTenure(15μg/dL+)
NumberofEBLLreferrals
AverageBLL
Probablerental
1,809
22
Probableowneroccupant
543
22
Unmatched
226
23
TOTAL
2,578
22
55
EBLLover15μg/dL:ReferralsbyYearbyPropertyClass
Numberofreferrals
‘08 ‘09 ‘10 ‘11 ‘12 ‘13 ‘14 ‘15 ‘16
OneFamily
77 89 105 59 56 45 61 66 71
TwoFamily
89 171 226 155 149 131 116 135 109
ThreeFamily
6 6 12 3 16 7 8 6 11
unmatchedaddresses
39 61 69 55 50 36 45 53 38
MultipleResidences
15 27 39 21 15 10 15 10 21
Apartments
9 7 13 8 5 11 7 6 8
DowntownRow
2 9 5 4 3 5 3 4 4
TOTAL
237
370 469 305 294
245
255 280
262
AverageEBLL
OneFamily
23 21 22 21 19 23 22 22 22
TwoFamily
24 23 23 22 22 23 22 24 23
ThreeFamily
22 23 27 20 22 17 29 22 23
unmatchedaddresses
26 24 25 21 21 24 23 23 26
MultipleResidences
21 21 23 19 24 21 19 21 23
Apartments
27 18 25 19 20 21 25 34 21
DowntownRow
25 20 27 17 17 22 30 17 17
WeightedAverage
24 22 23 21 21 23 22 23 23
ProfileofPropertieswithEBLLReferralover15μg/dLtoErie
County20082016
Certainor
Probable
Rental
Possible
Owner
Occupant
Total
InRental
Registry
OneFamily
352
258
610
335
TwoFamily
1,035
229
1,264
947
ThreeFamily
74
74
9
Unmatchedaddress
33
226
259
0
Apartments
73
73
2
MultipleResidences
142
29
171
130
DowntownRowType(detached)
14
25
39
0
AllOther
87
1
88
1
TOTAL
1,810
768
2,578
1,424
5
6
Analysis:ElevatedBloodLeadLevelReferrals
Aneffectiveleadpoisoningpreventionpolicyshouldtargetthosepartsofthecityand
thosebuildingandtenurecategoriesmostlikelytoendangerchildren.Thisanalysis
requiredthattheCityofBuffalo’spropertydatabasebematchedagainsttheEBLL
recordsunderthejurisdictionoftheECDOH.Astheresidentialaddressofthe
individualshowntohaveanEBLLhealthinformationiscoveredbythefederalHIPAA
law,CGRenteredintoaBusinessAssociateAgreementwiththeECDOH,which
permittedaccesstotheHIPAAprotecteddata.ECDOHprovidedCGRwithallreferrals
from200916of15μg/dLorhigher.
ThefollowingdescribestheprocessundertakentomatchtheEBLLrecordstothe
propertydatabase.
∞
CleanedEBLLdatabaseaddresses(2,813records)
∞ Edited/correctedstreetnames(DelavanEastv.EastDelavanorEDelavanor
“Delevan”)
∞ Matchedstreetclassification(e.g.whetherSt/Ave/Dretcisincludednotand
howwritten)
∞ Droppedapartmentdesignations(e.g.3or“back”or“upper)asthesearen’t
listedelsewhere—notethatthiscomplicatesanalysisasanaddressmayinclude
multipledwellings
∞ Createdsearchkeybasedonnumber,street,zip
∞
MatchedEBLLdatabaseaddresskeywithErieCountyassessmentdatabase
(360,000+records)&RentalRegistration(21,236records)
∞ Corrected20incorrectzips—matchsuccessful
∞ 446addressesremainedunmatched
∞
39addressesunmatchedinassessmentdatabaseDIDmatchaddressin
RentalRegistration—buildingspecificinfofromRRISusedinanalysis.
∞
259arewithintheCitybutdon’tmatchtheexistingtaxcentroiddatabase.
∞
TheremainderarealsomissingfromthefilebutareoutsideBuffalo,leaving
2,578parcels.
∞
Editedindividualrecordstoimproveowneroccupied/rentalclassification
∞ Comparedpropertyaddresstoowneraddressforpropertyclass210(onefamily
yearroundresidence)andpropertyclass220(twofamilyyearround
residence)—wheretheydiffered,addedto“InRentalRegistry”andassignedto
“CertainorProbableRental.”
∞ Althoughoneunitlikelyrented,“twofamily”propertieswithmatching
owner/propertyaddressincludedin“PossibleOwnerOccupant”.
∞ Allpropertyclass230(threefamilyyearroundresidence)propertiesincludedas
“CertainorProbableRental.”
∞ Unmatchedaddressesplacedin“PossibleOwnerOccupant.”
57
∞ Multipleresidencereferstosingletaxparcelwithmultipledwellings.Itis
possiblethatthesecouldbeowneroccupied.
∞ The“Other”categoryincludesanarrayofcategoriesthatarelargely
nonresidential,includingschoolsanddaycarecenters.
∞
Matchedneighborhoodcharacteristicstoindividualparcels
∞ EachparcelwasgeocodedandassignedtoaCensusBlockGroup
MedianhouseholdincomebyCensusBlockGroupwasdownloadedfromthe
AmericanCommunitySurvey201115
58
ErieCountyPrograms
Formanyyears,thefightagainstleadpoisoningwasfocusedonsecondary
prevention.LocalhealthdepartmentsacrosstheState,liketheECDOH,continueto
providesecondarypreventioninterventionstochildrenwithEBLLs.These
interventionsincludemedicalcasemanagementaswellasinvestigationand
identificationofsourcesofleadexposureinthechild’senvironment.
ErieCountymaintainsthreeprogramsaimedatprimary
andsecondarypreventionofleadpoisoning.Erie
CountywasoneofthefirstCountiestojointhe
NYSDOHCLPPPPprogramin2007.
LeadPoisoningPreventionProgram
ThisprogramincludesCountyfundedpersonnelandagrantfromNYSDOHwithan
annualentitlementperiod.Thepurposeoftheprogramistoidentifychildrenunder6
yearsofagewithEBLLs,ensuremedicalfollowup,andeliminatethesourceoflead
exposure.Theprogramcasemanageschildren06yearsofage,providesmedical
referrals,investigatesthesourcesofleadandprovideseducationalhomevisits.The
sourceoffundsforthegrantisfederalmonieschanneledthroughthestate.The
programpartnerswiththeCommunityFoundationforGreaterBuffaloforoutreachin
thecommunitytopromoteawarenessoftheimportanceofleadscreening,the
dangersofleadpoisoning,andGreenandHealthyhousingactivities.Eleven(11)staff,
includingSanitarian,medical,clericalandadministrativeworkinthisprogram.
ChildhoodLeadPoisoningPrimaryPrevention
ThisprogramisagrantfromNYSDOHwithanannualentitlementperiod.Thepurpose
ofthisgrantistoidentifyandaddressleadhazardsinhighriskzipcodesinErie
Countyinordertopreventatriskchildrenfrombecomingleadpoisoned.The
Programaccomplishesthisthroughneighborhoodsurveys,homepaintinspections
andleadriskassessments,provisionofservices,distributionofincentiveproductsfor
hazardcontrolandeducationclassesforpropertyownersandresidentsinErie
County.Theprogrampartnerswith;1)BelmontHousingServicesofWNYproviding
leadpoisoningpreventioneducationforfamiliesandassistanceforpropertyownersin
makingpropertiesleadsafe;and2)theCommunityFoundationforGreaterBuffalofor
outreachinthecommunitytoincorporateprimarypreventionofleadpoisoningin
GreenandHealthyhousingactivitiesandjobtraining.Fifteen(15)staffincluding
Sanitarian,Educator,clericalandadministrativeworkinthisprogram.
59
LeadPoisoningPrimaryPreventionInitiative
ThepurposeofthisInitiativeistoaggressivelyenhanceprimarypreventionofLead
PoisoninginErieCounty.TheInitiativewillaccomplishthisby:loweringthe‘action’
levelforanEBLLinErieCountyfrom>10μg/dLto>5μg/dLandensuremedical
followup;byincorporatingprimarypreventionactivitiesacrossallhousingbased
programsintheHealthDepartment;bycreatinga“WindowFund”toassistproperty
ownersinreplacingamajorsourceofleadhazards;andbyexpandingtheactivities
pioneeredbythePrimaryPreventiongranttoincludeallofErieCounty.
(Neighborhoodsurveys,homepaintinspectionsandleadriskassessments,provision
ofservices,distributionofincentiveproductsforhazardcontrolandeducationclasses
forpropertyownersandresidents)
ThisInitiative,createdbyCountyExecutiveMarkPoloncarz,isfundedforfiveyearsfor
$750,000peryear.TheInitiativeprovidesmatchingfundsfortheLeadHazard
ReductionDemonstrationgrant,a$3,400,000grantfromHUD.ThethreeyearHUD
grantwillsupportefficient,costeffectiveleadhazardreductionactivitiesinprivately
ownedhomesinErieCountythatareoccupiedandfrequentedbychildrenunderthe
ageofsix.Recruitmentisfocused,butnotlimitedto,theCitiesofBuffaloand
Lackawanna.Theprogrampartnerswith;1)BelmontHousingServicesofWNY
providingleadpoisoningpreventioneducationforfamiliesandassistanceforproperty
ownersinmakingpropertiesleadsafe;and2)theCommunityFoundationforGreater
Buffaloforoutreachinthecommunitytoincorporateprimarypreventionoflead
poisoninginGreenandHealthyhousingactivitiesandjobtraining.Ten(10)staff
includingSanitarian,medical,clericalandadministrativeworkintheInitiativeand
LHRDgrant.
TheErieCountyHealthDepartment’swebsitehasdetailedmoreinformationabout
theseprograms
*
.
CaseStudies:Preventinglead
poisoninginselectedcities
TheFlint,Michiganwatercrisisbroughtnewattentiontothehazardsoflead
poisoningandpromptedanumberofcitiestotightenexistinglawsandpassnew
ones.Thisseriesofcasestudiesattemptstoprovideanoverviewoftheregulatory
processandthechallengesentailed.

*
TheErieCountyDepartmentofEnvironmentandPlanningalsoprovidesleadremediationservices
throughtheCommunityBlockDevelopmentGrantprogram.Moreinformationcanbefoundat:
http://www2.erie.gov/environment/index.php?q=communitydevelopment.
60
Wehavemadeanefforttogatherconsistentinformationoneachoftheincluded
cities,buthavenotalwaysbeensuccessful.Informationonenforcementhasbeen
particularlydifficulttoobtain.Therearelessonstobelearned:
Mostcitieshaveseenasteadyandsubstantialdeclineintheshareofchildren
testedwithEBLLs.Partofthedeclinecanbeattributedtothetimeelapsedsince
leadwasremovedfromgasoline,paint,solderandotherproducts.
AstheEBLLdeclinesarenotuniversaloruniform,itisreasonabletoconcludethat
heightenedawarenessandimprovedpolicyhavemadeadifference.New
ordinanceshavebeenadoptedinmanycitiesandexistingordinanceshavebeen
strengthened.
Significantvariationintestingratesandenforcementprovisionsmakerobustpolicy
comparisondifficult.
SecondaryPrevention
Ourreviewsuggeststhathealthdepartmentsuniversallypossesstheauthorityto
addressleadpoisoningwhenithasbeendetectedbybloodscreening.Secondary
preventionisaimedatreducingoreliminatingfurtherexposureforchildrenalready
leadpoisonedandreducingtheriskofexposureforsubsequentresidentsofthe
contaminatedhousingunit.Wedidnotattempttoassessthediligencewithwhich
variouscitiespursuethisobligationortheireffectivenessatensuringcompliance.
Asprogramsandpracticesforsecondarypreventionarewellestablishedingeneral
andinthecityofBuffalo,thisstudyprincipallyaddressesprimaryprevention,
interventionsaimedatreducingtheriskofinitialleadexposure.
PrimaryPreventionPolicy
Effectivepolicytoreduceexposuretoleadisathreeleggedstool.
∞
Apolicyrequiresalegalframeworkthatdefineswhatisacceptablemanagement
ofleadhazards,particularlyforpropertyowners,andconferssufficientauthority
(includingconsequencesforviolations)onadministrativeagencieschargedwith
enforcingwhatthelawrequires.
∞
Astatuteisonlyeffectiveifitisenforced.Enforcementisresourcelimited.Some
statutesaremoreexpensivetoenforcethanothers.Penaltiesplayarolehere:
Significantfinesthatarewidelypublicized,forexample,canencouragemore
voluntarycompliance.Inallcases,policiesthatarerarelyorneverenforcedlose
theirpowertoreformpoorpractices.
61
∞
Justasaneffectivetestingregimeisnecessaryforsecondaryprevention,
measurementprovidesacriticalfeedbacklooptolegislatorsandadministrators
intendingtoreducetheriskofinitialleadexposure.Testingthatisconsistentand
rigorouswillguidepolicymakersastheyconsiderwhethercurrentstatutesandthe
enforcementmechanismstheyrequirearebeingeffective.
Thefollowingcasestudiesexploretheinteractionofthesethreecomponentsin
selectedcities.
MakingSenseofComparativeStatistics
Inthecasestudiesthatfollow,wehaverelayedreportedstatisticsontheshareof
childrentestedshowingEBLL.Comparisonsacrossthecasestudycitiesareinevitable
butshouldnotbeconsideredasconclusiveevidenceoftherelativeeffectivenessof
oneapproachoranother.
ThemeasuredaverageEBLLrateisstronglyinfluencedbytheshareofchildren
tested.Contextandpolicywillaffectthetestingrate.Ifchildreninpovertyare
missed,thereportedEBLLratewillappearlower.Evenwithidenticaltestrates,the
EBLLsharemaynotbecomparableifdifferentpopulationsweretested.
Forexample,Philadelphiareportsthat6.5%ofchildrentestedhaveanEBLL(5
μg/dL)andthat88%ofchildrenaretested.Thiswouldnotbedirectlycomparable
withthereportfromToledo:OhioreportsanaverageEBLLrateof5.5%(also
measuredas5μg/dL)butatestingratethatappearstobeabout23%.Itispossible
thatToledo’struerateisactuallyhigherthanPhiladelphia’s,werebothtoscreen
thesameshareofchildren
*
.
∞
CitiesandstatesestablishdifferentEBLLthresholds.NewYorkStatedesignates
theshareofchildrentestedwithabloodleadlevel(BLL)of10μg/dLorhigheras
“elevated”whileVermont’sthresholdforEBLLdesignationis5μg/dL.Thesame
communitywouldpresentwithahigherEBLLinVermontthaninNewYork.
Oneotherfactorinfluencingthesestatisticsistheuseofcapillaryv.venousblood
tests.Ascapillarytestsaremorelikelytoyieldafalsepositive,EBLLfindingsfrom
these“fingerstick”testsareideallyconfirmedinasubsequentvenoustest.Some
statesreporttheseresultsseparatelyormayreportonlyEBLLthathavebeen
confirmedwithavenoustest.

*
Seehttps://www.odh.ohio.gov/odhprograms/eh/lead_ch/lead_data.aspx
62
CaseStudySummary
Detailedcasestudiesfollow.Hereweofferasummaryoffindingsand,inthetable
following,comparativestatisticsandpolicies.
Thecomplexityofmeasuringtheincidenceandseverityofleadpoisoningmakes
crosscitycomparisonschallenging.Intheabsenceofnearuniversalscreening
againstacommonbenchmarkandscreeningtechnique,itisdifficulttorankone
city’spoliciesasdefinitivelymoreorlesseffectivethananother’s.
*
Thenatureofthecity’shousingaffectsthestartingpoint—age,shareofrental
housinginapartmentbuildingsv.13unitdwellings,shareofrenterv.owner
occupied,etc.
NewYorkStatestillreportsleadpoisoningincidencebya10μg/dLthreshold
whilemostcomparisoncitiesandtheirstateshaveshiftedtotheCDCpreferred
5μg/dLstandard.Comparisonacrossstandardsisverydifficult.
Comparablescreeningrateswillyielddifferentaveragesiftheincome
distributionoftestedchildrenvariesbycommunity.
Screeningratesarereportedonwidelyvaryingbases—shareofchildrenwithina
birthcohort,shareofallchildrentestedatleastonceinaspecificyear,shareof
childrenunderaparticularagethreshold,shareofchildrenscreenedtwicebya
certainagewillallyieldadifferentreportedscreeningrateforthesame
population.
Thekeyquestionsforpolicymakersshouldbe:
Istheincidenceandseverityofleadpoisoningdeclininginourcommunity?
Isthetestingregimeinplaceinourcommunitysufficienttoidentifyactive
casesofleadpoisoningandtoguidepolicydevelopment?
Whatstepscanandshouldbetakentoimproveoutcomesforourchildren?
Mostofthecasestudycitieshaveestablishedstatutoryauthoritytoreducelead
poisoningbuthavestruggledtoallocatesignificantfundstoenforcement.This
issuewasacommonthemeduringCGR’sinterviewswithcityrepresentatives.

*
Theyeartoyearvariabilityinoutcomemeasuresreinforcestheconclusionthattestingratesand
otherfactorsstronglyinfluencethe“shareoftestedchildrenexceedingthethreshold,”thestatisticmost
oftencited.Multiyearaveragesaremorereliable;singleyearvariation,whetherpositiveornegative,
shouldbediscounted.
63
Evenintheabsenceofrigorousenforcement,theincidenceandseverityoflead
poisoninghasbeendeclininginmostjurisdictions.
Thisimprovementmaybeattributabletomoreeffectivepubliceducation,the
threatofenforcementandreductionsinbackgroundlevelsofleadfromnew
paint,gasolineandothersources.
PublicitysurroundingtheFlintwatercrisishascertainlyinfluencedpublic
resolveandspurredthepassageofnewregulation.Attitudesandbehaviors
amongbothpropertyownersandresidentshavelikelybeeninfluenced,too.
TheeventsinFlint(whichcametolightin2015and2016)aretoorecenttobe
reflectedinleadpoisoningstatistics,however.
Routineinspectionofdwellingunitinteriors,whileauthorizedbyordinancein
manyjurisdictions,remainsrare.Inmostcases,interiorinspectionispromptedby
complaintorthroughacourtorder.Thisisrelatedtotheresourceconstraintnoted
above—routineinspectionofrentalhousingisadauntingtask.
Noneofthecasestudycitieshavefocusedattentiononowneroccupiedhousing.
Thereisapresumptionherethatownershavesufficientincentivetoaddressthe
problemasitaffectstheirownfamilies.Moreover,publichealthconcernis
appropriatelyweightedtowardrenters,astheyhavefewerresourcesandpower,as
group,todevotetotheproblem.
64
Baseline
Comparison
TestingRate
Trend
Keypolicy
tool
Enforcement
BUFFALO
2015:2.2%
BLL
>10μg/dL
(Erie
County)
61%of
children
born2012
14
screened
2xbyage3
2010:2.1%BLL
>10μg/dL(Erie
County)
Buffalohasestablisheda
rentalregistrationprocess
andpubliceducation
campaigninacity/county
partnership.Seebodyof
reportforadditionaldetail.
Seebodyofreport
fordiscussion.
BALTIMORE
2016:5
.7%BLL≥
5μg/dL
28%of
children
under
theage
of6were
reported
testedin
2016.
Statisticsat
the5μg/dL
levelonly
nowbeing
reported;
201016rate
at10μg/dL
threshold
showed
reduction
from1.6%to
1.0%.Decline
from12,908
EBLchildren
at≥10ug/dlin
1993to167in
2016.
Baltimorereliesonstate
lawtogovernlead
safety,supportedby
housingcodeand
HealthDept.Lead
Violationenforcement.
MDrequiresannual
registrationofall
propertiesbuiltbefore
1978&leadhazard
certification,incldust
testatunitturnoverand
inresponsetonoticeof
defect.Landlordsare
requiredtoprovide
relocationassistanceto
tenantwhenchildtests
forleadat10μg/dLor
higherifthepropertyis
notbroughtinto
compliance
immediately.
Stateissued
1,408violations
in2017fornon
compliancewith
inspection
certificationand
remediation
standardsof
stateleadlaw
includinga
significant
numberin
BaltimoreCity.
Cityhousing
code
enforcement
agencyrefersall
codechipping
paintviolations
over30daysto
stateforlead
law
enforcement.
65
Baseline
Comparison
TestingRate
Trend
Keypolicy
tool
Enforcement
BURLINGTON
2012:
Published
datafor
Chittenden
County
(Burlington
is1/4of
countypop)
shows10%
BLL
>5μg/dL
Stateof
Vermont
claims
near
universal
testing,up
from62%
in2003.
In2003,18%of
childrentested
hadBLL
>5μg/dL,8
pointsabovethe
2012figure.
Alllandlordsmustcertify
compliancewithVTEssential
MaintenancePractices,which
includesvisualinspections,
remediation&provideannual
statementofcompliance.
Cityinspections
occurevery5years
fornew,renovated
orviolationfree
units;more
frequentforunits
w/violationor
upontenant
complaint.
CHICAGO
2013:4%
BLL
>5μg/dL
>103,000
children
testedin
2013
In2010,6%BLL
>5μg/dL,thus2
pointreduction
for201013;
200813
reductionwas5
points.
Broadinspectionauthority
grantedtocityofficials;RRP
certificationrequiredfor
windowreplacement;
ordinancemandatesthat
propertiesfrequentedby
childrenbemaintainedfree
ofleadhazards.
Finesaremodest
whencomparedto
othercities,
althoughpenalties
escalateforrepeat
offenders.Dataon
enforcement
unavailable.
DETROIT
2015:7.5%
BLL
>5μg/dL(v.
3.4%
statewide)
Children
underage
6:37%
tested(v.
20%
statewide)
2010:13%BLL>
5μg/dL,
reductionof6.5
points.;same
testingrate.
Allownersofpre1978rentals
requiredtosecurelead
clearance,Certificateof
Compliance&Rental
Registration.
Finesaresignificant.
Evidencesuggests
weakenforcement,
however,with
DetroitNews
reporting4,174in
compliancein2016
(outofestimated
136,000units).
GRANDRAPIDS
2014:8.2%
BLL>
5μg/dL
25%of
children
underthe
ageof6
were
reported
testedin
2014.
In2007,22%BLL
>5μg/dL,nearly
14pointshigher
thanthefigure
reportedfor
2014.
ACertificateofCompliance
withtheCity'sleadordinance
isrequiredofallrental
propertiesbeforeoccupation.
ThisisissuedonlyafterCity
interiorinspectionforpeeling
&flakingpaint.Conditionat
timeoftestingdetermines
expirationofcertificate.Funds
madeavailabletoownersfor
remediation.
TheCitypublishesa
listofallproperties
foundtobein
substantial
compliancewith
theProperty
MaintenanceCode:
14,000,about42%
oftheestimated
total,areincluded,
suggesting
substantial
compliance.
66
Baseline
Comparison
TestingRate
Trend
Keypolicy
tool
Enforcement
PHILADELPHIA
2015:6.5%
BLL
>5μg/dL
Children
bornin
2012:88%
testedby
age3
2010:11.3%BLL
>5μg/dL;
medianBLLfell
from3.2μg/dLin
2010to2.4μg/dL
in2015
Mandatorycertification
appliestoallpre1978rentals
housingchildren6andunder.
Ofestimated18,000
rentalunitshousing
childrenunder6,
2,000hadlead
free/leadsafe
certificatesfiled
withthecity.
Fundingfor
preventionfellfrom
$11min2007to
<$2min2016.
ROCHESTER
2016:10.3%
BLL>
5μg/dL(City
&combined
city/county
zipcodes);
6.5%for
totalcounty
NYS
reports
that50%of
county
children
bornfrom
201214
were
testedby
age3.
From201316:
Felllessthana
point(essentially
nochange).
Figurespriorto
2013limitedto
BLL>10μg/dL:
From201016,
declinedfrom
3.7%to1.6%.City
notesthat%
BLL>10μg/dLfell
by1/3when
comparing5yrs
beforelawand5
yrsafter.
ReportedEBLLusedto
identify“highrisk”housingby
ZIPcode.Dustwiperequired
intheseareasregardlessof
visualinspectionresults.
Inspectionsarecarriedoutby
citycertifiedriskassessorsor
athirdpartyleadbasedpaint
inspector(certifiedbythe
EPA’sRRPstandards).
Inthefirsttwo
yearsofthe
program,28,000
dwellingunitswere
inspectedwith12%
failingeithervisual
inspectionoradust
wipetest.Program
compliancehas
beenconsistently
strong.
SANDIEGO
2016:1.9%>
BLL
4.5μg/dL
16,000
children
under6
testedin
2016,~16%
of
estimated
103,000
children
Published
countyEBLL
ratesfellfrom
3.6%to1.7%
from201013
withsame
testingrate
Landlordsofhousingbuilt
before1979requiredto
performvisualinspectionat
turnover;maintainsLeadSafe
HousingRegistry.
Althoughstatute
assertsinspection
powerwithout
complaint,thisis
notpursued;
programclosed33
casesinFY'17.
Enforcementrelies
almostsolelyon
complaints.
67
Baseline
Comparison
TestingRate
Trend
Keypolicy
tool
Enforcement
TOLEDO
2015:5.5%
BLL
>5μg/dL
23%ofan
estimated
23,000
children
underage
6were
testedin
2015.
In2010,14%BLL
>5μg/dL,thus
the2015resultis
asignificant
improvement.
Lawpassedin2016requires
allrentalsof4unitsorlessto
fileaLeadSafeReport
completedbyacertified
inspector.Certificatesexpire3
yrforpropertiesthatfail
initialinspection,6yr
otherwise.Mustberenewed
atdateoftransfer.
Enforcement
powersareclearly
articulatedinthe
legislation,however
therigorof
enforcement
remainstobeseen
aslawstillbeing
implemented.
WASHINGTON
D.C.
2015:~2%
BLL
>5μg/dL
91%of
children
aged23
screened
atleast
once;42%
twice
N/A
Strictdisclosurerequirements
per"reasonablyknown"
standard;tenantswith
childrenunderage6may
requestleadclearancebefore
takingoccupancy.
Inspections
triggeredbytenant
complaint&based
onreasonablebelief
inimminentthreat
tohealth&safety.
68
Numberofhousingunitsbuilt
before1980
Shareofhousingunitsbuilt
before1980
Shareofhousingunitsrented
Medianrent
Shareofrenterspaying>35%of
incomeinrent
Popover16inLaborForce
Popover16Employed
Popover16Unemployed
Medianhouseholdincome
(2016dollars)
Percapitaincome(2016dollars)
Sharewithhealthinsurance
WashingtonD.C.
248,189
81% 59% $1,362 40% 65% 61% 5%
$46,754
$25,231
95%
Toledo
119,698
86% 48% $651 45% 60% 52% 8%
$39,770
$23,696
88%
SanDiego
306,686
58% 53% $1,427 44% 62% 54% 7%
$34,548
$20,317
90%
Rochester
88,995
91% 64% $779 52% 68% 62% 6%
$42,019
$21,730
89%
Philadelphia
593,537
88% 48% $943 48% 54% 42% 12%
$26,249
$15,562
86%
GrandRapids
65,031
82% 46% $806 48% 62% 55% 7%
$44,262
$27,129
91%
Detroit
336,053
92% 52% $754 56% 66% 59% 7%
$50,434
$30,847
85%
Chicago
979,621
82% 56% $987 43% 69% 63% 6%
$72,935
$48,781
95%
Burlington
12,972
78% 60% $1,071 48% 67% 60% 5% $68,117
$35,199
88%
Baltimore
258,954
87% 53% $974 45% 62% 54% 8%
$31,684
$19,830
92%
Buffalo
121,407
93% 59% $710 46% 59% 53% 6% $33,119
$21,566
93%
69
Detroit
StatutoryFramework
Detroit’sleadpoisoningstaturesrequirestringentclearanceandinspectionprotocols.
Detroit’sPropertyMaintenanceCodewasrevisedin2010toimproveprimary
prevention
*
.Detroitrequirestheregistrationofallrentalproperties(renewed
annually),whichincludes”1and2familyhomes,multipledwellings,apartment
buildings,hotels,motels,shelters,roominghouses,etc.aswellasroomsrentedwithin
asinglefamily,owneroccupiedhome.”
Ownersofpre1978rentalunitsareobligatedtosubmitaleadclearancereport.
†
The
leadclearancereportbeginswithaleadinspectionandriskassessmentperformedby
acertifiedinspectororassessor.Iftheinspectionand/orassessmentidentifieslead
hazards,thepropertymustberemediedbyacertifiedabatementworker(pursuantto
therulespromulgatedundertheMichiganLeadAbatementAct)orbyimplementation
ofinterimcontrolsbyacertifiedrenovator(anindividualwhohasundergoneLead
SafetyforRenovation,RepairandPaintingTrainingpursuantto40CFR745(e)).
TheleadclearanceisrequiredtoobtainaCertificateofComplianceandRental
Registrationfromthecity.Ownerswhorentpropertieswithouthavingobtaineda
certificatearesubjecttofines.
ThePropertyMaintenanceCodeincludesprovisionstoavoidconflictofinterest
betweenpropertyowners,tenants,andthoseindividualsperformingassessments
and/orremedies.Afterleadabatement/interimcontrolshavebeenimplemented,the
ownermustobtainpostremedyclearance.Onlyafterthepostremedyclearance
reportcanthelandlordregisterthepre1978propertyandobtainacertificateof
compliance,asbothrequirementsmustbemetforthepropertyislegaltooccupy.
Dependingonthesizeofthepropertyandthenumberofoffensescommitted,
penaltiesfornoncomplianceissuedbythecityalonecanrangefrom$500to$8,000.
Offensesmaybeassessedonadailybasis.Moreover,thesefinesdonotreflectthe
additionofpenaltiesassociatedwithviolatingconditionspertainingtheCertificateof
Compliance.Additionalmunicipal,stateandfederalpenaltiesalsoapply.

*
Seehttp://www.detroitmi.gov/Portals/0/docs/Forms/BSEED/Lead_Ordinance_Requirements
for_Rental_Property_Owners.pdf.
†
Inspectionsmayalsobeinitiatedbasedonreceiptoftenantcomplaint(Sec.9135(d)2)
70
Themunicipalcodemakesnospecialprovisionfortherightofentryofbuildingsnot
owned,operated,and/ormaintainedbythecity,especiallywithregardtosuspicionof
leadhazards.
Testing
TheMichiganDepartmentofHealthandHumanServices(MDHHS)bloodlead
screeningratesarelow.Onlyafifthofchildrenundertheageofsixhadbeentestedas
of2015reporting.MDHHSisresponsibleforoverseeingboththetestingofchildrenfor
leadpoisoningandtheprovisionofcasemanagementandfollowupservices;
however,MDHHSlacksinfrastructurecapacityandadequatefundingtoimplement
currentlawandprogramrequirements.Fundingatthefederalandstatelevelshasnot
keptpacewithcurrentMichiganrequirementsforEBLtestingofallchildreninthe
MichiganMedicaidandWoman,Infants,andChildren(WIC)programs.
MDHHSreportsleadtestingdatabycountyandincludesthenumberofchildreninthe
population,thenumbertestedandtheshareoftestedchildrenwithabloodleadlevel
exceeding5μg/dL.The2015AnnualReport
*
indicatesthat20%ofchildrenunderage
sixhavebeentestedstatewide(usinganyscreeningmethod)withEBLLreportedfor
3.4%ofthosetested.TheEBLLrateforDetroitwasmorethantwicethestaterateat
7.5%.MDHHSreportsthat37%ofDetroit’schildrenunderagesixweretested.The
resultsoftestingarealsoreportedbyzipcode.
Enforcement
TheCensusBureau’sAmericanCommunitySurveyestimatesthatrentalhousingunits
totaledabout136,000in2015.TheDetroitNewsreportsthat4,174unitscompliedwith
theinspectionregimein2016,however.
Inresponse,MayorMikeDugganandCouncilmemberAndreSpiveyhaveproposed
toughnewenforcementrulesthatwouldprohibitlandlordsnotincompliancefrom
collectingrentfromtenantsorevictingtenants.Themayoralsoannouncedthat7
newinspectorshavebeenhiredandhascontractedwiththreeoutsidevendorsto
helpspeedtheprocess
†
.ItdoesnotappearthatCityCouncilhasactedonthetougher
enforcementrules,however.
Strengths&Weaknesses
∞
Comprehensiveness:Arigorousstatutoryframeworkforprimarypreventionin
rentalpropertiesisinplace.Allrentalpropertiesarecoveredbytheleadabatement
statute.Finesfornoncompliancecanbesignificant.

*
Seehttp://www.michigan.gov/documents/lead/2015_annual_report_2_7_17_551735_7.pdf
††
http://www.detroitnews.com/story/news/local/detroitcity/2017/05/24/landlords/102105486/
71
∞
Enforcement:Todate,thecityhasnotdevotedsufficientresourcestoenforcing
thestatutespassedbyCityCouncil,althoughrecentpressreportsindicatethat
additionalstaffinghasbeensecured.Significantlygreaterenforcementpowers
havebeenproposedbuthavenotyetbeenapprovedbyCityCouncil.Thereis
somequestionwhetherthestricterenforcementprovisionswouldsurvivealegal
challenge.
∞
Evidenceofimpact:TestingdatareleasedbythestateofMichiganindicatesa
steadydeclineintheproportionofchildrenwithEBLL.Thestate’s2010Annual
Reportindicatesthatwith37%ofDetroit’schildrenundertheageofsixhaving
beentestedwith13%showingBLLof5μg/dLorhigher.Asnotedabove,themost
recentdata,atthesametestingrate,indicatethatEBLLratehasfallento7.5%.
∞
Keyweaknessesinprimarypreventionstructure:Evenwithouttheproposed
dramaticincreaseinpenaltiesfornoncompliance,thefinestructurecombinedwith
betterenforcementshouldbesufficienttoachievesignificantimprovement,
providedthatenforcementactionsarewellpublicizedasadeterrent.Thelow
testingrateremainsproblematic,however,openingupthepossibilitythatapparent
reductionsinEBLLareanartifactoftheprocessbywhichchildrenareidentifiedfor
testing.
Philadelphia
StatutoryFramework
Philadelphia’sLeadPaintDisclosureandCertificationLaw(PhiladelphiaCode,title6,
ch.6,section6800[2011])
*
tookeffectinDecember2012.Thelawamendedthecity
healthcodetoincludemandatoryleadfree/leadsafecertificationsfortargeted
housingandmorestringentpenaltiesfornoncompliance.Targetedhousingislimited
topre1978unitsrentedtofamilieswithchildren6yearsorunder.Lessorsoftargeted
housingarerequiredtoprovidetheirtenant(s)andthecity’shealthdepartmentwitha
certificationformfromacertifiedleadinspector.Certifiedleadinspectorsarecertified
bythePhiladelphiaDepartmentofHealth,thestate(asan“inspectorriskassessor”),or
theEPA(asaleaddustsamplingtechnician)(Section6800(1)).Philadelphiarequires
thattargetedhousingunitsreceivealeadfree/leadsafecertificationpriortorentalbut
within24monthsoftheleasestart;Lessorsareobligatedtodisclose,inwriting,lead
free/leadsafecertificationstotenantswhointurnmustacknowledgereceiptofthe
certificationviasignature.
Asinmostlocalities,onceachildhasbeenfoundtohavebeenleadpoisoned,thecity
isempoweredtoenterthehome,testandenforceanynecessaryremediation.
Municipallawdoesnotappeartogivethecityexpeditedrightofentryaccessto

*
http://www.phila.gov/health/pdfs/Phila_Lead_Disclosure_and_Certification_Law_12_21_11.pdf
72
homesatriskof(interior)leadpoisoning.Thelawreads:“Priortoenteringintoaspace
nototherwiseopentothegeneralpublic,thecodeofficialshallmakeareasonable
efforttolocatetheownerorotherpersonhavingchargeorcontrolofthespaceor
premises,presentproperidentificationandrequestentry(A401.2.1Nonpublic
spaces).”
Remediesfornoncompliancerangefromamaximumfineof$2,000peroffenseeach
dayofnoncomplianceconstitutesaseparateoffensetoawardingtenants’rent
abatement,damagesforharm,andattorneys’feesandcosts.
AsofDecember2016,§6814(BillNo.160609)wasamendedtoensurethatFamily
ChildDayCarefacilitiesmustcomplywithsamecertificationrequirementsastargeted
housing.
Thecityhasalsoimplementedanoutreachandeducationprogramaimedattenants
andlandlords,includingrunningadvertisementsonpublictransitandthroughsocial
media.
Testing
Philadelphia’s2015ChildhoodLeadPoisoningSurveillanceReportindicatesthat88%
ofchildrenbornin2012hadbeentestedbyage3.Ofchildrenundertheageof6,6.5%
werenewlyidentifiedashavingaBLLof5μg/dLorhigher(usinganyscreening
method)
*
.
Enforcement
TheCityestimatesthatchildrenundertheageofsixresidein18,000rentalunitsin
Philadelphia.TheFinalReportofthePhiladelphiaChildhoodLeadPoisoning
PreventionAdvisoryGroup
†
,issuedJune30,2017,reportsthatabout2,000leadfreeor
leadsafecertificateswerefiledwiththecitybetween2012andMay2017.Despitethe
finesavailabletocityinspectorsunderthestatute,enforcementhasbeenlax,although
thecityadministrationhascommittedtoamoreactivestance.
TheAdvisoryGroupnotesthatfundingforleadpoisoningpreventionfromallsources
(federal,stateandlocal)fellfrom$11millionin2007tounder$2millionin2016.
Strengths&Weaknesses
∞
Comprehensiveness:Theleadstatute’slimitationtounitswithchildrenunderthe
ageofsixwasacknowledgedbytheAdvisoryGroupasamajorweakness.

*
https://beta.phila.gov/media/20161219112430/2015PhiladelphiaChildhoodLeadPoisoning
SurveillanceReport_FINAL1.pdf
†
http://www.phila.gov/health/pdfs/Lead%20Advisory%20Group%20Report.pdf
73
∞
Enforcement:Thelimitationtorentalunitshousingchildrenundertheageofsix
makescurrentstatutesverydifficulttoenforce.Evidencesuggeststhatfew
enforcementactionshavebeenundertakeninanyevent.AsnotedbytheAdvisory
Group,fundingforprimarypreventionisinsufficient.
∞
Evidenceofimpact:Dataontestingandtheresultsofthattestingarequitegood.
TheshareofchildrenundertheageofsixwithBLLabove5μg/dLfellfrom11.3%in
2010to6.5%in2015(usinganybloodsample).ThemedianBLLoftestedchildren
fellfrom3.2μg/dLin2010to2.4μg/dLby2015.
∞
Keyweaknessesinprimarypreventionstructure:TheAdvisoryGroup’sFinal
Reportrecommendsexpandingthestatutetoallrentalhousingbuiltbefore1978.
Increasingthebreadthofapplicationwillhavelittleeffectwithoutsteppedup
enforcement.Noncoveredunitsmightverywellincludestructuresthatpossessa
highriskofcontainingleadhazardsandthatarefrequentedbychildren6yearsor
under;grandparent’shomesareperfectexamples.Moreover,sincetargeted
housingiscenteredonprotectingfamilieswithyoungchildren,therearepossible
fairhousingconcernswherebylandlordsmightexhibitgreaterreluctanceto
providehousingtotenantswithyoungfamilies.
SanDiego
StatutoryFramework
SanDiegotakesasitspremisethatallstructures(includingdwellings)builtpriorto
1979(estimatedat310,000units)useleadbasedpaintintheinterior/ontheexterior,
asassertedinthecity’s2008statute.
*
Landlordsmayrebutthispresumptionbyhaving
acertifiedleadriskassessor/inspectorattestthatthedwellingisfreeofleadhazards.
Cityledinspectionsareprimarilytriggeredbytenantcomplaintsandobserved
exteriorconditions.Thestatutegrantsthecityadministrationbroadlatitudeto
conductinspectionswhentheappearanceofastructurewarrantsinvestigation.
Landlordsarerequiredtoperformavisualinspectionofdeterioratedpaintinallpre
1979structureswhenanoccupantvacatesthedwellingandbeforeunitturnover.
Moreover,oncealandlordreceivesnoticeabouttheexistenceofaleadhazard,the
landlordmustcorrectthehazardinlinewithcitycode(§54.1006).Theprocessof
correctingaleadhazardincludesproperdisclosuretotenants,specializedcleaning,
andclearanceinspections.Ifthelandlordfailstoperformthisvisualinspectionand/or
conformtostatuaryobligationstoaddressleadhazards,thelandlordwillbeliablefor
maintainingapublicnuisance.CurrentmunicipallawpermitsSanDiegotofinenon
compliantlandlordsupto$2,500perdayperviolation($250,000maximum).

*
https://www.sandiego.gov/sites/default/files/legacy/environmentalservices/pdf/ep/081017leadord.pdf
74
Thecitystatuteadditionallystipulatesthatchildcarefacilitiesmustrequirelead
poisonscreeningsfromparentsofchildrenages6monthsto7yearsaspartofthe
admissionprocess.
Citystaffmayonlyissueviolationnoticesafterinspectingthepropertyorportion
thereof,anddeterminingaleadhazardexists.Theymayissuea“NoticetoComply”
(NTC)basedonvisualevaluationofexteriorpaint,however,andreportgoodsuccess
withpropertyownershavingthehazardsremediatedbasedonthis.Ifownersdonot
comply,thecitycangothroughtheprocessofhavinganinspectionwarrantissued,
whichmustbebasedonreasonablecause.Nonetheless,tenantcomplaintstrigger
mostenforcementactions.Evidenceofachildbeingharmedbyleadexposurewill
triggeradditionalcomplianceactivity.
*

StaffreporttheencouragingnewsthatreferralsforEBLLsfromthecountyaredown
from30or40casesperyearinthepastto6or7currently.Itisunclearwhetherthe
reductioninreferralsreflectsareductionintherateofleadpoisoningoran
administrativelapseonthepartofthestateofCalifornia(seeTestingbelow).
SanDiegohasalsoinstituteda“LeadSafeHousingRegistry”listingrentalproperties
thathavehadleadhazardsremediatedthroughaU.S.DepartmentofHousingand
UrbanDevelopment(HUD)fundedgrantprogram.Propertyownersagree“togive
priorityinrentingtheseunitstofamilieswithachildundertheageofsixforatleast3
yearsafterthepropertyhadbeen“cleared”ofleadhazards.
†
”Presentlythelistincludes
38addresses,2/3from2016andtheremainderfrom2017.Althoughthisisapositive
step,itsimpactwillbelimitedunlessisachievessignificantscale.
AnotherissueinSanDiegobearsmentioning.Thecityhasidentifiedmanycasesof
leadpoisoningresultingfromcandies,homeremediesandproducecomingacrossthe
borderfromMexico.Thisisasourceofleadpoisoningthatshouldconcernpublic
healthauthoritiesacrosstheUnitedStates.Asabordertown,SanDiegoexperiencesa
higherincidenceofexposurefromthesesources.
Testing
TheStateofCalifornia’sDepartmentofPublicHealthprovidedunpublishedtesting
resultsfor2015and2016forthecityofSanDiego.Themostrecentpublishedstatistics
forthestateandcountiesarefrom2013,althoughmorerecentfigureswillbeposted

*
ThanksareowedtoChristopherLee,LeadSafety&HealthyHomesCoordinator,CityofSanDiego,for
informationonimplementationofthecity’sstatute(personalcommunication,8/2/17).
†
https://www.sandiego.gov/sites/default/files/lshregistry.pdf
75
verysoon.
*
About16,000childrenunderage6weretestedin2016.Ofthosetested,
1.9%werefoundtohaveaBLLof4.5μg/dLorhigher.Theshareofchildrentestedwith
EBLLabove9.5μg/dLwas0.2%.Asthereareanestimated103,000childrenages05,
thisisa16%testingrate.
†
Enforcement
Justunder60%ofallhousingunitswerebuiltbefore1980.
‡
Ifthisrateisconsistent
acrossthecity’s258,000rentalunits,thenabout150,000rentalunitswouldhavebeen
builtbefore1980.
FortheyearendingJune2017,SanDiego’sleadabatementprogramclosed33cases.
∞
A“NoticetoComply”wasissuedin12casesinvolving26residentialunits.
∞
A“NoticeofViolation”wasissuedin6casesaffecting38residentialunits.
∞
Abatementorderswereissuedin4casesinvolving13residentialunits.
∞
Inadozencases,citycitationof“UnsafeWorkPractices”spurredcleaningof
contaminatedworkareasin26residentialunits.
§
SanDiegostaffinterviewedobservethatenforcementdependsverymuchonlevelsof
funding.
Strengths&Weaknesses
∞
Comprehensiveness:Thisisthemostrigorousstatutoryenvironmentofallthe
comparisoncities.Notonlyarelandlordsobligatedtoprovideevidencethata
housingunitisleadsafe,butthecityadministrationisgrantedthepowerto
investigatepotentialleadhazards,bothinteriorandexterior,withoutthe
permissionofthepropertyownerorarequestbyatenant.Finesfor
noncompliancearesubstantialandprovidecityinspectorswithamplepowersto
spurcorrectiveaction.
∞
Enforcement:CodeenforcementinthecityofSanDiegoemploys14.4per
100,000housingunitsandallocates$1,543per100occupiedhousingunitsinthe
FY17budget.
∞
Evidenceofimpact:ThemostrecentresultsofleadpoisoninginthecityofSan
Diegoarepromising,althoughthetestingrateisrelativelylow.Thatsaid,the
improvementatthecountylevelbetween2010and2013isconsiderable,withthe

*
https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/CLPPB/CDPH%20Document%20Library/BLL%20C
ounts%202012%20by%20LHD%20final.pdf
†
JosephCourtney,ChildhoodLeadPoisoningPreventionBranch,CaliforniaDepartmentofPublic
Health,personalcommunication8/14/17.
‡
U.S.Census,AmericanCommunitySurvey201115(ACS_15_5YR_DP04_with_ann).
§
ChildhoodLeadPoisoningPreventionProgressReportsprovidedbyMr.Lee.
76
EBLLratefallingfrom3.6%to1.7%.Itisworthnotingthattheshareofchildren
testingabove9.5μg/dLin2013was0.2%.Roughlythesamenumberofchildren
weretestedineachoftheseyears.
Fiveyeartrend:Forothercasestudycitieswereporta20152015trend.To
preservecomparability,wereportthattheSanDiegocountyEBLLfigurefor2007
figurereportedwas5.4%.Thenumbertestedin2007wasaboutthreequartersof
thatreportedin2012,however.
∞
Keyweaknessesinprimarypreventionstructure:Thestatutorycontextfor
enforcementisinplace,althoughresourcesdevotedtoenforcementlimitthe
abilityofstafftomonitorcompliance.Improvementintheshareofchildrentested
iscertainlydesirable.Thuswhilethepowertoconductinspectionsisestablishedin
statute,alackoffundingmeansthatthispoweriswieldedrarely.
WashingtonD.C.
StatutoryFramework
WashingtonDC’sDepartmentofEnergyandtheEnvironment(DDOE)presumesthat
paintusedonanypre1978structurecontainslead
*
.Thedistrict’sLeadHazard
PreventionandEliminationActassertsthat“Alldwellingunits,commonareasof
multifamilyproperties,andchildoccupiedfacilitiesconstructedpriorto1978shallbe
maintainedfreeofleadbasedpainthazards.”Moreover,theordinanceallowstenants
inhouseholdswith,orregularlyvisitedbyapregnantwomanand/orachildunder6
yearsoldtosecureaprivateclearancereportpriortooccupancy.
†
TheLeadAct,inconjunctionwithsupportingregulation,alsorequiresstrictdisclosure
requirementsthatapplypriortoanytenantpurchasingorleasingapre1978property,
therenewalofaleaseoranincreaseinrent,orupondiscoveryofanewleadhazard.
Disclosurerequirementsarestrengthenedbyinsistingthatleadhazardinformation
conformstoa“reasonablyknown”standard.
Morebroadly,thecitywilllaunchinspectionsuponwrittentenantcomplaintof
potentialleadhazardsandbasedonreasonablebeliefofimminentthreattothehealth
andsafetyoftheoccupantsoftheproperty(§8231.05).Therightofentryallowsthe
citytoinspectaproperty’sexteriorandinterior,toconductriskassessments,andto
verifycompliancewithanyportionofthelaw.Anowner(theindividual/entitywho
holdsanyportionofthefreeholdorleaseholdinterestontheproperty)whodenies

*
https://doee.dc.gov/leadsafehealthyhomes
†
Personalcommunication,AmberA.Sturdivant,BranchChief,LeadSafeandHealthyHousingDivision,
DepartmentofEnergy&Environment,WashingtonD.C.,8/9/17.
77
thecityaccesstoconductleadinspectionswillbeinviolationoftheleadlawandwill
becomesubjecttotheappropriateciviland/orcriminalpenalties.Furtherregulations
protecttenantsbyobligatingpropertyowner’stoprovidetemporarycomparable
alternativelivingarrangementsforanaffectedtenantwheneverDDOErequires
relocationofthetenantduetothepresenceofleadbasedpainthazardsata
residentialrentalproperty.
Testing
BloodleadscreeninginWashingtonshowsencouragingresults.AsofFY2015,the
District’sDepartmentofEnergyandEnvironmentreportsthat91%ofchildrenbetween
ages2and3receivedatleastonebloodleadscreening.42%ofchildreninthisage
cohorthadbeenscreenedtwice.Over15,000childrenundertheageof6hadbeen
testedasofFY15.Only1.3%wereidentifiedasnewconfirmedcaseswithEBLLof5
μg/dLorhigher.Combiningnewconfirmedcases,newsuspectcasesandEBLL
recordedamongchildrenpreviouslyidentified,theEBLLshareisjustunder2%.
*
Enforcement
Violationsoftheleadlawcanresultthefollowing:issuanceofaceaseanddesist
order;placementofcontinuingandperpetuallien;infractionsrangingfrom$50to
$16,000forseriousandrepeatedviolations;civilpenalties(whereappropriate)not
exceeding$25,000perdayperoffensesuchthateachdayofaviolationconstitutesa
separateoffenseviaaNoticeofInfraction(NOI);criminalpenalties(where
appropriate)subjecttothesamemonetaryfinesascivilpenaltiesandinclusiveof
imprisonmentforuptooneyear.TheDDOE’senforcementauthorityadditionally
permitstoissueNoticesofViolation;OrderstoEliminateLeadBasedHazards;Orders
toRelocateTenants;NoticesofSuspension,Revocation,orDenialofaCertification;
andCeaseandDesistOrders.
Althoughtenantswithyoungchildrenhavetherightunderthestatutetorequest
evidenceofleadclearancebeforeassumingoccupancy,therequestgoestothe
landlord,notthedistrict.Complianceisnotmonitored—itwouldbesurprisingif
responsivenessamonglandlordswerenothighlyvariable.
Broadauthorityisgrantedwhenviolationshaveoccurred,specifically:“theDistrict
governmentmaydenyanylicense,registration,orpermitrelatingtotheuseor

*
LisaGilmore,BranchChief,LeadSafe&HealthyHousingDivision,PersonalCommunication8/16/17.
78
occupancyofachildoccupiedfacilityordwellingunittoanownerofthatpropertyif
theownerisinviolationofthischapter.”
*

Arequestonthefrequencyofinspectionsandotherenforcementactionsispending.
Strengths&Weaknesses
∞
Comprehensiveness:Thestatuteprovidessufficientpowertotheadministration
toaddressleadpoisoningonceithasoccurred.Itisnotclearthatamechanism
existstoenforcerequireddisclosureofknownhazards.Thereappearstobeno
mechanismtoidentifyandremediatepreviouslyundetectedhazards.
∞
Enforcement:InformationobtainedtodatefromtheD.C.governmentsuggests
thatinspectionsarelargelydrivenbytenantcomplaintandarenottriggeredbya
lackofcompliancewithreportingrequiredunderthestatute.
∞
Evidenceofimpact:ArequestfordataontheaveragetestedEBLLandtherateof
testingispending.
∞
Keyweaknessesinprimarypreventionstructure:Thestatutorybasisfor
enforcementexistsbutenforcementdoesnotappeartoberigorous.Without
publisheddataontherateanddegreeofleadpoisoning,itisimpossibleto
determineeffectiveness.
Burlington
StatutoryFramework
Burlington’slocalleadlawordinancewasenactedin2009andrequiresalllandlordsto
certifycompliancewiththestate’sEssentialMaintenancePractices(EMP)andemploy
leadsafepracticesduringrepairandrenovation
†
.EMPincludevisualinspections,
remediationofleadhazardsvialeadsafepractices,andstrictdisclosurerequirements.
Bothlandlordsandchildcarefacilitiesarerequiredtosignastatementofcompliance
annuallyandprovidethestatementtotenantsandthestateofVermont.
Cityinspectorsareauthorizedtoenterintorentalhomesonthebasisofcarryingout
local,periodicinspections.
‡
Ifinspectionsarerefused,VermontDistrictCourtmay
issuesearchwarrantsforunitentryprovidedprobablecause.Probablecausemaybe
establishedpursuanttothefollowingspecifiedinSection1823:
1) Thedwellingunithasnotbeeninspectedformorethanayear;

*
https://doee.dc.gov/sites/default/files/dc/sites/ddoe/publication/attachments/Lead
Hazard%20Prevention%20and%20Elimination%20Act.pdf
†
http://www.burlingtonleadprogram.org/freeservices/cityofburlingtonleadordinance/
‡
Doesthisrightextendtounitswheretheownerresides?Oristherelessconcernaboutleadhazardsin
thebuildinggiventheowner’spresence,andhence,theneedforinspectionislessened.
79
2) Thedwellingunitorotherunitswithinthepropertyhavefoundtobein
violationofanyrulewithinthewholeofChapter18;
3) Previousviolationshavebeenfoundinthisunitbeforeandtheagencyhasno
reasontobelievethatcorrectiveactionhastakenplace;and,
4) Awrittencomplaintfiledwiththeagencyforaparticularunitandtheagency
hasbeendeniedentry.
Ownersofrentaltargethousing
*
arerequiredtoconductavisualassessmentofeach
unitannuallyandattenantturnovertodetect,andthenappropriatelyremedy,
deterioratingpaint.Moreover,theowner(s)isrequiredtoperformaspecialized
cleaningofallinteriorsurfacessavetheceiling,andsubjecttoleadsafecleaning
procedures,attenantturnover.Furthermore,ownersarerequiredtomakecertain
disclosuresthatgobeyondfederalandstaterequirementsandprovidetenantswith
educationalresources.
Burlingtonhasanumberofenforcementmechanismsatitsdisposal.Failureto
observeleadsafepracticesmightresultina$500fineand/orastopworkorder.The
cityreservestherighttosuspendacertificateofcompliance,withoutwhicha
residencecannotbelegallyoccupied.Dependingonthecircumstance,civiland/or
criminalpenaltiesmaybeassessed.Civilpenaltiesrangefrom$75$100whereas
criminalpenaltiesincludefinesbetween$200and$500and/oramaximumof30days
injailperoffense;eachdayofnoncomplianceconstitutesaseparateoffense.
Testing
ThestateofVermonthasbeenverysuccessfulatachievingnearuniversalbloodlead
screeningforchildren.LookingonlyatChittendencounty(individualdatafor
Burlingtonarenotpublished),theshareofchildrentestedasashareofthebirth
cohortrosefrom62%in2003towhatstatestatisticsindicateasnearuniversaltesting
by2010
†
.Themostrecentreleaseatthecountylevel,however,is2012.Inthisyear,
theshareofchildrentestedwithaBLLover5μg/dLwas10%,belowthestatewide
averageof15%.Althoughasignificantimprovementfromthe18%reportedfor2003,
thefigureisstillhigh.Statewide,38%ofchildrentestedin2003showedBLLover5
μg/dLbasedonatestingrateof75%.
Enforcement
Thecity’sCodeEnforcementDivisionconductsperiodicinspectionstoensure
compliancewithEMP.Periodicinspections,whichincludeidentifyingleadhazards,are

*
Although“targethousing”isnotdefinedinthestatue,itmostlikelyrefersto(rental)homesbuiltprior
to1978,possiblyexclusiveofowneroccupiedstructures.
†
Seehttps://apps.health.vermont.gov/ias/querytool?Topic=EPHT&Theme1=Lead.
80
thustiedtotheexpirationandrenewalofthecertificateofcompliance.Acertificateof
compliance’slongevityisafunctionofthesize/typeoftherentalunitandthe
number/severityofprevioushousingcodeinfractions.Inpracticethen,periodic
inspectionsoccurevery5yearsfornewlyconstructed,significantlyrenovated,or
violationfreerentalunits,andevery4yearsto6monthsorlessforrentalunitsfound
tohavevaryingdegreescompliance.Tenantsareauthorizedtofilewrittencomplaints
whichtriggerinspectionswithin7daysofthecomplaint’sreceipt(1824).
Thelocalrentalhousingregistrywasneverfunded,whichinturn,madetracking
certificateofcomplianceexpirations(theprimaryinspectiontrigger)ineffectual.
Inspectionsaresporadicandlargelydrivenbytenantcomplaints.
Strengths&Weaknesses
∞
Comprehensiveness:Thestatutoryenvironmentissufficient,requiringlandlords
tocomplywiththestate’sEssentialMaintenancePracticesrequirements.Although
provisionismadeforperiodicinspections,theownerstoselfcertifycompliance
makesrigorousenforcementanecessity.
∞
Enforcement:TheCityCouncilwasneverabletofundtheprovisionsofthe2009
statute.Enforcementislimitedtorespondingtotenantcomplaints.
∞
Evidenceofimpact:Themostrecentinformationcomesfrom2012andindicates
thattheshareofchildrenundertheageofthreebeingtestedisveryhigh,reliably
indicatingthat10%ofchildrenshowedandEBLLof5μg/dLorhigher.Thisisdown
slightlyfrom11%in2010.Thefiveyeartrendto2012isareductionoftwo
percentagepoints(from12%to10%).
∞
Keyweaknessesinprimarypreventionstructure:ProgressatreducingEBLLis
slowinBurlington.Althoughanambitiousandcomprehensivestatutewaspassed
in2009,lackoffundsforenforcementhindersignificantimprovement.
Chicago
StatutoryFramework
TheChicagoLeadOrdinance
*
stipulatesthat”itisthedutyofownerstomaintain
residentialbuildings,childcarefacilities,andschoolsinamannerthatpreventsthe
existenceofleadhazards.”Andthat“Allbuildingsregularlyfrequentedbychildrensix
yearsofageandyoungermustbemaintainedsotheyarefreeofleadhazards.”This
fallsshortofstatutesthatmandateaspecificoutcome,i.e.thatdwellingsbe“leadsafe”
ataspecificBLLstandard,e.g.5or10μg/dL.

*
http://www.leadsafeillinois.org/uploads/documents/benchbook2chicagolawswithsummary.pdf
81
Thestatutegrantsbroadinspectionauthoritytocodeenforcementofficials:
74090Inspectionofbuildingsandcommercialestablishments.
“AnauthorizedrepresentativeoftheCityofChicagochargedwith
enforcementofthisordinance,uponpresentationifrequestedofthe
appropriatecredentialstotheowner,occupantorhisrepresentative,may
inspectchildcarefacilities,schools,dwellingsandresidentialbuildingsat
reasonabletimes,forthepurposesofascertainingthatallsurfacesaccessible
tochildrenareintactandingoodrepair,andforpurposesofascertainingthe
existenceofleadbearingsubstances.Anauthorizedrepresentativeofthecity
mayalsoinspectsoilsurroundingofsaidfacilitiesandmayalsoinspect
commercialestablishmentsforthepurposesofascertainingwhetheranylead
bearingsubstancesorleadhazardsarepresent.Suchrepresentativemay
removesamplesorobjectsnecessaryforlaboratoryanalysis.Ifaperson
entitledtowithholdconsenttoaninspectionrefusestoallowinspection,a
representativeofthecitymayapplyforawarranttopermitentry.”
In2011thecityaddressedproblemsresultingfromrenovation,passinganordinance
requiringRRPcertificationforwindowreplacementandworkthatdisturbspainted
surfacetotaling6SFintheinteriorspaceor20SFontheexterior.
Testing
Chicago’sleadlawrequiresevidenceofleadscreeningforadmittancetonursery
school,kindergartenordaycarewhichislikelytoincreasethetestingrate,provided
thattherequirementisenforced.TheChicagoDepartmentofPublicHealthreports
thatin2013morethan103,000childrenweretestedand4%werefoundtohave
EBLLs.
*
Althoughthetestingratewasnotreported,theCensusBureaureportsthat
eachbirthcohortinChicagoduringthisperiodincludedabout46,000children,
suggestingthatthetestingrateishigh.
Enforcement
Finesbetween$100and$500maybeleviedforeachoffense.Eachdayaviolationor
noncomplianceexistsisaseparateoffense.“Anypersonfoundguiltyofathirdor
subsequentviolationorfailuretocomplywithinatwoyearperiodispunishablebya
finebetween$500and$1,000and/orincarcerationnotinexcessof6months.”

*
AlthoughChicagohasadoptedtheCDC’s5μg/dLstandard,thesefiguresarebasedona6μg/dL
standardduetoaproblemwithoneofthetestinglabs.
82
Strengths&Weaknesses
∞
Comprehensiveness:Chicago’sstatutegrantsthecitypowertoinspectand
compelremediationwherethereissuspicionofharm.Proactiveleadexposure
reductioninhousingunitsnottargetedbyactualharmappearstobelimited.
∞
Enforcement:Unclearatthispointintime.
∞
Evidenceofimpact:Usinga6μg/dLorhigherthreshold,4%ofcityofChicago
childrenscreenedforleadwerefoundtohaveanelevatedlevelofleadinthe
blood,downfrom6%in2010.Thefiveyearreduction(from2008to2013)was5
percentagepoints.
∞
Keyweaknessesinprimarypreventionstructure:Unclearatthispointintime.
Toledo
StatutoryFramework
InOctober2016,thecityofToledopassedatoughnewlawgoverningthelead
hazard.TheLeadSafeOrdinancerequiresallrentalpropertiesof4unitsorlessplusin
homefamilydaycaresbuiltpriorto1978toregisterwiththeToledoLucasCounty
HealthDepartment
*
.RegistrationrequiresfilingaLeadSafeReportcompletedbya
LeadSafeInspectorwhohascompletedapprovedtraining.Propertiesforwhicha
LeadSafeCertificatehasnotbeenfilesmaynotberentedorsold.
The“toptierofthemostdangerouscensustracts”mustcomplywiththelawbyJune
30,2018.ThesecondtiermustcomplywiththelawbyJune30,2019.Allremaining
censustractsmustcomplywiththelawbyJune30,2020.Leadsafecertificatesare
issueduponsubmissionofleadsafecertificateapplicationandaleadsafereport.The
leadsafereportmustbecompletedbyalocalleadinspectorandmustcontainthe
resultsofandsubsequentrecommendationsbasedonalocalleadinspectioncarried
outbythelocalleadinspector(1760.032).
LocalleadinspectorsincludethoseindividualslicensedbytheOhioDepartmentof
Health,anEPAcertifiedleaddusttechnicians,orpersonswhomeetLucasCounty
HealthDepartmentlicensingstandards.Landlordsarepermittedtohireprivatelead
riskassessortoperforminspections.TheToledoLucasCountyHealthDepartment
reservestherighttoperforminspectionsonarandombasisorbasedonareasonable
suspicionthatleadinspectorsareimproperlyproducingleadsafereports(1760.07d).

*
http://www.lucascountyhealth.com/wpcontent/uploads/2017/04/ToledoLeadOrdinance4.18.17
Full.pdf
83
The“LeadSafeCertificate”shallexpirefromthedateofissuancebytheDirectoras
follows:
(1) three(3)yearsfromthedateofissuancebytheDirectorforanypropertythat
failstheinitialvisualinspectionordustwipetest;or
(2) six(6)yearsfromthedateofissuanceforanypropertythatpassestheinitial
visualanddustwipeinspection.
ALeadSafeCertificatemustberenewedatsale,purchase,ortransferofownershipof
thetargetedbuildings(1760.03c).
NoCertificateofPropertyCodeCompliancemaybeissuedtoatargetedbuilding
unlessthetargetedbuildinghasaLeadSafeCertificate(1763.021).TheCertificateof
PropertyCodeComplianceisissuedbyToledo’sDivisionofBuildingInspectiontothe
subjectpropertyandisvalidforthreeyearsfromtheissuingdate.
TheDepartmentwillalsocreateanelectronicLeadSafeResidentialRentalProperty
andFamilyChildCareHomeRegistrytohelptrackcompliancewiththe
implementationoflawaswellasinformprospectivetenants(1760.13).
TheCountyHealthDepartmentispermittedtoenteronandintoandinspectall
premises,dwellings,dwellingunitsandaccessorybuildingstoconfirmcompliance
withtheleadlaws,providedthatinspectionstakeplaceatreasonabletimes,
credentialsarepresentedtotheoccupant,andthatentryisrequestedandobtained.If
entryisdeniedandthereisprobablecausetobelievethataserious(read:lead)hazard
exits,theCountyhaslegalrecoursetotakeandgainentry(1303.09).
Intheeventthattenantsdeterminethattheirlandlordisnoncompliant,tenantsare
authorizedtotakeaprivaterightofactionagainstthepropertyowner(1770.10)and
escrowtheirrentforeachmonththatthepropertyownerisnoncompliant(1770.11).
Testing
ThemostrecentdatafortheCityofToledoareaisfrom2015.Totalchildrentested
undertheageof6was5,107ofanestimated23,000children,atestingrateof23%.
5.5%ofchildrentestedwithaBLLof5μg/dLorhigher.
Enforcement
Finesfornoncomplianceinclude:$50perdayadministrativefineperdwellingunit
withamaximumpenaltyoftenthousanddollars$10,000peryearperdwellingunit
forfailuretoobservestatutoryobligationsfortargetedproperties,and$500per
violationofleadinspectionstandardsandprotocols(1760.15(a),(c)).
84
TheToledolawalsorequirestheLucasCountyHealthDepartmenttopublishan
AnnualReporttosummarizetheDepartment’sprogress.Thereportmustincludethe
numberofapplicationsforLeadSafeCertificatesfiledfor,compliancestatusof,and
disciplinaryactiontakenbyrentalpropertiesandhomefamilydaycares(1760.09c).
Strengths&Weaknesses
∞
Comprehensiveness:Thisisaveryrobustandcomprehensivestatute.Byfocusing
onsmallerrentalproperties,theordinanceassumesthatthemajorityofthelead
contaminationisoccurringinthesmallerunits,notapartmentbuildings.By
requiringleadsafecertificationbeforea
∞
Enforcement:Asthestatuteisstillbeingimplemented,thelevelofenforcement
hasyettobedetermined.
∞
Evidenceofimpact:In2010,6,550childrenwerescreenedinToledowith14%
(912)testingatthe5μg/dLorhigher.Asnotedabove,the2015resultsaremuch
improvedwith5.5%testingat5μg/dLorhigher.
∞
Keyweaknessesinprimarypreventionstructure:Acontinuedemphasisonthe
testingratewillhelpensuresoundmeasurement.
Baltimore
StatutoryFramework
Unlikethemajorityofcitiessurveyedinthisreport,BaltimorereliesmoreonMaryland
statelawthanontosupplementitsownmunicipalcodetoprovidealegalframework
aroundprimarypreventionwork.SincethepassageoftheMarylandReductionofLead
RiskinHousingLawin1996,affectedrentalpropertiesinBaltimoreCityand
throughoutMarylandhavebeenrequiredtomandatorilymeetaleadremediationand
inspectioncertificationstandardinpre1950properties.In2015,thestate
environmentalcodewashasbeenamendedtomakestateleadlawsmorereflectiveof
leadingnationalpracticesandstandardsbyexpandingthelawtomandatorilyinclude
19501978rentalproperties.
Ownersofaffectedproperties,whichincludeanypropertiesbuiltbefore1978,are
requiredtoregistertheiraffectedpropertieswiththeMarylandDepartmentofthe
Environment(MDE).Propertyregistrationmustberenewedonanannualbasisalong
withthepaymentofa$30perunitregistrationfee.Thepropertylistispublicly
availableonMDE’ssearchablewebsitedatabaseoruponrequest.Rentalproperty
ownersmustalsoprovidealeadinformationalpamphletandaNoticeofTenants
Rightsbrochuretothetenantatthetimeoftenancyandeverytwoyearsthereafter.
85
Pre1978rentalpropertiesmustmeetfullriskreductionstandardsandcertification
priortounitturnover.Tomeetthisstandard,ownersmustpassavisualinspectionto
verifythatthereisnochippingpaintandaleaddcontainmentdustclearancetest,
whereindustsamplesfromeithertheexteriororarecollectedfromtheinteriorofthe
affectedpropertybyacertifiedprivateinspector.Ifthepropertypassesinspection,Risk
ReductionCertificateisissuedfortheproperty.Affectedrentalpropertyownersare
responsibleforleadhazardremediationabatementbywayofusingcertified
contractorsandworkersusingleadsafeworkpracticehabits.Individualsthatare
accreditedbyMaryland’sDepartmentofEnergyarepermittedtoconductleadhazard
abatement.MDEinspectorsconductregularspotchecksofthethirdpartyinspection
systemtoverifycomplianceandtomaintaintheintegrityoftheprocess.
AccordingtopriorMarylandstatelaw,allchildrenlivingin“atrisk”areasforlead
poisoningmustbetestedforEBLsLat12and24months;andtheentireCcityof
Baltimorewasisconsideredtobeaanatriskarea.Startingin2016,theStateof
Marylandimplementeduniversalbloodleadtesting.Atfirstblush,Baltimore’sbuilding
codesappeartoauthorizeproactiveinteriorinspectionofhighriskproperties.Indeed,
Sections104.6.1.13ofBaltimoreCity’sRevisedCodeindicatethatneitherasearch
warrantnorpriornoticeisneedediftenantsrequestandgrantpermissionforan
inspectionorifaninspectionofficialreasonablybelievesthatanimminentdanger
exists.However,severalofBaltimore’sleadspecifictriggersformandatory(interior)
inspectionaresecondarypreventionpolicies.Inparticular,probablecauseforan
interiorinspectionisestablishedifahealthcareprovider,theStateDepartmentofthe
Environment,ortheHealthCommissionerreceivesnoticeofachildwithEBLLof105
μg/dL.The105μg/dLthresholdiswellabovetheCDC’sactionlevelof5μg/dLandis
evenlessstringentthanNewYorkState’s10μg/dLlevel.
Thatsaid,andasperstatelaw,ifanownerreceivesnoticethatachild6andunderor
apregnantwomanasanEBLLgreaterthanorequalto10μg/dL,theownerisrequired
toprovidepermanentrelocationassistanceiftheownerdoesnotbringtheproperty
intocomplianceimmediately.reasonablealternativelivingaccommodationsthatare
MDEcertifiedleadfree.Within30daysofreceivingantheEBLLnoticeoranoticeof
defect,theownerisresponsibletomeetthemodifiedriskreductionstandardandpass
inspectioncertification.TheMDEreceivesandmonitorsEBLLnoticesandhasastrong
enforcementmechanismtoincreasecompliancerateswithbyutilizingoverfour
dedicatedAttorneyGeneralstoaggressivelypursueenforcementactionsagainstnon
compliantrentalpropertyowners.
BaltimoreCityhasanoteworthyhousingcodeenforcementprocessthroughHousing
Courtthatsupportsprimarypreventionbyenforcingcodeviolationsforchipping,
peelingpaint.TheCityreferscasestoMDEforenforcementoftheMarylandstatelead
86
lawwherehousingcodeviolationsthatcitechipping,peelingpainthavenotbeen
satisfiedwithin30days.Inaddition,theBaltimoreCityHealthDepartmenthasa
dedicatedattorneywhopursuescomplianceinHousingCourtofoutstandingHealth
DepartmentLeadViolations.Lastly,privateenforcementoftheleadstatelawis
providedthroughlocalDistrictCourtrentcourtactionswhererentalpropertyowners
aredeniedaccesstocollectrentuntiltheirpropertiesarebroughtintocompliance
withtheregistrationandinspectioncertificationrequirements.
Baltimorereportssignificantprogressonthenumberofchildrenwithbloodleadlevels
above10μg/dL.Seechartbelow.Baltimorereportssignificantprogressonthenumber
ofchildrenwithbloodleadlevelsabove10μg/dL.Seechartbelow.
*
Testing
TheStateofMarylandreportsthat34%ofchildrenundertheageof6werescreened
in2010with1.6%testingwithaBLLof10μg/dL.Resultsforthelower5μg/dLwere
notreportedatthecountylevelin2010butin2012therewere6.5%of(1,224)children
underage6inBaltimoreCitythatwerereportedbyMDEwithbloodleadlevelsof59
μg/dL.2016resultshavebeenreleasedwhichdoincludethesharetestingatthelower
threshold.Thetestingratefor2016isreportedas28%with1.0%testingat10μg/dLor
higher.Atthemorestringent59μg/dLthreshold,however,4.8%(804)werefoundto
haveEBLLsand5.7%at5μg/dLorhigherintotal.

*
BaltimoreCityHealthDepartment.Seehttps://goo.gl/sMbcbw
Figure14BaltimoreTrendinEBLL
87
Enforcement
Specificinformationontheuseofenforcementmeasureswasnotreadilyavailable,
althoughthereductioninEBLLwouldappeartosuggestthatCityenforcementof
housingandleadviolationscoupledwithstateleadlaweenforcementwouldappear
tohavesbeeneffectiveinhelpingproducinga99%declineinchildhoodlead
poisoningsince1993inBaltimoreCityfrom12,908childrenannuallyto167withEBLs
of10μg/dlorhigher.
Strengths&Weaknesses
∞
Comprehensiveness:ThecombinationofMarylandandBaltimoreCitylaws
supportacomprehensiveprimaryprevention,monitoringandenforcementregime
withsignificantprivatesectorinvestmenttomeetrentalpropertystandardsfor
leadsafety.
∞
Enforcement:Strongenforcementatcityandstatelevelaswellasinteragency
coordinationofenforcementproducingpreventionresults.Goodusageofhousing
codeenforcementforprimarypreventionobjectives.Substantiallocalandstate
finesandpenaltiesfornoncompliance.
∞
Evidenceofimpact:Asreportingatthe5μg/dLlevelisonlyavailableforthemost
recentyears,alongtermtrendisdifficulttoascertain.EBLLat10μg/dLhascome
donesignificantly,however.Leadpoisoninghasdeclinedby99%inBaltimoreCity
from1993to2016atbloodleadlevelsof10ug/dlorhigher.EBLsat5μg/dLor
higherinBaltimoreCitydeclinedfrom1,443childrenunderage6in2012to971
childrenin2016.
∞
Keyweaknessesinprimarypreventionstructure:n/a
GrandRapids
StatutoryFramework
AsofJuly1,2012,allrentalpropertiesinGrandRapidsarerequiredtohavea
CertificatesofCompliancebeforeoccupation.CertificatesofComplianceare
issued
“onlyaftertheCityhascompletedacomprehensiveinteriorandexteriorinspectionof
thepropertyandhasfoundittobeinsubstantialcompliancewiththeCity's
PropertyMaintenanceCode.”
*
CertificatesofCompliancearerenewedonatwo,four,
orsixyearbasis,dependingontheconditionsandhistoryoftherentalproperty.The
citycodemandatesthat“loosepaintparticlesmustberemoved(fromtheexterior)in
compliancewithleadsafeworkpractices(Sections304.2,304.2.1,304.6
PropertyMaintenanceCode)”andthat“interiorwallsurfaces,includingwindowsand

*
http://grcity.us/communitydevelopment/CodeComplianceDivision/Pages/Rental%20Properties.aspx
88
doors,shallbemaintainedingood,cleanandsanitarycondition(Section305.3
PropertyMaintenanceCode).
Singlefamilycertificationsmustberenewedevery4or6years,whiletwofamily
certificationsmustberenewedevery2,4,or6years.
Mostoftheresourcesfunneledtowardsleadabatementcomefromthecity’sLead
HazardControlprogram.Theprogrammakesfundingavailabletoeligible
landlords/homeownerstoperformleadremediationontheirproperties.Participation
istheprogramisvoluntary.Asof2016,theprogramhadinvested$14millioninlead
remediationrepairstorentalandowneroccupiedproperties.
Thecity’sHousingRehabilitationProgrampublishesthenumberofhomeownerunits
madeleadsafeperyear.Thecity’sLeadHazardControlprogramalsokeepstrackofthe
totalnumberofhomesthathavebeenmadeleadsafe.
0
5
10
15
0
200
400
600
800
1000
1200
1400
2011 2012 2013 2014 2015 2016
$Invested(Mil)
Homes
Year
HousesmadeLeadSafe(Total)
LeadHazardControlInvestment(Tot)
HousingRehabilitationProgram
LeadHazardControlProgram
Figure15GrandRapids:HousesMadeLeadSafe(total)
89
Testing
ThestateofMichiganreportsthat25%ofchildrenundertheageofsixhadbeen
screenedasof2014.Ofthattotal,8.2%werefoundtohaveaBLLexceeding5μg/dL
(bothvenousandcapillarytests).58%ofchildrenagesoneandtwoweretestedand
resultswerethesame.
Enforcement
TheHousingRehabilitationOfficepublishes
*
alistofallrentalpropertiesinthecity
thatwereinspected(bothinteriorandexterior)andwerefoundtobeinsubstantial
compliancewiththePropertyMaintenanceCode.Thelistincludesmorethan14,000
rentalproperties,42%ofthenumberofrentalpropertiesreportedbytheU.S.Census,
suggestingasubstantialrateofcompliance.

*
https://inspections.grcity.us/CitizenAccess/Report/ShowReport.aspx?module=Enforcement&reportID=3
03&reportType=LINK_REPORT_LIST
0
0.5
1
1.5
2
2.5
0
20
40
60
80
100
120
140
160
20112012 20122013 20132014 20142015 20152016
$Invetest(Mil)
Homes
HomesmadeLeadSafe(Annual)
HousingRehabilitationProgram
LeadHazardControlProgram
LeadHazardControlInvestment
Figure15GrandRapids:HousesMadeLeadSafebyYear
90
Strengths&Weaknesses
∞
Comprehensiveness:TheGrandRapidsordinanceiscomprehensiveandprovides
forbothinteriorandexteriorinspectionofallrentalpropertiesbythecity’scode
complianceoffice.
∞
Enforcement:Althoughnotallrentalpropertieshavebeeninspectedandcleared
bythecity,the42%rateofcomplianceissubstantialandsuggestsastronglevelof
enforcement.
∞
Evidenceofimpact:Figuresfor2007showthat22%ofGrandRapidschildren
underagesixtestedforleadwereabovethe5μg/dLthreshold,muchhigherthan
thefigurereportedfor2014(8.2%)withthesameshareofchildrenbeingtested.
∞
Keyweaknessesinprimarypreventionstructure:AlthoughGrandRapidshasa
strongprogram,theshareofchildrentestedstillfallsshortofwhatwouldbe
desirableandsuggeststhatthetruerateofleadpoisoningcouldbemuchhigher
thanwhatisreported.Continuedandexpandedenforcementofthestatuteshould
helpreducetherateoverall,however.
Rochester
StatutoryFramework
TheintentofRochester’sleadordinancewastocreatea
comprehensive,enforceableordinancethatinvolved
stakeholdersfromvariousdisciplinesinadditiontoanalysisof
scientific,medicalandhousingdata.Rochester’sordinance
addressesdatadrivenidentificationofhousingwithpotentialfor
leadhazards,interiorandexteriorinspections,qualitycontrolled
leadhazardremediation,andcompliancereporting.
*

Similartoothermunicipalities,Rochesterassumespaintonthe
interiorand/orexteriorofanyresidentialbuildingconstructed
priorto1978isleadbased.Aleadhazardinspectionisrequired
beforeacertificateofoccupancyforrentalpurposesisissuedor
renewed.
AkeytoprimarypreventioninRochesterisgainingaccesstotheinteriorofunitsfor
testing,requiringavisualexteriorandinteriorinspectionforpossibleleadsources.
AnalysisofhousinglocationsofreportedEBLLscreeningresultsisusedtoidentify

*
KorfmacherprovidesarobustoverviewofthecontextwithinwhichRochester’sleadlawwaspassed&
implemented:Korfmacher,Katrina.“BoundarynetworksandRochester’s“smart”leadlaw:Theuse
ofmultidisciplinaryinformationinacollaborativepolicyprocess”.NewSolut.2010;20(3):317–336.
doi:10.2190/NS.20.3.f.Seewww.goo.gl/PJWR4n
91
“highrisk”housingbyZIPcode,whichrequiresfurtherpassing(orclearance)
requirementswithadustwipe,regardlessofvisualinspectionresults.Inspectionsare
carriedoutbycitycertifiedriskassessorsorathirdpartyleadbasedpaintinspector
(certifiedbytheEPA’sRRPstandards),thelatterofwhicharesubjecttorandomized
auditstoensureconsistencyincompliance.
Allinspections,including,butnotlimitedto,inspectionsperformedaspartof
anapplicationforacertificateofoccupancy...,arenewalofacertificateof
occupancy,orbaseduponthefilingofacomplaint,shallincludeavisual
assessmentfordeterioratedpaintandbaresoilviolations.Withrespecttounits
instructurescontainingfiveorfewerunitsandlocatedinthehighriskarea
identifiedbytheMayorortheMayor'sdesignee,whenthevisualassessment
identifiesnointeriordeterioratedpaintviolation,theownershallcausedust
samplestobetakenandcertifiedtestresultstobeobtained...
*
ThecityinspectiondepartmentreportsinspectionfindingstotheMonroeCounty
HealthDepartmentonanannualbasistofacilitateprogramtransparency,track
progressandprovidedataforcommunitystakeholders.
InthefirstfouryearsoftheRochesterordinance,ownerswerereimbursed$100for
leadclearanceinspections(1,665reimbursementswerepaid).Fundingwas
discontinuedafterfouryears.
AnotherkeyfactorinpromotingleadinspectionswasMonroeCounty’spracticeof
sendingrentalassistancepaymentsdirectlytolandlords.Theabilitytowithholdrental
paymentsfromlandlordsnotincompliancewiththeleadordinanceservesasa
powerfultool.
Testing
From2007
†
through2015,justoversixtyeightthousand,or55%,ofthechildrenaged
6yearsandyoungerthatwerescreenedforbloodleadlevelsinMonroeCountyhad
cityorcombinedcity/countyZIPcodes.Ofthosechildren,3%testedwithabloodlevel
thatwas>=10μg/dL.Thiswasonethirdofthe9%ratethatoccurredoverthefive
yearspriortothenewlegislation.
InaccordancewithrecommendationsfromtheCentersforDiseaseControl,Rochester
modifieditsdefinitionofEBLLtoalowerthresholdof>=5μg/dLin2013.From2013
through2016,10.3%ofchildrenscreenedthatlivedinacityZIPcodehadanEBLLas

*
CityofRochesterPropertyCode§9055,Inspectionsforviolations.Seehttps://ecode360.com/8677786
†
thefirstfullcalendaryearafterRochester’supdatedcomprehensiveleadlawwentintoeffect
92
definedunderthenewCDCguidelines.Thisisonlyaslightimprovementfromthe
11.1%reportedfor2013.
Enforcement
IntheelevenyearssincetheCityofRochesterreviseditsleadordinance,interiorsof
over154,000unitshavebeenvisuallyinspectedfordeterioratingpaintwithanoverall
passrateof95%.Almost43,000ofthoseunitswereinhighriskZIPcodesandwere
referredfordustwipetestingpertheordinance.Overall,88%ofreferredunitswere
giventhewipetesting,ofwhich90%passed.Oftheunitsthatfailedtheinitialdust
wipetesting,98%ofunitswereclearedinsubsequenttesting.
Figure16Rochester:DustWipeTestingYears111
ThereasonforthedropinunitsdustwipetestedinYear6andforwardisunknown.A
possibilitycouldbethatinDecember2011anamendmentwentintoeffectthat
exemptedbuildingcomplexeswithtenormoreunits,seniorhousingandstudio
apartmentsfromdustwipetesting.Abreakdownofbuildingtypewithinthedustwipe
testingdatawasnotavailableforconfirmationofthistheory.Therehasalsobeena
notabledeclineinunitsthatcleareddustwipetestingafteraninitialviolationsince
Year6,fallingtoitslowestinYear11.
93
Almost100,000unitshavehadinspectionsforexteriorleadhazards(deteriorated
paintorbaresoil)sinceYear1,withanoverallpassrateof86%uponinitialinspection.
CostofImplementation&Compliance
Rochester’sexperienceindicatesthatwhilesomeviolationsarecostlytoremedy,
manyarenot.AsurveyoflandlordsconductedbyCGRaftertheprogramhadbeenin
placeforseveralyearsfoundthefollowing
*
:
Onethirdofrespondentsdidnotspendanymoneyonrepairsinpreparingforor
respondingtoaninspection,37%spentbetween$1and$1,000,andtheremaining
30%spentmorethan$1,000,withwindowreplacementscontributingtohigher
costsforsomelandlords.
Ofthoserespondentswhoreportedspendingmoneyonrepairs,theaverage
amountwas$2,618,andthemediancostabout$950.Lessthanhalfofthese
landlordsreplacedwindows;morethanthreequartersrepairedorpainted
windows.
Amajorityofrespondentsreporteddoingtheirownleadrepairwork,which
promptedthestudyteamtorecommendthecitycontinueitseffortstoeducate
andtrainworkerssotheydon’tinadvertentlycreatenewhazards.
Theaveragecostofclearingasingleviolation(morethanoneviolationcanbe
cited)wasabout$150.Duringthestudyperiod,landlordscouldapplyfora$100
granttohelpdefraythiscost.
TheCityofRochesterincurredanaverageannualcostofabout$600,000inlead
lawrelatedexpenses(e.g.,costofadditionalinspectors,dustwipetests,clearance
reimbursementstolandlords).
Duringthestudyperiod,MonroeCountyreceivedaStategrantofabout$246,000,
andinturncontractedwiththeCityforservices,whichhelpeddefraysomecosts.
Strengths&Weaknesses
∞
Comprehensiveness:Rentalunitsbuiltbefore1978mustreceivealeadclearance
beforeacertificateofoccupancyisissuedorrenewed.Housingidentifiedashigh
riskissubjecttoamorestringentleveloftesting.
∞
Enforcement:Apubliclyavailableleadsafehousingdatabaseismaintained,and
periodicreportingtotheMonroeCountyHealthDepartmentandother

*
Boyce,Sarah,etal,“AnEvaluationofRochester’sLeadLaw:20062008”CenterforGovernmental
Research,December2008.Seewww.goo.gl/k2m6e1
94
stakeholdersisrequired.Randomauditsofthirdpartyleadclearancecontractors
arealsoconducted.
∞
Evidenceofimpact:Therewere1,234childrenthathadabloodleadlevelof10
μg/dLorhigherin2002,whichdroppedby65%to426in2007(thefirstfull
calendaryearaftertheordinancewentintoeffect)andwas206in2015.Whenthe
thresholdfordeterminingEBLLwasloweredto5μg/dLorhigherin2013,689
childrenwereidentifiedashavingEBLL,whichroseto782in2015afteradipin
2014to470children.
∞
Keyweaknessesinprimarypreventionstructure:Rigorousenforcement
dependsoncontinuedfundingofcityinspection.