City of Cleveland: Lead Safe Living Program Primary Prevention Best Practices Objectives 01 Review Primary Prevention implementations in comparable municipalities to develop a Best Practices framework that guides Cleveland’s methods and legislation 02 Focus on Rental Registration & Certificate of Disclosure processes as means to collect Lead Statuses and proactively facilitate remediation 03 Identify strategies to maximize the efficacy of the Lead Safe Living Program while minimizing the burden imposed on citizens and city resources 01 Lead Safe Homes Registry 1 Lead Safe Living Program Activity 2 Pre-1978 Residential in Cleveland Rental Structures Rental Registration Lead Safe Homes Registry 3 Private Homes Being Sold Certificate of Disclosure Provides a web-based, public-facing registry that is searchable by address Lead Statuses Includes every structure with a known lead status, listing the status and date of most recent update Abated Remediated Sufficiently Controlled Assumed Safe (post-1978) Lead Status not Determined Lead Paint – No Hazard Visual Assessment – No Apparent Hazard Clearly defines Lead Statuses to help Citizens interpret results Under active development as part of current Accela expansion phase Case Studies Los Angeles Periodic housing inspections by City staff every 4 years, with community group support to facilitate education and proactive remediation Detroit Annual Rental Registration with full Lead Inspection Risk Assessment conducted by City staff that triggers lead hazard violations Rochester Requires periodic rental housing inspections with visual lead assessments conducted by City staff, plus dust wipe inspection by third party providers for target housing Philadelphia Lead Clearance required by third party inspection at lease initiation in target housing, with clearance valid 2 years Maryland Lead Rental Registry for pre-1978 homes only, which tracks lead status based on visual plus dust wipes inspections by third party inspectors Case Studies, Cont. Municipality Rochester Philadelphia Maryland Overview Implications Requires visual assessment (every 3-6 years) by city inspectors to obtain Certificate of Occupancy for rental properties, or in response to complaints; Issues violations based on findings, and may require dust wipe samples in high-risk areas; Utilizes existing legislation for recurring housing inspection to conduct lead inspections. Conditional on heavy resource usage by the city; Analysis since inception suggests that child lead poisoning cases have dropped noticeably without significant impact on the housing market. Requires visual plus dust wipes inspection for “target housing”, any rental structure where a child under 6 will reside; Lead Safe Certificate is valid for 2 years, with significant penalties in place resulting from failure to comply. Designed to link certification with existing Housing Rental License, widespread exemptions mean certification is conditional and difficult to enforce; The definition of target housing may encourage housing discrimination against families and women, rather than efficiently targeting clearance efforts; Recent reports highlight nonexistent enforcement, prompting exploration of further legislative change. Operates a Lead Rental Registry, where annual registration is required for pre-1978 rental structures, though it’s not dependent on lead inspection or report submission; Lead status is captured from a third party visual plus dust wipes inspection and is valid until tenant turnover; Inspection results don’t trigger violations. Limited enforcement has led to lower compliance, while functionally separating rental registration and lead certification reduces the efficacy of both to facilitate primary prevention. Certification at tenant turnover places an especially heavy burden on landlords, where high risk housing is likely associated with transient populations. Case Studies, Cont. Municipality Detroit Los Angeles Overview Implications Requires lead Certificate of Compliance to obtain Certificate of Rental Registration annually or within 90 days of sale; Certificate of Compliance is free but contingent upon a city-conducted, billable Lead Inspection Risk Assessment, valid for 1 year; Lead clearance examination in response to an issued violation must be obtained through a third part risk assessor. Extreme case of primary prevention that imposes heavy burdens on landlords in the interest of maximizing efficacy; Relies on a robust enforcement bureau with capacity to handle large volumes of violations to incentivize compliance; Insufficient staff for inspections has resulted in registration rates below 30% citywide due to outstanding inspections; Evidence suggests that with greater resources to execute, this law establishes an effective tool for primary prevention and revenue generation. City staff conduct rental housing inspections periodically (every 4 years) or in response to complaints; Inspections cost ~$43 and include identification of lead hazards and subsequent issuance of code violations; Community outreach partners work with homeowners prior to inspection to facilitate proactive remediation. Enforcement relies on a state law declaring lead hazards as code violations; Utilizing community partner outreach prior to inspection increases home entry by inspectors from 20% to 80%; Education provided by community partners also facilitates education and increased compliance; Legislation includes restrictions on cost passthrough to tenants related to inspections. Cleveland: Best Practices Primary Prevention Require periodic submission of an up-to-date lead status for pre-1978 rental structures or at residential property transfer Utilize existing City processes (Rental Registration and Certificate of Disclosure) to expand intake of Lead Statuses and populate the Lead Safe Homes Registry Require Visual Lead Inspection by a third party provider to mitigate the use of City staffing resources Require submission of a standardized Lead Status Document to streamline processing by City resources Manage intake in B&H, with review and enforcement initiated by CDPH Phase in requirements to distribute workload on City staff and to facilitate a private industry for inspection Provide primary prevention education to citizens through issued recommendations by CDPH Provide primary prevention resources to citizens through a more robust Lead Safe Homes Registry Cleveland: Best Practices, Cont. Why Visual Lead Assessments? Minimizes costs for homeowners and their tenants in lieu of full risk assessments Lowers the threshold of entry for service providers and encourages private industry growth Provides sufficient grounds to issue peeling paint violations and abatement recommendations, but not Lead Hazard Control Orders Maximizes the efficacy of inspection resources while minimizing the burden put on homeowners, tenants, and city staff alike to conduct and process. Maximize Inspection Efficacy Minimize Landlord & Tenant Burden Visual Inspection Considerations Legislation should include enforcement provisions that provide incentives for landlords and a mechanism for the City to ensure proper compliance Alternate avenues for Primary Prevention, especially community outreach partnerships and public education, must be considered in parallel Additional requirements placed on landlords and tenants should not adversely affect the housing market or availability of affordable rental housing Acceptance of Lead Status Certification documents should not hinder the existing Rental Registration intake or Building & Housing violation processes Short-term investment in lead hazard primary prevention produces desirable ROI from an economic and public health perspective Resources Rochester: http://ecode360.com/8677794 http://www.cityofrochester.gov/article.aspx?id=8589936091 Philadelphia: http://www.phila.gov/health/pdfs/Lead_Paint_Disclosure_and_Certification_Law.pdf http://www.phila.gov/health/pdfs/FAQleadlaw_3_13_13abc.pdf Maryland: http://www.mde.state.md.us/programs/Land/Documents/LeadFactSheets/LeadfsStandardOfCare.pdf http://www.mde.state.md.us/programs/Land/Documents/LeadFactSheets/LeadfsLeadPaintCertificatesForRentalHousing.pdf http://www.mde.state.md.us/programs/Land/LeadPoisoningPrevention/HealthCareProviders/Pages/Programs/LandPrograms/Lea dCoordination/healthCare/index.aspx Detroit: http://www.detroitmi.gov/How-Do-I/Register/Rental-Property-FAQs https://www.michigan.gov/documents/mdhhs/CLPPP_2013_Data_Report_502175_7.pdf Los Angeles: http://www.healthyhomescollaborative.org/Information/Lead/LACityLeadPoisoningPreventionPilotProgram/tabid/67/Default.aspx Other: EPA “Visual Plus Dust Wipes” Field Guide: https://www.epa.gov/sites/production/files/documents/ldstguide.pdf NCBI “Local Laws” Report: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967847/