NACCHO



Date Created:6-3-19Date Reviewed/Updated: 6-10-19PRIORITY AREAS: Lead Poisoning Prevention, Asthma Prevention, and Healthy HomesGOAL 1: Reduce the racial disparities in lead poisoning among children aged 0-5 years in the St. Louis Promise Zone from x to the overall rate for St. Louis City and County of y in the next 5 years. GOAL 2: Enable communities to create and sustain healthy homes.GOAL 3: Reduce the racial disparities in child ER visits due to asthma in the St. Louis Promise Zone from x to y in St. Louis City and County in the next 5 years.PERFORMANCE MEASURESShort Term IndicatorsSourceFrequencyIncrease in access to social services and supports for individuals and communities affected by unhealthy housing OneTouch, 2-1-1QuarterlyIncrease in healthy homes inspections for communities affected by unhealthy housingDOH, DPHQuarterlyCreate a coordinated network of service providers for lead poisoning prevention OneTouch 2-1-1PRNSemi-AnnualCreate a coordinated network of service providers for preventable asthma ER visitsOneTouch 2-1-1PRNSemi-AnnualLong Term IndicatorsSourceFrequencyReduce blood lead levels in children MOHSAICMODHSSPRNAnnuallyReduce indoor allergen levels Healthy Homes AssessmentsPRNIncrease the proportion of the local elementary, middle, and high schools that have official school policies and engage in practices that promote a healthy and safe physical school environment School DistrictsTBD(Developmental) Increase the proportion of persons living in pre-1978 housing that has been tested for the presence of lead-based paint or related hazards Government building divisions/inspectorsAnnuallyReduce the number of U.S. homes that are found to have lead-based paint or related hazardsU.S. Census BureauAnnually, 3-YR, 5-YR EstimatesReduce hospitalizations for asthma MODHSSAnnuallyReduce emergency department visits for asthmaMODHSSAnnuallyReduce asthma deathsMODHSSAnnuallyIncrease the proportion of persons with current asthma who receive formal patient educationAsthma and Allergy Foundation, HH Coalition Pediatricians TBDIncrease the proportion of persons with current asthma who receive appropriate asthma care according to NAEPP guidelinesAsthma and Allergy Foundation, HH Coalition PediatriciansTBDGOAL 1: Reduce the racial disparities in lead poisoning among children aged 0-5 years in the St. Louis Promise Zone from x to the overall rate for St. Louis City and County of y in the next 5 years. OBJECTIVE #1.1: Re-establish a LPP & HH Coalition in the St. Louis Region that connects health, home energy use, housing, home visiting, and repair service providers to address the upstream causes.Strategy 1.1.1: ActivitiesTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources1.1.1.1 Create a network of multi-sectoral service providersOctober 2019MOUs with providersDOH, DPH, and community agencies working in the St. Louis Promise Zone Health (PZ)Holistic and cross-sector partners committed to working togetherList of partners currently working in LPP1.1.1.2 Map out guided pathways for community members to access critical social services and supports April 2020MOUs with providers; e-referral database/platformUnited Way 2-1-1Service Delivery CommitteeEntry point for residents to access a curated group of services most likely to meet the most common and under-resourced needs of individuals with or at risk of EBLLsData to identify individuals with or at risk of EBLLs1.1.1.3 Mobilize “front door” organizations to respond to people impacted by lead poisoningMay 2020Trained volunteersFunding for “peer” workforce w/in existing programsUnited Way 2-1-1Service Delivery CommitteeTraining on how to access the guided pathways as well as how to coordinate between agenciesService provider agenciesList of partners currently working in LPP1.1.1.4 Build an integrated and coordinated e-referral systemMay 2020OneTouch or other database/platform such as 2-1-1Members of the HH CoalitionMore effective and efficient service deliveryKnowledge of OneTouch capacity1.1.1.5 Conduct health promotion activities on how to access support for lead poisoning preventionSpring 2020Day care/early childhood centers partnerships time at community meetings to share informationSt. Louis Regional Early Childhood CouncilHealth promotion campaign educating day care/ECE centers, families, and community on lead testing requirements, remediation options, and how to access supportNeighborhood Stabilization Officers (City of St. Louis); DOH, DPH staffOBJECTIVE #1.2: Advocate for funding and resources to support evidence-based practice for lead poisoning prevention (e.g., providing 0% interest loans to low- and moderate-income property owners) and to sustain current interventions Strategy 1.2.1: Use data to drive decision-makingActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources1.2.1.1 Improve public access to local data to better target local prevention and response efforts.OngoingStart date: October 2019MOHSAIC database accessPublic facing websiteEpidemiologists/biostatisticiansCity of St. Louis Department of HealthSaint Louis Department of Public HealthPublic facing dashboardPublished data briefsPresentations MOHSAIC database accessPublic facing websiteEpidemiologists/biostatisticians1.2.1.2 Make lead-risk data available to families, policymakers, and other stakeholdersApril 2020MOHSAIC database accessPublic facing websiteEpidemiologists/biostatisticiansHealth education specialistsCity of St. Louis Department of HealthSaint Louis Department of Public HealthDisseminations tailored to the audienceIncreased knowledge and awareness of lead risks and prevention effortsMOHSAIC database accessPublic facing websiteEpidemiologists/biostatisticiansHealth education specialists1.2.1.3 Decision-maker outreach, engagement, & educationApril 2020Identified decision-makersSocial marketing approachMembers of the HH CoalitionShared decision makingChanges in policy and practicesExpertise in social marketingSkills in stakeholder engagementOBJECTIVE #1.3: Improve childhood lead screening and treatment services among children in high risk areasStrategy 1.3.1: Identify children who have been exposed to leadActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources1.3.1.1 Co-locate blood lead testing in place-based, community settings- SchoolsAugust 2019MOUsSOPsTesting space, equipment, paperwork, staffNurse case manager, phlebotomist School district, schoolsIncreased number of children tested for lead Earlier identification of EBLLsStaff, staff expertiseRelationshipsSOPs1.3.1.2 Co-locate blood lead testing in place-based, community settings- recreation centersTBD with partnersMOUsSOPsTesting space, equipment, paperwork, staffNurse case manager, phlebotomist Increased number of children tested for leadEarlier identification of EBLLsStaff, staff expertiseRelationshipsSOPs1.3.1.3 Co-locate blood lead testing in place-based, community settings- faith-based facilities TBD with partnersMOUsSOPsTesting space, equipment, paperwork, staffNurse case manager, phlebotomist Increased number of children tested for leadEarlier identification of EBLLsStaff, staff expertiseRelationshipsSOPsStrategy 1.3.2: Refer children for proper follow-up treatment ActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources1.3.2.1 Enroll children with <20 ?g/dL in case managementOngoingSOPSNurse case managerImproved health outcomesCase management infrastructure1.3.2.2 Refer children with >20 ?g/dL to hospitalsOngoingSOPSNurse case managerImproved health outcomesCase management infrastructureRelationships Strategy 1.3.3: Ensure that ongoing lead treatment in the built environment is properly managed ActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources1.3.3.1 Remove lead-based paint hazards from pre-1978 homes and daycare centers2024Lead remediation funding, SOPs, legislationCity of St. Louis Building DivisionSaint Louis County Building DivisionReduced environmental hazardsReduced lead exposureImproved health outcomesGrant funding for lead remediation1.3.3.2 Address landlords and other problem property owners failing to comply with remediation mandates2024LegislationEnforcementLegal Services of Eastern MissouriRenter’s Bill of RightsLitigation assistanceImproved enforcementImproved housing conditionsLegislation for problem property ownersGOAL 2: Enable communities to create and sustain healthy homesOBJECTIVE #2.1: Enhance existing healthy homes programs in St. Louis City and CountyStrategy 2.1.1: Healthy Homes Assessments ActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources2.1.1.1 education provided during healthy home visits 2021HH educational materials contextual to the communityHealthy Homes Coalition membersTrained and/or certified Healthy Homes InspectorsImproved knowledgeIncreased skills to modify the home environmentIncreased resources to modify the home environmentExisting educational materials Healthy Homes inspectors2.1.1.2 increase access to services and programsDecember 2020Network of resource providersReferral system for resource providersHealthy Homes Coalition membersTrained and/or certified Healthy Homes InspectorsImproved knowledgeIncreased skills to modify the home environmentIncreased resources to modify the home environmentPartnerships – working on recruiting more!2.1.1.3 TBD with partnersGOAL 3: Reduce the racial disparities in child ER visits due to asthma in the St. Louis Promise Zone from x to y in St. Louis City and County in the next 5 years. Have city and county rates; need STLPZ rateOBJECTIVE #3.1: TBD with partnersStrategy 3.1.1: TBD with partners ActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources3.1.1.1 TBD with partners3.1.1.2 TBD with partners3.1.1.3 TBD with partnersOBJECTIVE #3.2: TBD with partnersStrategy 3.2.1: TBD with partners ActivityTarget DateResources RequiredLead Person/ OrganizationAnticipated Product or ResultExisting Resources3.2.1.1 TBD with partners3.2.1.2 TBD with partners3.2.1.3 TBD with partnersALIGNMENT WITH STATE/NATIONAL PRIORITIESHealthy People 2020National Prevention Strategy or OtherReduce hospitalizations for asthma (RD-2)TBDReduce emergency department visits for asthma (RD-3)TBDReduce asthma deaths (RD-1)TBDIncrease the proportion of persons with current asthma who receive formal patient education (RD-6)TBDIncrease the proportion of persons with current asthma who receive appropriate asthma care according to NAEPP guidelines (RD-7)TBDReduce blood lead levels in children (EH-8)TBDReduce indoor allergen levels (EH-13)TBDIncrease the proportion of the Nation’s elementary, middle, and high schools that have official school policies and engage in practices that promote a healthy and safe physical school environment (EH-16)TBD(Developmental) Increase the proportion of persons living in pre-1978 housing that has been tested for the presence of lead-based paint or related hazards (EH-17)TBDReduce the number of U.S. homes that are found to have lead-based paint or related hazards (EH-18)TBDCommunity Health Improvement MatrixLevel of PreventionLevels of Influence and InterventionIndividualInterpersonalOrganizationalCommunityPublic Policy Contextual/Primarypublic access to local LPP data (sources of exposure, resources available, & rates of exposure)education provided during healthy home visits; increase access to services and programscreate a network of multi-sectoral service providers; re-establish a LPP & HH coalition; build an integrated & coordinated e-referral system; on-boarding providers to the system; day care/early childhood centers educate children & families about lead screening requirementsresident outreach, engagement, & participation; educational presentations on lead hazards, healthy home environments, & available resources; screening events/testing fairsdecision-maker outreach, engagement, & awareness for support of new research and to increase funding for lead poisoning prevention (providing 0% interest loans to low- and moderate-income property owners)Secondary[free] blood lead testinghome inspections (lead-based paint); healthy home environmental assessments; lead laboratory analysis (blood, paint chips, soil, dust wipes, water)Tertiarycase management; care coordination for children with EBLLs; hospitals treat children w/ EBLLs (>20?g/dL)lead remediationservice referrals made to state partnersremoval of lead paint hazards from low-income housing built before 1978 and other places children spend time (day care centers); problem properties court mediates w/ landlords who fail to comply with remediation mandates ................
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