Residential Lead Abatement
Staff Briefing
September 22, 1999

Introduction. Lead is highly toxic and is considered a serious environmental health threat to children. The most common sources of lead poisoning exposure for children are lead-based paint (LBP) that has deteriorated into paint chips and lead dust, and soil contaminated with lead. Lead dust settles quickly, is difficult to clean up, and can be invisible to the naked eye. Young children are often poisoned through normal hand-to-mouth activity after they get lead dust on their hands and toys.

The sale of lead-based paint for residential use was banned in 1978. Less common sources of exposure include lead gasoline (which was banned in 1978), lead in household pipes, food cans (banned in the U.S. in 1995), imported ceramics and miniblinds, and some traditional folk remedies. In addition, parents who work in certain high-risk occupations may bring lead dust into the home.

Lead serves no purpose in the human body. Lead poisoning occurs because the body cannot distinguish between lead and calcium, which is a mineral that strengthens bones. When lead is absorbed into the body it remains in the bloodstream for several weeks before it is absorbed into the bones, where it can collect over a lifetime. Exposure to lead hazards is especially dangerous for children under age six because their brains and nervous systems are still developing, and, therefore, are particularly sensitive to the effects of lead.

Blood lead levels (BLLs) are used to measure the presence of lead in the body, and even low lead levels are associated with decreased intelligence, reduction in attention span, reading and learning disabilities, and behavioral problems. At high BLLs, lead poisoning can cause seizures, coma, and death. Elevated BLLs in pregnant women are also dangerous and are associated with an increased chance of illness during pregnancy as well as causing harm to the fetus.

CDC Guidance

Although the federal Center’s for Disease Control (CDC) does not mandate states screen children for lead poisoning, it issues guidelines, followed by most states including Connecticut, on lead screening and treatment. As the adverse health effects of lead poisoning have become known, the CDC has decreased the level of lead in blood it considers harmful. In 1985, the CDC lowered the level for diagnosing childhood lead poisoning by 40 percent from 40 to 25 micrograms (mcg) of lead per deciliter (dL) of blood. (A microgram is a millionth of a gram; a deciliter is about one-fifth of a pint.) The level was again lowered in 1991 from 25 mcg/dL to 10 mcg/dL.

CDC screening policy. Current screening guidelines were published in November 1997 in a document called Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials. The 1997 policy recognizes that lead exposure is highly variable across the country, with some children at high risk and others at very low risk. As a result, CDC recommends state and local health departments assess local data on lead risks and develop lead screening recommendations for health care providers in their jurisdictions, especially focusing on one- and two-year old children. Depending on state and local risk data, in some places it is appropriate to universally screen all children at ages one and two, and screen all children from 36 to 72 months of age who have not been screened previously. In other places, it is appropriate to screen only some children based on specific risk factors (targeted screening).

The CDC’s document provides detailed guidance for state and local health departments in establishing their state lead screening plans, including advice on assessing lead risks, promoting the participation of affected constituents in developing recommendations, and communicating the screening recommendations clearly. In its guidelines, the CDC recommends states focus on three groups because of their high risk for lead poisoning. They are children:

• living in geographic areas with a high concentration of old housing;
• receiving public assistance under programs for the poor, such as Medicaid and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and
• with other identified individual risk factors.

However, if states do not have the necessary data needed to develop a statewide plan and target screening, CDC recommends continuation of its 1991 policy of universal yearly screening for all children ages 6 months to 72 months.

Treatment policy. The CDC’s guidelines recommend all screening results equal to or greater than 10 mcg/dL be confirmed with a diagnostic test (venous) and various actions be taken at specific elevated blood lead levels (EBL). These guidelines are enumerated in Table I-1. In general, confirmed BLLs of 10 to 19 mcg/dL require monitoring the child by further testing and providing family education on how to reduce ongoing lead exposure. More aggressive measures, including a full medical evaluation and the need to have a complete environmental investigation (which may require abatement of lead hazards from the child’s residence and are discussed in Section II), are recommended at BLLs of 20 mcg/dL and above.

Blood lead level trends. The CDC’s National Health and Nutrition Examination surveys (NHANES), an ongoing series of national examinations of the health and nutritional status of the civilian noninstitutionalized population, have been the primary source for monitoring BLLs in the U.S. population. These surveys have shown a marked decline in the prevalence of elevated BLLs in recent years, primarily attributed to the ban on lead in: paint; gasoline; food and drink cans; and plumbing systems in the United States during the 1970s. Comparison of the data contained in the NHANES II survey performed between 1976–1980, and NHANES III (1991-1994), indicate the percentage of U.S. children less than age six with elevated BLLs dropped from 88.2 percent in the late 1970s to 4.4 percent in the early 1990s (see Figure I-1). In addition, the overall mean BLL for children one to five years old decreased from 15.0 to 2.7 mcg/dL during this time period.

Prevalence of lead poisoning in children. Despite public health goals to reduce lead poisoning and accompanying declines in lead poisoning, in 1997 the CDC estimated 890,000 (4.4 percent) of U.S. children under age six still have BLLs equal to or greater than 10 mcg/dL. Therefore, lead poisoning still remains a serious threat for many children. Recent studies conducted by the U.S. General Accounting Office (GAO) as well as results of the NHANES III survey have found children who are poor, non-Hispanic Black, and/or living in urban areas where older housing is deteriorated have a greater prevalence of lead poisoning. A discussion of these factors and their link to lead poisoning is discussed below.

Age factors. Table I-2 shows the results of the NHANES III survey by age group. Children in the one and two year age group are those most at risk from lead poisoning, and the survey indicated almost 6 percent in that age group had BLLs equal to or greater than 10 mcg/dL. This is somewhat higher than the prevalence in children overall, which is 4.4 percent. In addition, among children aged one to five years, 1.3 percent had BLLs greater than or equal to 15 mcg/dL, and only 0.4 percent had BLLs greater than or equal to 20 mcg/dL.

Race/Ethnicity factors. Information from NHANES III (shown in Table I-3) depicts a strong relationship between blood lead levels and race/ethnicity. For example, the table shows the percent of Black children with elevated BLLs (11.2 percent) is almost five times greater than White children (2.3 percent).

Income factors. Figure I-2 depicts the prevalence of children with elevated BLLs by family income (defined as the ratio of total family income to the poverty threshold for the year of the interview). Although all children are at risk for lead poisoning, the NHANES III survey indicates the prevalence of elevated BLLs for low-income children is much greater than for high-income children. Furthermore, the percent of children with elevated blood lead levels for middle-income children (1.9 percent) was almost double the high-income children (1 percent).

Children receiving federal health care programs. A January 1999 study by GAO based on NHANES III survey data, found the prevalence of elevated BLLs for children enrolled in federal health care programs was 8.4 percent, nearly five times the rate for children not in these programs. GAO analyzed data by individual health programs for children ages one through five and found the prevalence of elevated BLLs for children receiving Medicaid was 8 percent and WIC was almost 12 percent. In its report, GAO estimates 688,000 (77 percent) of the estimated 890,000 children who have elevated blood lead levels nationwide are enrolled in Medicaid or WIC, or are within the target population served by the Health Center Program (targeted to uninsured and low-income families).

Age of housing stock. The age of housing stock is another important factor in determining risk for exposure to lead hazards. Although the primary cause of lead poisoning in children is lead-based paint in pre-1978 housing, the mere presence of lead-based paint is not a hazard. Rather, childhood exposure to lead usually occurs in two ways: deteriorated paint (and resulting dust) in poorly maintained housing, and repainting and remodeling projects that disturb leaded paint without appropriate safeguards to control, contain, and clean-up lead dust.

All homes built prior to 1978 are considered to be potential sources of exposure to lead-based paint, however housing built before 1950 generally contains the highest amount of lead-based paint, since paint used at that time had a high lead content. A 1990 report issued by the Department of Housing and Urban Development (HUD) estimated full removal of lead-based paint in U.S. housing stock would cost $500 billion.

Table I-4 compares New England’s housing stock built before 1950 with the total housing units in each state as well as with the United States. As shown in the table, New England has a much higher percent of older housing stock compared to the U.S. total. Massachusetts has the greatest percentage of housing units built before 1950 (47 percent of total housing units), followed by Rhode Island (44 percent) and Maine (41 percent). In Connecticut, 35 percent of the state’s total housing units were built prior to 1950.

Screening. Blood lead screening of children is an important element in detecting lead poisoning since most children display no obvious symptoms. The state Department of Public Health (DPH) maintains a childhood Lead Surveillance System (LSS) as part of the Childhood Lead Poisoning Prevention Program. The system contains information on children under age six who have been tested for lead poisoning. However, there are several limitations to the database including:

• mandated reporting of all lead screening tests was not required until October 1998, thus data on the total number of children screened prior to that date is incomplete;
• the system does not distinguish between new lead poisoning cases and those carried over from a prior year;
• CDC guidelines do not mandate every child be screened annually up to age six, therefore, lower screening rates for older children do not mean poor state performance;
• data are maintained on a calendar year (CY) basis rather than for birth cohorts, and therefore calendar screening rates can be lower;
• no information is collected on children’s health insurers or family income, therefore, comparisons to national data cannot be performed; and
• although required by statute, race/ethnicity data are incomplete, therefore, incidence rates cannot be compared among various ethnic groups in Connecticut.

Screening rates. Given these caveats, Table I-5 shows screening rates for all children under age six as well as the percent of children aged one and two screened in CY 1998. Based on 1990 census data, there were 272,294 children less than six years old in Connecticut, of which 87,503 were age one or two. Twenty percent of children under age six (54,850) had a valid screen for lead poisoning in 1998. Furthermore, 30 percent of children aged one and two statewide had a valid lead screen in CY 1998. Children living in Hartford had the highest screening rate overall and those in Stamford the lowest.

Program review committee staff recognizes 1990 census data are not the most accurate population statistic to use in 1999, especially when measuring a segment of the population not even born in 1990. However, 1990 census data are the population database DPH uses as its base to calculate the percent of children screened for lead poisoning in each calendar year. Committee staff compared the 1990 population with 1998 population estimates and birth statistics statewide and calculated the number of children under age six in 1998 was approximately 263,000. This is a decrease of about 3.5 percent since 1990 but certainly not a significant decline. Further, the variation between the 1998 estimates and the 1990 census data for any of the individual towns cited did not exceed 5.5 percent in either direction.

Pilot project. The state Department of Public Health conducted a pilot project on lead screening rates in Hartford to determine if Medicaid recipients had received a blood lead screening in 1997 as required by Medicaid. The study examined children born in Hartford in 1995 who were Hartford residents and recipients of Medicaid managed care during all of 1997. The results show 73.5 percent of the children meeting the study criteria were screened in 1997. The percent of children screened increased to 93.2 percent when the study criteria were broadened to include children in the study group who were screened at any time since birth. In addition, the department tracked all Hartford residents born in 1995 and found 90 percent had been screened at least once for lead poisoning. Similar pilots are being conducted in Bridgeport, Montville, New Haven, Norwich, and Waterbury. Comparisons with national screening data however, could not be made because of the difference in methodology between this study and national surveys.

Incidence of lead poisoning. Table I-6 shows the number of children screened and identified statewide with an elevated blood lead level in 1998 and by the top five towns. (A complete listing for all towns is provided in Appendix A.) Overall there were 54,850 children less than age six with a valid lead screen -- 4.6 percent had a BLL equal to or exceeding 10 mcg/dL and of those, 1.1 percent were equal to or greater than 20 mcg/dL. Since CDC’s 1997 screening guidelines specifically recommend targeting children age one and two, incidence data for this age group are also shown in the table. In terms of one- and two-year-old children, there were 26,401 with a valid lead screen – of those, 4.6 percent had BLLs equal to or greater than 10 mcg/dL and 1.2 percent equal to or greater than 20 mcg/dL.

Of the 2,522 screening results with BLLs 10 or greater, 23 percent had levels equal or greater than 20 mcg/dL -- the level at which an epidemiological as well as an environmental investigation must occur under Connecticut’s lead law. For one and two year olds, 1,220 had levels of 10 mcg/dL or greater, and 26 percent of those children had an elevated level of 20 mcg/dL or greater.

As depicted in the table, Bridgeport had the greatest number of children with elevated blood lead levels, followed by New Haven, and Hartford. These three cities, the largest in Connecticut, have the greatest number of children less than six years old, high poverty rates, and a large portion of their housing stock was built prior to 1950.

Connecticut’s housing stock. As noted above, housing built prior to 1950 has the greatest likelihood of containing lead paint, and thus, children residing in those housing units are at a higher risk for lead poisoning. Thirty-five percent of Connecticut’s housing stock was built prior to 1950 and 84 percent before 1980. Table I-7 shows those Connecticut towns with the highest percentages of pre-1950 housing by county.

Housing condition is strongly related to the economic status of the people who live in it. Low-income households often cannot afford to adequately maintain and/or repair the units in which they live. As a result, a large portion of Connecticut’s housing stock presents a potential hazard for lead-based paint poisoning, and the major portion of that stock is found in larger municipalities where low- and very low-income persons are most likely to reside.

In its Consolidated Plan for Housing and Community Development (January 3, 1995), the Department of Economic and Community Development estimated the number of Connecticut housing units at high risk of having lead paint hazards. These estimates (shown in Table I-8) indicate 17.7 percent of CT’s total housing units present a potential lead-paint hazard to the families who live in them.

As shown in the table, there are 980,164 housing units in Connecticut, with low-income households occupying 306,191 units. Furthermore, the department estimates 77 percent (235,748) of low-income housing units are potentially high risk for containing lead paint hazards. Thus, a significant portion (24 percent) of Connecticut’s total housing stock presents a potential lead hazard risk. It is important to note, however, the number of low-income units occupied by children who are at the greatest risk for lead poisoning, is not estimated by the department.

Although BLLs in the U.S. population have dramatically declined since the late 1970s, the risk for lead exposure remains disproportionately high for some groups. As a result of the decline in prevalence, and survey data showing age, income level, race/ethnicity, and age of housing are key factors in determining children’s risk for lead poisoning, CDC revised its guidelines in 1997. The guidelines recommend state health departments assess local data on lead risks and develop

either universal or targeted screening recommendations based on the data. In addition, CDC recommends screening policy be focused on one- and two-year old children, since this age group nationally proved to have the highest prevalence of elevated blood lead levels.

Connecticut currently recommends, but does not mandate, all children between the ages of one and six be screened for lead poisoning, with particular focus on children ages one and two. Connecticut’s policy of universal screening is based on the fact 35 percent of the state’s housing stock was built before 1950 and prevalence data needed to develop a more targeted screening guideline are not available.

As the dangers of lead hazards to children have become more widely known, federal and state laws aimed at preventing childhood lead poisoning have grown more complex since legislation was first enacted in 1971. Multiple federal agencies are responsible for administering laws passed by Congress, providing funding to states, and developing regulations, policies, and guidelines to assist states in administering their own lead programs. This section describes the government structure in place to combat lead poisoning and the role of the federal government in lead prevention. Connecticut’s response to the federal initiatives is also summarized.

Introduction. Figure II-1 identifies federal, state, and local agencies responsible for lead prevention and/or abatement activities. At both the federal and state level, the focus is concentrated on two activities:

 

• ensuring primary and secondary lead prevention activities occur to protect or treat the child (i.e., education, screening, surveillance, and case/medical management, and environment clean-up); and

   

• establishing thresholds for abatement of lead hazards and ensuring proper abatement methods are used.

Federal structure. At the federal level, the Department of Health and Human Services, through the Centers for Disease Control, issues guidelines for screening young children, details case management activities for children who are lead poisoned, and provides funding for prevention and education programs. As noted in Section I, CDC recommends state and local health departments assess state and local data on lead risks and adopt a statewide lead screening plan that recommends either universal or targeted lead screening. In addition, CDC grants are available to states to conduct prevention activities.

Medicaid requirements. Under Medicaid, all children are considered at risk and must be screened for lead poisoning. The Health Care Financing Administration (HCFA) requires all Medicaid-eligible children receive a screening blood lead test at 12 months and 24 months of age. Children between the ages of 36 months and 72 months of age must receive a screening blood lead test, if they have not been previously screened for lead poisoning. If a state adopts a statewide plan for screening children for lead poisoning (as recommended by the CDC) the plan must require lead screening for all Medicaid-eligible children.

Other federal agencies. The Department of Housing and Urban Development (HUD) is the lead agency responsible for federal efforts to eliminate lead-based paint hazards from housing in the United States. Grants are available from HUD to state and local governments to provide financial assistance to private property owners to abate lead hazards. The Environmental Protection Agency (EPA) coordinates and uses its regulatory authority to reduce lead in the environment, and the Department of Labor protects workers from lead dangers. The EPA offers grants to states to operate their lead licensing and certification programs for lead contractors and workers.

State structure. At the state level, the Department of Public Health operates the Childhood Lead Poisoning Prevention Program, which oversees prevention activities, and ensures local health departments (LHDs) enforce Connecticut’s lead laws related to lead inspections and abatement. The department also issues screening and treatment guidelines, funds two Regional Lead Treatment Centers (one at Saint Francis Hospital and another at Yale), and promotes educational activities. In addition, the Department of Economic and Community Development administers federal and state grant/loan programs that can be used by private property owners to pay for lead abatement expenses.

Local structure. Finally, at the local level, 108 health departments/districts are responsible for conducting epidemiological investigations once a child is identified as lead poisoned. In addition, health departments/districts or local code enforcement agencies conduct environmental investigations, issue abatement orders to property owners if lead hazards are present, and ensure compliance with the order through re-inspection or referral to the courts. Educational activities focusing on the hazards of lead also occur at the local level.

Initial federal legislation. Concern about the hazards of lead prompted federal action in 1971 when Congress enacted the Lead-Based Paint Poisoning Prevention Act (LPPPA). The act provided a definition of lead-based paint (any paint containing more than 1 percent lead by weight) and also initiated programs to screen children and abate the sources of lead in residential housing by providing funds to states to establish programs. Amendments to the act gave HUD significant responsibility for lead-based paint hazards (1973) and lowered the standard for allowable lead in paint from 1 percent to .06 percent (1977), the current standard. Specifically, the LPPPA directed the Department of Health and Human Services to:

• prohibit the use of lead-based paint in residential structures constructed or rehabilitated by the federal government or with any form of federal assistance;
• establish a national program to encourage and assist states and cities to conduct mass screenings to identify children with elevated blood lead levels and make sure they receive medical treatment;
• investigate children’s residences for sources of lead; and
• order abatement of lead from the residences if necessary.

The CDC administered appropriations under the act, which provided for the establishment of screening programs until 1981, when funding was incorporated into the Maternal and Child Health Services Block Grant (MCH). Currently, states that receive MCH grants may, but are not required to use these funds for childhood lead poisoning prevention.

1988 federal legislation. The Lead Contamination Control Act (LCCA) was enacted in 1988. The act authorized CDC to provide grants to states and towns to administer a program for preventing childhood lead poisoning. As part of the program, funding is available for screening, referral of cases of elevated blood lead levels for treatment and environmental case management, and for education to high-risk communities. Major provisions of the act regulate drinking water to ensure it is lead safe.

The Residential Lead-Based Paint Hazard Reduction Act. Major changes in the law occurred in 1992, with the passage of "The Residential Lead-Based Paint Hazard Reduction Act" (Title X of the Housing and Community Development Act). The act shifted the requirements of previous federal lead legislation from full abatement of lead-based paint in federally subsidized housing (primarily public housing) to finding and fixing lead-based paint hazards in all housing before children are poisoned. The purpose of Title X is to:

• provide a priority-based framework for evaluating and reducing lead-based paint hazards;
• ensure responsible action by federal agencies;
• mobilize resources expeditiously for effective national prevention efforts; and
• strengthen the abatement industry’s quality and capacity by requiring licensing and certification of abatement contractors and other personnel.

Agencies responsible for implementation. The act requires several federal agencies to establish a coordinated effort to reduce lead hazards. Three main agencies are responsible for implementation of Title X -- the Department of Housing and Urban Development; the Environmental Protection Agency; and the Occupational Safety and Health Administration (OSHA) of the U.S. Department of Labor. Specific requirements of Title X, including the agency responsible for implementation, are listed in Table II-1. In general, the act:

• imposes detailed requirements and deadlines for lead hazard reduction on federally owned, insured, and assisted housing (with the exception of Section 8 housing);
• promotes lead hazard reduction in privately owned housing through the provision of state and local grants;
• requires training and certification or licensure of abatement contractors, risk assessors, and lead inspections;
• establishes a national task force to examine issues of lead abatement;
• requires disclosure of known lead hazards by private property owners;
• directs HUD to develop technical guidelines for hazard evaluation and control practices and to overhaul its regulations related to lead-based paint;
• directs EPA to set standards for lead contaminated dust and soil hazards and for states to accredit laboratories; and
• provides for public outreach and education.

Defining lead hazards. Title X defines "lead-based paint" as paint on surfaces with a lead concentration of 1.0 milligram per square centimeter (mg/cm2) or 0.5 percent by weight. The .06 percent threshold for the actual lead content in new paint, established in 1977, was not changed.

The act focuses resources on situations believed to present lead exposure hazards, not just on any lead paint, and defines the term "lead-based paint hazard" as any condition that causes exposure to lead sufficient to cause adverse human health effects. Six situations are cited:

• deteriorated LBP – any interior or exterior LBP that is peeling, chipping, chalking, or cracking or located on any surface or fixture that is damaged or deteriorated;
• LBP on any friction surface – an interior or exterior surface subject to abrasion or friction, such as painted floors and friction surfaces on windows;
• LBP on any impact surface – an interior or exterior surface subject to damage by repeated impacts, such as parts of door frames;
• lead-contaminated dust – surface dust in residential dwellings that contains an area or mass concentration of lead in excess of the standard to be established by EPA; and
• lead-contaminated soil – bare soil on residential property that contains lead in excess of the standard to be established by EPA.

Federal guidelines and standards. Title X requires HUD to develop technical guidelines for hazard evaluation and control practices and overhaul its regulations related to lead-based paint. The guidelines, developed in 1995, provide comprehensive, detailed technical information on how to identify and safely contain and control lead-based paint hazards in housing.

Furthermore, EPA issued guidelines in 1994 on dangerous levels of lead in paint, interior household dust, and soil, pending further research that would allow for adoption of health-based standards. Currently, EPA is in the process of finalizing proposed standards (as required under Title X) that identify the conditions and/or levels of lead in paint, dust, and soil that present risks to young children. The rule also establishes residential, lead-dust cleanup levels (i.e., what the acceptable thresholds are for lead dust after abatement) and revises dust and soil sampling requirements. Under the proposed rule, lead-based paint is considered to be in "poor condition" and, therefore, a hazard when there is:

• more than two square feet of deteriorated paint on interior components with large surface areas;
• more than 10 square feet of deteriorated paint on exterior components with large surfaces; or
• deteriorated paint on more than 10 percent of the total surface area of interior or exterior components with small surface areas.

The presence of lead-based paint is identified through an inspection or a risk assessment. A lead-based paint inspection is a surface-by-surface examination of a residence to determine the presence and location of lead-based paint. An inspection does not identify hazards; a risk assessment is used for that. A risk assessment is an on-site investigation to identify and report the existence, nature, severity, and location of lead-based paint hazards.

If the EPA rule is adopted, it will be limited to supporting the implementation of other provisions of Title X. These provisions include requiring property owners to disclose lead-based paint hazards to buyers or tenants, identifying and controlling hazards for federally assisted and federally owned housing, establishing criteria for risk assessors to use when conducting a lead-based paint risk assessment, and developing a standard to determine when certified lead workers are required.

In addition, HUD intends to link a state and local government’s eligibility for the HUD Lead-Based Paint Abatement Grant Program for private property owners to that state’s adoption of the EPA standard (or one at least as protective).

Title X requirements by type of housing. Title X addresses three types of housing – federally assisted or owned, public, and private. Figure II-2 shows the act’s requirements differ depending on the type of housing. For example, in federally assisted or owned housing, complete evaluations of lead-based paint hazards must be conducted and corrected by specific dates. A more detailed description of what the act requires, by type of housing, is provided below.

Federally assisted and associated housing. Many of the key provisions of Title X are designed to substantially expand the scope of lead-hazard evaluation and reduction activities in federally owned and assisted housing. As of January 1995, the act requires, within available appropriation, lead-hazard reduction (interim controls or abatement) in federally assisted, associated, or owned housing. This is to be accomplished by conducting risk assessments or inspections to identify the presence of lead paint hazards, using the six criteria cited above.

Specific time frames are laid out in Title X to conduct risk assessments and inspections and reduce hazards by using either short-term (interim controls) or long-term (abatement) interventions. Interim controls temporarily reduce exposure to lead hazards and include such measures as temporary containment, repairs, repainting, and specialized cleaning. Long-term interventions include abatement measures such as paint removal, enclosure, encapsulation, or component replacement (e.g., windows). Implementation of these requirements has been problematic according to DPH and DECD staff, and HUD has not met the time frames established under the act, largely due to lack of funding.

The act allows LBP-hazard evaluation and reduction activities to be eligible for funding under Community Development Block Grants, HOME grants, all HOPE programs, rural housing programs, FHA Home Improvement and Rehabilitation Loans, and makes them eligible insert rehabilitation activity under FHA Insurance for Multifamily Housing. Abatement requirements also apply to federal agencies that own or control properties that may eventually be transferred to residential property.

Public housing. For public housing, Title X leaves intact the 1988 statute’s requirements for inspections of all developments by December 1994, and abatement of all lead-based paint (not just lead-based paint hazards) in the course of modernization projects.

Private property. Although interim controls and abatement are required in federally owned and assisted properties, it is important to remember there are no similar federal mandates for privately owned property. However, the act does impact private property owners in three ways:

• Lead hazard disclosure for selling or leasing pre-1978 housing. Private property owners of pre-1978 properties and their agents seeking to sell or lease the property must provide prospective buyers and tenants an educational pamphlet (developed by EPA, HUD, and the Consumer Product Safety Commission) about lead hazards to children and disclose known information about the presence of lead-based paint and lead hazards in the particular property. In addition, buyers have up to 10 days to hire a lead inspector or a risk assessor to inspect the property at their own expense. Joint HUD and EPA regulations implementing these provisions became effective in December 1996. Civil penalties may be imposed on owners not complying.
• Renovation activities. As of June 1, 1999, the EPA requires renovators, working for compensation, to distribute a pamphlet to owners and occupants of most housing built prior to 1978 before beginning renovation activities. Renovation activities that disrupt more than 2 square feet of paint are covered by this rule. The pamphlet discusses ways in which individuals can protect themselves and their families from lead-based paint hazards.
• Grant funds to abate lead hazards in private property. Title X established a grant program that authorized HUD to distribute funds to states and municipalities to reduce lead paint hazards in privately owned housing built before 1978 and occupied by low-income families. Connecticut received a $6 million grant award in 1995, and recently submitted a $4 million application for another HUD grant. A decision is not expected until fall/winter 1999.

Task force recommendations. Title X also established a national task force to examine several issues including legal liability, insurance, and financing of lead abatement activities. Task force membership had broad representation and included: property owners; tenants; attorneys; lenders; insurers; contractors; and experts and advocates for lead poisoning prevention. The task force’s final report Putting the Pieces Together: Controlling Lead Hazards in the Nation's Housing was issued in July 1995 and contained numerous recommendations, which are discussed below.

Essential maintenance practices. The recommendations called for the establishment of a set of "benchmark standards," which identify the steps owners of rental property need to take to control lead hazards. For well -maintained properties, which are considered low risk, a set of "Essential Maintenance Practices" (EMPs) applies. EMPs are aimed at keeping paint intact and thus preventing deterioration of leaded paint. EMPs are considered low cost. They rely on property maintenance staff having a one-day basic training session in lead safety, which emphasizes the need to control, contain, and clean up lead dust generated in repair, repainting, and remodeling projects. In July 1997, HUD and EPA issued a one-day training course for rental property maintenance workers.

For "higher priority" properties, the task force called for more aggressive measures, including giving property owners the option of:

• hiring a certified risk assessor to determine if the paint contains hazardous lead levels and whether soil is contaminated, or
• performing a prescribed set of "Standard Treatments," primarily when the rental unit turns over. These include: repairing deteriorating paint; providing smooth, cleanable surfaces to avoid trapping lead dust; covering or limiting access to bare soil; specialized cleaning; and follow-up testing of floors and window sills to ensure successful removal of lead-contaminated dust.

The task force also recommended that states pass legislation to provide incentives for rental property owners to implement effective hazard controls, including limiting legal liability for those who can independently document compliance with maintenance practices. The task force’s recommendations were drafted into model legislation by the National Conference of State Legislatures (NCSL) in August 1996.

While no state has fully adopted the model law, several state and local governments have implemented parts of it. For example, since Vermont's lead law was passed in 1996, more than 6,500 individuals, primarily rental property owners and managers, have received Essential Maintenance Practices training.

The Department of Public Health has primary responsibility for lead prevention activities and oversight of enforcement actions conducted by local health department and code enforcement agencies. The Department of Economic and Community Development, the lead agency for housing programs, offers consumer loan/grant programs that private property owners may use to abate lead hazards. In addition, the Departments of Administrative Services, Consumer Protection, and Education have statutory responsibilities related to lead prevention activities.

History. Although Connecticut has required reporting of elevated blood lead levels by physicians since 1971, it did not begin an aggressive lead program until 1987. Public Act 87-304 established a Lead Poisoning Prevention Program (LPPP) in the then Department of Health Services (currently the Department of Public Health). The act required the health commissioner to:

• conduct educational and publicity activities on lead poisoning prevention;
• establish an early diagnosis and detection program that would routinely screen young children;
• attempt to identify dwellings and areas with toxic levels of lead;
• adopt regulations concerning certifying lead inspectors and lead abatement and removal contractors; and
• adopt regulations on removal and abatement materials.

The act also required that property owners remove or cover toxic lead materials if children under aged six resided in the dwelling.

Public Act 87-304 has been modified several times; each time the law became more stringent. For example, following the guidelines issued by the Centers for Disease Control two acts lowered the blood lead concentration that defines lead poisoning. Public Act 87-304 substituted 25 mcg/dL for the previous 40 mcg/dL as the reportable level for lead poisoning. Public Act 92-192 again lowered the reportable blood lead level threshold (from 25 mcg/dL to 10 mcg/dL) and specified the local health official must conduct an epidemiological investigation of the lead source upon receiving a report of a blood lead level of 20 mcg/dL. Most recently, P.A. 98-66 required the reporting of all blood lead tests, regardless of the lead level. Other legislation adopted in the early 1990s established two regional lead poisoning treatment centers and directed the DPH commissioner to establish guidelines for assessing the risk of lead poisoning, screening, and follow-up in accordance with CDC guidelines. (For a complete legislative history see Appendix B.)

Current law and regulations. Regulations for the program became effective September 1992 and, together with C.G.S. 19a-110 through 19a-111e, define Connecticut’s lead policy. Under Connecticut law, property owners are liable for abatement of defective interior and exterior surfaces that contain toxic levels of lead and are in a residential dwelling where children under the age of six reside or may reside. The regulations do not require a child be diagnosed with an elevated blood lead level in order for them to be applicable. However, if a child has been identified with an elevated blood lead level, stricter requirements ensue.

Reasons for inspections. In most cases, an epidemiological investigation by a local health department and an environmental investigation by either the LHD or code official is triggered by a report of a child’s elevated blood lead level equal to or greater than 20 mcg/dL. It is important to note, that 20 mcg/dL is the state-mandated blood lead level, which then requires health departments or code enforcement official to conduct an inspection. A town’s municipal ordinance or building code may have stricter requirements with lower thresholds. In addition, inspections can occur in rental properties as a result of a complaint by a tenant or at unit turnover. Inspections data are kept by DPH, but the data do not include the reasons for inspections.

Abatement requirements. Figure II-3 shows lead abatement requirements under the most common scenario (i.e., a child has a high lead level). As depicted in the figure, if a child is tested and his or her blood lead level is under 20 mcg/dL, or the child is six years old or older, the results must be reported to the Department of Public Health, but no further action is required. However, if the blood lead level is 20 mcg/dL or greater, and the child is under aged 6, the law requires an epidemiological investigation and an inspection of the child’s residence be conducted by the local health department or building code enforcement agency. The inspection requires a representative sample of walls, floors, windows, exterior surfaces, and soil be tested for lead content. If no lead is found, no action is required by the property owner, but the local health department will try to determine other sources of lead exposure.

Under the regulations, authority is vested in the local code enforcement agency to issue an order to the property owner to correct all defective lead-based surfaces requiring abatement and soil areas identified as a source, or potential source, for elevated blood levels. The regulations require an owner who has been issued an order to carry out all of the following:

• abate all defective lead-based surfaces when a child under age six resides in a dwelling unit;
• abate all defective exterior surfaces and all defective surfaces in common areas containing toxic levels when a child under age six resides in a dwelling;
• abate all lead-based chewable surfaces, whether or not that surface is defective, and all lead-based movable parts of windows and surfaces that rub against movable parts of windows when a child under age six has an elevated blood lead level;
• when a child under age six resides in a dwelling unit requiring lead abatement and exterior soil is found to be a source or a potential source of an elevated blood lead level, abate the soil.
• adequately manage all intact surfaces containing toxic levels of lead, which will remain and not be abated at the time; and
• post a notice of toxic levels of lead on each entrance to the dwelling unit or common area of the dwelling if affected, with the notice to remain until proper abatement and clearance is completed.

In addition, if the building is multi-family, the inspector must determine if any other children under age six live in the building, identify the units, and conduct an inspection. If no lead is found in those units, no further action is required by the property owner. However, if lead is found in any of those units, regardless of the blood lead level of the child, the property owner must abate all defective lead-based surfaces in the units, lead-based exterior surfaces, and common area surfaces. The reason for this is because defective lead is a potential source of lead poisoning for the children residing in those units. The soil is also tested for harmful levels of lead, and if found, it also must be abated.

Relocation. Finally, if a local director of health determines lead hazards will not be abated within a reasonable time frame and continued exposure will harm a child, the local health director is directed to use community resources to relocate the family. It is important to note, the director has the authority to permit occupancy in the unit during abatement, if such occupancy would not threaten the health and well-being of the occupants.

The regulations establish specific time frames for inspections, submission of management and abatement plans by the property owner, and abatement work to begin, once an order is issued. The time frames differ based on whether the inspection is a result of an elevated blood lead level report (Appendix C) or for another reason (Appendix D). The requirements include:

• the local health department or code enforcement agency has five working days to inspect a dwelling as a result of an elevated blood lead level and 30 days to inspect other dwellings where children reside, if an EBL child has been identified in a multi-unit building;
• a property owner must submit a written lead abatement plan to the director of the local health department within 15 working days of receipt of an order. Abatement shall begin only after the director has received and accepted a plan in compliance with the regulations;
• a property owner must prepare a lead management plan addressing intact lead-based surfaces, which will remain and not be abated at the time. The management plan must be prepared within 60 working days of the date that inspection results were received. This plan, and responsibility for compliance, is transferred with ownership upon transfer of title; and
• abatement must be initiated within 45 working days in dwellings where a child with an elevated blood lead level resides, and 90 days in dwellings where children with non-elevated blood lead levels reside.

The local health director has the authority to shorten any time frames stated in regulation. In addition, the regulations require the property owner to provide a summary report of the inspection and/or abatement plan and the post-abatement inspection to tenants.

Older dwellings. When a dwelling unit is 50 years or older and requires lead abatement, the owner must deliver a copy of the inspection report and a good quality photograph of the property to the Connecticut Historical Commission within five working days of receipt of an order. The commission has 10 days to certify whether the property is historic in order to provide guidance as to which lead abatement techniques are appropriate for historic properties.

Proposed Regulations

As noted above, the existing regulations were adopted in 1992 and were the first comprehensive statewide regulations to address lead prevention and abatement. In 1996, due to perceived shortcomings, the department formed a broad-based work group to review the regulations and recommend revisions. Several groups were represented on the work group, including: medical providers; municipal associations; housing officials; realtors; bankers; and property owners. The work group first met in October 1996.

The work group presented a report to the commissioner in April 1997 containing several significant changes to the regulations. The recommendations were based on a work group consensus. Although each stakeholder group had specific concerns addressed by various modifications, the proposed modifications were not entirely consistent with any one viewpoint.

The Department of Public Health reviewed the proposed recommendations and drafted a proposal to amend the existing regulations. The proposal was presented at a public hearing held by the public health committee on November 16, 1997. Following the hearing, the proposal was revised with minor changes and submitted to the Legislative Regulation Review Committee. The committee rejected the proposal without prejudice in June 1998. Objections to the proposed regulations had been raised by the Connecticut Association of Realtors, the Home Builders Association of Connecticut, and the Connecticut Property Owners Association.

A meeting was held with representatives of the above groups, DPH, and Representatives Arthur O’Neill and Alex Knopp in January 1999 to discuss the status of the proposed regulations. Representative O’Neill requested the groups with concerns meet, identify one or two items of greatest concern, and report back. Two issues were identified. The first was the proposed requirement that private sector lead inspectors be mandated to report findings of lead inspections to local health departments, even if the property owner had willfully hired the inspector. Second, the groups opposing the proposed regulations wanted to cap relocation costs, if a family needed to be temporarily relocated during abatement.

After meeting with various stakeholders in January 1999, DPH eliminated reference to mandatory reporting of lead inspections, requiring instead that mandatory notification of pending inspections be provided to local health departments who could then, on a case-by-case basis, require the subsequent report be filed. The department did not believe the issue of capping relocation costs should be addressed within the context of the regulation, and, therefore, no changes were made.

Subsequently, the program review committee voted to undertake a study of Residential Lead Abatement. As a result, the department decided not to resubmit regulatory changes to the Legislative Regulation Review Committee until the program review committee study was completed.

The most significant changes between the existing and proposed regulations are shown in Table II-2. The proposed regulations establish a third paint classification – deteriorated fair paint. Paint classified in this condition could be repaired, rather than abated. Discretion is also given to directors of local health departments to permit intact chewable surfaces (such as window sills, baseboards, and trim) to be placed in a management plan, rather than abated, if a child has an elevated blood lead level equal to or greater than 20 mcg/dL. Finally, the requirements for relocation of a family during abatement are somewhat vague under current statute (if abatement will not be completed in a reasonable time frame). The proposed regulations actively require the local health department director to permit occupancy, but set out conditions that must be met before such permission is allowed.

Hazardous Materials Program. Public Act 87-541 established the Hazardous Materials Program, housed at the Department of Economic and Community Development. The program was to provide funding for eligible developers, community housing development corporations, or any other person approved by the commissioner to obtain state financial assistance for lead abatement or asbestos removal. In actuality, the program has been operated as a consumer-oriented loan/grant program for property owners who have been issued orders by local health departments to abate lead or remove asbestos. The administration of this program is described in greater detail in Section IV.

Other Lead Laws

Consumer protection. There are several other laws that protect consumers from the hazards of lead paint. Laws requiring licensing and certification of lead contractors and workers are aimed at ensuring proper abatement methods are used when a consumer contracts for that work to be done. Similar to the federal law, state law requires property owners or their agents, at the time of sale, to disclose known lead hazards.

Several laws also govern tenant/landlord relations and require landlords: comply with all applicable building and housing codes; make all repairs and do whatever is necessary to keep the premises in a fit and habitable condition; and keep all common areas clean and safe. If landlords fail to comply with these conditions, by statute, tenants do not have to pay rent. In addition, the law requires paint on accessible surfaces not be chipped, blistered, flaking, loose, or peeling so as to constitute a health threat. Tenants also have responsibilities: including complying with applicable building; housing or fire codes affecting health and safety; and keeping the premises that he or she occupies clean and safe.

Screening. Each local or regional board of education also has the authority to require a child’s blood lead levels be tested prior to public school enrollment. Lead screening is required for children entering Head Start programs.

Compliance with orders. There are no enforcement penalties specific to Connecticut’s lead laws. Rather, local health departments and building code officials are given authority to issue orders to enforce the Public Health Code. If these orders are not complied with under C.G.S. Sec. 19a–206, the statute provides for health directors to institute a civil action for injunctive relief in any court. Noncompliant property owners are also subject to a civil penalty of $250 per day. In addition, C.G.S. 19a-220 provides for a Superior Court judge to issue a warrant requiring the noncompliant individual to carry out the order. Furthermore, other sections of the statute provide for civil penalties, if landlords fail to maintain their properties.

Multiple layers of government are involved in the prevention of childhood lead poisoning. The organizational structure in place at the federal level, responsible for administering lead laws passed by Congress and developing regulations and guidelines, is fragmented and involves several different agencies, each with a distinct area of expertise. Agencies are split into two discrete groups: the CDC and HCFA are concerned with lead prevention and treatment of lead poisoned children, while HUD and EPA efforts are targeted at ensuring lead hazards in the nation’s housing are addressed. Title X attempted to coordinate the efforts of the various agencies with limited success, since many of the mandates are directed only at certain properties under the jurisdiction of federal control.

Much of the funding to deal with lead prevention and abatement comes from a variety of federal government agencies, each with their own concerns and requirements. The funding is funneled to the states, and often down to the local level.

Connecticut’s law also focuses on ensuring housing is free of lead hazards. Beyond reporting screening results to the Department of Public Health, no other state mandates exist to ensure children are identified and, if found lead-poisoned, treated. The state performs primarily an oversight role with no direct responsibility for administering Connecticut’s lead law. Rather, local health departments/districts are the entities required to carry out investigations and ensure compliance with any orders issued.

The Department of Public Health is the lead agency for the state’s Childhood Lead Poisoning Prevention Program (CLPPP). The organizational structure for the program is depicted in Figure III-1. As the figure shows, no single division is responsible for all lead prevention activities. Rather, various aspects of the program are split among the department’s three bureaus. As shown in the figure, the department performs five major activities:

• education and outreach;
• testing of blood lead levels and analysis of paint and dust samples through the state laboratory to determine if lead is present;
• surveillance of the target population through the Environmental Epidemiology and Occupational Health Division (EEOH);
• oversight of the local health department’s enforcement of the lead laws and regulations by the Lead Environmental Management Unit; and
• licensing and certification of all lead contractors, and personnel.

In addition, Figure III-1 shows the relationship between DPH and the Department of Economic and Community Development in overseeing the administration of state and federal funds used to assist property owners in abating lead hazards from their properties. Since DECD has primary responsibility for this program, those activities are discussed in the next section. Selected activities of DPH are described in more detail below.

Environmental Epidemiology and Occupational Health Division. This division, organized into three program units, is located under the Bureau of Community Health. Two of the units, the Childhood Lead Poisoning Prevention Program and the Occupational Health and Special Projects (OHSP) are responsible for lead prevention activities.

The Childhood Lead Poisoning Prevention Program:

• maintains lead databases and reports quarterly to the CDC ;
• conducts surveillance for childhood lead exposure;
• performs primary (community outreach and education
• insert Figure III-1activities and professional education for providers) and secondary (oversight of screening, case management, and follow-up) prevention activities; and
• oversees:

In addition, the department’s Occupational Health and Special Projects Unit conducts surveillance for occupational diseases and adult lead-poisoning; and coordinates with DECD for the HUD lead abatement project.

Lead Environmental Management Unit. The Lead Environmental Management Unit (LEMU), located in the Division of Environmental Health, Bureau of Regulatory Services, has primary responsibility for overseeing lead inspections carried out by local health departments. The unit also is responsible for:

• analysis of quarterly lead reports submitted by LHDs required by statute;
• investigation of complaints involving lead-related issues and activities, including those that involve licensed lead contractors and certified lead abatement personnel and consultants;
• review and authorization of lead encapsulation products for use and overseeing their use;
• conducting audits of the larger local health departments;
• maintaining seven X-ray fluorescence analyzers, which are available to trained local health department staff for testing paint for lead content;
• developing department responses to federal lead related rule proposals; and
• managing the grant from EPA’s Office of Pollution, Prevention, and Toxics, which provides for a licensing and certification program for lead consultants, contractors, and workers.

The childhood lead program receives several federal grants to use for a variety of purposes. Figure III-2 shows the funding source, appropriated amounts, and distribution of funds for 1998. Altogether, the lead poisoning prevention program received $1.1 million in federal funds, with an additional $6 million in HUD funds that will be discussed in Section IV. Federal funds are used to pay DPH staff salaries, provide grants to local health departments to operate lead programs, and to operate a licensing and certification program for lead abatement contractors, consultants, and workers. State funds accounted for $876,558 and were used to support the two regional lead treatment centers, DPH staff salaries, and some local programs.

Selected highlights of EEOH and LEMU activities are provided below. It is important to note, however, a major activity of EEOH is collecting and analyzing screening data, which was already described in Section I.

Education. Education and outreach are major activities of the state’s lead program and may be conducted directly by DPH or through local health districts. Responsibilities for education and outreach are shared between EEOH’s Childhood Lead Poisoning Prevention Program and LEMU. Generally, outreach and education are targeted to four groups with LEMU responsible for providing information about interim controls and proper abatement methods, and the CLPPP responsible for screening and medical management information. The four groups include:

• families receiving outreach and education about lead hazards, interim controls, and the importance of screening high-risk children;
• health professionals receiving guidelines on screening, case management and treatment, and education on lead hazards in grand rounds;
• local health departments receiving a package of prepared responses from the Childhood Lead Program, which may be used to inform property owners of their responsibilities, and educational material to give to parents when a child is identified with a BLL equal to or greater than 10 mcg/dL; and
• home remodelers, the focus of recent DPH educational efforts through a lead awareness campaign at local hardware and paint stores.

The CLPPP recently issued a Comprehensive Guide on Prevention and Treatment, in the format of a three-ring binder. The guide contains a wealth of information on screening, medical management of children with elevated BLLs, responsibilities of local health departments, and advice for parents on how to reduce the risk of lead exposure in their environment. Distribution of the guide is targeted to a wide audience including health professionals, social workers, and local health departments and code enforcement officials.

Oversight of environmental investigations and enforcement. The lead prevention program maintains two methods for tracking childhood lead poisoning cases. First, the Surveillance Unit of the program maintains the Lead Surveillance System, which contains information from screening reports from clinical laboratories and medical care providers. The Lead Management Unit receives and compiles the statutorily required quarterly lead reports from local health departments and districts. These reports track lead inspection and abatement activities within each local health department or district. LEMU updates its records as each quarterly report is received and compiles them into an annual summary. Currently the two tracking databases are separate, and a third database for CDC required reporting is also maintained.

There are 108 health districts in Connecticut. Although statutorily required to submit quarterly reports, only 327 of the 432 required number were received by LEMU from health departments/districts in FY 98. Table III-1 compares the reporting distribution for FY 97 and FY 98, and as the results show, while compliance is basically good, some districts’ reporting are spotty.

In FY 98, 15 local health departments (14 percent) did not submit any quarterly report, while 93 submitted at least one during the year. In addition, 68 of the 108 LHDs indicated they had received no clinical reports of any children with an elevated blood level equal to or exceeding 20mg/dL during that quarter. Of those 68 LHDs, 46 reported all four quarters.

Program review committee staff found the database responsible for tracking local inspection and abatement activities contained several limitations. First, the data are self-reported by health departments/districts and are not audited by LEMU. Therefore, it is unknown if towns that did not report for all four quarters did not have any lead inspections, or they just went unreported. Second, discrepancies existed in the database between the number of inspections that identified lead hazards and the number of properties requiring abatement. Third, screening data maintained by EEOH could not be matched with LEMU inspection and order data, since individual names and addresses are not reported to LEMU. Finally, since health departments or districts report on inspection and abatement activities in the aggregate, it is impossible to know the length of time it takes for an inspection to be conducted and if lead is found, for abatement to be completed. Therefore, an inspection or abatement outstanding in one quarter may continue to be outstanding without DPH being aware of it. The database, however, does provide a broad overview of lead activity and identifies towns that perform a large number of inspections and issue most abatement orders.

Figure III-3 shows the number of lead inspections completed and outstanding as reported by the 95 local health departments and districts for FY 98 by quarter. An outstanding lead inspection is one where the residence has a child with a blood lead level equal to or greater than 20 mcg/dL, but the dwelling has not yet been inspected. There were a total of 903 inspections completed in FY 98. The greatest number (379) were completed in the first quarter of FY 98. The number of inspections decreased significantly to192 in the second quarter and then stabilized at that level in subsequent quarters, with 161 inspections in the third quarter and 171 in the last. One possible reason for the high number of inspections in the first quarter of FY 98 (7/1/98 – 9/30/98) is because more children are identified with elevated blood lead levels in the summer because of increased access to exterior porches (a common source of chipping lead paint) and lead dust created from opening and closing windows.

Figure III-3 also shows the number of inspections that remain outstanding is fairly constant from the quarter to quarter. There were 302 inspections outstanding in the first quarter of FY 98 and 306 in the last quarter.

LEMU also gathers aggregate information on the number of abatements outstanding and completed for each quarter (shown in Figure III-4). During FY 98, a total of 275 abatements were completed, only about 16 percent of the approximately 1,200 abatements orders outstanding throughout the year. The number outstanding increased 8 percent from the first quarter (1,183) to the last (1,272).

Greatest activity. Six of the states largest local health departments (Bridgeport, Hartford, New Britain, New Haven, Norwalk, and Waterbury) supplied complete information reports for all quarters of FY 98. Report highlights included:

• the six LHDs completed 829 inspections and reported 919 new dwelling units requiring inspection
• 336 of the inspected dwelling units (41 percent) contained lead hazards;
• 493 of the inspected dwelling units (60 percent) identified no lead hazards; and
• 228 abatements (83 percent) were reported complete, out of a total of 275 completed statewide.

Licensing and Certification of Lead Personnel

Through March 31, 1999, the department had issued 272 licenses to lead abatement and consultant contractors and 1,620 certificates to personnel in the five lead abatement and consulting disciplines. Additionally, 373 license renewals and 1,291 certificate renewals had been issued as of that date.

The Department of Public Health conducts a variety of activities in order to implement Connecticut’s lead law. Two of the department’s major responsibilities are split between different bureaus – one responsible for lead prevention activities; the other for regulatory oversight of inspections and abatements carried out by local health departments. As a result of the organizational structure, program review committee staff found separate databases are maintained by the two bureaus – one to track lead screening in children; the other to track lead inspections and compliance with abatement orders.

Better information is needed by LEMU to oversee the regulatory requirements of the state’s lead law. Self-reported data submitted from municipalities on lead inspections and abatements are provided in the aggregate, and therefore, individual properties cannot be tracked by LEMU to determine their inspection and abatement status. As a result, department staff was unable to resolve discrepancies identified by program review committee staff in FY 98 data between the number of units inspected identified with lead hazards and the number of abatement orders issued.

The Department of Economic and Community Development (DECD) is the state’s lead agency for housing related matters. The department administers state housing programs for citizens with low and moderate incomes, coordinates federal housing and community development programs, and develops and implements state housing policy. Although DECD offers several broad programs for substantial rehabilitation of housing which may include lead abatement, this study focused on programs specifically available to individual property owners (non-developer) for lead abatement. The administration and funding of past, current, and future programs for lead abatement are discussed in this section.

Hazardous Materials Program.

In 1987, the Connecticut General Assembly created the Hazardous Materials Program (C.G.S. Sec. 8-219(e)) funded with state bond money. Under this program, DECD is authorized to make loans, deferred loans, and grants to eligible developers, community housing development corporations, or any other person approved by the commissioner for lead abatement or asbestos removal. In actuality, the program has been operated as a consumer-oriented loan/grant program for property owners who have been issued orders by local health departments to abate lead or remove asbestos from residential dwelling units.

Program criteria. Under the program regulations, the amount of state financial assistance cannot exceed two-thirds of the total cost of the abatement or technical assistance. DECD may provide loans to any owner of housing where a lead-based paint hazard exists, regardless of the income of the owner or the tenant. Upon application, a property owner must show that a lead-based paint hazard is present in the unit and evidence of an approved abatement plan by the director of the local health department. The regulations require priority be given to:

• families with children having an elevated blood lead level; and
• owners of units containing lead-based paint hazards that are occupied by low- and moderate-income families (incomes at or below 100 percent of median).

The priorities are addressed in two ways: through the allocation of available funds and through the terms of the loan. Grant and loan terms established under the program are shown in Table IV-1.

Eligible borrowers qualify for financial assistance on a unit by unit basis, based on the category of the resident family’s income as a percentage of Area Median Income (as defined by the U.S. Department of Housing and Urban Development). For median incomes exceeding 200 percent, the property owner must show proof they sought a loan from a lending institution, but were rejected.

All loans to owners of rental property occupied by low- and moderate-income families carry a restriction prohibiting an increase in rental charges to cover loan payments. All loans are subject to immediate repayment, if the property is sold prior to the end of the loan term. If a grant is given, the grant amount is subject to a lien, which is decreased by 10 percent each year, until the 10^th year when the lien is released. Finally, owners participating in the program agree to continue to rent abated units to low- and moderate-income tenants for at least five years.

Funding. The state’s Hazardous Materials Program is funded through the sale of bonds, supplemented by a variety of federal funding sources. Since the program’s inception, the bond commission has allocated about $9.6 million, although not all of that amount has yet been expended. Total state Hazardous Materials and federal expenditures to date for lead abatement have been slightly more than $6.2 million and $5.3 million respectively. The Housing and Community Development program has provided an additional $1.1 million in funding. Lead has been abated in 722 dwelling units.

Until 1995, DECD directly administered the Hazardous Materials program. According to the department, under its administration, 340 units were abated and total expenditures were $2,428,755, for an average lead abatement cost of $7,143 per unit. DECD discontinued direct administration of the program when the department received a $6 million grant from HUD to abate lead and contracted with five high-risk municipalities to administer lead programs in their towns. In addition, the department entered into a $2.7 million contract in 1995 with the Connecticut Association for Community Action (CAFCA) to administer a lead abatement/rehabilitation program using some of the state Hazardous Materials Program funding and HOME funding. HOME is a federal housing program that provides funding to states to develop and support affordable housing. Both programs are described below.

Connecticut Association for Community Action Program.

In 1995, the Connecticut Association for Community Action received $1,424,489 in federal HOME funds and $745,000 in state Hazardous Material funds for lead abatement in conjunction with the rehabilitation of rental units for low- and moderate-income households. Although the money was committed in 1995, actual abatement projects did not begin until 1996. The program was short-lived; the last project began on May 13, 1998, and no more applications are being accepted. Table IV-2 shows the CAFCA program funding allocated by expenditure category.

Although CAFCA did not track dollars spent on rehabilitation versus lead abatement, there was a per-unit cap of $4,000 for all rehabilitation. Hypothetically, since rehabilitation was also a program goal, if each unit received the maximum dollar amount allowed for rehabilitation, the average lead abatement cost per unit would have been $15,230. To date, project expenditures are $1,561,567; however, some projects still have expenditures outstanding.

The program completed abatement on 98 units throughout the state. Almost all property owners received grants to abate lead with only two owners receiving a combined grant and partial loan. Table IV-3 shows the location of the properties and the number of units abated by municipality. The city of Hartford had the most units abated under the program, followed by the city of Waterbury.

HUD Lead-Based Paint Abatement Grant Program.

The second program that combines state Hazardous Materials money with federal funds became available in 1996. Under Title X of the Housing and Community Development Act, the Department of Housing and Urban Development is authorized to provide grants to states and municipalities to operate lead abatement programs for private property owners. The state of Connecticut, through a joint effort by the then Department of Housing and the Department of Public Health and Addiction Services (DPHAS), received a $6 million grant award in 1995 under HUD’s Lead-Based Paint Abatement Grant Program. The state augmented the HUD grant with a $6 million contribution from the Hazardous Materials Program and $2.4 million from the Housing and Community Development program. As part of the grant requirement, the five participating municipalities budgeted an additional $1,866,102 of cash and in-kind services.

As a result of the HUD grant, major changes in the state’s administration of the Hazardous Materials Program occurred. Using a risk index developed by DPHAS, based on age of housing stock, number of children below age five, and the percentage of those children below the poverty level the state identified the towns at highest risk for childhood lead poisoning. Federal HUD and state Hazardous Materials funds were made available only to the five municipalities with the highest-risk and interested in participating in the program: Hartford, New Britain, Norwich, Waterbury, and Windham.

Program goals. In its grant application to HUD, the Department of Housing projected abatement and relocation costs of $13,100 per unit thereby estimating 700 units (140 per municipality) could be abated under the grant/low interest loan finance program. In addition, the grant was to fund abatement activities to:

• establish 24 lead-safe houses;
• provide screening and case management for lead-poisoned children;
• conduct community education;
• develop and maintain a registry of "lead-safe" and "lead-free properties"; and
• monitor the health status of abatement and inspection personnel.

Under the HUD grant, data collection, inspections, abatement, education, outreach and administration could be funded. However, funds allocated to the state’s Hazardous Materials Program could only be used for lead abatement.

Responsibility for grant administration was divided between the then DECD and DPHAS. Through a Memorandum of Agreement, the Department of Economic and Community Development assumed responsibility for all fiscal administration and issues that generally fall within the expertise and jurisdiction of DECD. The Department of Public Health’s responsibilities include oversight and coordination of all public health aspects of program implementation -- screening and case management, risk reduction education, environmental follow-up and abatement guidance, and data management and analysis.

Program design. Each municipality selected to participate in the grant program was given broad latitude to design its own lead program including resource coordination, policies on temporary relocation, recruitment of property owners, educational campaigns, medical and social service referral systems, and selection of abatement contractors. Also each municipality determined how to provide case management and environmental professional services (i.e., hire new staff, subcontract, or use existing staff).

Although the state received the grant in March 1995, contracts with the towns were not signed until January 1, 1996, because regulations requiring lead abatement consultants and workers be licensed or certified were not in place until November 1995. This, along with the decentralized program design and voluminous federal reporting requirements, resulted in a noticeable lack of progress. By June 27, 1997, only 13 units had been cleared (i.e., abatement had been completed, reinspected, and no lead hazards found).

As a result, HUD reviewed the program and streamlined reporting requirements in 1998. In addition, HUD permitted DECD to decrease the original goal of lead hazard abatement in 700 units (140 in each municipality) to 610 units. In addition, the grant has received two extensions. It was originally supposed to be completed by March 1998, but it is now scheduled to end in September 1999.

Abatements. Figure IV-1 shows the number of units that have been cleared in each town as of June 30, 1999. A total of 284 units have been given clearance during the four-year period the program has been operational. (HUD has allowed the state to count an additional 101 units abated with state funds toward the required federal match even though they were not part of the HUD program, but these units are not included in the figure). As depicted, Norwich had the greatest number of units cleared (85) and Windham the least (32).

Costs. Table IV-4 shows financial data maintained by DPH on 322 lead abated units under the HUD program. Included in the table are units that have not received final clearance. Also depicted in the table is the amount of dollars spent on rehabilitation other than lead abatement. The HUD grant program allows funds to be used for modest rehabilitation (such as patching a leaky roof) to ensure the viability of lead hazard reduction activities, grant funds cannot be used to carry out major rehabilitation. According to the table, 212 of the 322 units (66 percent) abated also needed some other type of rehabilitation. This ranged from 29 percent of the units in Waterbury to 97 percent in Norwich.

In terms of costs, lead abatement costs ranged from $11,079 per unit in Norwich to $28,830 in Windham. The average cost per unit among the five municipalities was $14,430. It is unclear why Windham’s per unit costs are more than double those of the other four municipalities. Possible reasons suggested by the Department of Public Health were that units with more bedrooms, houses with historical significance, and single family homes all increase lead abatement costs.

Table IV-5 shows the total amount budgeted and expended by funding source for lead abatement as of March 31, 1999. Only about 54 percent of the total amount budgeted for lead abatement has been expended. As noted above, the grant is scheduled to end in September 1999.

Municipal HUD grants. It is important to note, municipalities are eligible to apply directly for HUD’s Lead-Based Paint Abatement Grant program and several in Connecticut have been awarded a grant to administer their own lead abatement program. Table IV-5 shows the grant funding round and the municipalities that have been awarded grants. In the most recent funding round, three of the municipalities that participated in the state-awarded HUD program described above, have submitted their own grant applications.

Round Seven HUD funding. The Department of Economic and Community Development, in consultation with the Department of Public Health, submitted a grant application to HUD in May 1999 for the next funding cycle (Round Seven). The application requests $4 million to conduct lead hazard control in 342 privately owned dwelling units. The program will give priority to low- and very low-income families. If selected for this round of funding, DECD will change the program design from a municipal administered program to a single statewide program administered by the Community Renewal Team (CRT), a community action agency based in Hartford.

Community Renewal Team Program

The Department of Economic and Community Development is planning to contract with CRT to administer several rehabilitation programs through a one-stop process for housing rehabilitation activities including:

• the Hazardous Materials Program;
• energy conservation improvements;
• septic tank system repair, removal, or enlargement; and
• senior citizen emergency repairs and rehabilitation projects.

Under the Hazardous Materials Program, only residential structures with six or fewer dwelling units will be eligible for lead abatement funding; commercial units are ineligible. The department intends to fund the program at $2.5 million. In addition, total funding for lead abatement activity will be capped at $15,000 per unit. Finally, it is DECD’s intention to encourage applicants that need to replace windows because they constitute a lead hazard to apply under the Energy Conservation Loan program. Funding provided through this program would not count toward the $15,000 cap under the Hazardous Materials program.

According to CRT, approximately 100 individuals are currently waiting for CRT’s program to be funded. The vast majority of these individuals will be applicants for the Hazardous Materials Program and are in need of financing to abate lead hazards.

Connecticut’s lead abatement program available to property owners underwent a major change in 1995 when the state received a HUD grant and targeted funding to only five municipalities. Several problems with the program design became apparent when only 13 units had received clearance by June 1997, 18 months after the program’s start-up. Further, even if the program meets its revised goal abating lead in 610 units, that would mean lead abatement was performed in only 152 units each year the HUD grant was operational. Average lead abatement costs per unit are about $15,000. Given these abatement costs and DECD’s estimates of 235,748 housing units in the state that potentially contain lead hazards, $3.5 billion would be needed to abate lead in these units.

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