F Flint Water Crisis Public Archive

Toni Larocco

Director of Nursing Services at Genesee County Health Department / Genesee

107

Emails

Sep 2015–Jan 2016

Archive range

107 emails found.

Re: Whaley Childrens Center 1201 N. Grand Traverse

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| met with Michelle Johnson, Director of Operations. On 10/16 United Way delivered filters to Whaley. Whaley recently replaced filter cartridges, because red indicator light. Children drink only bottled water from many donated sources. Whaley maintenance crew sampled water, but mistakenly only filled the liter bottles 1/2 way to top. The 2.516ppm is the employee restroom @ admin building. It's a newer hand sink fixture, but old plumbing. | couldn't remove aerator to check for lead particulate, because of the fixture design. No valve, so posted "Do Not Use." At the extreme level, | want to check with MDHHS toxicology regarding potential risks from lead residual from hands to mouth (not skin absorption) e 213 is off site at Rotary and no children are there. It will be posted or made inaccessible until demonstrated to be safe. e 029 is a classroom and concerning. Michelle will check in morning to see if it is drinking water and follow up with me. e Tomorrow appropriate resampling is scheduled by Whaley staff. | recommended sampling drinking fountains also and make them inaccessible until demonstrated safe. e Michelle estimated 27 children at Whaley, A. None age 0-5, B. One age 6, Cc. Oneage8 D. Twenty-five age 11-16. e Michelle indicated most children have same Hurley doctor, but not sure who physician's name. e She referred me to Michelle Shamel, Whaley's Director of Clinical for information regarding blood testing and physician. I'll follow up with her in morning. Jim Sent from my phone. woeeee Original message------

RE: Genesee County Health Department- EOC 1/4/16

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great. we have ebout 16,000 of our lead nutrition packets thet they can take with them for each clinic. they key is buying lunch for the practices - then you will have an audience, Mona Hanne-Altisha MID MIPH FAAP ectar Pedistde Residency Hudey Children’s Hospital at Hurley Michigan State U lege Denartment of Mhannal @hurleyme.com

RE: Genesee County Health Department- EOC 1/4/16

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if it would be of any help, we could have a lead case manager attend as well to put a name and contact infarmation in physicians hands. This morning Lasked the case managers to contact the largest pediatric practices and see about meeting with them regarding case management services, sources for filters, nutrition and answer any general questions they might have. Torti L LaRocce MS, RN Director of Nursing Services Genesee County Health Deparirnent 810.237 4544 [email protected] Goatihadte attoeke bee Sectrese af tke, (0 bared whet we have tle exoagh, aad mare, (0 toons densal ate # 4 fe F ty, 18 sae Sager 2 itd ee @ feast, a daiage its a dime, a Soranpon 3 5 o motes aa Sa otpoete oe csaeheceoing Bs ok BOGE PEED, GREE OO OLOM, GORRUSION UF Obs xxxEND_PAGE:dhhs03_b0236_0908_0932_01 000909 a é f é db keatitade makes wre of eae fae, f you have received this ¢- copes. Thank you. ‘Bere Ey

RE: Enhanced Lead testing

From
Johnson, M.d., Gary
To
Toni Larocco , Johnson, M.d., Gary
You each received, along with Eden Wells, what i received from the Genesee County Medical Society. | had sent this earlier there to Pete Levine, so | am thinking he sent this out to all members. April, you would probably have to put this on the HAN alert. itis harder to rake contact with the Ganesee County Osteapathic Society, but i will keep trying. Toni, what other “providers” were you thinking about?

RE: Newborn

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Okay....f just dort want peaple falling through the cracks. TorwwL LaRocco Ms, RN Director of Nursing Services Genesee County Healih Depariment 810.237 4544 [email protected] Se o. werk BO GaaBe, RES sOee, £8 tases dew’ ate ra fF oe. é a & rat . . z geonstance, chaos te eetes, conpasine & obenig, f wend ale a feast a ease whe a howe, a Sh ee a frvord, Grade Wake saber sense af our past, dolege coats. fos tala, get cmeates a ase fom Gemcnnsis~ 8 intended for ihe excuse . you are 4 of the content use of the addressee and may contain ded recipient, any d ute, u nsfribation, ted. HP you he scehved this &- Stroy alloomles Thank you, fidential or pros ney Of any sothon iy Ing f HF a website al hitec/Awwwy For & copy o' he Health Department's Notice of information Practices, contect the Health Denartrnent ar visit the Heallh ond uss Department's

RE: Genesee County Health Department- EOC 1/4/16

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Good morning , fwilrelay, with your permission of course, this email te our Medical Services Administration, with whorn | have had the same discussions. Rest assured that | saw a multi-point plan from this health plan about how to address the issues in their patient population, and these comrnunity engagement pieces are just one part. One issue all are trying to capture is the urgency under which the enhanced testing needs to be conducted, so this is one of a number of strategies the health plans are utilizing. Another part is of utmost concern, that i know is also in multiple health olans’ strategic approaches, is that of provider engagernent. Despite the news and the blast faxes and the Health Alerts and the Pravider Letters and the Toolkits, we continue to hear fron citizens, the Governior’s Task Force and EBL case investigators and case managers, that providers are not asking about lead exposure to Flint water since April 2014, nor asking about testing/screening, or whether families have filters. f tried to set up @ provider forurn in Nov-Dec to Httle or no interest, but ami now working to get one rolling regardless, in partnership with health plans, by end of this month. twould really be helpful ff you could be there to speak about this very issue and give the perspective of 2 local physician responding to the crisis, andi a leader of best practices. We will webinar it and archive it as well (lam wondering if car make it CME-able as weil}, and Dr. Reynoids, tt would be great to have you involved as well--- Eden Eden V. Wells, ME, MPH, FACRM Chieti Medical Executive ichigan Departrnent of Health and Hurnan Services 201 Townsend St, 5™ Floor CV8 Lansing, Mi48923

Enhanced Lead testing

From
Toni Larocco
To
Johnson, M.d., Gary
Importance: High Hi Dr. Johnson, xxxEND_PAGE:dhhs03_b0237_0933_0935_2 000935 Eden Wells just contacted me wanting to know if the information for providers to do enhanced testing went out blast fax to the Flint providers? Also, can we do that again blast fax, MiHAN and through the Medical Society. Toni Tow’ L LaRocco MS, RN Director of Nursing Services Genesee County Health Department 810.237 4544 [email protected] if ih a gt . f & teense what we have wto eneugh e Be fe : i : a ye sie comedies sbaos U7 ardex, 8 : rd . rd © fo» ze a house le x home, a Sheanpes inte & frivad Goat f fo. f GEESE OP caw DESL, GrvUBE geaee for Lectng, REE OPELLES OH: not th schon ni ints e-rnad | dastroy gi king Of any you have received the original and & yOu, For @ copy of ihe Health Department's Notice of Information Practices contact the Health Department or visi the Health Department's website at xxxEND_PAGE:dhhs03_b0237_0933_0935_3

RE: Genesee County Health Department- EOC 1/4/16

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xxxEND_PAGE:dhhs03_b0236_0908_0932_02 000910 Thanks for your reply, Eden. Yes, | have had discussions with Matt Davis about this as well and it was my understanding that it was recommended to expand screening, but dical homes as you said. if we all agree te drive kids te their medical homes first, the primacy of the medical home, why is that not being cone first? What are the medicaid HMOs doing to push kids fo their medical homes? How are they incentivizing visits, providing case Management, partnering with practices, enhanced transportation, etc? This is what needs te happen - nat only will all of this improve lead screening rates, but also immun rates and all other HEDIS measure that HMOs land providers} care about. Monu Hanne-Alticha MD MIPH FAAP Prograr rector Pech Residency Michiga Date: Human Me Denerira § aad Huraan Deyelonraent Mhaonal @hurleyme.corn

Re: Genesee County Health Department- EOC 1/4/16

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Hi Mona, The Governor's Task Force has made a number of preliminary recommendations to MDHHS last month, and a major one is to maximize blood lead screening. The primary care home is best, all agree, and health plans are identifying any children that have not been tested. Current thoughts are that there could be thousands. Health plans will be closely monitoring the provider follow up as well post initial screens. And, while it does not pick up potential lead exposure prior to Oct 1, water is still a potential source if public health measures are not being used, or used appropriately. Also there is a need to establish the prevalence of EBL in this impacted community- | have had long discussions with Matt Davis about this, and Larry is aware as well. | can discuss further if needed. But all, including Medicaid, agree with the primacy of the patient primary care home. E Sent from my iPhone

FW: Genesee County Health Department- EOC 1/4/16

From
Toni Larocco
To
Unknown recipient
At the request of MDHHS, we are working with the Medicaid health plans to screen kids that have not been screened. There are many kids that, for a multitude of reasons, have not been screened. Toni LaRocco MS, RN Director of Nursing Services Genesee County Health Department Begin forwarded message:

RE: Whaley Childrens Center 1201 N. Grand Traverse

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Thanks, I'm stopping by Whaley tonight to make sure that no one is drinking the water and the concerns below are addressed. traceived the attached water results this afternoon and t will bring a copy to help me identify the fixture locations at Whaley. Lintend to have the manager shut off the valve at Z.5lGppm, 0.39 of the attachment. Results orp. 19, 29, 32, 39, 48 are all elevated at Whaley and others are concerning, 2 xxxEND_PAGE:dhhs03_b0233_0876_0879_2 000878 itis not common for us to receive the MDEQ daily report with this many lead results or the number of elevated in one location. We commonty receive between 1-15 general water results, which most are usually bacteria, partial chemistry and arsenic, mixed in with a few lead and copper. Fil report back what | find at Whaley. Jin Henry RS, MBA Environmental Health Supervisor 630 S. Saginaw St. Suite 4 Flint. Mi 48502-1540 Phone (810} 257-3618 Fax (810) 257-3125 E-mail |[email protected] Genuses Codrily

Whaley Childrens Center 1201 N. Grand Traverse

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Jim, | just got a call from Eden Wells and DEQ just told her Whaley CC was given sample results of 213ppm and 2516ppm from two fixtures. As this is a center for foster kids it would be a good idea if we verify they are not using those fixtures. Find out if they have filters or are using bottled water. Are the kids there seen by a physician and tested for lead? Have they notified their physician(s) of the problem? Thanks Mark Valacak, MPH, Health Officer Genesee County Health Department, 630 S. Saginaw St. Suite 4 Flint, Ml 48502-1540 Phone 810-257-3588 Fax 810 257-3147 xxxEND_PAGE:dhhs03_b0233_0876_0879_3 000879 Please consider the environment before printing this e-mail. "There are two lasting bequests we can hope to give our children: one is roots; the other is wings.” Hodding Carter *NOTICE: This e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any disclosure, use, distribution, copying, or taking of any action in reliance of the contents of this e-mail is strictly prohibited. If you have received this e-mail in error, please notify me via e-mail and permanently delete the original and destroy all copies. Thank you. For a copy of the Health Departuent’s Notice of Information Practices, contact the Health Department or visit the Health Department's website at i chd.us/ xxxEND_PAGE:dhhs03_b0233_0876_0879_4

RE: Newborn

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Okay. Thanks. Toni l LaRocco MS, RN Director of Nursing Services Genesee County Health Department 810.237 4844 [email protected] aad wore, & beoas dental te wy oberg, & eae tore 2 ao it a feest @ Hinge ts & Hee, & Seeraegee e . ra of. f wos o ae ee & poe sah, Gratiade wales. Y goatee af BAP LRG, bvtege, perce for tokeg, ued txoaind & wisien Sor Gomorresd, ~ : fi of y fs ‘ Pattie Es #NOTICE: Tins om proprietary, confidential eepying, of faking of any a i m tera, please nobfy me we is intended for ine exchusi ve use of ihe address: Se and may co Hl nended recipier i *, USS, distribution, . is strictly @ peaelved this e- a and RHEE RAS delete the original aad desimy all copies. Thenk you, Hee aR Department's N jee ef information Pract conlacl ihe Healih Depariment of visi ine Health For a copy off

RE: Newborn

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xxxEND_PAGE:dhhs02_b1194_4563_4568_1 004564 Where are we with this issue? Bath the case rnanagement and how itis being sent to the state data base? Toni L LaRocco MS, RN Director of Nursing Services Genesee County Health Department 610.237 4544 [email protected] femny lensak pele i a . e os elf thee fellhes OP 8 if ihe, fb Laees wheal we have ote é g : : oot fear U8 683 ty, 10 ean taser a meal its RUS & howe, & Suranger Fesed va if Ea baa, dad eeaates & aisir See Comores, f f HS SENS OE Par £48, heise Posie soe 2 ive use of the ad ended recipier aoe For a copy Deparment h Deparmeni’s Notice of information Practices, contact the al Rip Awa sohd us! jeaglin Decariment or visi

Re: Newborn

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Toni- that is an excellent point as well- and will discuss with heads of Medicaid and Population health first thing in AM! Sent from my iPhone Yes I understand however sometimes the common sense doesn't rule the contract. Toni LaRocco MS, RN Director of Nursing Services Genesee County Health Department

Re: Newborn

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Given that this is a research study, the Hurley lab may not be handling the results in the same way as they handle other lead tests. Can the lab be contacted and asked about that, by someone on Dr. Hanna-Attisha's team? If the results are handled under a research protocol, would the results be required to be reported under the Public Health Code, or would they be considered confidential under the terms of the consent form signed by the research participants? In other words, what does the research protocol and the consent form say? | assume/hope the family would would welcome a home intervention, but need to be sure the research protocol re confidentiality isn't being violated. If it appears that way, then someone on the research team should get consent from the family for public health followup, | would think.

Fwd: Newborn

From
Toni Larocco
To
Jori July , Staylor@igcha. Us
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Jori and Eden, Please see below. Please note that this is a result below 5. We are happy in this extended circumstance to follow this family. | am off next week and will need you Eden, to advocate with state for the follow up by case managers as it does not fit the specified criteria. Merry Christmas! Toni Toni LaRocco MS, RN Director of Nursing Services Genesee County Health Department Begin forwarded message: xxxEND_PAGE:dhhs03_b0219_0833_0835_1 000834 Date: December 20, 2015 at 11:46:15 AM EST

Fwd: Newborn

From
Toni Larocco
To
Unknown recipient
Jori and Eden, xxxEND_PAGE:dhhs03_b0232_0871_0875_2 000873 Please see below. Please note that this is a result below 5. We are happy in this extended circumstance to follow this family. | am off next week and will need you Eden, to advocate with state for the follow up by case managers as it does not fit the specified criteria. Merry Christmas! Toni Toni LaRocco MS, RN Director of Nursing Services Genesee County Health Department Begin forwarded message:

Fwd: Newborn

From
Toni Larocco
To
Unknown recipient
Jori and Eden, xxxEND_PAGE:dhhs03_b0232_0871_0875_2 000873 Please see below. Please note that this is a result below 5. We are happy in this extended circumstance to follow this family. | am off next week and will need you Eden, to advocate with state for the follow up by case managers as it does not fit the specified criteria. Merry Christmas! Toni Toni LaRocco MS, RN Director of Nursing Services Genesee County Health Department Begin forwarded message:

RE: Molina events

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Lead screening with Molina on 2/12/16 at Freernan Elementary and 1/26/16 at Eisenhower fron 3:30-630 orn. There will be laad risk reduction aducation. Filter distribution and a rneal will be served. Partnering with Flint Schools, UM Flint Nursing Pragrarn, and Crirnm Fourdatian, Looking to offer at the Carriagetown Mission in February x2, which has shelter space for women and children. Also looking to offer with the Flint Housing Commissions. Ton’ L LaRoccr MS, RN Director of Nursing Services Genesee County Health Department 810.237 4544 [email protected] aE ate Rew ee ae and’ move, £ baswe denial ite . oe eg a Pe, ab Boake inte @ hoes, & Sie oa eNRren foe tesrinremee, ~ “mig, includin iene! or pri vieged | a sci a ar acti on ine EE xxxEND_PAGE:dhhs02_b0451_1814_1815_1 001815 fthe Health Department's Notice of information Practices, contect the Health Denartrnent ar view the Health ments website al hire/iwew gone ust

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