Kirk Smith

case management resources continue for families You are correct, Larry, that the MDHHS data is pulled out of the Data Warehouse by Flint zip. Eden

g xxxEND_PAGE:dhhs03_b0303_1121_1126_2 001123 Reynolds, Lawrence; Laura Carravallah; Marc Edwards; Valacak, Mark; Andy Leavitt; Base Camp Email; Lasher, Geralyn (DHHS); Eisner, Jennifer (DHHS); Dykema, Linda D. (DHHS)

case management resources continue for families Eden, i support frequent updates. Mona and her tearm can continue to de the GIS work and track progress {or lack thereof} in the blood leads. i think that overall, the latest data implies we are on the right track. We can use the upclates to reinforce the importance of using the Hiters and bottled water that are being provided... Kast Regards,

case management resources continue for families Hi Dr. Reynolds, | just got done with an email with Mona--- This is a general public report that is high level--not a technical report, and was not meant to represent a technical report. This is general information--of course our surveillance program is tracking by zip, Medicaid, locality, etc. We can discuss further what type of reporting may be useful to a technical audience---as long as not identifiable (some zips have to be suppressed) | don't see why this can't be done (probably not every two weeks like this public one would be) Warm Regards, Eden Michig. 201 Towns: lreys2@email. com> Sent: Thursday, December 3, 2015 3:25 PM

case management resources continue for families This is a good start but maybe lacking context . Would GIS software identify clusters ? |! am disappointed to see, at this moment , thatDr. Edward's study and Dr. Mona's study which have more granular reporting are given no credence. Is there a reason ? wonsenae == Forwarded message ----------

Press Release xxxEND_PAGE:dhhs03_b0303_1121_1126_4 001125 FOR IMMEDIATE RELEASE: December 3, 2015 MDHHS releases latest data outlining blood lead levels in Flint Follow-up care, case management resources continue for families LANSING, Mich. — Preliminary data indicates that 30 of 1,361 adults and children tested in Flint since October | had elevated blood lead levels, according to a report issued today by the Michigan Department of Health and Human Services. This marks the first summary report on lead testing called for in the state’s action plan related to health concerns about Flint’s water infrastructure. “Our goal is to help families reduce their exposure to lead sources,” said Dr. Eden Wells, MDHHS chief medical executive. “We have made progress in testing and identifying those with elevated blood lead levels, and the department will continue to work closely with the Genesee County Health Department to reach these families. We will remain diligent in our ongoing outreach and education efforts.” Information comes from tests administered citywide to 1,361 children and adults since October 1. Tests showed that 21 of 969 children age 17 or younger and 9 of 392 adults over the age 18 were identified with elevated blood lead levels. The report covers test results reported to MDHHS since the state action plan was put in place Oct. 2. It includes the number of tests and number of elevated blood lead levels greater than 5 micrograms per deciliter, and captures both capillary and venous blood tests that have been reported to MDHHS since the beginning of October. People who have had multiple tests are counted only once. Five micrograms per deciliter is the level that the Centers for Disease Control and Prevention considers elevated and triggers health care professional follow up with families. available. When reviewing historical trend data, the risk of lead exposure is highest during the third quarter of each year — July through September. Seasonal variation is the result of a number of factors including increased exposure to lead in dust and soil in the summer months. In the third quarter of 2010, 8.3 percent of Flint children 6 and under showed elevated blood lead levels. The figure gradually decreased to 4.1 percent in the third quarter of 2013. During the same months in 2014, the figure increased to 7.5 percent and decreased to 6.4 percent in the third quarter of 2015. Last month, MDHHS collaborated with the county health department and local partners to distribute educational resources and informational letters to Flint parents regarding lead testing. The state is providing 5 xxxEND_PAGE:dhhs03_b0303_1121_1126_5 001126 funding for GCHD nurses to work with families when an elevated blood lead level has been detected. During these follow-up visits, nurses coordinate with environmental health investigators to meet with families in their homes to identify lead exposures, address questions and provide water filters. People can be exposed to lead

Hi ail, Please see the attached for the update as of today. Thanks. Tamara Brickey, MS, CHES xxxEND_PAGE:deq24_b131_0347_0353_3 Public Health Division Director Genesee County Health Department 630 S. Saginaw Street Suite 4 Flint, MI 48502 (810) 257-3202 Fax: (810) 257-3147 tri @ of inform

Hi all, | would like to provide an update on how today has unfolded and where plans currently stand. e The University of Michigan-Flint has agreed to be our point of dispensing. They are graciously giving us space and helping us obtain volunteers, as well as helping us with logistical set up, and security/police. e United Way is having approximately 4,000 water filters delivered via the Home Depot to the University of Michigan- Flint Recreation Center. Hilda McShane (GCHD) is helping to facilitate this with Jamie and the U of M-Flint staff. © GCHD staff met with U of M-Flint Recreation Center staff today for a walk through. | will be working ona set up map tonight, and providing U ofM-Flint with details for our volunteers. xxxEND_PAGE:deq26_b092_0827_0831_2 t > °® UofM-Flint has also asked for recommendations on water filters for their campus. We will be sending them the same list shared with the United Way. ¢ — Following the recommendations of this group, GCHD has produced a list of priority groups to receive filters. Please see attached. . e Weare still awaiting data from MDHHS to do GIS mapping for our WIC clients. © GCHD will utilize a list of known WIC clients within the target areas and the city of Flint, and do call outs tomorrow _to clients to inform them of the water filters that will be available. We had hoped to reach the clients in the recognized target area first, however, due to media coverage we do not anticipate that it will be possible to limit to that specific area of Flint. We will be limiting to those listed as priority 1-4 on the attached sheet. e With the urging of U of M-Flint, due to security concerns, filter distribution will begin on Saturday, October 3 at 10am. Volunteers and staff will be reporting at 8am. : . © 3pm today, Genesee County announced via press conference that there is an official public health emergency declaration. , e — Sf any filters remain after distribution, they will be stored with Mott Children’s Health or at GCHD depending on volume. : e If further filters are obtained, assistance from the Red Cross will be necessary. ¢ 10:30ama press conference announcing the filter distribution and demonstration on how to use them will6ccur at the University of Michigan-Flint Happenings Room. That | believe is the run down for'today. Thank you to everyone who has provided input and feedback as needed. We are continuing to work with U of M-Flint and all of the partners on logistical needs, and will give further updates as they are available. : : Thanks, Tamara Brickey, MS, CHES Public Health Division Director Genesee County Health Department 630 S. Saginaw Street Suite 4: Flint, MI 48502 (810) 257-3202 Fax: (810) 257-3147 [email protected] ‘ *NOTICE: This e-mail, including attachments, is intended for the exclusive use ot 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 3 xxxEND_PAGE:deq26_b092_0827_0831_3 + * 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 Department's Notice of Information Practices, contdct the Health Department or visit the Health Department's website at http://www.gchd.us/

Hi Tamara, | was just speaking with Jamie Gaskin on a few updates. He shared that there was a Health Department meeting you were holding at 2:00 p.m. today (he thought) regarding the developing'filter distribution strategy. ” Based on what he shared (below) of who he-was aware was invited (we were not, and that’s fine), | want to confirm you have the relevant data to inform your strategy, e.g. data from Dr. Mona and her research team (GIS mapping), Howard Croft (lead service line detail), Andy Leavitt in Senator Ananich’s office, etc. to inform the strategic distribution process. Given the limited number of filters compared to the number of homes in the city, we’ve had strong consensus that initial resources go to the families and community sites most in need. Thére is a great deal of information out there to inform the process. Can you provide an update for those of us who. have been removed from the loop yet are still fielding lots of questions and working to secure additional resources for households in the city? v Thank you for your efforts on this important matter. xxxEND_PAGE:deq26_b092_0827_0831_4 . kirk Smith, MHSA President & CeO. Greater Flint: Health Coalition (810) 232-2228 [email protected]

Howard In review of both the Veolia and IRM they are both similar recommendations except for one item Water softening this item needs to be resolved to soften or not The technical committee can not answer this question Until this is decided we can not discuss the treatment process John O’Brien