Correspondence between

lagree with this: we'll stay ‘on hold’ until we hear from/receive consent. | think we would want a copy of the consent form for our records, and for GCHD records.

ATTOOO01.htm Sent from my iPhone Begin forwarded message:

Importance: High Despite the fact that we don’t have the modified letter, Nick requested that we pull together our responses to this draft document. Nick/Geralyn would Hke this by tornarrow, so can we all get our drafts to Linda Dykerna by noon tornerrow for consolidation.

Eden was going to talk to him but didn’t. think he was looking for suramary data only. Are you available to talk now? would be brief and maybe MSU! has a report he could be provided and that would be it

Yes, Vm here 5-9230

lhonestly dant know. The request didn’t carne to us, and i dort think we have Dr, Franzhiau’s contact information. 50 ra, | don’t think we have taken any action on it. Dic sornecne send him the DUA to complete and send to Bob? Are you thinking that Eden would talk to him first? Not sure of the stans in the process you are envisioning — would it heip to talk by phone?

Flint: We had discussed a request from Dr. Franzblau about provision of adult blood leads, 2010 to as current as possible. Is that something that was sent to Eden? Corinne xxxEND_PAGE:dhhs03_b0562_1962_1962_1

Hi Marcy, fagree that it makes sense for Bob to provide the weekly Flint updates to department leadership given that Fintisa very active situation. | would at sore point Hike to see epi re-run the Poisson analysis for Flint with confirmed (venous only} cases. And yes we need to set up another meeting. Rashmi had asked me last week if f was going to do that and EF will. [believe we will need to meet periodically, particularly in light of the Free Press request related to Detroit and other high burden communities. Bob -- thanks for sharing the weekly update. Corinne

{dort believe our outreach and education materials would duplicate CLPPPs, although we certainly need ta discuss what each group can contribute. Based on the cornmunity outreach and community meetings that environmental health staff routinely engage in at sites of contarnination or environmental areas of concern, our health education focuses or environmental risk communication. In this situation we will also need to help the technical advisory group with messaging as it implements sampling plans and determines response to findings,

Thanks for the information. We'll want to make sure we aren’t dunlicating efforts in the education and outreach area, as that is an active work area for CLPFP already, i heard from Budget again, understand there will be more conversation about the $850,000 this afterncon, and we'll receive further information later.

Two funding options for environmental investigations were presented to Kirn Stephen, including hiring environmental firms for the EBLs. Wes had already reached out to several firrns and received one written nronosal that was sent to Kim yesterday. She was going to check with LTB to sea if MBOHHS could contract directly with firrns to avoid going through an REF process - given this situation. in the two funding ontions, we requested funding for 50° of an enforcement staff miarmnber to oversee the ESL investigations. in adolition to the EH investigation cioliars we budgeted funding for part of a toxicologist and an environmental health educator, Both have been working with the DEO on the Flint situation but Linda was told by the federal funder that the Flint situation is not within scope of federal cooperative agreement objectives and we need to have them ston working on it, The toxicologist is working on intricate decision trees to suport environmental sampling activities and response. My understanding is that the flint technical advisory group will be relying an this information and the accompanying education materials thet need to te cevelaned. The option that we prefer is Option 2. Total cost is “$442,000 which includes contracting with environmental firm/s {some of which already have a presence in the Flint areal; 50% enforcernent FTE overswaing the EBLs, 20% tox are? CH health educator staff time and outreach materials, xxxEND_PAGE:dhhs02_b0203_0613_0614_1 000614 The cost of option 4 plus tox/eh education/brochures is ~ $700,000. Using this option, we are not confident that we could find Investigators with the right training, certification and background to immediately hit the ground running and to deliver quality work with efficiency, Corinne

Jennifer, The MCH epiderniology statf has provided the SAS code for the Poisson regression which is attached. For your information, Linde Dykerna js the lead toxicologist, The orediction modeling for Flint ts stl being worked on internally between the MDHHS and MBEOQ. Therefore it has not been finalized. With regard to data on other cornmmunities, childhood lead poisoning program and epiderniology staffs will be meeting ASAP to discuss next steps on data requests and analyses. We need to work out childhood EBL monitoring for Flint and then discuss next steps in terms of ather communities. t don’t think either Nancy or f can give a timeline for other communities at this point lexpect we would look at Detroit after Flint. Wes Priern reports to Linda Oykerna, who reports ta me. ican coordinate contact with Wes as Linda ts Hhely to be busy on Flint water for some time. For federal funds smecific to lead hazard control, Exetrait, Muskegon County, Wayne County ard MDBHHS currently receive funding from HUD. Wayne County is operating on what staff beliave is a one-year extension. MDHHS steff indicate that Wayne County's HUD lead hazard control grant originally had an end date of this past June. Counties or cities receive other HUD funds and they right use some of those to address lead hazards but it is impossible for us to track those tyoes of expenditures as they would be wragped into other nrojects. Corinne

Forwarding- Sent from my iPhone Begin forwarded message:

Sent from my iPhone Begin forwarded message:

Mona, The integers in your file are the values we have stored in our blood lead surveillance system; that's our current protocol. To my knowledge, the CDC's Lead program has not taken a stance on whether to store decimals or not. Bob

fluick question: We have the data and ara starting to georode it! All of your lead level results are single rumbers with no decimais?? It’s kinda weird. Al af aur lab data included decimals and there was aise kids with <0.5 levais {undetectable}. xxxEND_PAGE:dhhs02_b1011_3599_3601_1 003600 Does your lead data just not have decimals? Do nurnbers get round up or round down? Thanks! Mona {ido understand that it’s Friday. Sorry} Viena Hanne-Attisha MD MPH FAAP Prograrn Director Pediatric Residency Hurley Chil "s Hospital fey Medic University College: ent of Fediatrics and Murnan | [email protected] <irnapedOd jog>

Chick question: We have the data and are starting to geocada it! AH of your lead level results are single numbers with no decimals? ? {t's kinda weird. AH of our lab date included decirnais and there was also kids with <0.5 levels (undatectabla}. 1 xxxEND_PAGE:dhhs03_b0755_2621_2623_1 002622 Does your lead data just not have decimais? Do nurnbers get round up or round down? Thanks! Mona {ido understand that it’s Friday. Sorry Viena Hanne-Sttisha MD MPH FAAP Prograrn Director Pediatr ancy gan State University College of riment of Pediatrics and Murna Mhannai @hurleyme.caom

lve called to let staff know to stop hecause they don’t have to send it.

dust to confirm for all, we worked with Mona, she has the file and was able to oper ik Nancy

Nancy, So you don’t have to track down Bob Scott, at Eden’s request we are sending an encrypted DBF file to Hurley of the CLPPP data Bob provided to use for analysis. This will be the raw data before we started our work on it. Corinne xxxEND_PAGE:dhhs02_b1008_3593_3593_1

That sounds about right. May bash, is ii CLPP’s usual process to collect the lead data on an ongoing basis.if so, at what level is the data usually analyzed (by Epi?} iS it daily nmonthly? Quarterly? Annually? How would we normally detect/know if there is an issue in a particular iocality---do you look at it at county ievel ar smaller when you peruse your data? This question may arise. E

Hi all-- E talked to Sob to confirm the information | had shared about the Hurley lab results. itis a little more nuanced than | had explained, forwarding Bol‘s explanation, FY.

Importance: High Hi all- we have had a lot of communication coming from different sources and staff on Flint water situation- | would like to centralize all communication through Eden. | have asked Geralyn to communicate directly with Eden on any question/issues related to Flint water situation, Any e mail communication re: Flint water to Geralyn (or Nick/Nancy, communications office) should include cc to me and Eden, Thank you for your cooperation. Please share with other staff that need to know. Susan Moran MPH, Senior Deputy Director Population Health and Community Services Administration Capitol View Building 201 Townsend St 6 Floor Lansing, MI 48913 Phone: 517 335 8024 Fax: 517 335 9032 [email protected] xxxEND_PAGE:dhhs02_b0940_3256_3344_15 003271 Peeler, Nancy (DHHS)

Curious wheather they issued the same thing to Hurley, as their analysis sample (based an zip codes 48501-48507) alsa appears to extern beyond the city geogranhic boundaries, into Townships that are on Detroit water?

Additionally as Linda Dykema noted last week, the city water supply is in compliance with the lead rule, and the DEQ has not seen a change in the city's compliance with the lead rule since switching to the Flint River source.