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farm here- just got back from working with Katie

Hi, hoping to connect this morning to follow up an this before the pro call.

Importance: High Sharing FYI, so you are up to date.

Forwarding a5 an FYI

Please see attached. | did not cut out any columns this time, just sent them the whole shebang. Please note there are two tabs. Robert L. Scott Childhood Lead Poisoning Prevention Program Michigan Department of Health & Human Services (517) 335-8178 fax (517) 335-8509 xxxEND_PAGE:dhhs03_b0884_3119_3119_1

data Wanted to make sure you see this - FYE Nancy

My notes, FYI. | will share these in my daily update, and we can escalate the question about the CM and EBL always being together. xxxEND_PAGE:dhhs03_b0643_2167_2167_1

See below, trying to keep it short! Please copy me and Linda Dykema on the email to Candace. Thanks! Dear Candace, | just wanted to follow up on your inquiry to our program about assistance with Representative Neely’s upcoming health fair in Flint. We wanted to confirm that the Genesee County Health Department is your best resource for materials, and we understand they do have print materials about nutrition related to children and lead exposure. Either the WIC staff at the Genesee County Health Department, or potentially staff at MSU Extension, could be good resources related to your proposed ‘healthy eating’ demonstration. Good luck with your event! Karen Lishinski RN MA Nurse Consultant MDHHS Childhood Lead Poisoning Prevention Program 517 241 3599 xxxEND_PAGE:dhhs03_b0639_2158_2158_1

Sharing, FYL Update fram last Friday.

Forwarding, FYL

Forms: e Activity Log: No changes required ¢ Follow-up Visit: No changes required e Individualized Plan of Care: Fixed typos, updated revision date, under long-term development changed form to read "Date of ASQ screening" e Initial Home Visit: Revised name of form, added in ASQ under developmental screening, w/comment section and date, fixed form errors, updated form date e Referral Form: No changes re referral for Early On is described as being for BLL>10. Do we want to add "or other noted developmental delay"?) e Report to Health Care Provider: Fixed BLL repeat test protocol on second page. Updated date of form. e Case Closure: Updated date of form. Updated closure reason in section 2 of form to 1 BLL<5 ug/dL to be consistent with section 1. All form names are revised for naming convention consistency. Emily Houk, President and Chief Mischief Maker Research to Practice Consulting, LLC 216 North Chestnut Lansing, Michigan 48933 517-896-2712 xxxEND_PAGE:dhhs03_b0619_2080_2080_1

Revised Excel reporting form. Jori, please let us know if you have questions, identify other updates, etc. Nancy xxxEND_PAGE:dhhs03_b0605_2039_2039_1

GCHD Contract.Flint water 11.18.15.changes.docx Importance: High Fyi— follow up on my call today with dort. Let's talk about this on Monday — @ treviewed the updated contract language with Jori, as wall as the revised reporting spreadsheet She is going to review the reporting spreadsheet with the nurses, they are supposed to give feedback on the Tuasday call that you already have set up. e {asked her about the numbers on the first report they sent you~ we don’t know where they gat the 163 rurnber they fisted. | cari see that the totals they Hsted for rows band 2 are not accurate fas measured by the list of families that Bob sends ther} ~ she is hopefully going to get back to me today regarding that number. Rashmi has asked about it, and my detective work so far with Sob hasn't helped us to figure it cut. | do wonder if the tent on the renorting form was part of the problem, sa | tried to fix what! saw might be the problem. We'll see! See you on Mornay, hope it was a good (warm) weekend - you left just in time for our first snow!

Hi Nancy and Karen, One of our nurses working in Lead Case Management came to us concerned that you might not know the roles of Genesee County staff in the case management realm. If you have questions regarding budget or contract issues, that should be brought to myself or Jori. If you have questions regarding clients that would go to Sherry, Kim or Jan. If there are concerns about implementation process please discuss with Jori. | hope this is helpful. Thanks, Toni Towel LaRocca MS, RN Director of Nursing Services Genesee Courly Health Deparment 810.237 4644 tlarocco@achd us ¢ BAD MOPS, Zz 2 oS eneage, oe , , 3, fe Cat Oe" o te, ee whe a friend Geolfiade n seated : aw So eer DORE RHE, f +, , RE CMEake *NOTICE: This ened, inchulig att geidressee and may contain o not the intended reciolent, any dis gsedion in redian fthe contants ins e-mail in ersy, please act destroy al copies. Thank you. closure, use, distr inis e-mad is sin me vig o-mall and permane nly eu and @ the org For @ copy of u + Practices, contact the Health Cepartiment or vi Health Cepartments Notice of informatio! he Health Depariment’s website ath xxxEND_PAGE:dhhs03_b0591_2009_2010_2

Importance: High Per Sue’s request, we have modified the contract language with GCHD related to Flint water, see attached. Changes are highlighted in yellow. We had a phone call with GCHD staff to review the changes before submitting. Karen will email them this copy as an FYI, and we will be revising our reporting form to align with the new metrics, will send them that form to them tomorrow. Please let us know if you have any questions. Nancy xxxEND_PAGE:dhhs03_b0588_2005_2005_1

Fyi~ this will tie In to our discussion later this week or next week about tracking activities in Flint... @

Importance: High HI — when you are back, this is what | want to review/refine for the weekly status calls with Flint. Hope all went well with CM and HHLPSS training! Have a good Veteran’s Day off... xxxEND_PAGE:dhhs03_b0568_1974_1974_1

Here are the metrics that were included in our Case Management contract with GCHD: Metrics for Contract Monitoring Contract monitoring will be based on data recorded in the Healthy Homes and Lead Poisoning Surveillance System (HHLPSS), Medicaid Claims data from the MDHHS data warehouse, and via weekly review and status calls. 4. Number and percentage of target chilciren with elevated blood lead levels of > 5 ug/dL. that are successfully contacted and offered case management services. 2. Number and percentage of target children receiving case management services. 3. Number of Medicaid claims filed for children enrolled in Medicaid who receive testing or nursing assessment visits. Karen — on your weekly calls, we will need to get updates on these metrics. We will need them organized based on the testing protocol, so we can understand what is happening for each group of children listed in that protocol, and then overall. Karen, i will send you some additional information, wanted to make sure we put this on our list to review together. Wes ~ Karen has weekly calls scheduled with GCHD; do you want to have someone participate on those calls related to linking the case management and EBL investigation activities? Nancy xxxEND_PAGE:dhhs03_b0567_1973_1973_1

See attached, new FOIA. I can see the assignment, but not the actual request (may be something funky about my iPad and what it does or doesn't show?). Can you all see the actual FOIA request in what | am forwarding? I'll try to access later on my laptop. But if you all can starting looking at this now, see if you have any questions or concerns, etc, | would lead studies and associated discussion in Flint; ATTOO002.htm appreciate it! Nancy Sent from my iPad Begin forwarded message:

2015-10-21 - Lead - Flint Water FINAL (1).pdf Geralyn, forwarding Emily’s email that has all 3 attachments for the parent letter, including the nutrition document | mentioned before. riancy

And if you can itemize what the materials are please.

stealer nichiann go>; LaRocco, Toni <[email protected]> (michigan gov>; Moran, Susan (DHHS) 1 xxxEND_PAGE:dhhs03_b0055_0129_0130_1 000130

Ok...Nancy and I did our best to interpret the comments... Eden/Rashmi--is this more what you had in mind? (Happy to wordsmith as necessary). Emily Houk, President and Chief Mischief Maker Research to Practice Consulting, LLC 216 North Chestnut Lansing, Michigan 48933 517-896-2712 xxxEND_PAGE:dhhs02_b1067_3732_3732_1

Nancy and Karen, Please see attached. Any suggestions for changes? Column order? Sorting? General appearance? Different fields of information? These lists do not display children whose next test is not currently due, or whose level has fallen below 5. But I’m keeping everyone ona Master List that | will update each week. (Nobody drops off the Master List.) Bob Robert L. Scott Childhood Lead Poisoning Prevention Program Michigan Department of Health & Human Services (517) 335-8178 fax (517) 335-8509 xxxEND_PAGE:dhhs03_b0870_3056_3056_1