F Flint Water Crisis Public Archive

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Mona Hanna-Attisha Nancy Peeler

Updated Testing Protocol October 22, 2015

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Good morning, The updated testing protocol document is attached. Based on emails from last night, I: 1. Removed the Hurley column 2. Did NOT include 2-1-1 in the testing protocol xxxEND_PAGE:dhhs03_b0550_1911_1918_7 001918 Let me know if you have additional edits. Emily Emily Houk, President and Chief Mischief Maker Research to Practice Consulting, LLC 216 North Chestnut Lansing, Michigan 48933 517-896-2712 r2poonsultants com Emily Houk, President and Chief Mischief Maker Research to Practice Consulting, LLC 216 North Chestnut Lansing, Michigan 48933 517-896-2712 rpconsultents.com <Flint Blood Lead level Testing Protocol table v5.docx> <Flint Blood Lead Level Testing Protocol Table v8.docx> xxxEND_PAGE:dhhs03_b0550_1911_1918_8

RE: testing protocol

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At ane point, we mentioned doing a lead fair at the farmer's rnarket, but Toni followed up and the farmer's market folks were not interested | think secondary to some recent water-related pratests, fights, etc (the market is below our clinic}. We will dadly sae patients at cur clinic, but ave just fer blood work, we try to be theiy medical home. Mona Hanna-Attisha MD MPH Director, Pediatric Residency Program Hurley Children’s Hospital at Hurley Medical Center Assistant Professor, Department of Paediatrics and Human Development Michigan State University College of Human Medicine Office: $10-262-7257 [email protected]

RE: testing protocol

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great format. xxxEND_PAGE:dhhs02_b1070_3737_3738_1 003738 the "letter to families" column says throughe AUR i think the first “encouragas" should nat b: thera, it’s like that for whole column. The Hurley clinic is not open te the public. [t is the same as any primary care clinic. That column should be removed. Mayhe it should he replaced by the “Health Department" since that is another site for tasting. Mona Hanna-Attisha MID MPH Director, Pediatric Resiclancy Program Hurley Children’s Hospital at Hurley Medical Center Assistant Professer, Department of Pediatrics and Human Gevelapment Michigan State University College of Human Medicine Office: 810-262-7257 mbannal @hurleyme.corm

RE: SCHOOL TESTING_ ALERT

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interesting. Go these people understand that the half-life of lead in blood is only 1-2 months? What is the purpose of having these kids testing ~ normal levels may be falsely reassuring and it’s highly unlikely that we will pick ug many ESLLS in this school age population. There are aise issinss of consents, release of info to PMDs, follow-up, ete. But peaole want something done, and they want something done fast. People are understandably mad. fini just not sure if this is the best option, but there may be no choice.

SCHOOL TESTING_ ALERT

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Importance: High Folks, Got off the phone with our Director. He is pushing to have on-site lead testing at schools, particularly the 3, in addition to getting primary care providers involved. Pushing to have that done SOUN, Imagine sending horne permission slips on a Monday and attesting on a Thursday. Could get mass volunteers to help. His words! fwill need to get on the phone with a few politicians early this afternoon bout this as well. | will get back to you all.

RE: Blood Testing-Version 4 Call

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a.gov> i don't know if the “Tips for Flint Residents" is finalized, and I'ma not even sure if | was supposed to look at it, but! have afew edits. Sarry, i'm totally OCD. Under #2, peaple can alsa just call 211 to get a fitter (this can be added to andouts for filter access}. l'rm nat sure if it was Hteracy tested - some big words like accumulate, precautions, @ print at bottom is same as #1, can just add email to #1. i would alsa reword sentence under tithe to “Lead plumbing is comrnon throughout Filnt anc in all homes built before 1986, Always follow the befaw steps te ensure safe drinking water.” Attached are my revisions to the parent letter. | tried to simplify and consolidate — it’s in markup mode, | have a 8:15 meeting, but will try to take a stab at provider letter as well before Gam meeting Mona Hanna-Attisna MD MPH Director, Pediatric Residency Program Hurley Chidren's Hospital at Hurley Medical Center xxxEND_PAGE:dhhs03_b0539_1879_1883_1 — 001880 Assistant Professor, Department of Pediatrics and Human Development Michigan State University College of Human Medicine Office: 810-262-7297

RE: CDC response about BLLs for adults

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Great article, In box 1, lead in water is a risk factor and “blood lead testing should be performed Ifa single risk factor is identified at the earliest contact.” So | would take this at first contact with OB, blood lead should be done and education on nutrition and vitamins, ete. Gur QB's don't know this, This need to be shared.

Re: CDC response about BLLs for adults

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Let me check with our ATSDR doc, Mark Johnson (Boy there are a lot of Marks...)---because | wonder if the concerns for Flint beg the question. However, | have no idea what the medical removal for lead is for a pregnant women, is that chelation, and is it the same as a child? Anyway, | will follow up with him now.

RE: version with Hurley info

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My revisions attached. We will sort our unfollowed EBLL’s by PMD and get that infe to Toni fanyane else? — it could also be a CHAP intiative - Toni, we can bring that up tarnorrow}. cubiect! RE: version with fer info Attached Draft Blood Lead Testing Pretocol seen aan nee core SS ERI UA A a see cc Sent: Wednesday, October 14, 2015 8:27 AM

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