Correspondence between

Genesee County As below, Mikele andi chatted. 7H talk to Valacak this AM on options, but Mikelle figured we could just have Oakland for whontever} send us a voucher for the time, and we'll pay it out of aur PH&AS general furs S's. Shouldn't be too many of them. After you get with Karen, give mea call to consult, then | can try to cut a deal with the Health Officer in Cakdand. Mark

Weill, l'on not surprised. We didn’t retain any of the Flint CM funding ~ sent it all to Genesee - so we don’t have that source to pay another county for this work. Right now there are 2 kids, not sure if GCHD will find more. Probably afew, but my guess is it wan't be 4 high number, f the child is on Medicaid, yes it fs billable to Medicaid, and that should always be the first fund source, Oakland does not bill Medicaid, regardless. will have to get with Karen to get info on what Gakland currently does to respond to EBL cases, e.g. at what lavel do they send a letter vs. send out a nurse, ete. itis different for every county, so | want to make sure i get you accurate information. What we currently do in Oakland is that SurveiHance sends them their weekly data file of lead results, and they invoke their own policy about how thay will respond for not}, Remembering that Gakiand will have no idea ifa child nraviously iivedin Flint, unless we identify that for them. agree, we'll have to think about alternate fund sources.

Ginichigar. gey> xxxEND_PAGE:dhhs03_b0428_1572_1573_1 001573 | chatted with GCHD; they weren’t too enamored with our idea to have OCHD bill them. | told Mark V. I’d think of some more ideas and call him tomorrow. Mikelle figured if the #’s are low we’d just have them bill So how many do we think we'll have in this fiscal year? What would the bill be for case management? How would that be reduced if the child was on Medicaid? Are there nurses in Oakland who can do case management? If so, | can probably work out a deal with the HO, especially if we can pay them. How would we normally handle a kid ID’ed in Oakland with an elevated blood Pb level? Mark Miller Director, Local Health Services Michigan Department of Health & Human Services 201 Townsend, 6" Floor Lansing MI 48913 (517) 335-8032 xxxEND_PAGE:dhhs03_b0428_1572_1573_2

Nancy, ff we give the below talking points to Eden, are they accurate? ithink these would be some talking points for Eden: th fase management servires, There are 163 children with elevated blood lead levels reported since April 2074. Staff just started, but have We axpect these numbers to grow In the coming weeks.

fyi

Nurses Rashmi wants us to insert metrics into the contract, just haven't had a chance to even think about that yet. Tomorrow. But if you are otherwise OK with the language, we didn't miss anything you think needs to be in there, then we're a step closer. Sent from my iPad

Hi Mark and Nancy, We need the information for this project in order to add this to the Genesee County Health Department agreement. xxxEND_PAGE:dhhs03_b0580_1990_1993_2 001992 Please provide the project title, amount, and Attachment HE language for this project. Please sand this information to our mailbox as well as the budget liaisor. Please let me know if there will be a delay in forwarding this information. Thank you, Jeanette

Nurses, contract development for Flint As Nancy mentioned earlier in the week, we wil want to try, when possible, to have the nurse consultant and the EBL investigator perform the site visits at the sarne time. Language to this, should put into the contract. Secandiy, coordinating education and outreach events with bath the CLPPP program and our Healthy Homes Section is important, | believe that most of the data an the families wil be the same between the county and with CLPPP om there shouldn’t be a need to discuss this. Nancy will Genesee Ca. do any reporting functions?

Importance: High Good afternoon ~ we have received test results frorn the lab for the farnily whose situation we discussed at 2:30am. Both parents and ali 4 children have levels < 3 based on venous testing (basically, < 2 mears below the detectible limit}. Good news for all! Nancy

development for Flint Nancy, see below email from Ms. Hensler. We need to do the following (if everybody agrees}: Nancy should draft a letter for Sue’s signature, to Mark Valacak, that says we're sending him Sooo through Egrams, fora project called XMXXXX, for the time period XXX, and it should be for the following activities, reports, ete (a short list}. Say well work with ingrid Fink on the details and that we'd like all this finalized by the end of the week, Letter should co out today. Mark Valacak can take that to his administrator, ane it" } make # easier for him ta get started on logistics on his end. He might need some approvals from the County. Work with Jeanette and your budget Haison to develop aril execute the praject and amendment. The contract requirements will go in Attachment 1H, and as soon as we get the amendment executed, they (Genesee) can begin activities. Wes, is there any reason te build in any items from your area? Nancy, bulld in a bunch of specific metrics , aS there will be some int est in the outcomes from Sons way above my pay As Mark Valacak said yesterday, you can work directly with ingrid Fink on the budget particulars. fsuspect olf of this con be dene before the end of the week. Likewise Wes, Jeanette Hensler and staff will do whatever they can to facilitate your contracts. xxxEND_PAGE:dhhs03_b0359_1311_1313_1 001312

When: Tuesday, October 20, 2015 8:30 AM-9:00 AM (UTC-05:00) Eastern Time (US & Canada). Where: Conference Call Can we have a conference call on Tuesday, Oct. 20°, from 8:30 te 9:00 AM, te discuss the below situation in Flint? URXKARKARNK ANE AANA RN KARKA RN KAKA RK ARAE

Hi Mark - we know Sherry Taylor, who we agree is great, will be good to have her involved. If they can do the nursing via the health department, we concur with that approach. Nancy Sent from my iPad erai@mict

Sent from my iPhone Begin forwarded message:

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.