Correspondence between

BOV> Will be CC'ing you on response to Mona regarding this issue

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:

Good! Sent from my iPhone

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.

Thanks, Nancy, all good thoughts

Some additional ideas: --The health department has some great tools available that could be used to help locate families - it can check the WIC records, and/or check MCIR to see if there is a new address listed. --Between GCHD and MDHHS, we should also have a way to check Medicaid records for any new addresses. --We may also be able to work with other colleagues within MDHHS to see if they can check databases related to other public benefits such as SNAP. --Mark Miller also had a good suggestion, to connect with the STD (HIV?) investigator that works in Flint, to share the strategies he uses to locate people; Karen Lishinski has his name and can share it with the nurses, or the health department staff probably already know him. --The schools may also be able to share updated information they have about addresses (if the child is school- aged); we talked briefly to MDE about this last week, and they said the local school district would be the best resource, as the state school database doesn't retain the kind of information that the nurses would be seeking. Nancy Sent from my iPad Per our state-local call yesterday, it is hard to find some of these children with EBLs due to their changing addresses. Would partnering with the local health providers help, as these children are hopefully getting primary care locally? Gary, are you in touch with Drs. Hanna, Reynolds, Levine and others---perhaps there is a way to query their databases to locate children for follow-up of EBLS since April 2014? | am not sure if HIPAA would play a role, but seems that we could find a few of these children. Just thinking out loud... xxxEND_PAGE:dhhs03_b0174_0731_0732_1 000732 xxxEND_PAGE:dhhs03_b0174_0731_0732_2

11-9-15.xls; RTF NE.PDF; Talking Importance: High Nancy and Eden, We have gotten requests from GCHD and the USDA on how we are handling the requests for Ready to Feed Formula. We will like to send these docurnents to GCHD to use as a resource and USDA as information on what we are doing for outreach and requests for RTF. As you can see, cur WIC staff was consistent on the talking points document to ensure they include info that went out to the wider population through parent and provider letters. i wanted to give you both an opportunity to review first before ti send to our communications office. Please let me know if you have any questions or comments. Thanks, Rashirnl

Yes, wi can show tests by week and cumulative. “This week" refers to the work week ending Friday, 10/23/15. Every Friday ideally}, we process all recarels received for the week—adding ther to the CLPPP database anc sending them to the MDHHS Data Warehouse.

Can we show number of tests by week and curnulative? his when you Say “tests process «= 405, what week are you referring to?

Please see attached.

xxxEND_PAGE:dhhs03_b0560_1958_1960_1 001959 Hi Bob, Do we have an updated report? Thanks so much! Angela

My suggestions/comments attached. Let me know if you'd like to have Michelle Bruneau or another health educator review the draft.

I just talked to Linda Dykema. I am sending her the parent letter. Well Mark Bella check and I thought eight hours was appropriate she feel Linda thanks APA states you should do a mid day flush as well so that if the line is not been flushed for 3 to 4 hours. She will look at this and then I will go with whatever her recommendation is on the time. That note Nancy that at least on the other letters in general you flush the line 5 minutes but that's not meant to happen every single time one washes their hands or has need for unfiltered tap water during the day. Sent from my iPhone On Oct 26, 2015, at 12:08 PM, Peeler, Nancy (DHHS) < Two concerns — 1. The new language is not at a ae grade reading level like the rest of the letter. 2. iisn’t consistent with what the information in other documents - we have beer basing our docurnents on the EPA recommendations, and have consistently referenced running the water for S minutes, Nowhere else do we include in the information about running the tan first thing inthe morning or if the faucet has not been used in more than 6 hours. So - we can try te wordarnith it more, to bring the new bulist down in reading level, And, if we go with ail of this information, do we need to change other attachments {Parent Handout, etc.} to talk about running the tap in the morning/if not used in B hours? Angela, we defer to you as to whether to make more changes. Pil wait te hear back fram you before f have Emily do anything else — xxxEND_PAGE:dhhs03_b0557_1941_1950_01 001942 Nancy

can you all find a better statement in the parent letter that Tamara refers to? Good pick up Tamara!! Eden V. Wells, MD, MPH, FACPM MDHHS Sent from my iPad Begin forwarded message:

<MV Al AL AK @echd us>, "neeley repidi@amail con" <neeleyrep34@email com>, "Eileen sabes Re: Flint Schools Meeting FYI attached is a model school-based water in lead intervention and testing program. It's from EPA region 2. It's called the 3T's and if focuses on water testing and long term fixes. It has lots of great resources in it. xxxEND_PAGE:dhhs03_b0059_0137_0137_1

Not to be a pain, but if changes are required, they should be able to make those updates themselves rather than dictating them in an ernail. Updated letters with the correct phone number attached. Angela

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

Cool! Thanks! And some can be printed front and back to decrease page count, Geralyn-numbers 1 and 2 Sent from my iPhone > On Oct 23, 2015, at 4:14 PM, Peeler, Nancy (DHHS) <Pee! > > | believe there were 3 attachments for the Parent letter, total of 6 pages for the attachments. > > 1. Parent handout - is Your Child Safe from Lead Poisoning? (2 > pages) > .pdf 2. Lead in Flint Water - Frequently Asked Questions (2 pages) > http://www michigan - Lead - Flint Wa > 3. The third was created by request of > the group - 2 pages from an EPA document about Nutrition. Emily Houk did that work, and | don't have the final version. Emily, can you please send the Nutrition 2-pager? > > Nancy

Please let me know ASSp as we aligned the language of FAQ and press release and parents letter Sent from my iPhone Begin forwarded message:

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

Thanks- | do recall this- and much appreciated! E Sent from my iPhone > > Hi Eden - at one point in the discussions about Flint, someone had asked a question about Leadcare machines - Bob and Karen (our nurse) found this information, but since that discussion seemed to disappear, I'm not sure if it is still helpful to forward it on to you. Sharing now just in case. > > Nancy

Eden and Angela, Per your request, please see attached. Consider this a 1° (well, 3°) draft, and let me know if you have suggestions or questions. xxxEND_PAGE:dhhs03_b0560_1958_1960_2 001960 Thanks, Bob

A clarification — Geralyn will also provide the her input on the drafts that were set up on the letters last evening and I just center the updated testing protocol that Emily did. Thanks so things are moving! Sent from my iPhone