Correspondence among

All, l’ll be updating the attached HHS timeline as we go forward with our activities in the city of Flint. | can glean some items to include from the daily SitReps and I’m also asking that you provide any additional noteworthy items to me at the end of each week. Please forward to anyone that I’ve not included here. Thanks for your cooperation. Linda B. Dyhena, PAD. Environmental Public Health Director Giision of Environrnental Health Michigan Department of Health & Human Services S17,335.8566 dykermal@ michigan gov xxxEND_PAGE:dhhs02_b0492_1910_1910_1

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.

Martha, please see if we have the report on this test and give Courtney a heads up so we can coordinate EBL with CM. I'll be in after an 8:30 medical appointment. Sent from my iPhone Begin forwarded message:

Good afternoon, Rep Neeley, Mr. Tawwab, Jaime G (United Way), Eileen T, Director of School Nursing, Toni Larocco and Mark Valaceck and | met this morning at Flint City Superintendent’s office. Regardless of half-life of lead and potential for “false reassurance” which has been a concern of most of us, primary the providers, the Superintendent does want an event which will include parental education followed by testing if wanted, at one of his schools sites. GCHD agrees that there are children that need to be tested, regardless of the Flint River episode, and working with the schools is a great way to reach those children and educate and test as needed. All are comfortable with the following plan: o November 12" there will be a “Lead Awareness Event” (title still being worked on) being held by the Schools in partnership with GCHD. This will be held north of the city at Northwester school, where parents of children 0-5 will be targeted and asked to come for a lead awareness education event and testing if needed. There will be WIC, SNAP, Home Depot, cooking demos, etc. They do want Wes Priem’s program to be there to talk about abatement as well if they can make it (| know they will be there at the Burton GCHD one on the 5"). © One thing | may have been wrong on in the past: Adults who present for testing to GCHD, the Nov 5 or Nov 12" events will be asked to get their testing with their primary provider; this is in line with our prioritization for children 0-5. The Superintendent and Rep Neeley agree on this prioritization. o Rep Neeley interested in MDHHS reaching out to two radio stations to spread any messages out about lead (he gave me the contact info, and the Mayor emphasized last week about the usefulness of Channel 12. 1 xxxEND_PAGE:dhhs02_b0342_1286_1287_1 001287 Eeren Eeken V. Wells, MB, MPH, FACPI Chief Mretifeal Breeutine Mititigan Department ef Health anid Hurtin Serviees 201 Tewreehd St, 5" Fleer CVE Lansing, Ml 48918 xxxEND_PAGE:dhhs02_b0342_1286_1287_2

Eden, More analysis and review has been done by Sarah’ staff. Here are the talking points: The high risk Zip codes (48503 and 48504} Blood lead level rates among children under six years of age in the high risk Zip codes (48503, 48504} were 2.7 times higher than the rest of Genesee County before the switch to Flint River Water (o<0.0001}, After the switch to Flint River Water, rates in the high risk Zip codes were 3.2 times that of the rest of Genesee County {p<f.0001). Thus, compared to rates during 2040-2013, the rates after the switch to Flint River water in the high risk Zip codes increased 18 percent, although this difference did not reach statistical significance. xxxEND_PAGE:dhhs02_b0025_0147_0149_1 000148 Other Zip codes in Hint Rates of elevated blood lead levels among children under six years of age In other narts of the city of Hint were 2 times that of the rest of Genesee County before the switch to Flint River Water (p<0.0001). The magnitude of the elevated rate remained roughly the same during the period after the water source switch.

Date: Thursday, October 01, 2015 2:18:30 PM More analysis and review has been done by Sarah’s staff. Here are the talking points: The high risk Zip codes (48503 and 48504) Blood lead level rates among children under six years of age in the high risk Zip codes (48503, 48504} were 2.7 times higher than the rest of Genesee County before the switch to Flint River Water (p<0.0001}. After the switch to Flint River Water, rates in the high risk Zip codes were 3.2 times that of the rest of Genesee County (p<0.0004}. Thus, compared to rates during 2010-2013, the r: risk Zip codes increased 18 percent, although this difference did not reach statistical sig Other Zip codes in Flint Rates of elevated blood lead levels among children under six years of age in other parts of the city of Flint were 2 times that of the rest of Genesee County before the switch to Flint River Water (p<0.0001}. The magnitude of the elevated rate remained roughly the same during the period after switch. s after the switch to Flint River water in the high icance, the water source

Importance: High 2 things: 8 Leaded gasoline has been banned for use in road vehicies since 1996, so it’s not likely that Flint kids would be exposed that way 8 The sentence “Mast of the iead In household water usually comes from the slumbing in your house, not frarn the local water supply” is not completely accurate and could be challenged. On the call v EPA today | heard that maybe 50% of the city’s lead supaly lines are lead..these are outside the house and would include i portion of the run ow d by the resident and the portion owned by the city water s