Correspondence between

Copying Bob Scott for a response (Martha is working away from the office this afternoon).

Corinne needs to work that out with Medicaid. She's reached out but 1 con’t think she’s haard back yet - she reached out again today.

is there any way Eden can reiterate to Dr. Davis that our Medicaid metric (currently under development} will have Medicaid data in the numerator, not CLPP data?

FYI Sent from my iPhone Begin forwarded message: xxxEND_PAGE:dhhs03_b0224_0846_0848_1 000847

Just had a CLPPF meeting and Nancy stated that they are working on getting a follow-up test and they would keen us posted...

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.

Bob does not get cord blood. The other part of the issue here, as per my email from yesterday, is the research protocal and consent process under which this cord blood was obtained. My guess is that Or. Hanna Attisha would need to get consent fren the mother to release the rnother’s contact information to the state for public health follow-up. Since the original ernad frorn Dr, Hanna-Attisha went to Eden, | think Eden would need to be the one to talk to her about the const issue.untess she wants sorneone else here linchuding me} to follow-up. Please advise. xxxEND_PAGE:dhhs02_b1193_4558_4562_1 004559

fyi

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:

Patti, Corinne and | were on the phone with people from Medicaid to discuss how we could get denominator data from Medicaid for the Flint analysis. It turns out that they generate monthly lead testing rates (by Medicaid health plan). They are going to email us their specifications for how they do this, including calculating age. Corinne, Patti and I, plus Bob and you if you want, will discuss Friday which is the best methodology for calculating age of child going forward —the Bob way, the SAS INTICK way, or, if Medicaid has a different definition, their way. We also discussed Corinne giving a heads up to the Gov advisory via Matt Davis for our definitions moving forward and the rationale — whatever it ends up being. The decision made Friday is what Patti will use to generate the summary report on Monday, and she'll add in a technical note if she ends up using a different calculation than the INTICK one. So there’s the plan. Martha Stanbury, MSPH Division of Environmental Health Michigan Department of Health and Human Services PO Box 30195, Lansing, MI 48909 517-335-8364 xxxEND_PAGE:dhhs02_b0541_2045_2045_1

Weil, we aren't done yet! We have to address fan's concerns. Should | hist forward this to Mona and ask her to write up more justification?

Vrnichigary goy> Here is the original DUA and the IRB approval, if these help.

Bob is going ta do option 3, and let therm know if they want to use it for other things, then we will have te wark on the map.

Thanks for pursuing this. | corcur with the resolution,

This email trail is the result of ry attending a rneeting with Nancy, Rashmi and Brenda to discuss their new Medicaid plan, and at the end of that rneeting we discussed the problem that was being raised with GCHD wanting to include some kids for follow-up that were outside the criteria given to them in the contract. Rashmi et al asked for what the numbers would look like for kids outside of Flint and older than 5 that had elevated BL. | provided (using Patti's spreadsheet} and this is Rashmi’s conclusions,

The amendment to the DUA is attached, with Dr. Hanna-Attisha’s signature. Please forward if it needs Corinne’s or Colin’s review. Otherwise you can sign on Monday, if itis OK with you. Bob and | are fine with it. Martha Stanbury, MSPH Division of Environmental Health Michigan Department of Health and Human Services PO Box 30195, Lansing, MI 48909 64 xxxEND_PAGE:dhhs03_b0460_1677_1678_2

GCHD requested a map with kids with elevated BLLs. They want to use it in a presentation, as | understand it.. Please see attached. Does this violate confidentiality?

Thanks, Nancy said she’d give me the updated numbers for CM later today.

Martha]; McKane, Patricia DHHS) Administrative Group Patricia] cc: Miller, Corinne (DHHS) Administrative Group Corinne]; Scott, Robert L. DHHS) Administrative Group Robert L.]

On duty: Martha Stanbury, Bob Scott, Jessica Cooper e =Inresponse to a request from a reporter for lead surveillance data for the state of Michigan by zip code, there were communications between the epidemiology and surveillance management staff about case definitions and data suppression, to ensure that data analysis between what was released to the public and data that will be released in response to this request are as consistent as possible and that confidentiality is maintained. The data should be ready tomorrow. e Inresponse to a request from the research team at Hurley medical center for BLL data on children in Flint reported after September 15 , we will be adding an amendment to the existing Data Use Agreement. We will be talking with the team on Wednesday to be sure we are clear on what they are asking, and to ensure that the request is within the scope of their IRB approval. e Aweekly report on activities at GCHD to follow up on children with elevated BLLs was received today. This spreadsheet will continue to be updated on a weekly basis. The numbers of children needing follow-up has gone down from 183 to 169, because confirmatory venous tests have been received that are below 5 ug/dl. Martha Stanbury, MSPH Division of Environmental Healt Michigan Department of Health and Human Services PO Box 30195, Lansing, MI 48909 517-335-8364 xxxEND_PAGE:dhhs03_b0411_1543_1543_1

Until Junaicl has access to the warehouse, Pattl with Yan's additional support would be updating the blood leed test counts. Once Junaid has acress to the warehouse data he should be able to take this function an. {My understanding was that Patti has already demonstrated to you [Martha, Linda, Junaid] haw she pulis the data from the warehouse and then can provide SAS code for the analysis to Junaid.)

The other reporter was given counts by county. But only for verious, as | understand it. So this needs to be rerun and then suppression applied. And we probably should give the same information to the other reporter. Patti — are you OK with this?

But it seems to me that we should not release counts less than 6 — those cells should be suppressed. Your thoughts?

Good morning: xxxEND_PAGE:dhhs03_b0457_1664_1670_2 001666 Following up on this request from last week. We now have a second reporter, Ron Fonger with MLive, requesting the 2014 lead testing report by zip code. Do we have a timeframe on when we think this will be finalized and posted? Thank you, Jennifer Eisner Public Information Officer Michigan Department of Heaith and Human Services Office: 517-241-2112 oF §