Correspondence between

Thanks. (1 put these in the SitRep for today.

Flint #’s for this week, with totals added. Note the new last row, that shows all 6-17 year olds. xxxEND_PAGE:dhhs03_b0420_1558_1558_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.

ATTOOO01.htm Sent from my iPhone Begin forwarded message:

See attached, lots of activity for today. Please note item in red, which we would like to discuss during Thursday call. Nancy xxxEND_PAGE:dhhs03_b0383_1491_1491_1

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

e —CLPPP Nurse has maintained contact with GCHD nurses regarding child with EBLL, per our Nursing protocol. Per the GCHD Nurse, the child’s lead level has continued to decrease, to 20 pg/dl. e Received calls from Rep. Neely’s office regarding an upcoming Health Fair, asking about CLPPP participation or provision of materials (may be on December 15" at a Methodist church?). Suggested that GCHD staff may be their best contact; shared with GCHD that they may receive a call. xxxEND_PAGE:dhhs03_b0405_1532_1532_1

Wes Ok thanks. I'm sending to Linda Dykema to verify with the figure she may have because it was a higher figure at ane time. Linea, See Nancy’s notes below on the 163 EBL investigations, At one time, you had a different figure based on your analysis, Can you verify what figure you have. Thanks, Rashmi

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

<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

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

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 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.

Follow Up Flag: Follow up Flag Status: Flagged UPDATE: Here is a link to the VA Tech study re city of Flint drinking water There are some presentation links in the lower right. It appears that the researchers have completed testing of a lot of water samples and the results are significantly different than the city and DEQ data. It also appears that they've held public meetings in Flint, resulting in the concerns about the safety of the Flint water that have arisen in the last few days. I'm talking with Genesee County and the DEQ this afternoon about our outreach efforts and may know more after that call. Linda D. Dykema, PhD. Environmental Public Health Director Division of Environmental Health Michigan Department of Health & Human Services 517.335.8566 dykemal@michigan.gov

Geralyn, Vm net aware of a specific policy or process, but the Division of Environmental Health has at times recommended that the Director issue a “health advisory” to alert the public of a potential hazard. in each case, we have based this recommendation on data regarding levels of chemical contaminants in environmental media, wild game, or sport caught fish. We've also twice recommended that the Director make a finding of imrninent and substantial hazard when the available information suggests that a chemical storage facility presented 4 fire or explosive risk, When the issue of lead in city of Flint drinking water first came to my attention, | contacted the DEO Drinking Water Program and then provided a summary of my conversation with DEQ staff (please see the attached e- mail from July 23, 2015}. i've recently reviewed a written response drafted by DEG staff to Congressman Dan Kildee that suggests none of the information summarized in my e-mail has changed. We're continuing to follow the situation and have discussed with the DEG some options for a public outreach effort. We're having a call tornorrow with the DEQ and Genesee county staff to further axplore the options. Let me know if! can provide any further information. Linda ®. Dykema, PAD. Environmental Public Health Director Division of Environrnental Health Michigan Department of Health & Hurnan Services 517.335.8566 dykermal@michigan.gov

Importance: High Naney aiid LinttAMme hate gotten a call fim legislative offfess asking us to declare a “tadtth advisovy” in Flint due to Wait they belreve are high levels of lead im the weiter system so that the TC program ean then pay fer butted water aiid ready to feed fornia for pearte in the Flint area. \fe are fairly certain there is an actaal proses to hardte these tyees ef requests ard the department WoURn't just eescree a hedith advisey if the data didn't support it But can you help edifeite us on WheFe we Sstard on this Issue. Thartk you-eg xxxEND_PAGE:dhhs02_b0322_1242_1243_2

I spoke with Steve Busch, Lansing District Office manager, DEQ Office of Drinking Water & Municipal Assistance. The city of Flint recently conducted drinking water testing throughout the city with special attention to those areas known to have old service lines. The city water supply is in compliance with the lead rule, which means that 90% of the water samples were less than the lead action level of 15 ppb. DEQ will, however, recommend that Flint further “optimize” their corrosion control methods. The DEQ has not seen a change in the city's compliance with the lead tule since switching to the Flint River source. Some water samples had lead levels above 15 ppb. Homeowners receive their sampling results and those with elevated levels are provided with information regarding how to minimize their exposure, including replacement of water supply lines. The city pays for line replacement from the main to the property boundary. The property owner is responsible for some portion of the cost if the line replaced is on their property. To Steve's knowledge, there is no program in Flint to assist homeowners with limited financial means. Regarding the home with high drinking water lead levels: some years ago the supply line that serves the neighborhood was replaced, but somehow this house was not connected to the new line, such that the family's xxxEND_PAGE:dhhs02_b0904_3051_3052_1 003052 drinking writer supply Wis cominug fem the ek eurréeed fead pipe. Noite of the neiwhbers writer hadl eRevited fead levels, Whikth Wis likely why she Wis temporary comneeted by garden trese to a tap supplied by the Rew line. Site hes sinee been permanently eomneeted to the Hew line. Regarding the EPA drinking weiter official quoted in the press articles: the report that he issued Was a result ef his OWh reanesteh and Wats net revieeved of approved by EPA management. He hes essendally acted! outside his authority. xxxEND_PAGE:dhhs02_b0904_3051_3052_2