New Mexico: WX Plus Health September 14, 2012

The Path to Healthy Homes 2011: CDC funding opportunity to develop a program to address multiple hazards in homes and prevent diseases and/or injuries that result from housing-related hazards. Required collaboration with NM housing agency—NM Mortgage Finance Authority

The Path to Healthy Homes 2012: NM Dept. of Health received grant Requirements: –1) convene a Healthy Homes Strategic Planning Group to assist with program development –2) Confirm/identify hazards and high-risk populations –3) Develop primary prevention and case management approaches

Planning Process HH Strategic Planning Group meetings: –1 st meeting: March 15 th, Las Cruces (N=47) –2 nd meeting: April 18 th, Roswell (N=39) –3 rd meeting: May 30 th, Las Cruces (N=43) Two main groups: Primary prevention and Case management Participants: health, housing, community advocacy, and political sector

Potential Network

Risk Assessment Health Risk Variables Assessed: –Rates of asthma hospitalization –Elevated blood lead levels among children –Overall health status (income, education, health care coverage, risk behaviors, and causes of death)

Risk Assessment Housing Risk Variables: –Census Data: <50% area median income, number of cost-burdened renter households, deteriorating housing stock, lead paint risk, among others

Risk Assessment Housing Risk Variables: –Colonias: (1) Road data, (2) Household year built data, (3) Household structure type data, (4) NMED septic data, and (5) Epidemiologic data.

Risk Findings Overall housing risk: –42 communities in state have median income below 75% of NM median household income. 17 of these in SW/SE. –Deming Above-average risk for every category. >50% of housing stock at risk for lead paint; 63.7% of population below 80% of NM median income. –Sunland Park 59% of the 1600 renters are cost burdened (pay more than 30% of income toward rent) 49% of households are below 50% of the NM median income

Risk Findings Housing risk: –Hobbs Total of 4500 households at or below 80% of NM median income level 72% of all housing built before 1979 (lead paint risk) –Roswell 76% of housing built before % of rental homes cost burdened –Portales 2705 households below 80% of NM median 60% of renters are cost burdened –Colonias Along the Rio Grande Valley, Farming Communities, and those outside the city limits

Risk Findings Housing risk: –Deming, Sunland Park, Hobbs, Artesia and Carlsbad, Portales and Clovis –Colonias along the Rio Grande Valley, Farming Communities, and those outside the city limits Health Risk: SE and SW –Higher asthma hospitalization rates in SE compared to rest of state: Under-15 age group: Lea County=64.9, which is almost three times higher than the state rate. Curry County=57.8.

Risk Findings Health Risk: focus in SE and SW –Health Status Report: SE had the worst health status of any region. SW had the highest percentages of adults in low income households –Highest county rate for elevated blood lead levels =Lea County (6.5 per 1,000 children screened) –BUT, screening rates low in Southwest

Risk Findings Areas to Focus: –Lea County and Dona Ana County had most overlap of housing and health risk –Other counties that had at least some overlap: Eddy, Roosevelt, Curry

MFA’s Green Initiative Changes Add Healthy Home principles to: –New affordable housing financed by MFA will incorporate Healthy Home principles into design, construction, operation and maintenance –MFA will provide limited technical assistance to government entities and housing authorities in the southern third of NM that choose to implement new Healthy Homes policies within their jurisdiction –With HH Strategic Planning Group, MFA will develop a Healthy Homes Pilot Program

MFA’s Green Initiative Changes Healthy Homes Pilot –Referral System –Intervention via MFA’s NM Energy$mart and HOME Rehab service providers. –Healthy Home-specific measures added to existing programs.

Collaborative Network

Housing Partners Emerge CAA of Southern NM’s Child and Adult Food Care Program (300 homes, 6000 kids) Southwestern Regional Housing CDC (WAP & HOME Rehab service provider) NM Energy$mart Training Academy

Referral System K.I.S.S.: –Use a standardized form –Transmit client’s basic, public information –Indicate the referring organization –Indicate the level of severity of an existing problem

Assessments ??

NM Energy$mart + Health (January 2013) Referral Client is screened for WAP eligibility. Client is assigned a HH educator (WAP or other) visits the client and creates a plan of action. Provides client with do-it-yourself HH items. HH Assessment completed.

NM Energy$mart + Health (January 2013) HH educator summarizes the suspected HH problems, asthma, radon, falls, (other required areas) and makes HH upgrade recommendation and refers to WAP: –Keep It Ventilated –Keep It Safe –Keep It Clean –Keep It Dry –Keep It Contaminant-Free –Keep It Pest-Free –Keep It Well-Maintained

NM Energy$mart + Health (January 2013) HH educator coordinates with WAP energy auditor on suggested upgrades to be implemented in the EE upgrades process. HH Educator reviews the completed project and associates files, ensure the completeness of the project. WAP staff complete final inspection.

NM Energy$mart + Health (January 2013) Healthy Home Interventions: –Basic Weatherization –Basic Weatherization + HH Education –Basic Weatherization + HH Education + HH Intervention

NM Energy$mart + Health (January 2013) Basic Weatherization –Home Energy Audit, Energy Efficiency upgrades, combustion safety –Do No Harm: Lead Safe Work Practices, Asbestos awareness, Health & Safety Training –Energy Conservation Education

NM Energy$mart + Health (January 2013) Basic Weatherization + HH Education –Visual Survey of indoor air and health issues –Client interview –Completed Health Home Assessment –Provide client with recommended actions

NM Energy$mart + Health (January 2013) Basic Weatherization + HH Education + HH Intervention –Low Cost, no cost materials Damp wiping HEPA Vacuum + Filters Dust control strategies Walk off mats Dust mite covers on Pillows and mattresses Non-toxic Cleaning/ Green Cleaning kit –Radon Testing/Mitigation? –Roof?