Healthy Homes NC Housing Conference Sept 10, 2013

1. Housing Impacts Health: the impact of housing conditions on health and common issues we see in our community Principles of a Healthy Home: Basic practices to maintain a home in healthy conditions 3. Healthy Homes Rating System: A tool for assessing the level of health and safety risks in any given home. 4. Advancing Safe and Healthy Homes : Covers remediation, education, counseling, case management, and partnering with community agencies

Over $100 million is spent every year to provide health care to children in NC injured by substandard housing.

Making a home energy efficient can also make it healthy! For example…  sealing cracks to keep out cold and pests  fixing water leaks and adding vapor barrier to keep the insulation dry  venting gas appliances to keep carbon monoxide from becoming deadly.

Where is it coming from?  Roof leaks, plumbing leaks, drainage problems and inadequate ventilation can lead to mold and rotten wood throughout a home. Kerosene and mold?  Though mostly known for dangerous fumes and fires, kerosene heaters change the moisture level in the home, increasing the likelihood of mold. Moisture and Mold

Pests Integrated Pest Management is the healthy—and effective—way to eliminate pests: ‣ Rats and cockroaches are not just gross… the allergens they leave behind can trigger asthma attacks. Some tips… ‣ take away their water (fix leaks) ‣ their food (take out garbage) ‣ their hiding places (seal holes) ‣ then use baits in dark corners.

Safety Hazards Cracked switch plates aren’t just a cosmetic issue.  The exposure of wires can look inviting to little fingers, with shocking results. Physical Injuries ‣ Falls down stairs, in bathrooms, and on rotten floors can mean the end of independence for seniors or others with mobility challenges.

Even low levels of lead exposure in children can result in permanent brain damage (EPA).  Exposure is also linked to poor school performance and low test scores. Deteriorated lead-based paint in older housing is the primary cause of exposure to lead risks, impacting approximately 450,000 U.S. children. Lead

Big repairs cost much more than preventive maintenance!

Housing is not affordable… if tenants and homeowners can’t pay high utility bills AND rent or mortgage at the same time.

Enforcement penalties and lawsuits for substandard condition can add up costs! Deteriorating housing erodes the property values for surrounding neighbors.

 Occupant responsibilities: ◦ Wipe up spills ◦ Use ventilation to dry out ◦ Report water leaks to owner immediately  Owner responsibilities: ◦ Fix roof and plumbing leaks ◦ Check drainage to direct water away from the house ◦ Install vapor barrier in crawl space

 Occupant responsibilities: ◦ Wash dishes ◦ Store food in sealed containers ◦ Take out garbage ◦ Keep water service connected  Owner responsibilities: ◦ Install cleanable floors and other surfaces ◦ Provide for garbage removal

 Occupant responsibilities: ◦ Keep food away from pests (take out garbage, wash dishes, seal food) ◦ Use pest baits or traps instead of sprays ◦ Report water leaks and holes to owner  Owner responsibilities: ◦ Fix water leaks, cracks, and holes ◦ Don’t use sprays to chase pests--get a pest management professional who uses Integrated Pest Management

 Occupant responsibilities: ◦ Use bathroom and kitchen ventilation ◦ Don’t block vents for central heat/air ◦ Open windows when weather is mild ◦ Don’t use unventilated kerosene or gas heaters ◦ Change filters  Owner responsibilities: ◦ Assure that heating and air conditioning are functioning properly ◦ Install bath and kitchen fans ◦ Assure that filters are changed regularly

 Occupant responsibilities: ◦ Keep fresh batteries in smoke detectors ◦ Use handrails and grab bars ◦ Don’t use extension cords ◦ Report immediately if carbon monoxide alarm sounds  Owner responsibilities: ◦ Install smoke detector and carbon monoxide alarm ◦ Assure electrical wiring is safe ◦ Install or repair handrails on steps ◦ Replace rotten boards on floors or steps

 Occupant responsibilities: ◦ Clean often to remove lead dust (especially if home built before 1978) ◦ Don’t use air fresheners or fragrances ◦ Store medications safely  Owner responsibilities: ◦ Maintain paint to prevent peeling and chipping of lead paint (especially if home built before 1978) ◦ Don’t install products that expose to VOC’s

 Occupant responsibilities: ◦ Keep the home clean and neat ◦ Prevent damage to the home from accidents by family members or guests  Owner responsibilities: ◦ Check the home on a seasonal basis (or more often) to make sure everything is functioning properly ◦ Clean gutters, change filters, remove clutter

HHRS is a tool  Initially developed in the United Kingdom, by comparing medical records with housing conditions to analyze the connection between injuries/illnesses and patients’ homes Looks at the “effect of the defect”  Not a checklist of problems but the expected impact of the condition  Based on 29 identified hazards, for calculating the likelihood or probability and the severity of injury from each housing condition observed in a housing assessment.

1. Damp and mold 2. Excess cold 3. Excess heat 4. Asbestos 5. Biocides (treated wood) 6. Carbon monoxide 7. Lead 8. Radiation 9. Uncombusted gases 10. VOC’s 11. Crowding 12. Security (entry by intruders) 13. Lighting 14. Noise 15. Pests and garbage 16. Food safety (storage) 17. Sanitation and drainage 18. Water supply 19. Falling in bathroom 20. Falling on level surfaces 21. Falling on stairs 22. Falling between levels 23. Electrical hazards 24. Fire 25. Hot surfaces 26. Collision and entrapment 27. Explosions 28. Position of amenities 29. Structural collapse

Fixing the health risks found through HHRS… Breaking down the silos—examples:  Addressing moisture problems and ventilation when doing energy efficiency measures  Finding ways to correct safety problems when remediating lead hazards Partnering with other programs to leverage resources for repairs outside the scope of one program Requiring rental owners or homeowners to do the additional repairs (outside the scope of any program)

Teaching occupant responsibilities  What tenants and homeowners can do themselves to make homes healthier (7 principles)  How tenants can request repairs from landlords  What homeowners need to do as owners Case management during remediation process  Connecting to health care and mental health services  Referring for employment or other services Counseling about choices ‣ Remaining in the home and trying to get it repaired ‣ Moving to safer housing

Negotiating with rental owners  Educate (about housing-related health risks)  Offer (repair grants and loans to leverage  their own investment in repairs)  Enforce (minimum safety standards)  Encourage (cooperation with tenants in maintaining properties) Collaborating with community partners for mutual referrals  One Touch concept (among agencies who visit homes)  Referrals (repair programs refer for social services, social workers refer for home repairs)

Advocating for effective policies  Local ordinances with penalties for non-compliance with minimum safety standards  State legislation impacting housing conditions Enforcing safe housing  Code enforcement  Legal action by tenants  Fair housing enforcement  RRP* rule enforcement *Renovation Repair Painting rule requiring lead-safe work practices in homes built before 1978

Raising public awareness of healthy home  Video documentaries and teaching tools  Print media—stories, editorials, letters  Greensboro’s 10 th Annual Healthy homes Bus Tour— October 2, 2013 Evaluating and measuring outcomes ‣ Asthma ROI Demonstration Project ‣ Data collection and analysis to show reductions in lead poisonings, asthma, and injuries

Identifying potential partners ‣ List potential partners in your community ‣ Consider what they can offer ‣ What do they expect or need to participate? Reviewing policies to see what’s effective  Policies about inspections  Policies about scope of work, silo effect Expanding resources  Funding applications  Seeking in-kind contributions GHC can help convene and consult!

Thanks to: The Kresge Foundation City of Greensboro Contact information: Greensboro Housing Coalition Beth McKee-Huger, Brett Byerly, Dominica Darby Office Phone: