Engaging other Lead Poisoning
A drinking water utility’s core expertise is delivering water to its customers. Other programs, both government and non-profit, in the community may have greater expertise when it comes to housing, health, and lead poisoning prevention. This is also true at the state level where one-third of the state drinking water programs are based in the health department while the balance are in environmental agencies. When these programs collaborate to accelerate lead service line (LSL) replacement, the effort is likely to be more effective.
To identify potential partners, it is helpful to understand the federal lead poisoning prevention programs beyond drinking water. At the Environmental Protection Agency (EPA), there are programs to address lead-based paint, air emissions of lead, and contaminated waste sites involving lead. The Centers for Disease Control and Prevention (CDC) and Department of Housing and Urban Development (HUD) also have programs dedicated to reducing exposure to lead. In addition, the Occupational Safety and Health Administration (OSHA), Food and Drug Administration (FDA), Consumer Product Safety Commission (CPSC), and Center for Medicaid and Medicare Services (CMS) have significant requirements regarding lead.
All of these agencies are represented on the President’s Task Force on Environmental Health and Safety Risks to Children. In 2000, the Task Force developed a strategic plan to eliminate lead poisoning as a public health problem. The Task Force published an inventory of key federal programs related to lead in November 2016. In December 2018, the Task Force released a “Federal Action Plan to Reduce Lead Exposure.”
The lead-based paint programs at HUD and EPA significantly overlap with EPA’s lead in drinking water program because both lead paint and lead pipes:
The HUD and EPA lead-based paint programs include the following:
Beyond lead-based paint, CMS requires that young children served by Medicaid be tested for lead and authorizes states to use Medicaid funds to provide case management and environmental investigation services for those found to have elevated blood lead levels. In addition, CDC provides grants to state health departments to operate lead poisoning prevention programs that include educating health professionals and communities about the risks of lead. These programs can address lead in drinking water.
Many of these lead poisoning prevention programs have integrated their work into a larger effort to make homes healthier. This approach is generally more effective at reaching property owners and residents because it deals with a broader range of hazards such as mold, pests, water damage, carbon monoxide, and allergens in a coordinated manner. Unfortunately, most of these programs do not deal with lead in drinking water in a significant manner. Even within EPA they are not closely coordinated. Some of the limitations are grounded in the statute.
Opportunities to support efforts include: