History

1. Genesee County Health Department2012 Public Health Week ConferenceGreen & Healthy Homes Initiative™National OverviewApril 3, 2012

2. GHHI used housing as a platform for health to offer integratedhealth, safety, lead hazard reduction, energy efficiency, and weatherization interventions in low to moderate income homes. • GHHI maximizes public and philanthropic investments for 6 major benefits: • Government innovation in service delivery • Development of sustainable community-based “green collar” jobs and social enterprise • Creation of stable and sustainable green and healthy homes in low-income neighborhoods • Measurable improvements in health outcomes for children and families • Wealth Retention and Foreclosure Prevention • New Tool Development to ensure sustainable system changes

3. History • Formulated initially around increased investments in energy efficiency to enhance investments by integration with Healthy Homes • Sites designated by White House, Coalition, HUD, and Council on Foundations • Coalition directs the national effort and provides technical assistance, funding and training

4. Key National Partners • Council on Foundations and Philanthropy • HUD, CDC, DOE, EPA and the Healthy Homes Work Group • The White House (Recovery, Domestic Policy, CEQ, SC2) • US Conference of Mayors / National League of Cities • Enterprise Community Partners/ Green for All/ Emerald Cities • 17 Current Sites (Urban, Rural and Tribal)

5. Current & Next Generation GHHI Sites • Seattle • Cowlitz Indian Tribe • Spokane • Spirit Lake Nation Tribe State of Connecticut • Portland • Minneapolis / St. Paul • Boston • Boise • Providence • Buffalo • Flint • Milwaukee • New Haven • Dubuque • Erie • Detroit • New York City • Chicago • Cleveland • Philadelphia • Toledo • Cedar Rapids • Omaha • Salt Lake County Baltimore• • Oakland • State of Delaware • Denver • San Francisco • Kansas City • St. Louis • Greensboro • Riverside • Raleigh • Nashville • Santa Fe • Los Angeles • Albuquerque • Mesa • Atlanta • Green – Current GHHI sites • Blue – possible next generation GHHI sites • Montgomery • Jackson • Austin • San Antonio • New Orleans • Houston • Miami

6. The Burden of Unhealthy and Energy Inefficient Homes • American taxpayers lose billions every year in medical bills, skyrocketing energy costs and lost wages due to inefficient and unhealthy housing conditions. • Annual costs for home-based childhood environmental diseases are estimated to be $54.9 billion. • Trip and Fall Injuries for seniors cost taxpayers over $19 billion per year. • •Low income households spend 14% of income on energy compared with only 3.5% for other households.

7. Asthma Afflicts 22.9 million Americans (6.8 million children) yearly and causes: • 2 million emergency room visits per year • 500,000 hospitalizations per year • $20.7 billion in asthma related medical costs per year • Leading medical cause of school absenteeism: 14 million missed school days

8. Lead Poisoning • 442,000 Lead Poisoned Children in the United States (>5 mg/dL) • 24 million U.S. homes contain lead hazards • Children poisoned by lead are 7 times more likely to drop out of school and 6 times more likely to end up in the juvenile justice system • Lead poisoning costs $43.4 billion annually in medical, special education, lost earnings, and criminal justice costs

9. Household Injury • 10 million ER visits per year • 13 million preventable home related injuries • 18,000 unintentional home injury deaths occur each year • Household injury is the leading cause of death among children • $222 billion in annual medical costs

10. The Strategy The ABC’s of the GHHI Approach

11. Private State Philanthropy Federal DOE Treasury HUD HHS DOL $ $ $ $ $ $ $ $ $ $ $ $ WIA ETA EERE EECBG Lead CSBG WAP Lead CDFI Medicaid Medicare LIHEAP Green Jobs IAQ Fed Loan Bank Board Interventions TA Info Education Standard Model

12. Single Intake Portal • Common referral form • Common eligibility criteria (income) • Cross benefit qualifications • Data Collaborative • ETO GHHI data platform • Track key indicators: • Improved efficiencies and cost benefits from integrated assessment and intervention model • Reductions in health care costs (asthma, lead poisoning, injury) and energy consumption costs • Reductions in maintenance costs, foreclosures and tenant evictions • Improvements in income mobility and neighborhood stabilization

13. Comprehensive Assessment Tool Benefits • Cost effective approach by completing combined activities during a single visit using a single inspector • Fewer home visits required and less client drop-out • Integrated Scope of Work is produced • Better alignment and leveraging of resources • Multi-faceted interventions can then be completed by cross-trained workforce • Allows for more effective cost benefit analysis

14. Integrated Intervention • Framework for integrated, single stream interventions: • --Lead hazard reduction • --Healthy Homes (indoor allergens, safety hazards) • --Weatherization • --Energy Efficiency • Systematic braiding of funds to maximize resources • Reduce duplication and inefficiencies

15. Post-Intervention Education • Post remediation education with occupants to enhance intervention • Behavioral change –ETS, Energy, Healthy Homes • Behavioral training component to educate occupants on energy efficiency and reduction of energy usage • Post remediation education with owners on how to sustain the intervention (Lead safe work practices, ongoing maintenance)

16. Innovative New Financing and Braiding Existing Resources • What is Braiding? • Strategic coordination of relative funding streams • Sequenced funding and activities • Co-investment • What is the benefit of new funding streams? • Doing the most good – now! • Achieving more with existing resources • Positioning for additional investment

17. Impact of GHHI • Unit production: +2,530 units completed; 4,225 in the pipeline – initial goal was 3,500 units • Health & safety benefits (+70% reduction in ER visits and hospitalizations) • Energy consumption and cost reductions (~$499/year) • Intervention cost savings (up to 20%) • Increased access to resources for families (one stop shop) and increased coordination among agencies • Over 500 persons trained in Green and Healthy assessments and interventions • Reduction in WAP deferrals

18. $637.6M Total Health Care Savings …results in reductions in health care expenses based on 7,000 units $70M investment Injury $5.8M Lead $136.8M Asthma $494.6M

19. Deteriorated inefficient windows Water leaks creating mold hazards Old allergen-ridden carpets How Families Experience Silos Defective gutters causing water leaks Broken hot water heater and furnace Asthma related medical costs were substantial due to Dwayne going to the ER or being hospitalized 4-5 times per year. Home heating costs and repairs were so expensive that the family couldn’t afford to pay to repair the furnace or replace the hot water heater Chipping paint Safety hazards Air loss increasing heating bills

20. Mold remediated; dehumidifier installed Carpets removed and allergens reduced Energy Star windows installed How Families Experience The Networked Platform HUD (HHDP) Gutters and downspouts repaired New furnace and hot water heater installed HUD (HHDP) HUD (HHDP) HUD (HHDP) An integrated approach that cost 25% less to implement (total cost of $12,057 versus $16,096), has kept the family out of the hospital for asthma related emergency room visits or hospitalizations, improved school attendance and performance, and reduced monthly heating bills Blown insulation installed; air sealing performed Tripping hazards repaired and floors resurfaced Paint stabilized Private Leverage Partner HUD (HHDP) HUD (HHDP) DOE (WAP)

21. Beth Bingham Director, Communications & Strategic Development Green & Healthy Homes Initiative (GHHI) 410-534-6447 bbingham@ghhi.org www.ghhi.org GHHI™ is a program of the Coalition to End Childhood Lead Poisoning