►
Description
Minneapolis Health, Environment & Community Engagement Committee Meeting
A
Good
afternoon
I'm
going
to
order
this
meeting
of
the
health
environment
and
community
engagement
committee.
My
name
is
Ken
Gordon
I'm,
chair
of
the
committee
and
today
I'm
joined
by
a
council
members,
Cano
Andrew,
Johnson,
Lisa,
vendor
and
Jacob
Frye.
We
are
a
quorum
of
the
committee,
so
he
can
conduct
our
business
there's
four
items
on
the
agenda
today.
A
A
All
those
in
favor
say
aye,
like
any
opposed.
Those
two
items
then
pass
the
committee
unanimously
and
then
we're
going
to
go
back
to
our
public
hearing
and
we're
going
to
start
that
with
a
staff
report
and
I
think
that
mr.
doulton
is
gonna.
Give
us
there
are
no
he's
not
here.
There
is
okay,
sorry
about
that.
A
report
first
to
kind
of
start
this
out.
This
is
a
ordinance
amendment
having
to
do
with
our
abrasive
blasting
permits
and
that's
an
interesting,
interesting
chair.
B
Glamorous
appreciate
the
time-
and
my
name
is
Jim-
don't
and
I'm
the
environmental
services
manager
for
the
health
department,
and
we
here
before
you
to
talk
about
some
changes.
We
proposed
in
the
abrasive,
blasting
ordinance
and
just
give
a
background.
We've
had
a
history
of
enforcement
issues
with
the
abrasive
blasting
ordinance
in
one
of
the
problems
we
have
is
the
ambiguity
in
the
current
language,
which
states
that
the
sand
or
the
bracelet
material
be
contained
on
site.
B
What
we've
done
is
gone
in
did
research
across
the
country
and
looking
at
different
ordinances
and
see
how
they've
worked
with
the
language
web
we've
selected.
It
comes
from
Boston,
it
was
approved
in
the
mid-1980s
and
has
been
executed
very
successfully
out
there
and
since
it
since
has
been
adopted
a
countrywide
by
many
other
anissa
palliative
cities
or
towns.
B
What
it
basically
states
is
that
a
violation
will
constitute
visible
emissions
beyond
the
vertically
extended
lines
of
the
property,
deposition
of
visible
amounts
of
particular
matter
on
public
or
private
property
adjacent
or
failure
to
a
gauge
get
a
permit
prior
to
getting
the
permit.
The
second
part
is
deals
with
the
lead
portion
of
it,
and
what
we've
done
in
the
past
is
that
we
required
lead
testing
of
the
property
if
the
person
who
did
not
complete
the
lead
that
portion
of
it.
B
What
the
city
did
then
is
go
on
out
and
test
the
surfaces
ourselves
to
verify
that
it's
led
free
or
confirm
the
presence
of
lead.
What
we
are
proposing
to
do
is
put
that
onto
the
contractors
part
of
the
permit
to
obtain
lead
testing
prior
by
a
certified.
Let
assessor
and
the
permit
will
not
be
complete
without
that
part
of
the
application
and
basically
get
us
out
of
the
lead
testing
business,
we're
fairly
short
staffed
and
it's
a
strain
on
city
resources.
B
A
Don't
see
any
questions,
thank
you
very
much
for
those
report.
It's
pretty
straightforward
I'm.
With
that
then
I'm
going
to
open
the
public
hearing.
We
have
a
public
hearing.
Whenever
there
is
a
ordinance
being
amended.
Is
anyone
signed
up,
I'm,
quick,
seeing
none
men
looks
like
nobody's
here
to
speak
on
this
issue.
A
Anybody
will
be
your
last
chance
then,
to
raise
any
concerns
or
give
us
any
insights,
seeing
them
and
I'll
close
the
public
hearing
any
comments
or
discussion
council
members
I
move
approval
of
this
then
seeing
no
discussion,
all
those
in
favor
say
aye
any
opposed
that
carries
them
and
that
will
go
forward
for
final
approval
to
the
City
Council,
the
other
items
we've
approved,
and
now
we
have
a
discussion
item
our
last
item
and
this
is
having
to
do
it.
Asthma,.
C
D
You
mr.
chair
council
members,
my
name
is
Dan.
I'm
the
director
of
environmental
health
within
the
minneapolis
health
department
there
has
been
continues
to
be
a
lot
of
concern
around
asthma
in
our
community,
and
so
we
wanted
to
take
the
opportunity
today
to
share
some
of
our
expertise
from
the
health
department
on
the
multiple
causes
of
asthma
and
what
are
some
of
things
were
doing
to
address
this
I
am
joined
today,
in
addition
to
the
my
co-presenters
Lisa
smestad
and
Patrick
Hanlon
by
Megan.
D
Canes
again
is
a
epidemiologist
in
health
department
and
was
the
author
of
the
briefing
paper
that
is
part
of
the
RCA
today
and
then
I'm
also
joined
vile
eyes,
a
shell
who
is
than
one
of
our
project
managers
in
our
Healthy
Homes
grant
and
also
worked
on
for
the
asthma
grants
that
Lisa
will
be
talking
about.
Some
pretty
astounding
results
that
we
received
at
that.
D
First
of
all,
I
just
want
to
go
over
what
asthma
is.
Asthma
is
an
inflammatory
response
in
the
lungs
it
causes
breathing
to
be
quite
difficult
for
those
of
us
who
have
either
suffered
from
asthma
or
have
loved
ones
that
have.
We
know
how
difficult
that
is
for
someone
who's
suffering
from
an
asthma
attack.
D
Asthma
is
complex,
it's
a
complex,
inflammatory
response
and
it's
not
exactly
clear
what
causes
asthma,
but
we
know
there
are
a
lot
of
asthma
triggers
and
the
barrel
theory
says
that
once
someone's
barrel
is
full,
then
that
trigger
is
an
asthmatic
attack.
Now
everyone
has
different
sized
barrel.
Some
people
are
incredibly
resilient
and
you
know
it
may
be
a
huge
water
tank
full
before
they
overflow,
while
some
people
may
have
a
barrel
the
size
of
a
thimble.
To
kind
of
give
you
an
example
of
this.
D
Let's
say
if
it
was
a
dog
you'd
own
the
dog,
but
we
know
that
we
don't
own
cats,
so,
let's
say
you're
owed
by
a
cat
that
already
provides
some
allergen,
so
your
bear
already
has
some
kind
of
stuff
in
it.
Let's
say:
you're
allergic
to
eggs
and
you
eat
eggs.
Then
it
goes
up
even
higher
and
then
it's
ragweed
season
and
that
you
know
you're
allergic
to
ragweed
you're
full.
D
Any
slight
thing
would
then
push
it
over
into
that
inflammatory
cascade
once
that
cascade
starts,
it
often
has
a
synergistic
effect
with
itself
and
causes
that
severe
asthmatic
attack.
So
that's
one
of
the
things
we
talked
about
with
the
the
barrel.
Theory
different
people
respond
different
ways
to
different
triggers
and
there
is
somehow
a
summative
effect,
but
also
there
is
some
type
of
logarithmic
effect
at
times
as
these
interact
with
each
other,
so,
asthma
triggers.
D
We
have
things
that
we
call
an
inflammatory
trigger
and
we
have
things
that
we
call
an
irritant
trigger
inflammatory
means
that
it
elicits
an
immune
response.
So
it's
your
body
thinking
that
it's
something
it
needs
to
fight
off.
These
are
allergies
often
referred,
two
cockroaches
dust
cats
or
animals,
dogs,
pollen
food,
allergies,
mold.
These
are
things
that,
if
you
are
sensitive
to
this,
then
it
could
trigger
an
inflammatory
response
in
your
body.
Some
people
can
tolerate
mold.
Some
people
can't
same
thing
with
dogs
or
cats.
It
really
depends
on
the
own
individuals.
D
D
Ozone
is
a
it's
a
highly
reactive,
unstable
chemical
and
therefore
it
robs
tissue
of
Rob's
other
molecules
of
atoms
and
therefore
he
stabilizes
those
in
a
sense
it
destroys
your
tissues
because
it's
robbing
molecules
away
from
it,
so
that
is
an
irritant
that
actually
will
destroy
living
tissue.
So
air
pollution
is
a
common.
When
we
talk
about
irritants,
you
know
if
you
run
in
the
cold
you're
going
to
get
irritated
and
your
lungs
you're
going
to
respond
to
that.
D
So
asthma
is
a
complex
interplay
between
inflammatory
and
irritant
Reuters.
Now,
if
we
look
at
asthma
hospitalizations
know
this
is
an
important
thing
to
talk
about
we're
not
talking
about
people
who
had
asthma,
we're
talking
about
people
whose
asthma,
for
whatever
reason,
has
become
so
bad
that
they
actually
were
admitted
to
a
hospital.
And
if
we
look,
we
see
not
all
the
state
is
equal
in
hospitalizations
for
asthma
and
if
we
go
deeper
down
to
Hennepin
County.
A
D
Minneapolis
we
have
a
disproportionate
number
of
people
that
are
being
hospitalized
for
as
when
a
little
deeper
still
we
see
in
Minneapolis
it's
not
just
that
all
of
Minneapolis
has
a
higher
incidence
of
asthma,
but
it
is
really
located
within
a
couple
of
areas
within
the
city.
So
one
of
the
things
we
should
talk
about
is
what's
driving
this
inequity.
There's
something
difference
between
someone
who
lives
in
Phillips
neighborhood
and
someone
that
lives
in
Dakota
County.
There's
a
difference
between
someone
who
lives
in
Phillips,
neighborhood
and
minnetrista,
and
there's
something
between
Phillips
and
bancroft
neighborhoods.
D
One
of
the
things
and
we're
not
going
to
talk
about
in
this
conversation
today,
but
it
is
a
driver
of
the
inequity,
and
that
is
healthcare
policy.
If
someone
has
a
good
health
care
home
and
they
seek
that
health
care,
home
and
good,
affordable
health
care
and
they're
able
to
have
a
good
relationship
with
their
provider,
they
manage
or
more
likely
to
manage
that
asthma
and
not
end
up
in
the
hospital
with
uncontrolled
asthma.
D
D
Lisa
and
Patrick
are
going
to
talk
to
you
about
different
ways
that
the
barrel
gets
filled
so
that
we
can
talk
about.
How
can
we
lower
that
barrel
and
then
we're
also
Lisa
and
Patrick
will
talk
about
what
are
the
things
the
city
is
doing
now
to
help
to
address
those
things
that
fill
up
our
barrel
right.
Thank
you.
I'll
turn
it
over
to
Lisa
Patrick.
C
Cheer
Gordon
members,
my
name
is
Patrick
Hanlon
I'm,
the
environmental
initiatives
manager
for
the
city
of
Minneapolis
I'm,
going
to
talk
about
air
pollution
in
its
relation
to
asthma,
but
first
I
just
want
to
start
out
by
talking
a
little
bit
about
the
balance
of
talking
about
air
pollution.
We
live
in
a
city,
that's
relatively
clean
in
terms
of
air
quality
and
relatively
low
in
the
amount
of
pollution
in
Minneapolis.
C
We
face
a
lot
of
issues
concerning
air
pollution
that
are
outside
of
our
control.
A
few
weeks
ago
we
had,
or
maybe,
a
month
ago
we
had
some
of
the
forest
fires
in
Canada
we're
affecting
our
air
quality
here
in
Minneapolis.
So
there's
some
of
those
issues
that
are
at
play.
We
have
coal
mines
in
or
coal
factories
in
China
that
affect
our
air
quality
here.
So
there's
aspects
that
are
outside
of
our
control
could.
E
C
B
C
And
so
there's
still
areas
of
concern.
Looking
at
particulate
matter,
that's
one
of
the
issues
with
in
Minneapolis
and
I'll.
Show
you
some
slides
here
that
there
is
concerns
with
particulate
matter
that
has
great
impacts
on
on
health,
not
only
with
asthma
but
other
conditions.
Ground-Level
ozone.
You
had
a
presentation
before
council
about
a
month
ago
talking
about
the
federal
air
quality
standards
and
then
there's
also
number
of
days
that
are
over
health
risk
values.
C
I'll
go
over
that
there
are
environmental
justice
issues
and
I'll
go
as
we
go
through
these
slides
keep
those
in
mind
as
you
look
at
the
areas
that
are
affected
by
air
pollution
and,
like
I,
said,
the
issues
go
beyond.
Asthma
will
be
talking
about
asthma
today,
but
these
things
affect
respiratory
respiratory
areas
and
then
also
cancer
with
some
of
the
air
pollution
issues
that
we
have
cancer
rates
in
Minneapolis.
C
According
to
the
mpca
and
mvh
report
that
was
put
out
a
couple
weeks
ago,
a
joint
report
that
was
put
out
there
about
600
emergency
room
visits
due
to
asthma
due
to
air
pollution
for
asthma,
and
in
that
report
the
Commissioner
had
stated
of
sensitive
populations
are
more
directly
impacted
by
poor
air
pollution.
So
looking
at
the
elderly
and
then
looking
at
children,
and
especially
children
that
have
uncontrolled
asthma
and
so
there's
also
aspects
of
access
to
affordable
health
care.
C
I
know
my
sister
had
asthma
growing
up
in
those
cases
where
we
had
a
asthma
inhaler
was
not
present.
Those
were
very
scary
times,
and
so
I
can
imagine
how
people
without
access
to
those
medications,
can
have
a
much
higher
concern
with
constraining
asthma
and
getting
access
to
health
care.
The
report
I'm
going
to
go
over
I'm
going
to
use
this
report
the
major
findings
from
this
report.
C
Here
in
Minneapolis,
asthma
and
major
air
pollutants
have
can
cause
significant
lung
deficiencies
and
those
deficiencies
can
be
permanent
into
adulthood,
and
so
looking
at
the
major
air
pollutants,
nitrogen
dioxide,
atmospheric
acidity
Knox,
nitrogen
dioxide
and
sulfur
dioxide
have
associations
with
that
atmospheric
acidity,
PM,
2.5
and
PM
10.
Those
are
the
fine
particulates
cause
that
decreased
lung
function
in
this
map
right
years
of
nitrogen
dioxide.
You
may
have
seen
this
in
the
news.
C
Last
year
it
was
University
of
Minnesota
study,
the
Marshall
group,
looking
at
national
amounts
of
nationally
looking
at
nitrogen
dioxide
levels
in
Minneapolis,
you
see
a
clear
disparity
within
the
Minneapolis
Center,
compared
to
the
suburban
outer
rings.
I
asked
our
friends
over
the
Minnesota
Pollution
Control
Agency
to
send
us
this
data.
This
is
PM
2.5,
so
this
is
fine
particulates.
C
Looking
at
Minneapolis
again,
you
see
the
disparity
between
suburban
areas
and
the
amount
of
fine
particulates
in
the
urban
center
and
even
places
within
the
urban
center,
and
so
these,
this
PM
2.5
can
be
like
Dan
said,
is
a
trigger
for
causing
asthma,
and
so
you
see
the
discrepancy
between
outer
suburban
areas
and
Minneapolis,
again,
asthma
and
major
air
pollutants.
This
graph
off
to
the
left
shows
distance
from
roadways.
C
Those
fine
particulates
spread
out
from
those
roadways
and
it
heads
out
to
Bloomington
avenue
south,
which
in
itself
is
in
the
small
roadway,
and
so
you
can
see
how
some
of
the
pollution
that
comes
from
transportation
can
be
a
major
issue
in
a
city
where
you
have
major
roadways
that
are
running
together
on
top
of
certain
industrial
areas.
That
can
be
that
can
contribute
to
those
fine
particulate
issues,
asthma
and
ozone
children.
C
Local
exposures
bald
organic
compounds,
those
can
also
be
they
can
be
an
inflammatory
and
of
irritant
trigger
and
so
there's.
This
is
a
study
by
the
British
Medical
Association
that
children
exposed
to
some
bald
organic
compounds
can
be
four
times
as
likely
to
develop
asthma
than
those
who
are
not
and
so,
and
then
there's
another
quote
there
from
inhaling
paint
fumes
and
those
can
be
some
of
the
those
household
things
that
we
sent
might
get
into
where
children
exposed
to
those.
You
can
develop
asthma
from
that
as
well
or
they
can
be
asthma
triggers.
C
So
the
Minneapolis
air
quality
study
that
we're
doing
right
now
is
looking
at
the
specific
volatile
organic
compounds
around
the
city
and
where
we
might
have
exposure.
People
might
have
exposures
within
our
city
to
those
Walt
organic
compounds,
and
this
map
is
showing
where
we
found
hits
around
Minneapolis
and
doing
our
sampling,
that
are
over
health
risk
values
for
vault
organic
compounds
and
we'll
be
having
a
report
on
that
study.
We
just
did
our
the
last
round
of
that
study
last
week.
C
C
Is
a
lot
of
looking
at
this?
It
sounds
like
a
lot
of
bad
news.
The
good
news
is
that
when
the
research
has
shown
that
when
children
who
moved
to
cleaner
environments
when
they
moved
to
those
areas,
they
show
improvements
in
lung
function,
and
so
the
lesson
from
that
is
not
that
we
want
people
to
move,
but
that
if
we
improve
the
air
quality
here
in
Minneapolis,
we
can
see
improvements
in
children
and
their
lung
function
with
how
it
relates
to
asthma.
C
So
what
are
we
doing
in
Minneapolis
to
address
air
quality,
the
things
that
we're
doing
to
increase
bikeways
and
be
one
of
the
best
bikeable
cities
in
the
united
states?
The
efforts
that
we're
doing
in
mass
transit
to
get
people
off
the
roads?
Those
are
the
transportation
is
a
major
pollutant.
We
have
one
of
the
greenest
fleets
in
the
United
States
for
a
major
city,
looking
at
improved
traffic
flow
studies
to
reduce
idling
times
so
getting
looking
at
times
that
we
can
stop
people
from
idling
at
stoplights
and
getting
people
moving
through
the
city.
C
Some
of
the
green
business
match
work
that
we're
doing
with
the
city
or
with
the
state
in
reducing
pollution.
We're
looking
at
25,000
pounds
of
emission
reduction
through
the
green
business
matching
grant
program.
Looking
at
some
of
our
energy
use,
reduction
through
the
Glink
Clean
Energy
Partnership,
and
some
of
the
benchmark
marking
work
that
we're
doing
and
reducing
emissions
that
are
coming
from
our
energy
use.
C
Tree
plantings
around
the
city,
tree
plantings,
trees,
improve
air
quality,
both
and
fine
particulates,
and
then
also
reducing
urban
heat
island
effect
and
then
taking
new
research
with
when
the
University
of
Minnesota
comes
out
with
new
research
and
examining
how
we
can
use
that
information
to
which
our
address
air
quality
in
Minneapolis.
Looking
at
how
we
can
use
some
of
our
air
quality
data
that
we're
doing
here
and
then
both
with
the
state
and
how
we
can
address
air
quality
in
Minneapolis
and
then
regulations.
C
Jim
just
came
up
here
and
talked
about
one
that
can
be
of
with
abrasive
blasting
in
passing.
That
is
having
standards
for
abrasive,
blasting
and
then
another
example.
That
would
be
our
idling
ordinance
and
getting
people
to
stop
idling,
especially
in
areas
that
were
a
lot
of
people,
congregate
around
schools
and
facilities
where
buses
are
idling.
C
B
F
Council
Council
Chair
garden
council
members,
I'm
Lisa,
said
I'm
the
manager
of
the
lead,
healthy
homes
unit
for
the
city
of
Minneapolis,
like
many
other
health
determinants,
lettin
asthma
prevalence
seems
to
be
linked
to
poverty.
As
seen
on
this
map,
the
three
highest
zip
codes
for
asthma
are
in
North
and
Northeast.
Minneapolis
outdoor
air
quality
alone
does
not
account
for
the
disparity
we
see
in
these
mats.
It
could
be
affected
by
the
lack
of
adequate
health
care
or
the
conditions
in
the
home
and
the
indoor
air
allergen
exposure
back
in
the
early
2000s
during
inspections.
F
F
We
were
awarded
to
competitive
HUD
grants
for
healthy
homes
that
range
from
2003
to
2009
and
asthma
was
big
focus
of
these
two
grants,
but
by
2012
HUD
was
not
receiving
enough
funding
to
offer
separate
Healthy
Homes
grants
and
a
switch
to
including
Healthy
Homes
initiative
money
and
lead
hazard
control
grants,
but
it
could
only
be
spent
on
properties
enrolled
in
the
grid.
I
hesitate
to
say
it's
a
problem,
but
not
all
children
with
asthma
have
lead
poisoning,
nor
are
they
under
six
and
those
two
items
are
required
for
as
mandatory
qualifications
to
receive
services.
F
Under
this
grant
funding,
we
have
a
small
you
care
grant
that
was
granted
this
year
that
we
are
working
on,
but
that's
only
going
to
serve
maybe
20
children.
Through
all
of
these
grants.
We
are
working
with
community
nurses,
American
Lung,
Ramsey,
County,
Health
Department
and
the
Minnesota
Department
of
Health.
F
Mold
in
your
home
has
been
recognized
as
a
health
hazard
for
a
few
thousand
years,
as
seen
by
this
quote
from
the
Bible
renters,
are
particularly
vulnerable
to
mold
exposure
because
they
don't
control
the
building.
Maintenance
staff
may
respond
to
complaints,
but
they
do
not
think
about
what
happens
to
the
other
side
of
the
wall.
In
this
in
this
photo,
the
renter
upstairs
had
a
bath
tub
overflow
and
the
renter
below
did
not
notice.
F
The
move
towards
more
water,
absorbing
materials
makes
like
purp
cavort
cabinets
in
bathroom
cabinets,
&
kitchen
results
in
occupants
having
more
mold
exposure.
A
fact
of
plumbing
I've
noticed
is
that
sooner
or
later
it
leaks.
This
was
caused
by
it.
This
mold
infestation
you
see
here
was
caused
by
a
slow
drip
leak
under
the
sink.
The
landlord
was
labeled
Lee
in
the
tenant
as
a
crazy
old
lady,
because
the
cabinet
was
tried
to
touch,
but
it
was
worked
and
when
we
cut
it
open,
we
found
an
excellent
breeding
ground
for
mold.
F
The
building
code
requires
ventilation
in
the
bathroom,
but
that
can
mean
a
window
that
opens
in
a
Minnesota
winner.
You
don't
open
the
windows
when
taking
a
shower
warm
wet
air,
meets
cold
air
and
a
cold
surface,
and
it
results
in
condensation.
The
picture
on
the
right
is
where
a
metal
frame
of
the
window
causes
cold
spot
on
the
sheet
rock
next
to
the
windows.
Again,
we've
changed
how
we're
doing
our
buildings.
Current
research
is
starting
to
length
mold
exposure
for
young
children
to
causing
asthma
instead
of
just
being
a
trigger
for
established
asthma.
F
Most
people
don't
know
why
they're
sick
in
their
houses.
What
is
causing
the
asthma
this
family
didn't
know
until
a
trained
inspector
pulled
the
bed
away
from
an
exterior
wall,
furniture
pushed
up
against
walls
can
trap
moist
air,
creating
a
microclimate
where
mold
can
grow.
When
there
are
economic
downturns,
relatives
crowd
into
housing
meant
for
fewer
people
and
high
rents,
make
it
hard
for
large
families
to
find
affordable
places
to
live
another
housing
based
asthma
trigger.
We
see
a
lot
of
our
cockroaches.
F
This
picture
shows
the
cockroach
cockroach
poop,
which
is
visible
at
this
property
and,
as
a
well-known
asthma
trigger
some
of
these.
As
the
allergens
we
bring
into
our
own
homes.
A
cat
can
keep
mice
out,
but
dry
cats
alive
as
an
allergen.
Many
people
respond
to
a
mold
odor
by
trying
to
cover
it
up
with
deodorizers,
which
really
just
add
to
problems
by
adding
additional
volatile.
Organic
particles
to
the
air.
Personal
products
like
cologne
or
hairspray
can
cause
problems
and
even
burning
candles
with
candles,
which
adds
very
small
particles
to
indoor
air.
F
So
what
did
we
do
with
all
this
money?
We
got
from
the
HUD
grants.
What
we
did
inspections
we
issued
corrective
orders
and
rental
properties
and
some
properties
we
fixed
up
things
like
doing
integrated
pest
management
services,
but
mostly,
we
provided
these
three
products
that
we
have
here
before
you
today.
F
So
let
me
tell
you
about
some
of
our
one
of
our
clients.
Most
referrals
came
from
nurses
with
pediatric
asthma
patients.
One
child
was
referred
by
school
nurse
because
of
too
many
missed
days
of
school
related
to
asthma.
This
child
had
nosebleeds
almost
every
morning
we
gave
them
a
HEPA
air
cleaner
for
the
child's
bedroom
and
the
asthma
or
in
the
nosebleed
stopped.
In
addition,
conditions
allow
a
mold
to
grow
were
identified
and
corrected.
We
did
integrated
pest
management
in
response
to
a
mice
infestation
and
we
provided
allergen
pillow
covers
and
mattress
covers.
F
We
provided
also
provided
an
allergen
rated
vacuum.
Nomadic
the
family
also
was
not
keep
didn't,
have
medications
in
the
house
appropriate
to
the
child.
Appointments
were
not
being
made
with
the
primary
care
physician
and
they
didn't
have
an
asthma
action
plan
to
resolve
the
insert'
insurance
issues.
They
prefer
to
state
Public
Programs.
The
nurse
that
came
in
with
us
under
this
program
completed
an
asthma
action
plan
for
the
child
and
beyond
asthma.
The
home
was
referred
to
our
let
hazard
control
program,
so
they
got
new
windows
and
the
lead
hazards
were
reduced
in
the
house.
F
They
didn't
have
a
lot
of
furniture.
They
referred
into
house
calls
and
provided
with
furniture,
and
then
they
had
ongoing
asthma
care
because
they
now
had
insurance
and
it
was
provided
by
the
nurses
to
provide
proper
inhaler
technique
and
they
were
referred
to
a
specialist
care
by
their
primary
care
physician
and
they
kept
up
on
their
medical
visits.
F
Multiple
research
projects
in
the
state
and
across
the
nation
have
similar
results
to
what
we
did
with
our
HUD
project.
They're,
showing
that
a
home
visit
by
a
nurse
and
a
housing
inspector
provides
a
big
return
on
investment.
It
is
cheaper
to
provide
these
services
than
to
provide
hospitalizations.
F
The
Health
Department
has
been
working
on
the
coalition
around
how
house
file
1479
to
allow
Medicaid
reimbursement
for
similar
services
as
the
grants
provided.
This
is
one
way
to
get
funding
to
pay
for
the
practical
solution
of
how
to
reduce
asthma
and
many
states
are
in
the
process
of
getting
similar
legislation
passed
to
have
Medicaid
pay
for
inspections
and
some
of
these
products.
F
All
of
the
previous
research
done
in
Minneapolis
in
the
metro
area
and
out
state
Minnesota
is
lining
up
with
the
national
demonstration
projects
I'm
going
to
end
with
this
slide
on
the
impact
on
school
attendance.
Asthma
care
is
an
equity
issue
for
health
care
and
housing
that
impacts
school
attendance.
Our
research
showed
that
a
child
would
be
in
school
after
they
went
through
our
program.
A
child
would
be
in
school
for
22
more
days
in
that
school
year
than
they
would
have
been
because
of
missing
because
of
asthma.
F
All
studies
following
these
models
are
showing
fewer
hospitalizations
fewer
emergency
department
visits
more
days
in
school
and
more
days
where
a
child
and
their
families
activities
were
not
being
defined
by
their
asthma.
The
return
on
investment
was
not
just
in
dollars,
but
in
the
changes
and
how
families
were
living.
F
A
A
A
little
harder
time
getting
around
is
the
air
pollution
problem
seems
like
it
comes
from
many
sources
talking
about
cars,
particulates,
I
noticed
you
didn't
necessarily
mention
burning
wood
in
the
city
or
the
garbage
burner,
and
you
don't
necessarily
have
to
I'm
a
trick.
We've
looked
at
that,
but
it
just
tells
me
that
all
the
little
sources
can
add
to
this
particular
matter.
I
know
we
get
the
biggest,
maybe
bang,
for
our
efforts
with
the
volatile
compounds
and
when
we
can
really
address
some
of
those,
some
industry
and
some
of
that
business.
E
E
You
know
that's
what
we
need
to
be
doing
over
the
long
term
to
make
sure
we're
addressing
this,
but
I
also
appreciate
that
we
are
doing
the
immediate
steps
that
are
needed
to
address
this
home
by
home
in
the
city
and
getting
into
the
places
where
kids
are
being
hospitalized
and
impacted
today.
So
I
think
that's
a
good
balance
and
I
I
think
both
are
really
important.
You
know
as
we're
making
these
longer-term
changes.