Rapid Health Impact Assessment: Weatherization Plus Health in - PowerPoint PPT Presentation

Rapid Health Impact Assessment: Weatherization Plus Health in Connecticut Presented by: New Opportunities, Inc. 10 Franklin Square, New Britain, CT 06052 Wednesday, April 10, 2013

HIA Stakeholders Joanne Balaschak, Mike Gurecka and Jeff Rouleau, New Opportunities, Inc. • Christopher Corcoran, Children’s Hospital/Lead Action for Medicaid Primary Prevention • Michael Coyle, Department of Energy and Environmental Protection/DOE WAP Program • Manager • Chris Ehlert and Pat McDonnell, United Illuminating/CT Efficient and Healthy Homes Initiative Sylvia Gafford-Alexander, Department of Social Services • Jamie Howland, Environment Northeast/Energy Efficiency Board • • Edith P. Karsky and Rhonda Evans, CAFCA • Francesca Provenzano, Department of Public Health/Healthy Homes Initiative Glenn Reed, Energy Futures Group/Energy Efficiency Board • Lomont White, Connecticut Light and Power Company • Technical Advisors : Amy McLean Salls and Jonathan Wilson (National Center for Healthy Housing), Ellen Tohn (Tohn Environmental Strategies), Lynne Page Snyder (National Association for State Community Services Programs) Funding : • DOE’s Weatherization Plus Health initiative, implemented by NASCSP (www.wxplushealth.org), NCHH’s Small Grant Program, supported by CDC and the American Public Health Association •

Why A Health Impact Assessment? Connecticut energy efficiency goal = weatherize 80% of housing stock by 2030. • Decisions around how best to invest public and utility ratepayer resources to reach this goal have implications for the health of Connecticut residents and especially for low- income households, where housing has a considerable impact on health and the life chances of children. • Decision(s) to be made by EEB, DEEP, PURA • What is role of health and safety? How can Connecticut achieve its energy goal and create positive health outcomes, while reducing potentially negative impacts on health? 3

What is Health Impact Assessment? • “A framework or process that predicts anticipated health outcomes of a decision/project • Translates that information into recommendations for well- informed policies • Informs an active decision-making process • Helps folks outside the heath field understand the direct health impacts of their work • HIA’s purpose is to improve health, track unintended consequences and mitigate risk” Source: Health Impact Project 4

Why a Holistic Approach? Structural Structural Damage Damage Moisture Mold Asthma Exacerbation Source: NCHH, 2013.

Why Connecticut? • DEEP’s first Comprehensive Energy Strategy Plan for Connecticut, role of Energy Efficiency • Ongoing projects that integrate weatherization & healthy homes – CT Efficient and Healthy Homes Initiative/UI – Children’s Hospital Lead Action for Medicaid Primary Prevention – DEEP/DOE WAP Program • Statewide Dept Public Health/Healthy Homes Task Force

Beaver Street Project Housing Authority In March 2011, New Opportunities, Inc. conducted energy audits with our auditing contractor Wesson Energy. This is a 70 unit, 12 building HUD property and while conducting CAZ testing 5 of the buildings gas furnace rooms had CO levels in the amounts of 4232ppm, 1437ppm, 421ppm, 1657ppm & 2724ppm. As required by BPI, all 5 systems were shut down immediately. An NOI HVAC contractor was called in and Yankee Gas called due to gas leaks. Little did we know that in November 2005 four tenants at this site were rushed to the hospital for CO poisoning. Two victims were taken to Hartford Hospital and two were taken to Danbury Hospital. Yankee Gas also discovered a major gas leak outside one of the buildings. Seven years later, if New Opportunities was not conducting the energy audits, this scenario could have been repeated or even worse. Through utilization of ARRA funding, New Opportunities was able to replace the boilers in 5 buildings, and add outside CO monitoring alarms, correct the heating distribution systems in all 12 buildings.

Beaver Street Project Housing Authority In addition to the heating system replacements, NOI installed rim joist insulation, added smoke detectors, CO detectors in units, electrical gaskets, low flow showerheads, aerators, door sweeps, weather- stripping, CFL’s, air sealant measures and window replacements in all 12 buildings. During the window replacement process, NOI discovered major structural damage in 3 of the buildings. Major Termite damage and water damaged halted the project until the Housing Authority and HUD could make the structural repairs. The Beaver Street project was a collaboration of ARRA DOE funds, CL&P HES-IE funds and HUD/Housing Authority funds to address these Health & Safety measures found routinely in the field by home performance contractors in Connecticut .

ARRA DOE CL&P HES-IE/LAMPP Another example of collaboration to address health and safety measures was discovered in this home in Waterbury. Originally audited under the ARRA DOE program, the audit uncovered an asbestos covered coal converted boiler. The only measures that could be done under ARRA/DOE were insulation, LRRP window replacements, smoke detectors and CO detectors. HES-IE utility measures were installed, under the core measures. Although the client’s file was closed out under the ARRA/DOE program, NOI continued to work with the client by referring them to the LAMPP program. They are currently having the asbestos abated as well as a host of other health & safety repairs completed. Once finished by LAMPP they will be referred to CHIF for inclusion in the low interest loan program to replace their inefficient furnace based on loan approval.

Policy/Funding Decisions • DOE WAP Health & Safety, State Plan • PURA Oversight of HES, HES-IE: – What health & safety measures to include? – Who should pay? – How to incorporate health and safety to maximize positive and minimize negative health outcomes?

Scope: Impacts of Decisions About Weatherization on Health

Energy Upgrades Create Health Benefits: “Heat or Eat” Young Children Receiving LIHEAP Vs. Other Low Income Children Are: 20% less likely to be underweight 30% less likely to require admission after hospital emergency room visit 25% of LIHEAP households report going without food for 1 day due to high energy bills

Rapid HIA: Assessment • Profile existing conditions – Health, health disparities/inequities – Current health and safety measures in CT WAP, HES, HES-IE • Literature reviews • Ranking evidence to create priority list of health and safety measures – Major causes of deferrals? – Readily integrated with weatherization? – Addresses health inequities? • Estimate costs and benefits (ROI) for selected health and safety measures • Set of findings  Recommendations

Enhance Reduce Energy Significant ✚ Repairs will reduce health inequalities Deferrals Savings Health Benefit Health Benefits/Cost Repairs Reduce Deferrals, Save Energy & Improve Health Minor Moisture Repairs ✚ ✔ ✔ ✔ X $1.14/1 Asbestos Abatement ✔ ✔ data not available Gas Leak Detection and Repair ✔ X likely >$1/1 ✔ Knob & Tube Wiring Repair data not available Air Sealing with Pest Exclusion ✚ ✔ ✔ X likely >$1/1 Window Replacement of Leaded X $1.79/1 (includes Single Pane ✚ ✔ ✔ energy benefits) Repairs Create Significant Health Savings Injury Prevention Minor Repairs ✚ ✔ data not available Radon Testing ✚ ✔ X $51/1 Radon Mitigation (if work increases radon > EPA threshold) ✚ ✔ X $47/1 Remove Unvented Gas Appliances ✔ X likely >$1/1 Smoke Alarms ✚ ✔ X $33/1 Smoking Education and Referral ✚ ✔ X likely >$1/1 Repairs Recommended by EPA Protocols Carbon Monoxide Detectors ✚ X $1.25/1 Ventilation Upgrades data not available

Recommendations 1. Include health and safety measures with significant health benefits or EPA endorsement in CT DOE WAP Health and Safety Plan – Completed 2. Fund energy efficiency programs fully to achieve energy and health/safety benefits • Fund measures that reduce deferrals and achieve energy savings and health benefits – “green” highlighted repairs Identify sustainable funding/financing to support repairs • producing significant health/safety benefits – “yellow” and “orange” highlighted repairs (reassess orange repairs)

Recommendations 3. Refer Connecticut residents who receive Department of Social Services benefits to energy efficiency programs, to leverage existing state investments in population health. Institutionalize referrals to link energy and social services • (e.g., vendors to document knowledge of referral partners, healthy homes specialist credential) 17

Recommendations 4. State health, environment, social service and housing agencies, utilities, and non-governmental organizations should collaborate to secure the necessary resources to sustain funding for added health and safety measures. Establish Task Force to identify strategies to secure added resources and improve data sharing, set deadline 18

Recommendations 5. Conduct evaluations to track the health benefits of added health and safety repairs during energy work. Identify measures that are most effective in reducing • health inequities among CT residents. Support evaluation of Weatherization Plus Health pilot • project funded by CT DSS