Pillars of Governmental Environmental Public Health | A Guide to Scalable Environmental Public Health Programs
whether it be rental properties or owner-occupied prop- erties. Because rental homes often provide housing for people who have lower incomes, it is important to make sure the program protects the health of this at-risk popu- lation to ensure that rental properties comply with lead- safe requirements through assessment and remediation. Lead testing as part of a rental registry can help identify properties of concern. An outcome measure could be the proportion of rental properties that have been deemed lead-safe out of the number of rental property registra- tions there are. This measure can apply to rental property permits but also construction permits. When a contrac- tor applies for a construction permit on an older home, a meaningful outcome measure would be how many of those permits or homes have a lead assessment con- ducted by the EPH program. Another helpful measure was stated as being able to track the number of children with blood lead levels and how many of those cases continue to have elevated levels after multiple tests and having their property undergo remedi- ation strategies once they enter the surveillance system. This measure requires surveillance systems that can track individuals and laboratory reports over time. Partnerships with community-based organizations to reach at-risk communities might also be an important part of their work. There could be community development organizations that serve as community ambassadors and consultants who can conduct lead consultations. Through partnerships with these organizations, healthcare provid- ers, and clinics, programs can promote screening and edu- cation so that children are tested for blood lead levels.
time required for these visits directly affects staff capacity and workload. Research indicates that 2–3 lead prevention activities per week were considered reasonable for EPH professionals. Programs can use this guidance along with their estimated annual activity needs to determine appropriate staffing levels. Respondents in the focus groups also noted that jurisdictions could consider the desirable minimum staffing for this EPH program as a median of 1.2 FTEs per 100,000 population served. Some participants also noted that much of the remediation work is currently being conducted by private third-party companies who can charge property owners drastically different prices. Additionally, some noted that jurisdictions might want dedicated FTEs to do the remediation work that is currently done by third-party companies, though there was no consensus on this suggestion.
Education/Training/Certifications
Staffing
A bachelor’s degree in a science field was identified as the preferred minimum education requirement for lead pre- vention programs. For some specialized roles, participants noted that community health educator positions could benefit from degrees in public health or nutrition, while community health worker roles could have a high school diploma as a minimum requirement. The REHS/RS credential was recognized as valuable for this program area. While not considered essential for per- forming lead prevention duties, the credential provides foundational knowledge that supports EPH professionals across program areas. A state lead risk assessor license might be necessary in some jurisdictions to conduct lead investigations and make recommendations for remediation. Respondents men- tioned that for some state requirements, only a sanitarian
Lead prevention programs can determine staffing based on three key factors: 1) population served, 2) number of pre-1978 properties, and 3) geographic coverage area. Home visits generally represent a core program function, particularly when children test positive for lead. The travel
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