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INSIDE STORIES
White Knights
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Junniy Marsuliti .
ometimes. tuning .3 everything Pinnacle reform initiatives have been enacted in states li>
SHealth Cart Enterprises of Vj^uvo had run Maasaclmsetts. Connecticut, Maine. Verroor.c and Aj lasses of $4 nduoo and loads of dex Vet us 101is, and (he Repigiluan governors of New fork an president. Jade Mazur, a disbarred Lawyer Wisconsin lve petipened sweeping reforms. who nad been charged e botn securities and CivilIrarucalfy, the most outspoken proponent of can
fraud, were eqyensnMy awared sum and drove tfoepig- n finance reform m the New Jersey uegrslaaire 1
of-Qie-ine ears
renht years has been Sen. Joint A. tynd
And Aght before the 1997 *cwort
0-MidOUShk Lynch and Pasjyde jus ha,
race, slate official? watched as Mazurs
pen to be mortal political tne.T.,cs j>
company effectively drove off with We to
much for natural alliances far campaign 1
sses of HIP-He&ifn Plan of New Jersey, its
nance refotm in New Jersey
health care cetitefs and 200 000 patients
Barbara Plagdraid, a Sister,ouse re
ur cover stojy opens with a con
porter for me Associated Prwrs. runes that
versation -with Wayne Peters, an
Mazur and Pinnacle were a pair of unlikely
irvuigtan hatr.ecwr.er wtiose sot
-white knights-for anHMOtXai -w losing money, sue was not yet insolvent Bet
recently Bet-anus eneof 2.Q71 eluidcen , New Jersey found to ltave elevated lead
within a year after officials handed Pinna cle the keys. the finsiusal ocnditior. of rtiP-Heaiw Plan of New Jersey had deteriorated Su repeky that was d&tr the PIMO was sedng K have to doe m doors.
Fifzgaalds article focuses an the Whitman edmmiscrslionh decissr. to allow A-viadr Co take over KIP in what some lawmakers have characterized an a hasty move to stave Lift a messy HwO failure in Che final staged ol Whitmans rejection campaign.
She questions Our states failure to adequately in vestigate Pinnacles Background and impose adequate regtiiarory safeguards on tiis out-of-state firm.
Finally, she asks whether New Jersey state govern, meric nugftt have bees better off stepping ut tu take over HIP itself TJat option was eserauec by South Carolina this spang in an effort to avert the financial failure Of an HMO CtiaT serves Medicaid pa&rfds.
levels in their Wood Su! the story didru cuJ there fhrwilx' Lauren Otrs. Hj reporting takes us inside me convoluted bureauciaty establishes to help ndents protect inemaenws ard the-r children ftotn the insidious aide effecs of ovru.posure u Lead
Wtule New Jersey lee the nafion m bartnihs lead paint, uur tdtildren eonunue to auffa.- permment braih
(janage due x lead exposure. Otw problem is amply the age of our housing stock-mure than S5 percent 0
New Jersey? housing stock was built prior a 19SC. when house pairtf eonfalned its highest lead esneetv tradOfl Atiufiier IS what Oos descrl as *a dizzying anay' oflews, rggnliniotis and programs gmierrung lead screening. fteaUAChi ana eiean-ups.
The worst problem is found in Newark, wliers see tors somifliS keep children hospitalized for weeks waiting See their families 10 tod a home mans not oar
Tltting is also an issue in the campaign reform movement in New Jersey and nafionaUy flany Pazyde the outspoken -While laughs" of New
tarwMed. And ffb Uiere, in New Jerseys largest tu.. where a solution.may also be discoveied
EftiOy Cue uaue.
Jersey Gontmoti Cause, has drawn nanana. atleabwi
with nts ^ass-roots CKacns Army and tus efforts to
push campaign finance and ethics ordinances through
town councils and (,-utiurunea. a'j 5 managing editor
Biehard Hansen porno Out.
PosyckfV irran-by-cotm strategy reprusetes a taoi
admission that campaign finance reform has no chance
of passage in the New Jersey Legislature Tins caches
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j j n &'j u .v io t v o l 26 issue 10
REPORTER
ON THE COVER
SILENT SCOURGE 16 Laws attacking lead
contamination are strong, Cut enforcement and cleanup efforts fall short
By La u REn OTiS
24 Newark Seeks Silver Bullet
DEPARTMENTS
2 Inside Stories 4 Slate Street 38 For Policy Wonics 40 Public Policy Calendar 43 Drawn and Quartered
COLUMNS
34 Peter SuchSDaum
35 Amy Hanaiin
36 jim Goodman
37 Carl Golden
CENTER AT TRENTON
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is p e r ma n e n t l y c l o s e d
J*X-Ea SE DIRECT a UL INQUIRIES a n d CONCERNS TO) I-S00-240-7S24 (HEP/NJ) .
FEATURES
THE FALL OF HIP
8 Failure of State Oversight Leaves 200*000 Looking for New HMQ
BY Ba RBa Ra fiTZGERALD
14 States wrestle witn mMO oversight as failures, fiscal troubles mount
BY CAROu in E n SiMRSOn
CAMPAIGN FINANCE REFORM
26 Common Cause, Uncommon Solution
BY RiCk a RD MARTTEN
32 Tne Changing Face of Municipal Misconauct
BY ROBERT BERNESS
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Laws attacking lead contamination are strong, but enforcement and cleanup efforts fall short
,-1A
BY LAUREN OTIS
ayne Peters knows about the cost of lead firsthand. For 10 years, he has lived in Irrington
Wwith his family in the top apartment of a two-family house he owns. In December 1997, his son Collin was found to have elevated levels of lead m his blood. The source was de termined to be dust from the window moldings and .sills in the apartment. Peters was faced with a cost ly decision -- pay lead abatement contractors licensed by the state upwards of S7.500 to replace his 16 windows, or pay steep fines for doing nothing.
sac Peters, Wtiu ruu a modest carpat cleaning business and makes money on cue side as a handyman, found a unique way out -- fie studied for and obtained rus own official deSSnahou us a lead super* 'visor so he could do the worie itimself. at a fraction at the Mist. He xnuws hut cfesliue solution is not si, option for most. "Other jwipte u> cry suluauon wno cannot be band, ana correct the situation themselves, they are left to me merry of me system." tie said, adding. "A -ot of people ran barely . pay for cite menchiy water bill, now
t New June* RcpOctOi'
die? iueve to pay 55.000 to set me lead out" In the 27 years since a law banning lead
paint in the stele went mtu effect -- sue years prior to a national tun -- New Jersey Iibo assembled a dizzying array or laws. reg ulations and programs governing lead screening, crestme n; ano eman-ups Through the state Department of Health anc Senior Services ana Department ot Community Affairs, New Jersey spends about 5S Bullion annually, much of it ob tained through federal gratis, un ijentJy* mg ana combating lean poisoning and re*
moving lead hazards. Many tnarucipaJine* allocate money in addition to wnat they re* eewe horn the state.
While New Jerseys laws and regulation* are among the mast senngera in the coun try. pervasive lead hazards and thousands ot ear.tJiuir.g case* of er.Jdrer. Ht un
healthy levels of lead m their blood around the slate irulwatr evidence that progress has been far coo stow Ctines fauit the cate
for felling to mate reswutu-es available t i*apkanont its laws, foe a feeii of coordination between agencies, and for Being Slow in
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hazards first hand * mayor of Union Qcr between 1986 and 1992.
True ooes not liave the pnonzy mat iz shouldhave," said Menenses 'Many re sources are devoted to eunns disease, and I am ali for that. but. here's one we know wt<at tiie cure is...We coaid save a lot of children and save a lot ol nwney. whether on medical care, special education or else where. we pay in a variety of ways. W know how to Cure it Out we are not dedi cating. at a local or a state level, the re sources to bring it off '
MeuiWuiaaMi
Peters questions (he existing program ZWhy would somebody wait until some body's kid has a high lead level before taking action, then they take severe accon against the parents themselves'* he asked "One of the (wags trie government siwuM do n have some incentive programs, tv gel the lead out of the house '* But when he turned to Irvington officials fur help, Peters said he was (eld no abatement grant funds were available.
Ilurry Payaen, as Nciglilwrtiood Preser vation Program Coordinator fur the town of
JunWJuir 1999
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Irvington, adicnowieUgetl fruit infilled funds allucatec By irvlngion far lead abatement were not available Fur Peters and directed him tu a. lead abatemerit loan program ai
Summit Sank Yet Peters found even the di*counted loan terms toe expensive *!r is a Catch-22 We nave people who need to have lead hazards abated,' Rayden said "Lfnfertw irately, as a town we dur.T 1raver enough mon ey to assist each and every one of them.'
Joan Luckharw of the New Jersey Task fore* on Prevtton of Lead Poisorung said the legislature Ms done better than the agencies. 'After mure than 25 years of ad dressing this. since the severities, it seems we could have dene UuS Settee,"' she added.
Mer.er.de2 tailed lead poisoning the sleeper disease' Decause 'unless you tao* about it, you don't knew a is there lunang.
you dent know that your child IS ST nsk *
Lead can cio seiious and permanent damage to a endds brain without obvaous and visible symptoms When lead is absorbed into the human Body, u affects the blood. kidneys ana nervous system, causing learning (us abilities
Unlike other public health problems, lead can do serious and permanent uaniage to a child without o d v j o u s and visible symptoms
But there are signs that lead's sleeper status could change in the very near future Borrowing from the states' recent successrui legal strategy against tobacco compa nies. the attorneys general of a number of states are considering filing civil suits against lead pam: and pigment nuumfiuiurers fur compensation of the public health costs their tunes have incurred as a result of compaang lead poisoning and lead paint hazards Several cities, including Nematic, are looking at sung lead yam; uianutacear-
ers themselves, modeiug their leas! strate gy or- the high-profile suits many cities around the country hove died against both
gun rnanu&cmrera and tobacco cornpanies Jack McConnell, whose Charleston. 5 C
firm Ness, Motley, Lnadlu-iltit, Rictiardson &
Puole lias been uwolved m the sate tobneuo litigation, has been uoriang with at Rhode Island Attorney General's office on a suit against lead punit manufacturers, wtnea. tie said, slsjuld be filed by the end of the sum mer Additionally, the Him nas contracted with the City of Newark to draw up a lead industry suit or. its behalf (see Newark S4c~ twrj "Another 10 to 12 sum, iitoniey gen eral offices nave contacted us and naked us to investigate the possibility of Mug sun against lead paint and pigment manufactur ers * said McConnell, who declined to name die states
Roger Shatzkux a spokesperson with tne New Jersey Attorney General's office said, "We have been in comae: with Qie Rhode Is land Attorney General's office on this lead issue. TSie Aitomcy General m beginning to be briefed about it. he has nad some conven sailors with a couple of oJterexu people and essentially it Is uider review
Paint and pigment conipatues maintain
that char voluntary reduction of lead levels in painc m the 1950s showed a good fiuth ef fort to roirunuae potential health hazards, and that any lawsuits are without basis. Sul. chase w!io want to horn manufacturers legally accountable eay that, similar to to bacco companies. Uw paint manufacturers knowingly withheld from Qte public tooudedge of the tenor efrects of their produces Critics cite industry oocunuiULations, and knowledge which already had resulted ui leaded paint being banned m much of Eu rope by the 1920s.
Jeff Miller, executive director of the Sparta. NJ.-baeed Lead industries Associa tion. says there is case law going back. 10 years in favor of tne paint uui pigment in dustry, wiin no conspiracies or wvJciolding of infbnnausn from the public having beer, proved. Regarding the possibility of a new
round of state and city suits, ttilkr said. *Tnere has been a lot of U1K. and maybe flat is the asomeys' way of drumming up business.' but he notes tliar. so far, no suits nave been Sled.
.r
. a.ia^s-
cb'n^^^^ousand^ermene^ \ rf
VamagW^' M-gfulcI without obvious.
and visible symptoms..
Sen Torricelli has cu-spensored fedi legislation which would pave the w^y teg U S government to sue lews pautt tureis
In the tinned States, lead has banned from all such uses, with the
that blood lead teveis in die general
non ha been significantly reduced, the mean sen poses s threat because, or
present, n never leave* the environment tyj natural means Anc medical research detennmed char lead can damage at even low levels of exposure Rei the accumulated teed from the ov
has been deemed unrealistic because pervasiveness would make the cost asi nontfeal UAUiam Connolly, director of the vision of codes and standard* in the Ni Jersey Department of Community a ana chairman of an interagency task oil the prevention of load poisoning in N Jersey, sad. *Uy own parsotial estimate
$50 billion in New Jersey to get lead out the environment.'
Don Ryan, executive director of thi Waslungton, C.C -based Alliance tu End" Child Lead Poisoning, smu lead hazards In housing from peeling pamc aid paint eclipse all other sources of exposure The1 best proxy for the presence of potential paint hazards is tite percentage of pre-ISSQj AOusmg stock ui mi area, said Ryan paint was used until 1973. paint with the| highest concentration* uf lead was i Uitcd before the 1950s
In New Jersey, 35 2 percent of tne 1 ug stock is pre-i9a0, well above the nan avenge of 26.9 percent, nuking tne statej
major repository of lead paint and lead 1 ards. Ryan said "Every county ir. tin?:
has more than 10,000 housing units built 1 fore 1950," according to the state 1 men: or health auuj Senior Servsctss in i
cal year 1998 report entitled -CiuJdhoo Lead Poiserung m New Jersey" The J report states. 'Because lead-based paint i
other lead-eontainina substances are : sent throughout the environment m New^ Jersey, ail children in the state are at risk" . One of the many compucatuig IbceoisJ about mad policy is, 'It is a highly pobti charged subject, there is an argument whether u i* a medical or social problem^ said Dr. Steven Marcus, wne is aJbliafef
with Newark Beth Israel Hospital aid is ' rector of the New Jersey Poiscnlp.fonnatiai^
and Education System As a result. 'Ev oedy can stand them aul point their f
in the opposite direction." he added Roughly 10 percent of tne state's lo
potso.ung cases occur si upper income i cat. wner. people retxcn.au- old houses, i
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co.-tuas to John wooer. lend program vuordinaiot with New Jersey Cito.cn Action But, the attitude tiiar die disease hula only in pour, urban, minority areal si trie sate
where eider luxrsat* has ae left to flMcnoraLe still predominates, he said.
The mother lode of New Jersey* KU proorem a in Newark. Frequently, that nc/s travails overshadow problems elsewhere in the state According cs tire sure health de partment. Cl fiscal year 1998 Newark alone had 656 children wrch e-evaied blood lead lewis, S2 percent of the total 2,071 children
with elevated levels ih the state. Essex County, vlueh houses Newark, had 1 .Old or S9.1 percent of the elevated cases Anti Newark* straggle agamst lead lota been in the spotlight.
the 'Cure* for lead poisoning tun (wo tacases- Treating children and abating (.re moving or scaling mi lead hazards where the/ live -- called secondary prevention -- and identifying and ileuns lead hazards be fore they poison elu.dreh -- caueo primary prevention Although pnmaiy piyreoiron u the ultunate goal, because of the resources n would require, most states including New
Jersey have to date concentrated on the more realistic goal of secondary prevention
Thus doesnT sit well with these * ob serve iu treat lead poiioiutig firsthand. "You need to prevent the problem before it happens," said Dr Mcfida Elsaity. director of the lead program af the University of Medicine ana Dentistry of New Jersey in Newer*: "Once you nave lead ponofting it is irreversible." Or Eisafty said of the mental and physical 'Jopaamena which Tesult from children ingesting lead.
In American industrial society today medical experts assume that everyone has some lead in their body in children younger
war. five, the US Center for Disease Con trol currently considers e blood lead level above 10 micrograms per deciliter to be a level or concern." New Jersey considers a blood lead level of 2U ug'db or above to be at: elevated level, requiring action by local health officials, although fellow up testing ana lesser action is required at levels above 10 ugidb. Currently, we CDC states tluu even low levels of lead in a ctulas stood can result m permanent intellect reductions, cmurionai and physical problems requiring
treatment or added attention. Such as spe cial education At toxic blood lead levels, around 40 ug/df. or above, die ordy treatmerit is cheixboti therapy, a painful series of injections for leaching me lead out of 3 ermai system
Miller u.r tne Leaa Industries ASSouiafiion said too Mils attention it paid to new fir
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lead levels have un]ire>4 in recen: decades, and the industry's voluntary rate in this success story. Noting that. currently.
4 4 percent of tfte children in America age five or under nave blood lead levels at or above 10 ug/dL, Mailer said that IQ years ago, 30 percent tad levels at or above 10 ufi/dL, and 30 years ago 75 percent did. 'Ilu m toy Satie* When 1 was a kid, every,
body w* above 1C * he said ` DHSS estimates conservatively that
there are at least 8.000 duldren in New Jen aey wuli elevated Blood ie*c." os fiscal year 1998 lead poisoning report states, noting that earty detection and prevention of lead poisoning (or these children would result in potential savings of *7.8 million in medical costs and *20 million in pubt-c expendi tures for special education.
New JerseyS> record of passing laws to
taclde its lead problem, as well as updating them when needed, lias been a good one. said Kevin McNally, program coordinator, Childhood Lead Poisoning Prevention at the state Division or Family Health Ser vices, an ami of the New Jersey health and Senior Services Department *uie were cer tainly one of the firs: sates to identify lead paint as a health hazard, and recognized it m passing a law m I9?i," he added *ln New Jersey, what I would tUce to see done better is coordination Between the health and housing sectors, particularly at the mu nicipal depanmenu *
a New Jersey law enacted in 1996 re
quires mandatory lead screening of all chil dren In the state, at least twice, before they
reach age six (previously, only children identified as at high rule were screened} if a bleed lead level of 30 ugfdL Or greater is found, the haltn department with authori ty over Oic child in question must, under
Chapter 13 of the State Sanaary Code, send state certified lead inspector* tn the childs residence to determine if a lead hazard is present If a hazard eidsta, it must be abat ed by the property owner using state certi fied contractors, according to sate mandat ed went practices Local health officials are responsible for case management and en suring dial the abatement e> completed.
Figures in the DHSS fiscal 1998 annual report on child lead poisoning indicate that the rapidity with wluch local officials are able to respond to lead hazards ranes con. sideraeQp For fiscal year 1996. of l.OEiS lo cal health inspections required statewide due to elevated blood lean testa. 1,207 ur 74 percent had been completed by the end of the fiscal year, June 30, 1996. according to the report. Of me 701 load hazards found statewide, only 251 as 36 percent of
abatements nod been cwupiecea ever the same period
Of the counties wall the highest inci dences of lead problems for fiscal year 1998, Essex lias completed 76 percent (624 of 828) inspections and 30 percent (94 of 316} abatements: Passaic (us com pleted 82 percent (19a uf 337) inspections and 46 percent (67 of H6j abatements, and Hudson has completed 52 percent (66 of 106} of inspections ai 4 37 percent (17 uf 42} sbatetnenis. t>y June 80 1998 accord ing to the OHSS Other counties ranged from aero to 100 percent compt-riior. rues in both inspections and abatements
New Jerseys rules ucre recently revised to incorporate up to daze knowledge about lead hazard identification, such as the use
of dust wipes for analyse, and only five oth er states in the country have a universal lead screening law for children on tneubooks. John Weber 0: New Jersey Citizen
Acuon. calls the screening and elevated blood lead level inspectioicabacemer.: re quirements good, bus Lie others ui tne state, has questions about tiwix efTeeuve implementation
he Stale Department of Health
Tand Senior Services came under wide criticism either tins year when the fUeai j-ear 1998 report it released indicated mat 13.59b chiidren were screened the first year the universal screening law took effect, a aromatic drop from mere than 17.000 screenings conduct ed m Uw prior year
But McNally reports *s lot of misconcep tion* about tnese statistics The numbers did not reflect all the tests performed statewide, he said The reported number* included ad state lab luuoo wad tens brut many private labs reported only tests that turned up elevated blood lead levels, Mc Nally explained
"If private labs are reporting 1,000 ele vated blood lead tests, that a the np of the iceberg for all the tests they made, mcnidirvg those without elevated levels,' McNally raid (the fiscal year 1998 DKSS report lists lb.213 stale tab tests. 83.5 percent of which had results of less that lu ugoL and 3.38a private lab tests. So 8 percent of which had results of less tint 10 ygoi.) The problem will be resolved when a OHSS internet fonipuitr cupsram; system scr lues char na been delayed is put ih place uii year, he said, and die DHSS annex, report on cniid lead poisoning for fiscal -*ar 2000 will be the first with complete retorting of testing aaca. as a result
State Sen. Louis Bsossho. K-Lc u o a, T\c i*Kisoid the universal lestitig law in 1995
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as weu as an earlier mu sctang lead abate ment standards. said fin pushed universal te$Cifig because the Oroblem ~st noc just ur ban housing, it it aftere Of housing is old " Ouf housing and ksul luuuinh exist all over New Jersey, even ui upper mean* suburban areas, and the only way co find them is through testing. he sain *1 trunk you have to go with the universal casting Hist, until you find where the hot spec* are." and wen a more targeted approach ran be pursued.
Bassanc said he doesn't trunk further legislation is needed at present Rather. *U is a matter of time, and lighting a fire under the Department of Health." as well as. partops. setting aside more money in the Bud get ter lead programs, he said
Ye;, doubt remains over how dose New Jersey can get to universal testing of its
600.000 to TOO,000 children under age six Noting that 'screening Is the one area where we could prvbahty do tl* most good t>>* doing better." Citiaer. Action's Weber lays tlur change from fee-far-serHee health, care to managed cure has immstruns the lav since it was drafted
"The HMDs will not pay the doctor to draw blood in their office, because they have this pig contract with a lab- So, the doctor sends them To the lab, the lab isn't Open at night, the lab isnt open on week ends and guess what happens* The child is n't screened far lead." said Weber.
Joan Luclehara: agreed, noting the need to make a separata lab appointment for a loud teat, -wnetnar or not you are poor, tlai is a lot to ask people to do. to find anotlier time, sake a day off. drag tne piss to the clinic.' Additionally, she said, rather than pay for one test before 15 months and one after, as required by state law, HMOs are 'cutting the difference. acung one test at 18 months "
But Paul lahgevin, president of the As sociation of Health Plans of New Jersey, suu
HMQs have less ability to alter physician be
havior than people think HMDs are well aware of the importance of screening for lead and the much lugr.er costs down tne road if a child witn elevated blood levels is n't tested and jdenuiiea, but many physi cians 'don't think screenings need co be done, when they may be necessary,' he said
McNally said the 1998 testing law incor porates no enforcement mechanisms lor
monitoring physician testing or car penafumg doctors who Am to test ctiildren for lead
'Son* of die difVivUies char have been en countered subsequently kind of confirms the sense chat a Inc of us had hen.- that how ever well ihfoncioned the law is. a physician mandate [for universal testing) witiiout i
enforcement mechanism -- and there is no enforcement mechanism in the Uw -- is dif-
Scull to aclueve.' Dr. Wayne Thnhui. a Midland Pure pedia
trician and immediate past president of the New Jersey Chapter of tne American Acade my of Pediatrics, said the NJAAP does tiot support Che universal tesong law. because ir does not give doctors who do the testing any say and wastes valuable resource*. The a a P does support testing targeted to highrisk areas, similar to CDC recommenda tions, he said. *111 many, many practices we Should rest everyone, but where my prac tice is upper middle dan -- educated peo ple who renovate and move out -- it makes no sense to test uruvcRalty.' he added.
Cu Bassano's rationale on first finding high-risk areas through universal testing and then taigecmg them. Or kankus said, -Scientifically, that makes great sense, but who pays ter Jc*"
He said the expense of abiding by federal blood Candling regulations is wiiy doctors don't draw and test blood m their offices.
Doctors would test more for lead if die cap illary, or finger sack blood lend test, that
they can easily administer in their offices were more accurate. but it is nor. he says, often resulting in telse readings at elevated blood lead levels (in New Jersey, finger stick tests nmet be verified by a venous test in volving drawing a full blooc sample;.
Because so many underprivileged chil dren considered at liign nsk for lead poison ing we insured Ly Medicaid, the federal gov ernment requires that every child insured by Medicaid be screened By the states for lead. But a January 1999 General Account ing Office report round that states had a ter rible screening record, managing to screen oruy gj-percem of Medicaid children for lead. The Ca O findings were what prompt ed Pep Menendea and Sen Torricelli to
sponsor legislation tying state Medicaid
screening levels to a senes of ''carrots and
sticks,' as Mesichdez pui it New Jersey ranked second highest in
percent of Medicaid children who received a lead test even Uiough it screened only 39 percent, according to the Ca O Edward Ko gan, a spokesman for die state Department of Human Services, which oversees Medic aid. said, ~I: looks like tl* compliance rates ere coming up sotnewiiar for lead screening They are more bke 45 to 50 percert'
In 6kail year 1995 Medicaid's medical ser vice was moved from fce-foi-setvice to man aged care by the state, said Kogan. 7b reme dy the situation, he said. *W? will be building into our annual contract with HMDs a Gnarr cal penalty for fading to screen ctoldren for lead * a 75 percent screening figure a the number which will nicety be the cut-off, be low wfoch penalties will be levied, but details nave not been lUlQr worked out yet. ne said
Screening evy Medicaid child in New Jer sey, as federal law requires, a the ultimate
goal, bur it would be unrealistic to be ex pected to go frocn 40 percent to 300 percent m one step, Kogan said.
Unnl a few years age. New Jersey haa no srate program in place for helping home owners and landlords with lead abatement. The state Deportment of Consigner Affairs received in initial $4.25 mifoan grant from trie u S Department of Housing and Urban Development in 1993 to start a program helping property owners conduct lead abatements as part of ocher renovations. The DCa received a sesend $6 million HUD grant in 3995. and is currently apjilyuig for a third
Done JOnnanr. supervisor of DCA3 losdbased point aoatemcnr program, soys tiiat oliiiough abatement of lead hsaards is voluiilacy unless * enwa wun in elevated biowl lead :**; resides at a property, sne has
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>: - v
-- m A.'.
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found property owners receptive to DCa help in conducting proactive abatements
Kiiin&iie acknowledges that the DCa program cant hope v> fully meet the wed Car lead work in the sate. "There are 2.6 million nousing units in New Jersey built be fore 1978. If we aid modest work on those,
say Jio.uou a shot, that's a tremendous
amount of money/ she said. "We Wc to push a lot of the dungs that can be easily and effectively done/ she added, such as
pushing education and safe praeoees such
as no dry sanding o; burning of old paint ui renovations
"Right now, there isn't * tremendous
amount Of money out there to do lead week, and lead work in New Jersey is very expen
sive. as opposed to neighboring states." says Kinnone, because uf the level of reguaaen in New Jersey, requiring certlied eerjRctars and state mandated work practices, like dosmg m the area whore the work a done and cleaning up carefully afterwards.
Currently. "We are giving awards of about *200.000 to towns and Counties, and with that they are doing eight to ten units That doesn't seem like much but those are new ten lead-safe homes/ Kmnane said
The DCA lias taken a long time to get
even its current modest program going "Our program really didnk get up and run ning until 1996/ Kinnane said. "Compared to many of our state grantees, they have been one of the slower ones," Uic Ellis
"'r~r C&UHD/
;y
Percent lOu^/dL
Percent ^XCer^liUl^ 20**0j/<11.
/'-i, . i -
?1
1 1
"A
1
w*an .flassa'ic' - saiem ' Somerset-
Sussex' Union Warren | Total
V'^sS'1 'A
:vtA ' : 17.6
: io.i 10.5 3-3 12.8 3.7 14.S
,v!'W<>';7 -O "r.v*'- - k
"-3.4 .-3 0
''.s'
.4 ............... 8.8
Golouuai, director of Che grant program in HUD'S load Daaard control office. Ttw New Jersey DCab alow stars can be explained by the tact that "they undercook a very amtuLious program of unolvins their muniripeuties* and nad to adept legislation as well, said Goldman. adding. "Now tliai they are up to speed, wt look forward to working with them*
To date, property owners have beer pretty much on their own when tt comes to
paying tor lead abatements -Quite honest ly. oilier than our hinds, chare hasn't been a
lot of funding available to address the lead problem." Kinnane said
Although property insurers are required co defend and indemnity property owners for liability in cases of lead poisoning in Now Jersey, insurers routinely refuse to pay for " lead abatement procedures, according to Steve Buch. a fufioine apartment owner ana tttar-agar In Maplewood and board memnvr of the New Jersey Property Owners Associ ation T went through a lead abatement my self last year/ he said. Kis insurer refused to pay any of the cost sul Chen, this year, raid him it was dropping him tor lead liability coverage.
Bueh said a new state law says, "it the owner proves the apartment is lead safe, ac cording :c the standards of the DCa . then uie insutsnee earner must offer him co*et." The catch is, the sate has yet to adopt leadsafe standards "So. property owners are in
a legal limbo/ he said. He has had certain of his properties Certified lead-safe by feder al standards, Buch said, but there is no way of knowing whether New jersey will ulti mately adept those standards.
The only private source of lead abate ment funding in the state is the Sortunit Bank loan program as part of its Community Reinvestment Act obligation The program
started almost four years ago. when the bulk was approached by Citizen Action, says Lewu Hurd, community development officer. Although u. got off to a tow start. Hurd says Summit now makes tnree or four loans per month, averaging S9.000 tu *10,000 each, and would like to increase die volume Cibaen Action* Weber said, "1 sun absolutely convinced tnat through that pro gram we have gotten abatements to happen which would not nave happened under any otner circumstances -
New Jersey Sid convene an mier-agency task kirve several years ago. to loots az ways the sate could implement federal recom mendations for primary prevention The task force, disbanded this year, consisted of representatives from government, advo cates for lead poisoruna prevention, land-
21 New jersey Reporter
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Earning erne earafScaee enoetcd Wbyne Pacers to avod paying more man 37. SOO so neve lead removed from ns Irvington noma Fa,i,ng ze remove me lead tvOuid nave resulted in steep fine*
lords, attorneys and uisuranee Companies, and was (.-inured ay wuuam Connolly, the OCAS director of ttir Division of Codes ana
Standards. Connolly said that, uiumaeegt. cnre was
no agreement By task force members on polity recommendations, bur that were was enough common ground U draw up a state
strategy "to put together a system that would prevent earlier man respond to etulshood lead poisoning "
First, according to Connolly, it was agreed tliat owners of property buili before 1S78 should undertake essentia! lead-cafe moinv-nanc* practices, including regular in spections, repairs and education of resi dents For pre-1950 property, more rigorous Oust wipe testing arid lead-safe cleaning should also be done. Connolly said The practices would be includes! as part of the housing code, and enforced uvouoh inspec tors Of sLate and local autnentics, he said
An Yipr fair* prm/lvinn wavrtnwri up. mt i der which landlords who demonstrate thal their property is lead-free. or draw uu a eus. tu:n lead-safe plan tnar receives housing ap
proval. may avoid the maintenance proce dures. Connolly said Although many on the task force thought the opt Out provi sions gave fledlDUiry to the guideline*. rep resentatives of the property industry did not support them, wanting the state re
quirements to only carpet areas wtveh rrSearcii had shown had significant lead haz ards. he said
nddioenaliy, access to insurance u ex
amined, with recommendations for insurers Co be required by the state to provide at least limited coverage for liability and ex penses related to lead exposure and clean up (such as relocation uf tenanted for prop erty owners wno 'self-certified' that uiay abided oy the aforementioned lead mainte nance practices and abated according to scale rules. Connolly sud He noted that, us date. iiiSurers appeared not to lia-e de clined to write lead natality an a wide scale m. New Jersey, as they have in other states, rinr a<1flop, *1 dur.t know if inut eduction u
goeng to lost.4 The last piece or the pusilc ado-owed
l/y the task force was we setting of appro
priate prat-ikes for everyday routine hous
ing maintenance and repair work, covering
the proposed ban on dry sanding and burn
ing off paint with a lortih. plus containing
and collecting dust and work refuse, and
disposing ofit appropnarely, says Connolly.
The next step is to put the task force
recommendations into the housing code,
winch, Connolly said, can be done through
admlnistracve rule untiring rather than leg
islation He said. W's have not established a
schedule for beginning the rule-making
Process " Other task force recommenda
tions, such u a statewide lead-safe housing
registry and a compensation fund of last re
sort for victims of iced poisoning who haw
no access to insurance to pay tnemoai and
oilier expensed, Mil require legislation.
Tlie voiauons are an eOiiipUuaxea. ont-
consutrung and expensive, bui tlveie senns
to be no other way *if there wrt easy
aiuvr>," Dr Marcus said. -Thvrr
WSld Ct ,U kwl
wyiuun *
Ouurert Oils is c. jcwmaiiSt baton in
ThrrUisn
juncvJuL-1999 i-'i
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he City of Newark is, without doubt, the area of New Jersey most ravaged by lead poison
Ting. It houses 3 percent of the state's population and has nearly 33 percent of the cases of elevated child blood iead levels. Essex County, which encompasses Newark, accounts for al most half of the elevated blood cases in the state. Fifty-one percent of Newark's housing stock was built before 1950, when lead concentrations in paint were highest. WiUi the busiest high ways in the state passing through it and a history as a home to heavy industry, Newark for years re ceived additional environmental lead from manufacturing and leaded gasoline exhaust fumes.
For years. Newark has been equally incapable or sunuuofurig the resources
to effectively light Sack against lea<3 haz ards within its bowers, which is why the City of Newark was one of Che first to give notice Uvat it intends to sue lead painr and pigment manufacturers to re coup current and furore costs tome by Newark in cleaning up lead-based pamc. inditsvud iead, and Curing for those poi soned by it.
On June Id, 1995 the Newark Cu> Council adopted a resolution tu hire the law firm Ness, lloiiey. Load noli, Richardson & Poole to draw up a lawsuit against l. DuPont, CidCen Corp., SCM Chemicals. Slierwin-Williams Co.. FoUer-
O'Brien, American Cyaiiinude Co.. N.L industries, AftCO. The Lead Industries Association and any other lead mar.utaetuicrs, successor coinpantes or their in surers. Ness. Motley, a Charleston, South Carolina-based firm, has also been retained by the Rhode Island Attorney Generals office to draw up a suit against lead paint and pigment manufacturers. The Lrra played an important rale in to bacco industry litigation initiated by state attorneys general Ut resulted in a $2<*3 billion settlement. mid has also been involved in extensive civil litigation
against manufacturers of asbestos prod ucts
The Newark resolution states that with 'staggering- problems and costs re sulting trow lead poisoning. and 'perma
nent ana devastating health problems for the children of the City of Newark." cou pled with the (act tliar 'the lead industry
failed to take reasonable, responsible steps which would have prevented Lead poisoning in Newark." Chat the City or Newark nas decided to take action by insbruCJig suit agamst the lead industry '
Ness, Motley and a local Wni Orange law firm Gordon & Goraon, nave been retained on a contingency oasis by Newark ana win be paid 2b to 30 percent of the net amount of money collected from the suit, according to a contract drawn up by the City Council on June lb. They will litigate as the 'City or
Newark Lead Litigation Croup ' Jeff Miller, executive director of the
Lead Industries Association in Sparta, N J . says ne wasn't aware that Newark
was preparing to file a lawsuit. He says until the dry actually file* one there a no reason ro respond.
Several eliter cities are reported tu bo also looking at the possibility Of suing . lead paint manufacturers including Providence. R.I., Buffalo. N.Y, and New York City Only the Rhode Island Attor ney General has publicly staled that ne intends TO Sue lead paint manufacturers, although Jack McCohneu a Providencebased partner wun Ness, Motley, says up
tu 12 other states have approached hi$ Cnn about such a sue.
Repeated attempts to get comment or, tne suit, or on other aspects of
Newark's iead problem, from the Mayur Sharp# James' office, including from
Catherine Cuomo-Ceeere. his Health and Htiman Services director, were unsuc
cessful City Council President Donald Bradley aiso did not return repeated messages left at his office
Much of tli# focus on load poisoning in New Jersey nas been on Newark, ami over Ume me picture tnat has emerged has hut always been a flattering one. Most recently, it was disclosed shat Newark b down to a single certified lead inspector to cover its hundreds of lead hazard inspections and follow ups.
"That needs cc change and quirk says John Weber, lead program coordina
tor for New Jersey Citizen Action "There is no way one person can investi gation the hundreds of new iui poison
ing cases that emerge every year in Newark."
Cuomo-Cecere told the Mratar*. ScarLedejCr in June Out the city "has exjienenced difficulty in recruiting' inspectors
"Our position is to be encouraging Newark to make improvements eased Oh Our retomaendaciuns rather man high lighting their iitadoQuacies." says Kevin McNally, program coordinator. Child rood Lead Poisoning Provenuoi, with trie state Division of Finely Health ser/ices
McNally says about dbOO.UOO of tnciate health department* Si huilion in stati ana lederai funding for le programs goes directly to Newark
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Newark also has recaved criticism Tor ia lack of lead safe ileuses where chil dren with elevated lead levels and their
families could reside while their resi dence was abated. Around 193* Newark received special HUD appropriations to taling over SI million Co build sale nous es.
But. today, Newark has three safe Houses with two dwelling units in each, which is not enough." says Dr. Mofjda Sisany, director of Uie lead program at the University of Medicine and Dentistry of New Jersey in Newark. Dr Elsafty says *ne has children who have Been treated for lead poisoning in the hospital and are ready to be discharged but, "I nave nowner* to put them after, their
house is 9tiL (tiled -drh lead Mayor a clulil is ready to be discharged from the hospital after nve days out they stay mere three or four weeks oceans* we arc looking fora home tot him,' site says
Dr Steven Marcus, affiliated with Newark Beth Israel Hospital and director of the New Jersey Poison Information
and Education System, concurs "Weve got one kid m uie hospital ngnt now who has been here fur over a month" because there is no housing or roster care to put him in. says Dr. Marcus
"Newark is ready a good example of the difficulties of coordinating acrvzces." says Dr Marcus. Newark's situation
highlights all the social as well and adnunistrative difficulties of grappling with
lead poisoning, where poor families and officials working with them are dealing
with numerous other problems in addi tion Cu a poisoned child, he explains. "Newark doesnx exist because the pool families move all over, kids bounce all over the place that we treat," says Or Marcus, adding "I try to thirjc of Newark as rhe greater Newark area,"
Newark, recently signed a comract with Beth bred f-,,,r Seth Israel affiliated nurses to Kelp the city coordinate cake management uf lead poisoned children,
says Marcus McNally says tm* ls re
sulted in "progress being made but there
is certainly a tot more g o Be done * Marcus says Newark officials "need to
get out to the community, we need to be going almost door-to-door to educate people. Such education efforts can be as effective as medical intervention, teach ing people new ro keep iheir house clean, control jead dos;"
In December 1987 Newark's ncattU department, with state help, established the Newark Partnership for Lead Sare Children, to reach ouc to community groups, social service agencies, ana oth er interested parties to begin to bring about a coordinated, collaborative ap
proach to lead poisoning Newark offers free lead screenings to residents But all programs require funds arid Newark's limitless need for money to grapple with us lead program is universally acknowl edged. According to the Newark Part nership fur Lead Safe Children, in fiscal year 1997 the city provided follow-up services for children with lean poisoning to a total of S2&4 children
ClUs Goldman, director of me division of program management vt HUDi office of lead liasard control says Newark has applied ui years past for direct grants from HUD for lean abatement, bui has
noc been awarded any money Cthe spe cial appropriation Newark received for creating lead safe houses was not pert of the grant program and was attached by a member of Congress. Goldman says) Goldman says he cannot comment on why past Newark grant applications wore turned down or or. the status or a cur rent HUD grant application the acy has pending. HUD does factor m organisa tional expertise, soundness of approach, effective implementation and coordina tion as well as need when awarding grants, he says
Sung ttie lead industry is an even big ger question mark at this stage Old lead paiht manufacturers have fended off at tempts to hold them legally responsible for lead painr tti Die past, argulftg that prior to bans on lead pair.t m 1973 (1972 in New Jersey) they withheld no damag ing information about lead's toicoity, and there is no way to tie specific manufac turers to the anonymous coats of paint on old house walls But a "market share" legal strategy --holding paint manufac turers responsible in proportion to tlieir market share at the time -- has made some headway in recent years
---Ad-siren Oris
Ju.u-JJ-4, lUStl 25
49 TOC 001905
4 **