Weatherization Plus Health: Leveraging Funds For Client Health

LeveragingFunds_Lead Hazard

Access to the right kind of funding, and enough of it, truly can make a difference on the health and safety side of the equation for the Weatherization Assistance Program (WAP) and the clients that it serves.

We know that health regulations have had a major impact; the U.S. Department of Energy’s (DOE) Lead-Safe Work (LSW) practices and the implementation of the U.S. Environmental Protection Agency’s (EPA) Renovation, Repair, and Painting (RRP) rule have been estimated to save millions of dollars in health care costs as well as criminal justice due to the lowered exposure of children to harmful leaded paint dust, which has been linked to permanent brain damage and future delinquency. Beyond regulation, funding that enables weatherization programs to leverage their health and safety activities and budgets can be vital. When WAP crews install carbon monoxide detectors, for example, they implement a healthy homes measure that saves lives in the short term. This article looks at one of the many ways that the Weatherization Plus Health project is helping to connect the WAP network with funds for improving health and safety.

Although we all think of WAP as an energy efficiency program, in its reach and scope it is one of the biggest public health programs for low-income households in the United States. Americans spend most of their time—up to 80 percent of it—indoors according to one recent study, and young children and their caregivers, as well as seniors and people with disabilities, are even more likely to be at home on a given day. Indoor environmental conditions matter for health, whether that environment includes dust that triggers asthma symptoms or lead from chipping or peeling paint, or whether it is uncomfortably cold because it is too costly, or impossible, to keep a home warm in winter. Poverty is one of the strongest influences on health, and the specific ways that poverty affects housing are clear to the weatherization crews that tackle these problems in thousands of homes around the country each month.

Weatherization crews address health and safety hazards: they ensure combustion safety and diagnose gas leaks, install smoke and carbon monoxide detectors, identify problems with electrical wiring or moisture for follow up, replace heating or cooling systems that pose a danger, and install fans and other means to improve indoor air quality. Energy efficiency education delivered during the course of weatherization is also a chance to identify health issues affecting household members and to connect with needed health and social service programs. The health and safety section of each state’s WAP plan provides a starting point for addressing some of the many ways that indoor environments affect the health and safety of our clients, whose homes can exacerbate existing health conditions.

How can each state WAP make the best use of limited resources where health and safety is concerned? Although every state plan has a health and safety section, there are many ways to bring in new partners. WAP grantees and sub-grantees in every state and territory, and in many tribal communities, have dozens of potential collaborators in the areas of health and safety who can deliver client education on smoking cessation and other changes at home that can reduce the likelihood of asthma, test for radon gas levels indoors, provide home visitors to help pregnant women and new parents take care of their young children, and offer many other services through programs operated by health departments and community action agencies.

The DOE’s Weatherization Plus Health initiative is a national, voluntary initiative to identify resources for energy, health, and safety in low-income homes and to help the WAP network coordinate these resources strategically in order to leverage WAP funds. The National Association of State Community Services Programs (NASCSP) is implementing the project on behalf of the DOE. The goal of Weatherization Plus Health is to ensure energy-efficient and healthy indoor environments by facilitating the establishment of strong, effective partnerships between WAP grantees and providers of healthy homes services through:

  • Training and technical assistance for healthy homes and WAP providers;
  • Dissemination of best practices for referrals between the programs;
  • Regional conferences to bring together providers, identify gaps between existing partnerships, and encourage new partnerships;
  • Reports that profile healthy homes and weatherization resources and activities in every state and territory; and
  • A public web portal to map programs nationwide and include an inventory of projects funded by the U.S. Department of Housing and Urban Development (HUD), EPA, Centers for Disease Control, and the U.S. Department of Agriculture, as well as the DOE.

These partnerships work best, and are more likely to succeed and be sustained, when they leverage or tap existing funding streams as efficiently as possible. In the case of health and safety, there are potential funders at the state and local levels, both public and private. As with most ventures that bring together different types of organizations, attention to the level of funding, and to coordination of different funding streams, is critical. NASCSP’s Weatherization Plus Health project is identifying models for funding partnerships between the WAP and healthy homes programs to connect clients with resources to change health-related behavior and take full advantage of the housing improvements made through weatherization.

HUD has taken a big step to encourage new collaborations between housing-related health projects (healthy homes) and weatherization with its planned Safe and Healthy Homes Investment Partnership (SHHIP) certification. In addition to funding a range of affordable housing programs, such as the HOME and Community Development Block Grant familiar to the WAP network, HUD’s Office of Healthy Homes and Lead Hazard Control operates seven competitive grants for which local and state government units are eligible. These include Demonstration Grants and Healthy Homes Production Grants to support pilots and Technical Studies Grants for research that develops new evidence and approaches to healthy homes interventions. In FY 2011, awards for the demonstration and production grants ranged from $500,000 to $3.5 million for multiple-year awards.

HUD pilot dollars have supported some of the most promising collaborations between weatherization and healthy homes providers to date, including:

  • The One Touch model being piloted in New Hampshire and Nebraska, in which participating health departments and WAP sub-grantees are using new healthy homes assessment checklists and establishing formal referrals of clients between energy and health programs, including Head Start, smoking cessation, and maternal and child health; and
  • Connecticut’s Efficient Healthy Homes Initiative, a joint effort of the Connecticut Children’s Medical Center (Lead Action for Medicaid Primary Prevention) and the United Illuminating Company, which received a Weatherization Innovation Pilot Program award.

Perhaps the most well-known of these HUD-supported models is the Green and Healthy Homes Initiative (GHHI) of the Coalition to End Childhood Lead Poisoning (www.ghhi.org). GHHI has developed and piloted an approach to needs assessment, coordination of funding sources, the nurturing of partnerships across agency and sector, and technical capacity building that is being supported at almost two dozen sites around the country. All three models bring to the table a shared focus on improving the efficiency and effectiveness of public dollars devoted to improving housing quality and to promoting the health and safety of the low-income households they serve.

With the SHHIP certification, HUD is stepping up its commitment to partnership with the WAP network as a way to both leverage increasingly scarce resources and to improve outcomes for clients. The SHHIP certification, expected to be released during FY 2012, will add points to the score of funding proposals submitted to HUD that meet a criteria for partnerships and coordination among energy, health, and housing agencies, including state offices or WAP sub-grantees. Certification will be given by HUD on a two-year, renewable basis to all partners in a qualifying funding proposal. The draft criteria for certification as a SHHIP community were published in the Federal Register for comment in late 2011. These criteria cover:

  • Development of the professional workforce, direct delivery of services, capacity to sustain the program in the long run, and promotion of the health and safety of community members.
  • Methods to be included in projects, such as the appointment of a dedicated project coordinator, use of HUD’s Healthy Homes Rating Tool, coordination of training and services delivery across energy, housing, and health providers, and specifications for data reporting and quality assurance related to outcomes.

For the WAP network, certi-fication as part of a SHHIP community brings an advantage in the often-challenging competition for funds, not only at HUD but across federal agencies. In addition, it builds in a number of best practices from the start, taking lessons learned from existing, successful WAP and healthy homes collaborations. SHHIP certification makes project—and program—success much more likely for a WAP sub-grantee new to the world of healthy homes.

In the coming months, NASCSP’s Weatherization Plus Health team will be highlighting SHHIP certification as well as other tools that can assist the network in leveraging its health and safety resources through new partnerships and funding opportunities. Visit www.nascsp.org
to learn more about SHHIP and for updates as HUD solicitations are released.