C-86-17-032-3-02 MOU A2 EXHIBIT P SC LEAD PD F-E.PDF

Agenda Item Id:
Item Title
AMENDMENT TO MEMORANDUM OF UNDERSTANDING WITH ADHS FOR SHARING CHILDHOOD LEAD
POISONING DATA
C Number: C-86-17-032-3-02
Action Requested:
Approve non-financial Amendment 2 to Memorandum of Understanding (MOU), Exhibit P. Childhood
Lead Poisoning Data to MOU, HU756005, for the Sharing of Public Health Data between Arizona
Department of Health Services (ADHS) and Maricopa County through its Department of Public Health
(MCDPH), Office of Family Services (OFHS) to gather childhood lead poisoning data from designated
Housing Authorities (HA) within Maricopa County (MC). MC will enter in a data sharing agreement with
authorized HA using (Attachment A) Public Use Data Agreement. This Amendment 2 revises and
replaces Amendment 1 in the entirety. All other terms and conditions of this Amendment 2 shall
supersede Amendment 1. All other terms and conditions of the Memorandum of Understanding MOU
will remain the same.
Board Required Information:
Additional Information:
MOU approval history:
Amendment 1 was approved 2/7/2018 under item no. C-86-17-32-3-01;
Base MOU was approved on 1/11/2017 under item no. C-86-17-032-3-00.
Expenditure Impact By FY:
No Impact
Item Notes:
(3/15/2018 1:24:45 PM) - Step: CIrkOfBrd
User: Juanita Garza
Response: APPROVE
(3/12/2018 1:04:18 PM) - Step: OMB
User: Brian Hushek
Response: APPROVE
Comments:

Recommend approval.
(3/9/2018 3:30:32 PM) - Step: CountyAtty
User: Nikolaus Decker
Response: APPROVE
(3/9/2018 2:44:10 PM) - Step: OMELC2
User: Kirstin Chernin
Response: APPROVE
Comments:
Recommend approval.
(3/9/2018 2:41:35 PM) Step: OMB_Cl
User: Kirstin Chernin
Response: APPROVE
Comments:
Recommend approval.
(3/9/2018 1:41:58 PM) - Step: DepartmentChief
User: MaryEllen Sheppard
Response: APPROVE
Comments:
Approve
(3/9/2018 10:36:21 AM) - Step: DeptHead
User: Cheryl Rentscheler
Response: APPROVE
Comments:
Approve
(3/9/2018 10:27:34 AM) -Step: DeptCoor
User: Cheryl Rentscheler
Response: APPROVE
Comments:
Approve
(3/6/2018 6:20:40 PM) - Step: DepartmentChief
User: MaryEllen Sheppard
Response: APPROVE
Comments:

Approve
(3/6/2018 10:14:38 AM) - Step: DeptHead
User: Max Porter
Response: APPROVE
(3/6/2018 10:09:55 AM) - Step: DeptCoor
User: Cheryl Rentscheler
Response: APPROVE
Comments:
Approve
(3/6/2018 9:49:54 AMI- Step: Originator
User: Matt Juan
Response: APPROVE
Is there a Financial Impact?
no
Is there related Managing for Results information?
yes
—
rogram Activitc Perform ance /Demand nticipated Results - -
Measure -_-
Epidemiology & General Epidemiological Reporting Anticipated number 1,787 reports requested
Disease Surveillance reports requested
General Item information
Department: Department of Public Health
Constellation:
Contact Name: Tracy Sloat
Phone Number: 602-506-0610
Return To: Matt Juan
Phone Number: 602-372-0675
Location: Supervisors' Auditorium
Board:
Meeting Date: 3/21/2018

Item Tracking
Step '6t16n User IDte
Originator APPROVE Matt Juan 3/6/2018 9:49:53 AM
DeptCoor APPROVE Cheryl Rentscheler 3/6/2018 10:09:54 AM
DeptHead APPROVE Max Porter 3/6/2018 10:14:38 AM
DepartmentChief APPROVE MaryEllen Sheppard 3/6/2018 6:20:39 PM
OriginatorMonitor RECALL Matt Juan 3/7/2018 8:30:42 AM
DeptCoor APPROVE Cheryl Rentscheler 3/9/2018 10:27:33 AM
DeptHead APPROVE Cheryl Rentscheler 3/9/2018 10:36:20 AM
DepartmentChief APPROVE MaryEllen Sheppard 3/9/2018 1:41:57 PM
Legal APPROVE Nikolaus Decker 3/9/2018 3:30:30 PM
OMB APPROVE Brian Hushek 3/12/2018 1:04:17 PM
CIrkOfBrd APPROVE Juanita Garza 3/15/2018 1:24:44 PM
CountyManager APPROVE JoAnn Rangel 3/15/2018 2:11:35 PM
Board of Supervisors / Directors Approved on 3/21/2018.

C-g6 -17-032-3-Oa
MEMURANDUM OF UNDERSTAND11,.J
HU756005
AMENDMENT #2
EXHIBIT P CHILDHOOD LEAD POISONING DATA
This Amendment 2 revises and replaces Amendment 1 in its entirety. All terms and conditions of
this Amendment 2 shall supersede Amendment 1.
1. BACKGROUND & PURPOSE:
Houses and apartments built prior to the 1978 federal ban of lead-based paint have an
increased risk of containing lead. An estimated 24 million housing units in the United States are
contaminated. Lead sources may come from deteriorating paint, dust, and soil. Lead painted
surfaces may not become a hazard if they are kept in good condition. However, deteriorating
paint (paint that is peeling, chipping, chalking, cracking, or damaged), due to age or being on an
impact or friction surface is highly hazardous. Surfaces such as windows and sills, doors and
door frames, stairs, railings, banisters, and porches, have all been identified as areas where dry
scraping, sanding, heating, or heavy use can lead to deteriorating paint and lead dust.
The objective of sharing childhood lead poisoning data is to ensure housing-related lead
exposures are evaluated, reduced and/or eliminated for children identified with elevated blood
lead levels residing in Maricopa County.
Numerous individual Housing Authorities within Maricopa County receive funding from the U.S.
Department of Housing and Urban Development (HUD) for public housing and rental assistance.
These Housing Authorities aim to prevent childhood lead poisoning by ensuring lead-safe
housing per the Lead-Safe Housing Rule (24 CFR 35, subpart L.). They are required to
complete an environmental investigation and lead-based paint hazard reduction (when
applicable) of the dwelling unit to which this subpart applies, when a child aged six or less has
been identified with elevated blood lead levels.
Arizona Department of Health Services (ADHS) is authorized by statute to develop and conduct
local programs for the prevention, detection and treatment of lead-based paint poisoning,
including programs to detect incidents of lead poisoning due to lead-based paint and other
sources among community residents.
Pursuant to this agreement, Maricopa County Department of Public Health (MCDPH) has
designated Housing Authorities within Maricopa County, or Housing Authorities that are divisions
of the Maricopa County Government, as their authorized agents to both receive lead poisoning
public health data shared under this MOU, and to conduct all public health interventions deemed
necessary and appropriate. These interventions may include evaluation of lead hazards in the
homes of individuals identified with elevated blood serum lead levels, and actions undertaken to
mitigate lead exposure to occupants of the household. The objective shared by both MCDPH
and their designated agent in using the public health data shared under this MOU is limited to
public health intervention activity to decrease the prevalence of lead-based paint poisoning
among children residing within Maricopa County. Both MCDPH and their authorized agents will
be subject to the limitations and protections of shared public health data owned by ADHS as set
forth in this MOU.
Sharing between ADHS and MCDPH, the addresses for children aged six or less who have
elevated blood lead levels will allow both entities to identify barriers to eliminate blood lead
poisoning such as:
1.1. Lead-based paint hazards in the home.
The shared vision of the AGENCY and ADHS includes:
Page 1 of 4

MEMuRANDUM OF UNDERSTANDING
HU756005
AMENDMENT #2
1.2. Identify the source(s) and locations of lead-based paint exposure in Maricopa County
dwellings receiving assistance from the Housing Authority
1.3. Eliminate the lead source(s) when possible
2. DESCRIPTION OF SERVICES:
ADHS shares data, with MCDPH and their authorized agents (Housing Authorities), of children
identified with elevated blood lead levels residing in Maricopa County to determine whether the
child's dwelling is being subsidized by available housing assistance programs.
2.1. ADHS will:
Provide MCDPH access as an environmental epidemiologist role to ADHS' blood lead reporting
system, MEDSIS, for children residing in Maricopa County for whom an elevated blood lead level
of 5 pg/dL or greater has been reported or for whom a blood lead test report has been submitted
by a health care provider through MEDSIS. Blood lead test reports received through electronic
laboratory reporting (ELR), but not attached to a MEDSIS record, will not be accessible.
2.2. Maricopa County will:
2.2.1. Enter into data sharing agreements with authorized Housing Authorities
within Maricopa County for the purposes of determining 1) whether children
identified with elevated blood lead levels are residing in housing units
subsidized by HUD Assisted Housing Programs, and if so, 2) the status of
any environmental lead testing and remediation activities.
2.2.2. Provide the designated authorized Housing Authority with information
received from ADHS' blood lead reporting system regarding children aged six
or less who reside in their jurisdiction and for whom an elevated blood lead
level of 5 pg/dL or greater has been reported. The information shall consist of
the child's age and address. Reports will be provided on a quarterly basis.
2.2.3. Compile data received from the Housing Authorities regarding environmental
lead testing and remediation activities on all units within their jurisdiction
identified as housing children aged six or less for whom an elevated blood
lead level of 5 pg/d L was identified.
Upload environmental investigation reports and enter case notes, including
correspondence with housing authorities, in MEDSIS according to ADHS-
specified protocols within 30 days of receipt of case updates.
2.2.4. Will release data only in accordance to MEDSIS policies and procedures.
2.2.5. Ensure ADHS is given the opportunity to review and approve or deny data
prepared for publications for peer-review and presentations before
submission. Data should be attributed to ADHS and precautions must be
taken to protect patient privacy.
3. PAYMENT AND AMOUNT:
There are no payments associated with this Agreement.
4. AMENDMENTS:
4.1. All requests for additional services shall be in writing and signed by both parties.
Page 2 of 4

MEMURANDUM OF UNDERSTANDING
HU756005
AMENDMENT #2
5. CORRESPONDENCE:
All programmatic correspondence pertaining to Childhood Lead Poisoning Data covered under
this MOU shall be submitted by MCPDH to the attention of the ADHS Office of
Environmental Health.
5.1. For the Arizona Department of Health Services:
ADHS/OEH
Arizona Department of Health Services
Bureau of Epidemiology and Disease Control
ATTN: Jessica Rigler, Branch Chief
Phone Number: (602) 364-3909
Email: Jessica. riolera,azdhs.dov
150 N 18th Avenue, Ste. 100
Phoenix, Arizona 85007
5.2. Notices, correspondence, and reports from ADHS to MCDPH shall be sent to:
Maricopa County Department of Public Health
Attn: MCDPH Director
4041 North Central Avenue #1400
Phoenix, AZ 85334
Phone: 602-506-6900
Page 3 of 4

MEMORANDUM OF UNDERSTANDING
HU756005
AMENDMENT #2
6. SignatureslApprovals:
FOR: Maricopa County by and through its FOR: Arizona Department of Health Services
Department of Public Health
Steve Chucri, Chief Procurement Officer or Designee
Chairman, Board of Supervisors
APR 06 701B
4(51z-kt k1a.vg6sti..), -.wr6a-1444 e/it
Date Print Name and Title
Date
.1)4,6hcleirc of the Board
APR 06 2010
Date
APPROVED AS TO FORM:
,ft/7440/43
Date
Page4of4

ATTACHMENT A
PUBLIC USE DATA AGREEMENT
Background and Purpose:
Houses and apartments built prior to the 1978 federal ban of lead-based paint have an increased risk of
containing lead. An estimated 24 million housing units in the United States are contaminated. Lead
sources may come from deteriorating paint, dust, and soil. Lead paint that is peeling, chipping,
chalking, cracking, or damaged due to age or high impact is highly hazardous.
The United States Department of Housing and Urban Development (HUD) addressed the issue of
environmental lead in federally owned and subsidized housing with the Lead Safe Housing Rule (24
CFR 35, subpart L.), which requires Housing Authorities to complete an environmental investigation
and lead-based paint hazard reduction (when applicable) of the dwelling unit to which this subpart
applies, when a child aged six or less has been identified with an elevated blood lead level of 5 p.g/dL or
greater.
Lead poisoning can cause serious developmental damage to children that can last a lifetime, yet it is
completely preventable if lead hazards are removed. The purpose of this project is to reduce the
incidence of childhood lead poisoning due to environmental causes in the home by monitoring lead
poisoning reports and implementing environmental remediation when needed.
Process:
In the proposed project, childhood blood lead level data reported in Maricopa County will be used to
determine locations for environmental testing on housing authority property within Maricopa County. If
environmental treatment and/or remediation is necessary, it will be completed by the responsible
housing authority. All results will be reported back to the Maricopa County by and through its
Department of Public Health (MCDPH) and Arizona Department of Health Services (ADHS).
Housing Authority will:
1. 'Provide MCDPH with quarterly list of current addresses of the Housing Authority dwelling units
to which the Lead Safe Housing Rule applies.
2. Provide MCDPH with monthly reports, on a date agreed upon by both parties, regarding any
action taken to conduct environmental testing and/or remediation on a Housing Authority
dwelling unit identified by MCDPH as the residence of a child under age 6 with a positive blood
lead level of 5 u.g/dL or greater.
MCDPH will:
1. Determine if any child under six that tests positive for an elevated blood lead level of S pg/dL or
greater resides in an applicable Housing Authority dwelling unit. MCDPH will provide the
addresses of any positive cases to the appropriate Housing Authority on a monthly basis.
2. Provide ADHS with data received from the Housing Authority regarding actions taken to conduct
environmental testing and/or remediation.
1

ATTACHMENT A
By using these data you agree to comply with the following data use restrictions.
The Maricopa County by and through its Department of Public Health (MCDPH) does all it can to assure
that the identity of data subjects cannot be disclosed. All direct identifiers including name, SSN, and
DOB, as well as any characteristics that might lead to identification, are omitted from the dataset. Users
shall not attempt to identify individuals from any computer file, nor shall they link with a computer file
containing patient identifiers. Any intentional identification or disclosure of a person or establishment
violates the assurances of confidentiality given to the providers of the information.
Therefore, users must agree to these provisions:
• You will not use nor permit others to use the data in any way other than for the purposes of
identifying locations to carry out environmental testing.
• You will not attempt to link, nor permit others to link the data with individually identified
records in other MCDPH or non-MCDPH databases.
• You will not attempt to learn the identity of any person whose address is contained in the
supplied file(s).
• If the identity of any person is discovered inadvertently, then the following action should be
taken:
o No use will be made of this knowledge
o You will not share the discovered identity with others
• You will not release nor permit others to release the data in full or in part to any person except
with the written approval of MCDPH.
• If accessing the data from a centralized location on a time-sharing computer system or LAN, you
will not share your logon name and password with any other individuals. You will also not allow
any other individuals to use your computer account after you have logged on with your logon
name and password.
• You will share any results/findings from analysis of these data with MCDPH before findings are
presented outside the requesting organization.
• You will be held accountable for any violation of these data use restrictions.
Signatures/Approvals:
FOR: Maricopa County by and through its FOR: Housing Authority
Department of Public Health
Department Director Chief Procurement Officer or Designee
Chief Health Officer
Print Name and Title Print Name and Title
Date Date
2

ATTACHMENT A
IN WITNESS WHEREOF, the parties agree to enter into this contract:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date