Lancaster General Health Invests in Healthy Homes

Lancaster County is home to picturesque countryside, busy suburban neighborhoods, and an urban center steeped in rich history and historic homes. As Lancaster’s population continues to grow – according to the 2020 U.S. census, Lancaster County’s population increased 6.5 percent in the last 10 years – more and more individuals and families are calling Lancaster County home. With more than 70 percent of the county’s homes built before 1978, when lead paint was deemed illegal, many of those older homes pose a potential risk to the county’s growing population.

At Penn Medicine, our mission to advance the health and well-being of the communities we serve does not begin in the waiting room of our facilities. An individual’s health and well-being are influenced by the social and economic factors in the places where they work, learn, and, most importantly, live.

“As health care professionals, we know that the majority of health and wellness happens outside of the hospital,” said Alice Yoder, Penn Medicine Lancaster General Health’s executive director of Community Health. “What happens in the home matters, and it is part of our larger organization’s mission – to improve the health and well-being of the communities we serve.”

In partnership with fellow community health leaders, Penn Medicine Lancaster General Health oversees a Community Health Needs Assessment (CHNA) every three years. (Penn Medicine Princeton Health also does its own CHNA, and the other hospitals in the Health System collaborate with Philadelphia and suburban counterparts for a combined regional CHNA.) The CHNA identifies needs based on the prevalence of health risks within a hospital’s local community. In LG Health’s 2019 assessment, affordable and healthy housing was identified as a concern. Following the assessment, the team developed a Community Health Improvement Plan with strategies to work with the community to help ensure housing for Lancaster County residents was safe – specifically, addressing the presence of lead paint in homes.

Armed with the data from the 2019 CHNA and the desire to make a substantial impact, the Lancaster General Health Board of Trustees approved an investment of $50 million over 10 years to support lead remediation within the community, and thus the Lead-Free Families initiative was born.

The comprehensive program is the first of its kind in the United States, as it is 100 percent funded and led by a community health system.

Dangers of Lead Poisoning

Lead paint was used before the dangers of lead poisoning in children were widely known. Since lead-based paint was more durable than other paint types, it was often used on exterior windows, doors, porches, and window frames. While the houses may have since been painted over, in many of the homes the lead paint was never properly removed or remediated. Today, we know that lead-based paint can cause a number of health concerns for children under the age of 6 and pregnant mothers.

“There is no cure for lead poisoning. Once it’s in your system, you can’t get it out, and the mental and physical effects are irreversible,” said Jeffrey R. Martin, MD, chair of the Department of Family and Community Medicine at LG Health and member of the statewide Lead Free Promise Project.

Although lead poisoning is 100 percent preventable, it can result in serious and lifelong health and developmental issues, including lower IQ, slowed growth, learning problems, behavioral issues, hyperactivity, and hearing and speech-development problems. It can also cause pregnancy problems, including low birth weight; premature birth; damage to the baby’s brain, kidneys and nervous system; and even miscarriage.

LG Health Gets the Lead Out

Over the next decade, the Lead-Free Families team will identify and remediate lead hazards in at least 2,800 Lancaster County homes and provide education and awareness around the risk of lead exposure to children and pregnant mothers.

“This is part of our ‘journey upstream’ where we address root causes of health issues,” Yoder said.

Any Lancaster County resident, homeowner or renter, can apply to the Lead-Free Families program. Applications are reviewed to ensure they meet eligibility requirements, including that a child age 6 or under is living in the home or visiting. Residents do not have to be LG Health patients to apply.

In addition to in-home lead testing and remediation, Lead-Free Families provides blood lead screenings for children and pregnant individuals. The program also offers home visits with health-care and social service support, community education and outreach, and public policy advocacy and education.

“Lead Free-Families, and its unique connection to a health system, allows health care providers in our community to achieve the broader goal of primary prevention, by eliminating the risk of lead poisoning, and preventing its devastating effects in vulnerable populations,” Martin continued.

The LG Health team collaborated with Green and Healthy Homes, a nationally recognized lead-abatement organization, to promote the program to the community and begin lead remediation.

“Our LG Health team works with the individual families on education surrounding the possible lead in their home and does the home inspections,” said Marisol Maldonado, manager of the Lead Poisoning Prevention Program. “Then, the Green and Healthy Homes contractors come in to do the remediation while the family is provided temporary housing while the work is being completed.”

In August 2021, Penn Medicine Lancaster General invited community leaders to announce the official start of the program in Columbia, PA.

“Penn Medicine Lancaster General Health is committed to reaching beyond the walls of our hospitals and doctor’s offices to make Lancaster County the healthiest place to live, work and play,” said John J. Herman, CEO of Penn Medicine Lancaster General Health.

What About Other Household Dangers?

Although the program’s primary focus is lead remediation, the team found that in some cases, other harmful health hazards, not just lead, were present during home inspections.

LG Health’s Grants department mobilized to identify additional funding opportunities to enable the health system to address the other household hazards, ultimately ensuring that Lead-Free Families provides the safest and healthiest homes possible for local residents.

The team applied for and received the U.S. Department of Housing and Urban Development (HUD) Healthy Homes Production Grant, which awarded Penn Medicine Lancaster General Health nearly $2 million to mitigate additional health hazards in the homes of 150 Lancaster County families.

LG Health is one of three grant recipients in Pennsylvania and one of two health systems nationally to receive the HUD funding.

“The success of any grant application is dependent on the collaborative efforts of both the grants team and the project team,” said Katie Weinrich, executive director, Legal Services & Grants. “For a grant application of this value and duration, there were many late nights over several weeks for our team of two grant writers and grant specialist. The team works very hard to ensure that all of the voices of the project team are heard, that the proposal is supported with convincing data, and that there is a clear vision.”

In addition to the $50M invested from LG Health, the additional $1,999,155.06 HUD grant will address other home hazards, such as mold, radon, and ensuring up-to-code fire and carbon monoxide detectors.

“The Lead-Free Families Program has been a blessing to our family,” said Ashley R., a program participant and mom to 18-month-old Avery. “You do everything you can to keep your child safe – to learn that our house was causing detriment to our child’s health was hard to accept. This program ensured that our family is now safe in our home, and we couldn’t be more thankful.”

For more information on Lead-Free Families, or to apply for the program, visit LeadFreeFamilies.org, or call 717-544-LEAD (5323).

The work that provided the basis for this publication was supported by funding under an award with the U.S. Department of Housing and Urban Development. The substance and findings of the work are dedicated to the public. The author and publisher are solely responsible for the accuracy of the statements and interpretations contained in this publication. Such interpretations do not necessarily reflect the views of the Government.