Project Title: Lead Awareness Outreach in CMHA 

Project Title: Lead Awareness Outreach in CMHA (proposed)

Please describe the project/program that would be supported by requested funds. Identify specific activities that will take place, who will be involved in the project (staff, key partners, clients), how it will be implemented, and the timeline for completion. (Tip: think “who, what, when, where, how”) (suggested character limit: 3,000)

CLASH Theory of Change

CLASH has learned through study and experience that there are four steps to create and sustain social change in the area of childhood lead poisoning. Our theory of change is: Awareness>Activism>Advocacy and Governance. 

Awareness is a constant challenge for change agents for many reasons. Unlike COVID most victims of childhood lead poisoning are symptom free or have symptoms that are attributed to other more familiar ailments. Couple this with relentless efforts by the lead industry to deny and obfuscate the impact of childhood lead poisoning. Finally, mass media have relentlessly cited the dramatic drop in childhood lead poisoning that was associated with the removal of lead from gasoline in the 1980s. That “chart” coupled with steady decline in childhood lead testing had contributed to the notion that lead is no longer a problem. Only when there is a crisis like Flint where a mass of children are affected does lead come back into public awareness.

Activism happens when families become aware of lead hazards in their homes and communities and take steps like home inspections and child testing to protect themselves. 

Advocacy is built on the experience of activists. Erin Brockovich has said “Every single time one of these environmental disasters happens, it's always a pissed off mom that rises up....Every. Single. Time.”  Advocacy in its many forms (testimony, lobbying, marching) is standing up for the community’s safety, not just an individual.

And Advocacy moves to Governance wherein the values of lead safety and elimination of lead hazards is institutionalized in the form of laws, policies and practices in the public sector.

CMHA residents have been told for years that their properties were lead safe and ubjected to regular inspections. Some residents who have become aware  of lead hazards through their experiences have moved, others have been stigmatized from becoming activists, others were made to believe  that they are responsible for their child’s condition or assured by well-meaning medical professionals that “they will grow out of it.”

Specific Activities

1. CLASH will create and print lead awareness materials that are relevant to CMHA residents. CLASH will use generic sources (Using Nutrition to Fight Lead Poisoning and EPA’s Protect Your Family from Lead), and CLASH will also create materials based on HUD’s Lead Safe Housing Rule, which governing the rights and duties of public housing tenants in regard to lead hazards.

2. CLASH will oversee the distribution of these printed materials door-to-door to 1500 CMHA households, with a focus on properties that were built before 1978 and where there is no record of interim upgrades. Priority will go to units that are likely to provide housing for children under 6 years of age as residents or long-term visitors. CLASH will also create awareness static displays (countertop boxes and stand alone store-style displays) at child care centers, community centers, health and social service organizations that are close CMHA properties.

3. CLASH will gather data from 150 CMHA residents about their knowledge of lead safety issues and their interest in becoming active in addressing lead safety in their homes and communities. Online survey respondents will be encouraged to provide their contact information in exchange for a gift card so that CLASH volunteers can follow up with additional information. Survey respondents will be encouraged to sign up for the CLASH Stay in Touch e-news; participate in a CLASH-sponsored education/outreach events, or sponsor an in-building event for neighbors.

4. CLASH in cooperation with the Progressive Action Council (PAC) and CMHA Resident Services will offer a range of lead safety presentations to CMHA residents, CMHA staff and health and social service providers serving CMHA residents. Training events will include: 

   1. short 10-15 minute Q&A sessions that are a part of an “in building” meeting, 

   2. Understanding Lead (a 45 minute presentation created by US EPA), 

   3. At least one Lead Safe Resource Fair, and 

   4. At least one Train the Trainer session.based on a 5 hour curriculum designed by US EPA) for service providers who work with CMHA residents. (Service providers may be charged a fee to cover the cost of a box lunch).

Who will be involved?

1. CLASH volunteers will create Lead Awareness materials for distribution to CMHA residents.

2. Northeast Ohio Coalition for the Homeless (a CLASH organizational member) will hire canvassers to distribute lead safe information to 1500 households using door hangers. NEOCH’s canvassers will be supplemented by resident volunteers from the PAC. CLASH volunteers will set up and maintain static displays at child care centers, community centers and other public locations that are frequented by CMHA residents. Lead awareness materials will encourage residents to engage in a lead safe activity as a result of receiving the literature (move from Awareness to Activism on the CLASH scale). Lead safe activities might include: participate in resident survey, participate in a lead safe training activity (see below), or report lead hazards in their units or common areas.

3. Lead Awareness presentations will be conducted by CLASH volunteers with assistance from health and social service providers to be recruited to address specific needs, eg. medical, case management or child care services.

How to implement CLASH activities will be

• Broadly collaborative. CLASH will work closely with Progressive Action Council (PAC) and CMHA Resident Services in the development of materials, 

• Inclusive. Materials will be prepared in English and Spanish. 

• Complement other CMHA initiatives including Child Lead Testing events and Lead Risk Assessments.

Timeline for completion

 A. At our own expense, CLASH will use the first quarter of 2025 to prepare outreach materials and work with NEOBHC around canvassing procedures. January 2025* through March 2025.

B. Canvassing and surveys April 2025-August 2025

Lead Awareness training April 2025-October 2025. The end of formal outreach will take place immediately at the end of Lead Poisoning Prevention Week in October.

C. CLASH and our collaborating partners, including PAC, NEOCH, CMHA Resident Services and Cleveland City Council will review and reorganization will take place in November and December of 2025.

Factors in timelines. 

• *CLASH has already met with the PAC and has reviewed requirements under the HUD Lead Safe Housing Rule in order to gather information about resident needs and opportunities. PAC and CMHA Resident Services will be invited to review and edit the CLASH-prepared materials and the survey forms to assure that the information provided is clear and culturally sensitive.

• CLASH will schedule resident awareness activities to maximize the synergies with CMHA-Council lead related activities including Lead Risk Assessments and Child Lead Testing events, as well as existing activities of the PAC and local organizations that provide health and social services to CMHA residents

What are the current needs, challenges, or recent events that led your organization to submit this proposal? (i.e.: why are you hiring new staff/ or initiating this program, why is now the right time to do so, etc.). Where applicable, please identify what data, feedback, or information has been used to validate the community need which your project is trying to address. (suggested character limit: 5,000)

Needs, challenges, recent events

On July 16, 2024, HUD’s Office of Inspector General released a report entitled. “The Cuyahoga Metropolitan Housing Authority Did Not Have Adequate Oversight of Lead-Based Paint in Its Public Housing” which detailed failure of CMHA’s failure to address lead poisoning issues in their properties. Details of the following brouhaha are detailed here: 

https://www.clashcle.org/home/learn-more-about-clash/cmha-in-the-newsPD and CLASH response and City Council initiative. At the time, CLASH made a series of recommendations to Cleveland City Council’s Health Committee. In September 2024, the Plain Dealer called for the firing of CMHA Director Jeffery Patterson and CLASH responded calling on Mayor Bibb to take action to require CMHA to correct the problems. As a result of these public discussions, Cleveland City Council's Health Committee Chairman, Kevin Conwell. invited CLASH and the Lead Safe Cleveland Coalition to meet with CEO Patterson and Council reps to outline a plan to address the concerns raised in the OIG report.

Challenges:

Besides the legacy of unawareness of lead safety among residents as outlined above, CMHA residents have expressed fears of retaliation for participation, guilt around the persistence of the lead problems, and concerns about the interests of outside change agents like CLASH and NEOCH when they call attention to the conditions on the properties. Building trust between "outsiders" and residents will take a series of confidence building activities that focus on future success instead of blame for past performance. Face-to-face contacts with clear and consistent messaging are key to bringing residents to the point of becoming engaged in lead safety in their homes and their communities.

Data/feedback/information used to validate the community need. 

1. CLASH’s 2023-24 study of barriers to child lead testing identify many of these fears held by low income families. A prepublication copy of this study is available upon request. 

2. The HUD OIG report states clearly that: “HUD OIG made several key recommendations the Authority must take to improve its procedures and controls concerning cases of elevated blood lead levels, environmental investigations and timeliness of visual assessments for lead-based paint, and staff training and technical assistance.” Making these goals in clear simple empowerment language will support tenant engagement. 

3. Around the same time that the HUD OIG report was issued, Mayor Bibb issued an Executive Order on lead safe housing which puts CMHA's work on the issue in a larger framework so that CMHA and CMHA residents are not being singled out for attention, but are, in fact, providing leadership to a broader civic agenda. 

Synergies: CLASH views the Lead Awareness Project as a part of these larger scope activities to promote lead safety in Cleveland. In 2025, CLASH will be a sub-grantee in a Federally funded study by the University of Arizona to share the results of our study of Barriers to Childhood lead testing. CMHA residents who are “activated” by this project can become participants in this larger study CLASH expects to be participating in efforts to enact Universal Child Testing and promoting the experience of our organizational member Black Child Development Institute in sponsoring mobile on site testing of at risk children. Most important to CLASH is the fact that under the HUD Lead Safe Housing Rule, CMHA residents will elevated blood lead levels could qualify for early interventions sooner than required by Ohio Law. Finally, CMHA’s commitment to conduct up to 8,000 lead risk assessments will help to build the capacity of lead professionals in the community. The slow pace of the City’s Lead Safe Certificate program had not created the volume of work necessary to create a workforce necessary to address the needs of the estimated 80,000 units of pre-1978 properties in Cleveland.

Identify up to three priority outcomes your organization plans to achieve with this project. If awarded funding, you will be required to report on these outcomes. Include any relevant data and metrics used to indicate progress toward these outcomes. (suggested character limit: 3,000)

Three expected outcomes of this project are: 

1. 150 CMHA residents will be actively involved in lead awareness activities as a result of CLASH Lead Awareness project. Building relationships based on trust and confidence will take some effort in a system that has failed to deliver in the past. 

2. There will be an increase in the number of children with elevated blood lead levels who live in CMHA properties. This is a counter intuitive outcome for lead safe advocates to cite as an outcome, but the reality is that, for too long, children with elevated blood lead levels have not been identified at a time when they are most easily treated by removing the lead hazard and the stigma of treatment. One of the barriers to the accomplishment of this outcome is the fact that there are no good baseline statistics. We may have to rely on anecdotal reports to create a baseline for future studies.

3. One or more new residents organizations will be formed by residents who are brought together by lead awareness and activism training. Building a collaborative relationship among activists who become advocates would represent a third stage on the CLASH ladder of engagement.

Is there any other information not captured elsewhere regarding your organization, program, or project that you believe will help Cleveland Foundation staff understand this proposal? (suggested character limit: 3,000)

CLASH’s Website https://www.clashcle.org/home is a treasure trove of information about our efforts to address lead safety since 2016.