LEPAC Annual Report to HHS (2020)

Overview

Annually for 5 years (pending funding availability) as determined necessary by the Secretary or as required by Congress, the Committee shall submit a report to the Secretary, the Committees on Finance, Health, Education, Labor, and Pensions, and Agriculture, Nutrition, and Forestry of the Senate and the Committees on Education and the Workforce, Energy and Commerce, and Agriculture of the House of Representatives.

The report shall include 1) an evaluation of the effectiveness of the Federal programs and services available to individuals and communities exposed to lead; 2) an evaluation of additional lead exposure research needs; 3) an assessment of any effective screening methods or best practices used or developed to prevent or screen for lead poisoning; 4) input and recommendations for improved access to effective services relating to health care, education, or nutrition for individuals and communities impacted by lead exposure; and 5) any other recommendations for communities affected by lead exposure, as appropriate.

2020 LEPAC Annual Report – Printable PDF

LEPAC activities

The objective of the Lead Exposure and Prevention Advisory Committee (LEPAC) is to review research and Federal programs and services related to lead poisoning and to identify effective services and best practices for addressing and preventing lead exposure in communities. Following the enactment of Public Law 114-322, "Water Infrastructure Improvements for the Nation Act" and subsequent nomination of committee members, LEPAC has held two meetings in 2020 since its establishment in 2018.

During the inaugural and second LEPAC meetings held in 2020, a series of presentations followed by facilitated discussions were held to orient committee members to LEPAC and identify themes and priority areas for guiding the LEPAC's future work. As a result of discussions during the first meeting, the Centers for Disease Control and Prevention (CDC) formed the Blood Lead Reference Value (BLRV) Workgroup to advise the LEPAC on an update to the reference value. More details about the BLRV Workgroup are provided below.

LEPAC members also discussed LEPAC's charge: 1) reviewing Federal programs and services available to individuals and communities; 2) reviewing current research on lead exposure to identify additional research needs; 3) reviewing and identifying best practices, or the need for best practices, regarding lead screening and the prevention of lead poisoning; 4) identifying effective services, including services relating to healthcare, education, and nutrition for individuals and communities affected by lead exposure and lead poisoning, including in consultation with, as appropriate, the lead exposure registry as established in Section 2203 (b) of Public Law 114-322, and 5) undertaking any other review or activities that the Department of Health and Human Services (HHS) Secretary determines to be appropriate.

In 2018, the President's Task Force on Environmental Health and Safety Risks to Children, developed the "Federal Lead Action Plan" and the "Key Federal Programs to Reduce Childhood Lead Exposures and Eliminate Associated Health Impacts".1 These publications identified the federal programs available to individuals and communities exposed to lead and included information about the impact of federal actions.

The Action Plan focused on reducing sources of lead exposures, expanding efforts to identify children in high-risk communities for targeting intervention and services, enhancing risk communication efforts, and advancing the scientific understanding of multi-media lead exposures and their relationship to blood lead levels. Federal agencies are responsible for implementing the recommendations included in the Lead Action Plan. In October 2019, EPA published a progress report on the Federal Lead Action Plan. This report identified best practices and actions taken by federal, state, and local jurisdictions.

During the meetings, LEPAC members discussed the recommendations from the Lead Action Plan. They identified potential best practices and many potential research gaps including evaluating existing programs and current interventions; reviewing existing funding structures and identifying resources that have the most impact; conducting cost-benefit analysis; and verifying existing lead hazard models. The LEPAC Committee had robust discussion about the plan and will continue to examine the ongoing efforts of all the federal agencies.

Summary of comittee actions

LEPAC held two meetings with presentations and facilitated discussions to identify themes and priority areas to guide future work in alignment with the committee's charge.2

As a result of discussions at the April 2020 LEPAC meeting, CDC formed the BLRV Workgroup to provide guidance to the LEPAC on recommendations regarding the BLRV and its use.

BLRV Workgroup

The BLRV Workgroup's inaugural meeting was held on September 22, 2020. In total, the workgroup has held five meetings in 2020, with the last meeting of the year occurring on December 15, 2020. The BLRV workgroup is specifically tasked with providing recommendations to CDC through LEPAC on how to define, use, and update the BLRV. The workgroup will accomplish this objective by providing advice and guidance regarding new scientific knowledge and technological developments to inform the BLRV.

The BLRV Workgroup is in the process of preparing a report that will be discussed at the May 2021 meeting and will address the following:

• How to define the BLRV
• How the BLRV is currently used by the Centers for Disease Control and Prevention (CDC) and other entities
• The status of the BLRV
• The BLRV Workgroup's recommendations

Looking ahead

• The LEPAC will hold its next meeting on May 14, 2021 from 9:00 AM to 4:30 PM EST.
• The Committee will consider next steps for reporting on best practices for programs and interventions and identifying research gaps.
• Additional information including meeting notes can be found on the LEPAC website.

Appendix I LEPAC member roster

Lead Exposure and Advisory Committee (LEPAC) Member Roster

The committee consists of 15 voting Federal and non-Federal members, including the Chair, appointed by the HHS Secretary. Members include experts in the fields of epidemiology, toxicology, mental health, pediatrics, early childhood education, special education, diet and nutrition, and environmental health.

Half of the committee (eight members) consists of Federal representatives. CDC solicited Federal members from HHS, the Consumer Product Safety Commission, Department of Agriculture, Department of Education, Department of Housing and Urban Development, Environmental Protection Agency, Occupational Safety and Health Administration, and the U.S. Geological Survey. Non-Federal members are deemed Special Government Employees (SGEs) and were solicited via a Federal Register Notice (FRN). All members are invited to serve for a term of not more than three years, and the HHS Secretary may reappoint members for consecutive terms.

CDC also selected a Federal employee to serve as the Designated Federal Official (DFO) to attend each meeting and ensure that all procedures are within applicable statutory, regulatory, and HHS General Administration Manual directives.

Designated federal officer

Perri Ruckart, DrPH (cand), M.P.H.

Health Scientist, Team Lead Program Development, Communications, and Evaluation Team Lead Poisoning Prevention and Surveillance Branch (proposed)

Division of Environmental Health Science and Practice

National Center for Environmental Health

Centers for Disease Control and Prevention

Chair

Matthew Ammon, M.S.

Director

Office of Lead Hazard Control and Healthy Homes

U.S. Department of Housing and Urban Development

Washington, DC

Term: 7/1/19-6/30/22

Members

Tammy Barnhill-Proctor, M.S.

Supervisory Education Program Specialist. Office of Innovation and Early Learning. Office of Elementary and Secondary Education. U.S. Department of Education. Washington, DC. Term: 7/10/19-6/30/22

Jeanne Briskin, M.S.

Director. Office of Children's Health Protection. U.S. Environmental Protection Agency. Washington, DC. Term: 12/2/19-6/30/22

Wallace Chambers Jr., M.H.A.

Deputy Director. Environmental Public Health. Cuyahoga County Board of Health. Parma, OH. Term: 7/1/19-6/30/21

Tiffany DeFoe, M.S.

Director. Office of Chemical Hazards-Metals. Occupational Safety & Health Administration. U.S. Department of Labor. Washington, DC. Term: 7/1/19-6/30/22

Donna Johnson-Bailey, M.P.H., R.D.

Senior Nutrition Advisor. Office of Policy Support. U.S. Department of Agriculture Food and Nutrition Service. Alexandria, VA. Term: 1/28/20-6/30/22

Michael Focazio, Ph.D., M.S.

Program Coordinator. U.S. Geological Survey. Reston, VA. Term: 7/1/19-6/30/22

Monique Fountain Hanna, M.D., M.P.H., M.B.A.

Senior Regional Medical Consultant. Health Resources and Services Administration. Philadelphia, PA. Term: 7/1/19-6/30/22

Nathan Graber, M.D., M.P.H.

Pediatrician. St. Peter's Health Partner Medical Associates. Clifton Park, NY. Term: 7/1/19-6/30/21

Karla Johnson, M.P.H.

Administrator. Marion County Public Health Department. Indianapolis, IN. Term: 7/1/19-6/30/21

Erika Marquez, Ph.D., M.P.H.

Assistant Professor. School of Public Health. University of Nevada, Las Vegas. Las Vegas, NV. Term: 7/3/19-6/30/21

Howard Mielke, Ph.D., M.S.

Professor. Department of Pharmacology. Tulane University School of Medicine. New Orleans, LA. Term: 7/1/19-6/30/21

Anshu Mohllajee, Sc.D., M.P.H.

Research Scientist Supervisor ICalifornia Department of Public HealthRichmond, CATerm: 7/2/19-6/30/21

Jill Ryer-Powder, Ph.D., M.N.S.P.

Principal Health Scientist. Environmental Health Decisions. Ladara Ranch, CA. Term: 7/1/19-6/30/21

Unscheduled vacancy: Consumer Product Safety Commission (CPSC)

A nomination package was submitted to fill the unscheduled vacancy with another CPSC employee. The nominee was approved for the final slate and a final nomination package was submitted on August 10, 2020.

NOTE: Terms for current special government employee (SGE) members end in June 2021. A FRN was published to solicit nominations for appointment to the LEPAC. Nominations were due by November 27, 2020.

Appendix II BLRV Workgroup member roster

Blood Lead Reference Value (BLRV) Workgroup Member Roster

The workgroup is comprised of eight experts in the fields of lead screening, prevention, laboratory issues, and surveillance. The workgroup is required to have at least two SGEs who are currently LEPAC members and a DFO from the CDC. In coordination with the DFO, the LEPAC Chair named a chair for this workgroup from the participating SGEs.

Designated Federal Officer

Ginger Chew, Sc.D.

Health Scientist

Division of Environmental Health Science and Practice

National Center for Environment Health

Centers for Disease Control and Prevention NCEH, CDC

Workgroup Chair

Jill Ryer-Powder, Ph.D., M.N.S.P.

LEPAC Member

Principal Health Scientist

Environmental Health Decisions

Members

Wallace Chambers Jr., M.H.A.

LEPAC Member. Deputy Director. Environmental Public Health. Cuyahoga County Board of Health

Nathan Graber, M.D., M.P.H.

LEPAC Member. Pediatrician. St. Peter's Health Partners Medical Associates

Bruce Lanphear, M.D., M.P.H.

Professor. Simon Frasier University

Julianne Nassif, M.S.

Director of Environmental Health. Association of Public Health Laboratories (APHL)

Amanda Reddy, M.S.

Executive Director. National Center for Healthy Housing (NCHH)

Mark Werner, Ph.D., M.S.

Director. Bureau of Environmental and Occupational Health. Wisconsin Department of Public Health

Nsedu Obot Witherspoon, M.P.H.

Executive Director. Children's Environmental Health Network (CEHN)