Our History of Success

Since 1991, HCOP has been at the forefront of protecting young children from environmental hazards in San Francisco.  Here is a partial list of our recent accomplishments in creating a safer environment for children:

Implementing Family Support Strategic Plan.  HCOP successfully promoted the inclusion of “Healthy Homes/Healthy Public Environments” in the recently formed Family Support Network’s vision of what it takes to support and retain low-income families in San Francisco.  In November 2005 HCOP organized and facilitated a conference and training for the Network’s members [family resource centers, child care centers and more] and Department of Public Health staff to begin implementing the policy.  The focus was on educating and training family support providers to help caregivers learn how to clean their homes with non-toxic products.

Purchasing Environmentally Preferred Products.  HCOP participated in the Bay Area Working Group on the Precautionary Principle that worked in partnership with the San Francisco Department of the Environment to advocate for passing of legislation requiring City Agencies to purchase environmentally preferred products.  The legislation became effective on July 17, 2005.  When fully implemented it will protect females working for the City from toxic exposures that can be passed on to their fetuses and young children.  In addition, children using City agency facilities will be less likely to be exposed to toxins used to clean the facilities and/or to kill pests. The School District is not directly subject to the Board of Supervisor’s law making powers.  For that reason, HCOP is asking the School District to purchase environmentally preferable products for its use like other City agencies, especially because that is where many low-income pre-kindergarten and school age children spend most of their waking hours.

Making City Agencies Responsible for Protecting Children’s Environmental Health. HCOP created a model program for monitoring City agencies’ implementation of lead prevention and other legislation to protect children’s health.  With widespread community support, HCOP successfully advocated for the passage of childhood lead prevention legislation in 1992. The legislation requires that the Department of Public Health [Department] periodically submit a “Health Code Section 1609 Report” to the Board of Supervisors on how well city agencies are complying with mandated childhood lead poisoning prevention activities. The latest HC §1609 report was issued in December of 2003. HOCP ensured that the Report did not gather dust on the shelves of the city’s Supervisors.  HCOP asked the President of the Board of Supervisors to: [1] prepare a resolution directed to each agency in the Report requesting that it implement the report’s recommendations, and [2] write letters to the agencies requesting them to prepare a written response to the Report’s recommendations.  They were also asked to appear before a Board subcommittee to describe their efforts pursuant to the legislation. After the Board’s hearing in September 2005, HCOP requested that each agency be required to prepare a workplan every year as part of its regular budget process, and that the monitoring and evaluation of each agency’s work be incorporated into those work plans so the Mayor, the City Controller and the public can ensure their compliance with the 1992 legislation.

Promoting Healthy Homes. We need healthy homes to protect children from environmental hazards.  This is a real challenge in San Francisco, especially in our low-income and minority neighborhoods. Most of the housing in these neighborhoods is literally painted with lead (94% of all homes in San Francisco were built before lead was banned from residential paint), and many of those homes are also contaminated with mold and mildew.

• Public Housing.  The local Housing Authority provides homes for thousands of children under six years old in facilities built in the 1940s and 1950s.  Since 1991, HCOP has worked with the Housing Authority representatives and the Lead Poisoning Prevention Citizens Advisory Committee to develop and implement a comprehensive action plan for making family housing lead-safe. More recently we have been working with the City’s Asthma Task Force, community organizations and tenants to help make public housing asthma trigger-safe.
• Private Housing 1996. With HCOP facilitating the process, the City’s Lead Hazard Reduction Citizen Advisory Committee recommended legislation giving the Department of Public Health the authority to order property owners to clean up lead hazards in the homes of lead-poisoned children.  In addition, the landlord and tenant members negotiated an agreement to provide relocation benefits for tenants when needed and to protect tenants’ rights under the City’s rent control ordinance.  This was and still is landmark legislation.
• Exteriors—Private Housing, Commercial and Industrial Buildings 1997. In response to numerous complaints about lead hazards being created by work done on building exteriors throughout San Francisco, HCOP and the Lead Hazard Reduction Citizens Advisory Committee developed another piece of landmark legislation requiring lead-safe work practices on the exteriors of pre-1979 buildings, including commercial and industrial buildings many of which are in close proximity to homes, child care facilities and playgrounds. The Department of Building Inspection agreed to implement and enforce the legislation that was enacted in 1997. Several years later we can say that there is a significant improvement in work practices when disturbing lead paint on the exteriors of older buildings. There is much greater awareness among contractors about how to do this work right.
• Interiors—Private Housing 2004. HCOP lead the Committee’s effort to recommend legislation requiring lead-safe work practices on the interiors of all pre-1979 residences and child care centers in San Francisco.  Most of San Francisco’s homes were built before 1979 and literally painted with lead. This is an important step forward in providing lead-safe, healthy housing.  The Board of Supervisors approved the legislation in May, and the mayor signed it in early June 2004.  This too is landmark legislation in California and much of the rest of the country.

Collaborating for Healthy Children. HCOP works with community-based organizations (CBOs) providing family and children’s services to build their communities’ capacity to educate parents about environmental hazards and preventable childhood diseases. We believe that community education means education by the community, especially in a diverse city full of non-English speaking immigrants. In 1999, HCOP and a collaboration of seven CBOs from different low income communities in San Francisco received a two-year grant from The California Endowment. During the grant period the collaboration:

• helped more than 60 community groups to integrate health promotion and disease prevention into their services, distributed educational materials, offered trainings to parents and advocated that city agencies do more to prevent lead poisoning, asthma and other diseases;
• reached at least 5,800 parents and other caregivers with prevention information;
• participated in 50 community fairs and events providing that kind of information to families; and,
• placed 26 articles about protecting children from environmental hazards published in local newspapers and newsletters.

Making Public Facilities Healthy for Children.  Many low-income children spend substantial time in city facilities that contain environmental hazards. HCOP could not ignore the fact that these facilities may be making children sick.

• Recreation and Parks Department. The Recreation and Parks Department has more than 200 sites and most were built before 1950. Many are used by young children.  In response to HCOP’s efforts over several years, in 1998 the Department committed to making its facilities lead-safe. HCOP helped the Department obtain funding to hire qualified staff to meet this commitment. The program has been doing a good job. Seven years later, most of the highest priority sites [used by young children, contain lead hazards] are lead-safe.  But more needs to be done to remediate the other sites and properly maintain and repair the ones that have been remediated to keep them lead-safe. After the Department began to remediate its facilities, HCOP learned that many child care providers use those facilities, but the Department had no idea who they were and which facilities they used. Fortunately, HCOP works closely with the two large child care resource and referral agencies in the city and a number of child care provider networks and associations. With the cooperation of the family child care agencies, the state Department of Social Services [licenses child care centers] and the Childhood Lead Prevention Program in the Department of Public Health, providers were surveyed and Department sites used by thousands of children in licensed child care programs [family day care homes] were identified. The Department revised its priorities based on that information.  At HCOP’s request, it also provided a list of the facilities used by the providers and the status of cleanup efforts for each of those facilities. HCOP distributed that list to the Childcare Planning and Advisory Committee so it could pass this information on to individual providers in January of 2004.  This is an excellent example of how to implement a “complete” project that truly responds to the needs of the children being exposed to environmental hazards.  We advocated for change; we won commitments from the Department and worked with the Department to implement those commitments; we helped find the money in the City budget to hire staff and do the work needed; we worked with several organizations involved in child care to identify the parks to which children were being taken so the program could ensure that those sites had the highest priority for clean-up; and, we let childcare providers know about the conditions of the sites they were using.
• School District - Lead Hazards.  After many years of advocacy by HCOP, the SF Unified School District adopted a policy designed to make its facilities lead-safe in 1998.  In 2000 it issued a lead-in-paint report for sites used by 1400 pre-kindergarteners (mostly 3 1/2-4 year olds) and several thousand young elementary school-aged children [pre and after school programs]. Fifty sites had lead hazards.  By November 2001 District staff had stabilized these sites. But temporary stabilization isn’t enough. The exposure threat continues. The District’s schools, including these 50 sites, continue to deteriorate because of inadequate maintenance and repair.
• Healthy, “High Performing” Facilities. In the summer of 2003, HCOP sponsored the Board of Education’s enactment of a policy requiring the District to use “High Performance School Design Guidelines” for new construction and renovations. “High performance” school designs promote good indoor air quality and the use of the least toxic building materials available. HCOP organized support for the Resolution from other community-based organizations, parents groups and the teachers’ union. In addition, we recruited several outside agencies who are experts in developing guidelines to support our efforts: the Collaboration for High Performance Schools, the San Francisco Department of Environment, the State’s Architect’s Office’s program for designing sustainable schools, and the federal Environmental Protection Agency. The Board appointed an advisory committee to aid the District in fully integrating these design guidelines into its renovation and modernization [state funded] efforts. The membership includes HCOP’s director and representatives from all of the other outside agencies recruited by HCOP to help in this effort. In November of 2003, the voters passed a $295,000,000 bond to pay for the district’s efforts to begin renovating its facilities to comply with an ADA court settlement. A representative of the master architect for the renovations consulted with the committee, and the District’s new guidelines were officially published in March 2005. These type of guidelines were originally conceived for use with the construction of new schools. But the District isn’t building many new schools and needed guidelines for renovations. These are the first such guidelines published in California and probably the country. HCOP is now asking that the District prepare a matrix describing when the guidelines should be used for each construction project so we can ensure their use and evaluate the District’s performance under the guidelines.
• Environmentally Preferred Products [EPP]. HCOP is currently requesting that the District follow the City of San Francisco [a separate political entity] by purchasing less toxic/non-toxic products, especially those used for maintenance, repair and construction work.  The Guidelines also call for using EPPs.  See the discussion regarding the Precautionary Principle and the City’s mandate to purchase EPPs.
• Tools 4 Schools.  This program established by the US EPA encourages school districts to employ low cost/no cost measures to improve indoor air quality in classrooms and elsewhere in schools.  HCOP joined with the City’s Asthma Task Force to successfully advocate for a School Board resolution mandating implementation of this program in the School District.  Now we are advocating for its full implementation.
• Williams Settlement. The District is required to make important repairs in 43 of its schools, designated as low performing, the costs of which will be reimbursed by the State. HCOP is helping to ensure that the District will take full advantage of this opportunity to improve the environment for children and teachers in these schools.
• Public Housing.  See the previous section discussing HCOP’s promotion of Healthy Housing.

Protecting Children from Asthma.  Asthma is the most common chronic childhood disease in America. Asthma and allergies are the number one cause of school absences, and asthma is responsible for one third of all pediatric ER visits.  African American and Latino hospitalization rates are two to three times higher than other children’s rates in the city.

• HCOP helped write and get the Board of Education to enact the school district’s current Indoor Air Policy in 1998.  HCOP participated for many years in a community-based predecessor to the San Francisco Asthma Task Force created by legislation in 2001. This task force is responsible for developing city-wide policies to prevent and manage asthma.  HCOP spent considerable time helping the task force prepare its recommendations.  See the discussion in the previous section on HCOP’s efforts in the District’s schools.
• HCOP works with the City’s Asthma Task Force to improve indoor air quality with respect to mold and mildew in public “family” housing [as opposed to senior and adult non-family]. See the discussion in the following section about “Our Work—Promoting mold-safe, healthy public housing.”
• Since the middle of 2005, HCOP begins working with the City’s Asthma Task Force to improve indoor environmental quality, including mold and other asthma triggers, in private housing. See the discussion regarding the Family Support Network at the beginning of “The History of Our Success” section.

Educating Caregivers through City Agencies.  Our city agencies serve thousands of low-income children and their families. HCOP works with these agencies to have them educate caregivers using their services about protecting children from environmental hazards.

• Public Library.  The San Francisco Public Library has a network of 26 branches covering the city and is an ideal avenue for providing large numbers of caregivers and children with environmental health information. Through the efforts of HCOP and the Lead Poisoning Prevention Citizens Advisory Committee and the Childhood Lead Prevention Program in the Department of Public Health,  the Library improved its program to educate caregivers about lead poisoning. It stocked HCOP’s “Kids At Risk” lead prevention video in appropriate languages at each branch. The Library distributed lead prevention education materials and provided bookmarks at library checkout desks. In addition, it trained staff to do a better job of providing this information to library users.  Unfortunately, these activities have not been institutionalized into librarians’ regular work, and the recent hearing before the Board of Supervisors revealed the need for a renewed effort to do so.  See the discussion about HCOP’s efforts to monitor and improve City agencies’ compliance with 1992 legislation requiring them to help educate caregivers about protecting children from lead poisoning.
• Human Services Agency.  The Human Services Agency (HSA) now educates foster parents about how to prevent lead poisoning. DHS is also training CalWORKS (the state’s welfare-to-work program) and child protection services staff about environmental hazards and the impact of toxins on young children. In addition, DHS provides CalWORKS parents with lead poisoning prevention information.
• Department of Public Health [DPH]. The program formed in response to the 1992 lead poisoning prevention legislation sponsored by HCOP has performed admirably over the years. In the late 1990s it’s work expanded to include developing effective asthma control services and preventing asthma attacks in the home, along with a change in name from the Childhood Lead Prevention Program to the Children’s Environmental Health Promotion [CEHP] program. CEHP is a good source of information for preventing lead poisoning and responds to complaints about lead hazards in housing and consumer products. The CEHP’s director helps lead the efforts of the Asthma Task Force and is one of the key players on its Environment Committee which is focused on creating healthy housing.  See its website at: http://www.sfgov.org/site/frame.asp?u=http://www.dph.sf.ca.us/  HCOP is currently advocating for improved coordination between maternal, child and adolescent services in the department so that parents learn about protecting children’s health wherever they enter the public health system. As a result of HCOP’s efforts, the Department of Public Health is gradually exploring integrating environmental health information into the Department’s home visiting and maternal child health programs. The exploration for which HCOP advocated began with a half-day conference in June 2004 with the home visiting public health nursing staff. HCOP would like to see the Department move much more quickly.  Public health departments across the country need to be proactive in helping prevent childhood exposures to indoor environmental hazards.

Lawsuits—The Last Resort.  Normally we refrain from advocating for litigation because HCOP’s director, formerly Deputy Attorney General for the State of California, believes that community action is more effective over the long-term. But sometimes there is no other option.  For example:

• HCOP vs. State of California (Department of Health Services).  In 2001 HCOP was the lead plaintiff in a case filed against the State Department of Health Services for failing to comply with 1991 legislation mandating the development of regulations requiring doctors to test children’s blood lead levels.  The court ruled in HCOP’s favor.  The regulations have been issued, and the court has maintained jurisdiction of the case to monitor the effectiveness of the regulations. The regulations are nice, but demonstrate why law suits are the last resort. HCOP has not been provided with the regulation information that are helping increase the pre-law suit settlement testing rates to an acceptable level.  More needs to be done.
• City and County of San Francisco vs. Paint Manufacturers.  In 2001 HCOP persuaded the City to join a lawsuit brought by several California counties and cities against the major manufacturers of lead-based paint and their trade association. The purpose is to make them pay to remove lead hazards from public facilities and private housing. In pre-trial proceedings, the court ruled against the plaintiffs. But the court of appeals ruled in favor of the plaintiffs in the first opinion of its kind in the country and the litigation is moving foward, albeit slowly.