presented by: the association of state and territorial
TRANSCRIPT
Presented by: The Association of State and Territorial Health Officials
(ASTHO) &
The National Association of County and City Health Officials (NACCHO)
December 16th, 2014
1:00-2:30pm ET
•Play audio through your computer speakers • Audience participants should not use a telephone number that may have
been included in the webinar registration notices • If you have trouble with audio, be sure your speakers are turned on and
the volume is up • Contact technical support by calling 800-843-9166
•Submit questions through the Chat Box • Questions will be addressed after all speakers have presented
For Audio Component
• Welcome and Introductions from ASTHO & NACCHO • Erica Haller-Stevenson, National Association of County and City Health
Officials • Diana Karczmarczyk, Association of State and Territorial Health Officials
• Peter Ashley, U.S. Dept. of Housing & Urban Development • Scott Alderman, Landura Management Associates • Esmirna Damaso and Kathleen McCabe, MA Department of Public Health • John Walker, Nashville Metropolitan Development and Housing Agency • Peter Ashley, U.S. Dept. of Housing & Urban Development • Resources • Interactive Q&A Session
Webinar Agenda
• Multiunit housing (synonymous with multi-family) • Housing categories:
• Public housing (government-owned) • Private government-assisted housing • Private market rate housing
• Smoke-free multiunit housing
Terminology
Peter J. Ashley, DrPH Office of Lead Hazard Control and Healthy Homes U.S. Department of Housing and Urban Development
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Introduction
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1. Background of HUD’s smoke-free housing initiative
2. HUD smoke-free (SF) housing toolkits
3. Change is in the Air Action Guide
4. Why have a smoke-free housing policy?
5. HUD SF activities for 2015
HUD Smoke-Free Initiative
• 2009: Office of Public and Indian Housing issued Notice PIH 2009-21
• 2010: Office of Housing issued Notice 2010-21
• 2012: Office of Public and Indian Housing issued Notice 2012-25 and HUD released “Smoke-free Housing” toolkit
• 2012 Federal Register Notice published soliciting feedback on HUD initiative and best practices for implementation
• 2014: Office of Lead Hazard Control and Healthy Homes releases Action Guide
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HUD’s Smoke-Free Housing Toolkits
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- Released in June, 2012
- Endorsed by American Academy of Pediatrics, the American Lung Association, and CDC Office of Smoking and Health
- Sent to directors of ~ 2,200 PHAs in the U.S. in 2013
- Separate toolkit created for residents
Toolkit Contents (managers)
• Reasons to adopt SF policies
• Legal issues (SF requirements are legal)
• Recommended steps for adopting SF policies
• FAQs
• HUD Notices/other resources
(note: the toolkit reproduces existing materials; e.g., brochure from the National Center for Healthy Housing, etc.)
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•HUD published a October 2012 Federal Register Notice to solicit input on SF housing initiative
•116 comments received •Used responses to develop more detailed “best practices” guidance
•Also, in-depth interviews with nine smoke-free pioneers
•Action Guide released in October, 2014
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Major Contents of Action Guide
• Reasons to adopt a SF housing policy
• Interviews with 9 SF housing “Pioneers” (representing: public housing authorities; federally subsidized Multifamily; market-rate housing)
• Recommended steps to adopting a SF policy
• Frequently asked questions
• Appendices (HUD Notices; Resources; summary of Fed Reg comments)
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Smoke-Free Pioneer
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I was adamant that the policy was going to take too much effort, and we were going to be spending our whole lives to get people to stop smoking. It was not actually like that at all. Diane Martin, Property Manager, Housing and Redevelopment Authority of Duluth, Minnesota
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Why a Smoke-Free
Housing Policy?
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Additional Health and Safety Considerations
•> 4,000 chemicals have been identified in tobacco smoke; this includes at least 69 carcinogens.
•The U.S. Surgeon General has concluded that there is no safe level of exposure to secondhand smoke.
•Tobacco smoking is the leading cause of fatal fires in the U.S.
•Secondhand smoke (SHS) is a significant source of lead exposure for children and adults and there is no “safe” level of lead exposure for young children.
•SHS exposure is associated with both the development and exacerbation of asthma in children.
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1. Get Started •Review HUD Notices
•Contact Owners/Agents of Properties with Smoke-Free Policies
•Learn about Local Smoke-Free Laws
•Review Examples of Smoke-Free Policies
•Look for Community Partners
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4 Recommended Steps to Adopt a SF Policy
2. Move Forward •Present the Idea of a Smoke-Free Policy to Staff, Board and Resident Council
•Survey Residents
•Develop Your Policy and Plan
•Introduce the Policy and Set an Implementation Timeline
•Obtain Board Approval to Begin Comment Period
•Notify Residents and Begin Comment Period
•Obtain Board Approval
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4 Recommended Steps to Adopt a SF Policy
3. Prepare to Implement • Train Staff
• Focus on Vulnerable Residents
• Help Residents Set Appropriate Expectations
• Schedule Lease or House Rules Signings
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4 Recommended Steps to Adopt a SF Policy
4. Stay Committed to Enforcement
• Follow up on all complaints and address all violations
• Continue to communicate with residents to build support for the policy
• Provide assistance to residents or staff who want to quit
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4 Recommended Steps to Adopt a SF Policy
Accessing HUD Smoke-Free Housing Toolkits and the Action Guide for Establishing Smoke-Free Public Housing and Multifamily Properties: http://portal.hud.gov/hudportal/HUD?src=/smokefreetoolkits1
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Progress to Date
• From review of publically available information: ~ 470 Public Housing Agencies with SF policies (~ 15% of 3,090 PHAs that administer conventional public housing)
• This covers ~ 186,000 housing units
• 9 tribally designated housing entities ID’d with SF policies
• Adoption by federally subsidized multifamily owners/agents (i.e., project-based Section 8) thought to be significant.
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HUD Plans for Smoke-Free Housing Support Activities in FY15
• Deliver 2 webinars, with one expected to focus on enforcement of SF housing policies.
• Significant expansion of content on SF housing website (Office of Lead Hazard Control and Healthy Homes).
• Develop a standard SF housing presentation for HUD staff and an “executive briefing” presentation and materials for housing managers, boards, etc.
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SMOKE FREE HOUSING
Why Smoke Free Housing?
• Health • Safety • Reduce Risk • Insurance Implications • Reduce long-term
O&M and capital needs • Resident Appeal &
Marketability
The Healthy Choice • Second-hand smoke has
proven harmful effects
• Can drift through units & buildings undetected
• Neighboring residents
and staff are put at risk
• Some residents do choose to quit smoking as a result of policy implementation
Smoke Free for Safety US Fire Administration Stats:
(for smoking-related residential fires)
• Smoking causes 9,000 fires / yr
• 67% started by abandoned or discarded smoking materials
• Bedroom is top origin at 27% Porch & Balcony is 2nd
• 8x higher death rate & 3x higher
injury rate vs. other fire causes
Who is Really at Risk? • Fires pose imminent
danger to residents, staff, fire & rescue teams
• Smoking-related fires can put innocent people out of their homes too
• The best way to handle losses is prevention!
• If injury or death occurs, could you face charges of negligence by having knowingly let it continue?
Why continue to accept this risk? • 40-Unit RD 515 / Tax Credit Site for the Elderly & Disabled •10 units totally destroyed & 30 others unoccupied 3+ weeks •Firewalls prevented a total loss - Actual Loss Cost: $769,100
Could this be your property? •Smoking Caused - Resident’s oxygen determined an accelerant •6 units affected at this RD 515 family site •Entire building taken offline until Certificate of Occupancy received •Actual Loss Cost: $513,366
How could it cost so much?
• Cost of demolition & reconstruction • Add-in required code upgrades • Permits, architectural costs & other fees • Fees from fire department, security costs • Rent loss for entire duration of vacancy • Potential legal costs • Doesn’t include the hard-to-quantify time
required of corporate and site staff
But we’re pretty well insured… • The deductible likely hits your reserve account
• Will your insurance carrier drop coverage afterward? How will you convince them it won’t happen again?
• If you retain existing coverage, major losses could easily hike your premiums 15% or more
• May have to accept a higher deductible just to keep premiums low - a future threat to savings & reserves
• Some insurers offer Smoke Free Housing discounts
Reduce Your Ongoing Costs • Routine Maintenance
– Repainting – Air filters & repairs – Floor cover cleaning – Market-ready turnover
• Capital Components – HVAC – Flooring – Blinds – Lights & Fixtures – Appliances
Resident Appeal & Marketability • Smoke disturbs the peaceful
enjoyment of non-smokers
• Polls & surveys show support
• Smoking outside a national trend -Bans implemented in many states for public areas
• Use it as a marketing advantage www.smokefreeapartments.org www.smokefreerental.com
• May appeal to a specific market segment of new potential residents
Is it allowable? • Generally, smokers are not a protected class • HUD has encouraged Owner/Agents in writing • Other housing programs have been receptive • Revised Lease Addendum and House Rules &
Regulations make smoking a lease violation • Some offices suggest possibility of reasonable
accommodations or for hardship situations
• Refer technical questions to your legal counsel
How Does It Work? • No one is required to quit smoking • The Policy prohibits smoking in:
– Common areas: lobbies, halls, bathrooms, community rooms and playgrounds
– All apartment units, balconies, patios, porches
– Within 25 feet of all buildings & common areas – or restrict to specifically designated areas
• Applies to everyone who visits, lives and works at the site
What is the process? • Work with your legal counsel to draft documentation • Submit to RD, HUD or applicable agency for approval • Provide the required notice to residents & applicants • Have residents sign the lease addendum and/or rules • Advise staff and notify any third parties or contractors • Provide informational resources for quitting (optional) • Purchase and install smoking waste receptacles • Advertise as a Smoke Free Property • Monitor the implementation process & enforcement
Sample Notice to Residents
Sample Lease Addendum
FAQ & Smoking Cessation Information
Sample Tenant Warning
Costs of Implementing Smoke Free Housing
• Staff time • Legal preparation • Mailings & postage • Proper waste
receptacles • Designated facilities
(optional) • Enforcement costs
Enforcement • Identify in routine inspections • Look for cigarette butts, ash
trays and evident odors • Potential lease violations:
– No smoking clauses – Health & safety issues – Disrupting the peaceful
enjoyment of residents • Photographs can be evidence • Charge for related damages • Issue warning or terminations
Common Questions • Leasing Concerns:
If in doubt, consider test sites before your entire portfolio, such as where you have stable occupancy, or phase-in implementation. Keep Fair Housing concerns in mind.
• Grandfathering: Not Required
• Resident protests: Very few complaints received (<2%). Let them know they can save money by not smoking!!!
Even if you decide Smoke Free isn’t for you, consider strict enforcement of no smoking in units with oxygen
equipment for safety reasons.
For Slides, Resources or Assistance Contact: Scott Alderman – Landura Management Associates PO Box 25088 Winston-Salem, NC 27114-5088 Phone: 336-760-8100 Fax: 336-760-8111 E-mail: [email protected] Web: www.LanduraManagement.com
Massachusetts Smoke-Free Housing In Multiunit Dwellings
Massachusetts Department of Public Health December 16, 2014 Presenters: Esmirna Damaso and Kathleen McCabe
Objectives Listeners will be able to: Explain the need for addressing secondhand
smoke in the multiunit dwellings Identify key partners for process Describe the Massachusetts approach Understand how smoke-free policies are
implemented Describe the multi-pronged approach to effective
enforcement
Why address secondhand smoke in multiunit dwellings?
Demand Increased number of complaints about exposure to secondhand
smoke in the home to local and state health departments after the 2004 implementation of the MA Smoke-Free Workplace Law.
Landlords showed interest in going smoke-free, but surveys indicated a need for legal and process technical assistance
Data BRFSS Surgeon general’s report
Key Partners and Approach Traditional partners:
Local tobacco programs including local boards of health
Landlords (public and private) and condo associations
Public health attorneys
Approach: In 2008, the Massachusetts Department of Public Health began to promote the voluntary adoption of smoke-free housing policies
Through our statewide technical assistance partners, we educate housing providers
(i.e. private landlords, condo associations, and affordable housing agencies)
Provide tools, training, process recommendations and policy guidance
Emphasize education and resident engagement
Accommodating all needs Evolutionary process
Initial efforts focused landlord education (with resident engagement at core of the process)
Increased concern about potential resident displacement lead us to partner with additional resident advocacy and service organizations.
Lessons learned from our work with the Boston Housing Authority
A focus on ensuring compliance has led us to new partners Legal aid lawyers
Judges and clerk magistrates
Tenancy Preservation Programs (advocates for the formerly homeless, substance abuse and mental health advocates, etc.)
How can we implement effective policies that provide healthy homes for all residents while preserving housing for those that are struggling to comply?
Implementation Smoke-free housing policies are adopted voluntarily by landlords,
condominiums and management companies
Department of Public Health funds statewide technical assistance providers and local programs to:
Create and provide tools, training, technical assistance, resident education and engagement through the development, implementation and enforcement of smoke-free housing policies
Promote systems change
Department of Housing and Community Development (DHCD) guidance
Explore incentives for creating smoke-free multi-unit housing
Educate the judiciary
Integrate smoke-free housing into healthy homes approach
Enforcement / compliance Policies are only effective if resident comply:
• Emphasize a resident-driven process
o Engage resident champions
• Provide enough time for implementation of the rule
• Offer trainings for staff and other partners
o Emphasize consistency and on-going education
• Engage new partners to help reduce the likelihood of
displacement
• Be open to creative solutions
Successes
• DHCD guidance • By the end of 2015, over 70 public housing
authorities will be smoke-free • Working with 15+ community development
corporations in Boston • Provided TA to several major management
companies as they’ve adopted portfolio-wide policies
Resources
http://makesmokinghistory.org/smoke-free-
environments/
MA Health Promotion Clearinghouse:
http://massclearinghouse.ehs.state.ma.us/cat
egory/TOB.html
Contact Information Esmirna Damaso, MA Department of Public Health, [email protected] Kathleen McCabe, Health Resources in Action, [email protected]
Nashville Metropolitan Development and Housing Agency JOHN WALKER, SOCIAL SERVICE COORDINATOR
This image cannot currently be displayed.
About Nashville MDHA The Nashville Metropolitan Development and Housing Agency has a total of 20 properties with a mix of public housing, including elderly and family properties. All seven high-rise buildings are smokefree.
John Walker, Social Service Coordinator [email protected]
Enforcing a Smoke-free Policy
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Enforcing a Smoke-free Policy • Clearly explain that policy applies to residents, visitors,
and staff. • Enforcement procedures must be communicated clearly
to residents. • Residents should be encouraged to report violations and
not be confrontational (e.g., provide # to call; create a form residents can submit anonymously).
• Maintenance staff can detect smoking when in units doing standard maintenance.
• Management should respond quickly and consistently to violations; use a step-wise process for repeat violations.
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Enforcement Process Example (Duluth, MN Housing Authority)
• 1st violation: Verbal discussion with the property manager and a “breach of policy” letter
• 2nd violation: Discussion of policy with property manager and a written notification of violation that resident must sign to show agreement to the lease (termination after 3 violations)
• 3rd violation: Eviction letter, which results in eviction or a probationary agreement
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Enforcement Process Example (Home Forward, Portland, OR)
• 1st violation: Verbal warning and cessation materials
• 2nd violation: Verbal warning, cessation materials, resident service referral
• 3rd violation: Written warning, cessation materials, resident service referral
• 4th violation: Notice to vacate with option to remedy, cessation materials, resident service referral
• 5th violation: 10-day Notice to vacate without the option to remedy
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NACCHO Tobacco Webpage www.naccho.org/topics/HPDP/tobacco/ Tobacco Toolkit – Chronic Disease Prevention www.naccho.org/toolbox For technical assistance, contact: [email protected]
NACCHO Tobacco Resources
www.astho.org/Programs/Prevention/Tobacco/ Comprehensive Tobacco Control: Guide for State & Territorial Health Officials Issue Brief: Recommendations for State and Territorial Health Agencies ◦ Role of state and territorial health agencies ◦ Recommendations ◦ Resources ◦ State examples
ASTHO Tobacco Resources
If you would like to ask a question, please type it into the chat box on your screen.
Q & A
Diana Karczmarczyk, ASTHO [email protected]
www.astho.org/Programs/Prevention/Tobacco/
Erica Haller-Stevenson, NACCHO [email protected]
www.naccho.org/topics/HPDP/tobacco/