U.S. Environmental Protection Agency
Region 6

Children's Environmental Health
Fifth Annual Program Highlights Report

Protecting Children Where They Live, Learn, and Play

EPA

United States
Environmental Protection
Agency

October 2014 - September 2015


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Contents

Introduction	3-4

Children's Health Strategy
Summary of Results

Children's Health on the Border	5-6

Children's Environmental Health Symposium
Protecting Kids from Pesticide Exposure

Children's Health Month	7

Activities from October, 2014

Healthy Schools	8-10

Pesticide Safety and Integrated Pest Management in Schools
Food Recovery Challenge in Schools

Healthy Homes	11

Training events in North and South Texas

Health Child Care	12-13

Training in Texas and Arkansas

Health and Wellness Alliance for Children	14-15

A Collective Impact Approach to Addressing Asthma in Dallas County

Internal Coordination	16-17

Coordinating Across Regional Programs

Environmental Education	18

Addressing Children's Health through Education Initiatives

Webcasts, Social Media, etc.	19

Using Social Media, Webcasts and Blogs to Address Children's Health
Issues

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Introduction

A New Strategic Approach to Children's Health Protection

Early in 2015, EPA published the first Agency Strategy for
Protecting Children's Health: FY 2015-FY2018 to help make
children's health considerations a key part of our day-to-day
operations. The Strategy grew out of an Agency-wide coordination
with all national programs and regional offices, several months of
planning calls, and an in-person meeting in Washington, DC during
Children's Health Month with the Children's Health Coordinators
from EPA regions across the country.

The strategy is ground-breaking because for the first time, it pulls
together children's health-specific objectives, measures, and
indicators under each of the five Agency goals and four cross-
cutting strategies:

EPA Goals

Addressing Climate Change and
Improving Air Quality
Protecting America's Waters
Cleaning up Communities and
Advancing Sustainable
Development

Ensuring the Safety of Chemicals
and Preventing Pollution
Protecting Human Health and the
Environment by Enforcing Laws
and Assuring Compliance

Cross Agency Strategies

Working Toward a Sustainable
Future

Working to Make a Visible
Difference in Communities
Launching a New Era of State,
Tribal, Local, and International
Partnerships

Embracing EPA as a High-
Performing Organization

In addition, it allows Regions to capture work that might not otherwise be measured under
mandatory Annual Commitment System metrics, or other program measures and
indicators.

To promote knowledge and use of the strategy in Region 6, the Children's Health
Coordinator accompanied Regional Administrator, Ron Curry to several All-Hands Division
meetings this summer, and introduced the strategy to each Division. During Children's
Health Month in October, an All Employee memo was sent out reinforcing the importance
of the new strategy. The strategy is available on EPA's internal SharePoint site at:
https://usepa.sharepoint.com/sites/QA/ochp/Shared%20Documents/EPA Strategy to Pr
otect Children's Environmental Health FY15-18 final.pdf

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Introduction

Summary of Results

The Children's Health Symposium held in El Paso this fall accomplished several goals.
Approximately 135 health care providers were trained potentially impacting 100
patients per provider and ultimately improving health outcomes for 13,500 people in
border communities. In addition, 1) The Symposium raised awareness and increased the
understanding of the role of the Pediatric Environmental Health Speciality Units among
stakeholders; 2) It facilitated the understanding of children's environmental health (CEH)
issues along the US/Mexico Border among Agency leaders to better address problems
facing the children in some of the poorest communities in the nation; and 3) It addressed
several measures in the EPA Strategy for Protecting Children's Health and Annual
Commitment System measures, meeting target numbers for FY14.

Outreach on pesticide exposure to migrant students, teachers, and families along the
border reached an audience of approximately 1,000 people and an environmental health
fair in Arkansas reached more than 500 children and in the school environment, EPA
trained and provided technical assistance to 450 people including school nurses, district
administrators, facilities management, pest management professionals, building and
construction professionals, and others.

During Children's Health Month, dozens of teachers and hundreds of families received
information about how to protect children from environmental health risks; during Lead
Poisoning Prevention Week, the last week of October, Region 6 distributed 11,000 lead
planners to raise awareness about the Renovation, Repair, and Painting Rule and
childhood lead poisoning.

More than 218 professionals were trained in the two-day Essentials for Healthy Home
Practitioners course and Eco-Healthy Child Care (and Lunch and Learn series) training for
supervisors. These train-the-trainer events focus on providing the tools that child care
supervisors and public housing and environmental professionals need to be change agents
for improving environmental health conditions of thousands of families across the nation.

This year, the Region 6 Circuit Rider traveled to more than 110 communities and met with
more than 135 individuals at city/county health or environmental offices, schools,
libraries, and clinics, provided information at 6 health fairs or community events.

Children's health messages were disseminated via Face Book, Twitter, Blogs, online
articles, radio broadcasts, webcasts, and press releases reaching thousands of parents,
teachers, health care providers, and the general public. Increasing the audience through
these mechanisms has provided an expanded reach of EPA's message to protect children
from environmental health risks where they live, learn, and play.

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Chi dren's Health on the Border

EPA is working with partners along the US/Mexico Border to address binational
environmental challenges and disproportionate health impacts that burden border
communities. Health impacts include poor indoor and outdoor air quality, mismanagement
of pesticides, misuse of chemicals and other waste, poor water quality, and binational
chemical emergencies.

First EPA Children's Health Symposium on the Border

EPA launched Children's Health Month on September 24-25, 2015 by co-hosting, Children's
Environmental Health on the Border: Protecting Children Where They Live, Learn, and
Play, a bi-national symposium was held on the campus of Texas Tech in El Paso, and hosted
by the Southwest Center for Pediatric Environmental Health. Texas Tech is a new EPA
partner and now home to the newest Pediatric Environmental Health Speciality Unit
(PEHSU).

The PEHSU is a network of physicians jointly funded by EPA and the Agency for Toxic
Substances and Disease Registry. The symposium
utilized the PEHSU network to put on the training
and Texas Tech provided continuing education
credits for attendees. About 150 doctors, nurses,
promotoras, and public health professionals
attended the two-day session in which thirty
experts presented on issues such as asthma, lead
and mercury exposure, climate change impacts on
children's health and a dozen other topics.

Simultaneous English/Spanish translation was
provided for all the presentations.

Results

Protecting kid's health is central to EPA's mission and the symposium was one of many
CEH initiatives along the Border. Together with our partners at state agencies, universities,
non-profits, and local municipalities, EPA has been working to specifically address
children's health protection in border communities. The US/Mexico Border program
(Regions 6 and 9) has provided funding to assist a dozen organizations, with more than
$500,000 over the past three years specifically to address children's health. Funding
has supported capacity-building through training for child care and school personnel, for
environmental home assessments, to educate farm workers about take-home pesticide
exposures, and to train those who train others. Directly, these efforts have impacted about
25,000 people. However, when a promotora carries the message about children's health
protection into a community, or physicians hear about children's health protection in grand
rounds, on via on-line training, they may have long-term impacts within a community. So,
25,000 people trained becomes 35,000, or even 50,000 or more reached.

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Chi dren's Health on the Border

Protecting Farm Workers and Their Families

The Region 6 Pesticides Program continues to
adder ss safe work practices among farm
workers, especially children. Region 6
provided support for the play, El Moscasy Los
Pesticidas to be performed on May 27, and June
3, 2015. It was performed and hosted by Telon De
Arena at the Chamizal National Memorial, an
urban park located in El Paso, Texas. ElMoscas
y Los Pesticidas is a humorous and interactive
play (in Spanish) developed by Region 6 in 2009
to help increase pesticide safety awareness for
farm workers and prevent "take-home" risks to
their families. At least three schools consisting of
4th, 5th and 6th grade students from El Paso TX
and Las Cruces NM attended the performance.

Results

Before and after the play, pre-and-post evaluation forms were distributed to the audience to
assess the audience's knowledge gained through the play. Based on the final report, the post
evaluation forms show an overall increase on pesticides safety awareness knowledge. This
project reached an audience of approximately 1,000 people including migrant students and
teachers.

New Pesticides Rule Proposed

Reaching far beyond the US/Mexico Border area, EPA issued a proposal to revise the
Certification of Pesticide Applicators rule on August 5, 2015. The proposed rule
strengthens training and certification standards for pesticide applicators who are certified
to apply the riskiest pesticides, known as restricted use pesticides (RUPs). Federal
regulations require applicators to be certified in order to apply RUPs. Additionally, RUPs
may be used only by, or under the direct supervision of, certified applicators. The proposed
rule also establishes a first time-ever nation-wide minimum age of 18 for certified
applicators and persons working under their direct supervision. The goal is to reduce the
likelihood of harm from the misapplication of RUPs and ensure a consistent level of
protection among states. EPA is accepting comments on the revised rule until November
23, 2015. For more information, visit the website, http://www2.epa.gov/pesticide-worker-
safety/epa-proposes-stronger-standards-people-applying-riskiest-pesticides

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Chi dren's Health Month

Throughout October, EPA places special emphasis on children's environmental health
issues. EPA staff participa ted in several outreach events to recognize Children's Health
Month in FY14, Region 6 has an ongoing partnership with the Perot Museum of Nature
and Science which resulted in three key events in FY 15.

EPA partnered with the City of Dallas to promote

Children's Health Month by distributing children's health posters at Green Feston the
Bridge. The family event day on the Continental Avenue Pedestrian bridge showcased
informational booths on conservation, recycling, sustainability, and healthy lifestyles.

During Lead Poisoning Prevention Week, also in October, Region 6 distributed 11,000 lead
planners to raise awareness about the Renovation, Repair, and Painting Rule and childhood
lead poisoning. In addition to the planners, CEH materials were sent to Arkansas and
Border communities to support their outreach efforts.

Dallas, Children's Health presentations were made at Habitat for Humanity, the Health and
Wellness Alliance for Children, and the West Dallas Coalition meeting.

The Children's Health Coordinator published a blog for the EPA website on Healthy Homes
and Environmental Justice and it was picked up by the online Internally, a memo was sent to
employees encouraging them to take the voluntary children's health training, and the
Children's Health Coordinator represented Region 6 at children's health strategy meetings
in Washington, DC, and the Children's Environmental Health Symposium in Central Texas.

EPA staffed a booth during Perot's, Teachers Open House on the evening of October
3rd, sharing information on SunWise, Clean, Green, and Healthy Schools, and
environmental education programs. In addition to speaking to several dozen
teachers, Region 6 received 53 follow up calls for additional information.

Regional Administrator, Ron Curry introduced a live webinar produced on-site in
the museum's Being Human Hall, featuring a
presentation by Dr. Sala Senkayi on childhood
leukemia.

In February, the Region 6 Children's Health and
Special Emphasis programs came together with
the Perot Museum to recognize Black History
Month and Engineers Week. EPA hosted a
fascinating program with special guests, NASA
astronaut Colonel Benjamin Alvin Drew and
Tuskegee Airman Lt. Calvin Spann.

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Healthy Schools

Making schools a safer place for children to learn is an important role for EPA, and several
programs address healthy school environments by providing guidance that schools may
choose to follow. There are numerous tools available for parents, teachers, school nurses,
administrators, facilities personnel and others to be able to make informed choices about
protecting students and staff from potentially dangerous contaminants. For information
about air quality, healthy buildings, transportation issues, chemicals and a comprehensive
set of suggested guidelines for school environmental health, visit the E
http://www2.epa.gov/schools.

Pesticide Safety and Integrated Pest Management in Schools

In 2012, EPA released its Strategic and Implementation Plans for School
Integrated Pest Management for FY12-14. This document, the FY2011
2015 EPA Strategic Plan, and the US EPA Region 6 Pesticides Program
2012-2015 Integrated Pest Management Program Action Plan were are
the foundation for all Region 6 pesticide safety and integrated pest
management (IPM) in schools activities.

Stakeholder and Regional Collaboration

The Region 6 Pesticides Program continued to focus its pesticide safety and IPM in schools
efforts to promote a "wholesale" approach to establishing sustainable and verifiable
programs that mitigate pests and reduce reliance on pesticides. This included serving on
the Southern IPM Center's Advisory Council, and collaborating and consulting the Southern
IPM Center's IPM in Schools working group which represents State Lead Agency, Extension
Services, and industry in the southern States, to include Arkansas, Louisiana, Oklahoma,
and Texas. Region 6 staff drafted an updated version of the US EPA "Pest Control in the
School Environment: Adopting a Pest Management Program" which will be available soon
for use by schools across the nation. Region 6 continued to expand its regional stakeholder
outreach to include representatives and groups from the school health sector to include
school health nurses, state health department school and adolescent health programs,
university public health researchers, and not-for-profit organizations focused on improving
health outcomes for children.

In FY 2015, Region 6 further expanded its Pesticide Safety and School IPM in Indian

Country outreach and consultation capacity by including pesticide safety and IPM in
schools in its cooperative grant with the Eight Northern Indian Pueblo Council (ENIPC).
The ENIPC provides outreach, training, and consultation to 22 Pueblos and Tribes

shools website at

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Healthy Schools

throughout New Mexico. Region 6 representatives participated in three separate
collaboration meetings with the Bureau of Indian Affairs environmental program and
Indian Health Service environmental health regional staffs to promote pesticide safety and
IPM in Tribal schools. Consultative outreach included a review and comment on the school
IPM plan developed by Bernalillo Public Schools, NM, site assessment and technical
assistance to Cochiti Elementaiy/Middle School, Pueblo of Cochiti on rodent mitigation, site
assessment and technical assistance to Haak'u Learning Center, Pueblo of Acoma on prairie
dog mitigation, and electronic consultation to 17 New Mexico school districts who operate
schools in Indian Country on both the New Mexico Administrative Code "Standards for
Excellence in Pest Control" which they must abide and the federal FIFRA certification
requirement for use of restricted use pesticides in Indian Country.

Results

Region 6 conducted 11 outreach and training activities at eight separate venues. A total of
450 district administrators, school nurses, facilities management, stakeholder
state/tribal/federal agency staff, IPM coordinators, pest management professionals,
building and construction professionals, and associated professional organization
members from across the region were trained and consulted at these events:

•	18th Annual Indoor Air Quality Association Meeting, Grapevine, Texas

•	Pesticide Safety and IPM in Schools Workshop, Pueblo of Acoma, New Mexico

•	Southern NM Public Facility Managers Round Table, Las Cruces, New Mexico

•	Ascension Parish Public Schools, School Nurse Annual Training Gonzales, Louisiana

•	Texas A&M Agrilife Extension Annual Statewide IPM Coordinator Conference,

Corpus Christi, Texas

•	19th Annual South Texas Pest and Agricultural Workshop, Corpus Christi, Texas

•	18th Annual Tribal Environmental Summit, Dallas, Texas

•	Region 6 State/Tribal Pre-SFIREG Annual Meeting Dallas, Texas

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Healthy Schools

Food Recovery Challenge

Food sustainability seeks to reduce wasted food and associated environmental impacts for
everyone, especially children. In 2012, the U.S. Department of Agriculture National School
Lunch Program provided nutritionally balanced, low-cost or free lunches to more than 31
million children each school day. Reducing wasted food nationwide, in homes and schools,
can help feed the nation's children. EPA is helping change the way society protects the
environment and conserves resources for future generations. The amount of food
Americans throw away each year is staggering; more than 31 percent of food goes to waste.
In 2013 alone, more than 37 million tons of food waste was generated, with only five
percent diverted from landfills and incinerators for composting. EPA estimates that more
food reaches landfills and incinerators than any other single material in our everyday trash,
constituting 21 percent of discarded municipal solid waste. Additionally, the U.S.
Department of Agriculture (USDA) reports that Americans wasted over one third of the
vegetables and fruit bought in 2010.

Preventing food waste saves resources, reduces greenhouse gas emissions from landfills, as
well as during food production, and it keeps nutrients in the soil. It also saves money. As
part of EPA's Food Recovery Challenge (FRC), organizations pledge to improve their
sustainable food management practices and report their results. Organizations are
encouraged to follow the Food Recovery Hierarchy to prioritize their actions to prevent
and divert wasted food.

In Region 6, staff are providing technical assistance,
working with the City of Dallas to potentially use
schools as a pilot for the program. The Dallas
Independent School District and the Early College High
School Cafeteria at Mountain View College have joined
the FRC, along with Hutton High School who is
planning to perform a food recovery audit in the fall.
Audits have also been performed at four elementary
schools in Arkansas.

Learn more about the sustainable management of food

and EPA's Food Recovery Program at

http://www2.epa.gov/sustainable-management-food

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Healthy Homes

In recent years, EPA's Office of Children's Health Protection has funded training courses
conducted by the National Center for Healthy Housing. Using the train-the-trainer model,
courses are targeted to train those who are responsible for the health and safety of
families—especially children. In FY15, Region 6 was able to train more than 100 people
from a broad spectrum of housing professionals, community health workers, and others in
several cities.

Description of the Course

The two-day Essentials for Healthy Home Practitioners course is designed to provide
attendees with an understanding of the connection between health and housing and how to
take a holistic approach to identify and resolve problems that
threaten the health and well-being of residents. The training
addresses hazard-specific issues such as lead-based paint, radon,
mold, pests, and asbestos. It identifies causes of health problems
such as asthma, lead poisoning, and cancer risks in the
home environment and links them to seven principles of
healthy housing.

Results

The Office of Children's Health Protection supported two
Healthy Homes training courses this summer featuring
partnerships between the Region 6 Children's Health and
Environmental Justice programs, Houston Department of Health and Human Services,
Texas Public Health Training Center, Texas Commission on Environmental Quality, the City
of Brownsville' Public Health Department, and Hidalgo County Health and Human Services
Department. Classes were held August 10-11 in Brownsville, and August 13-14 in Hidalgo
County. During the four days, 46 people received certification from the National Center for
Healthy Housing including code inspectors, registered sanitarians, pest control applicators
and technicians, community health workers, social workers. Continuing education units
were offered for most of these professi ons.

In November 2014, EPA partnered with the Health and Wellness Alliance for Children to
train city code inspectors from Dallas. The goal was to provide inspectors with the tools
they need to provide a healthy living environments for residents of rental properties in
Dallas. OCHP is providing funding for the training that supports the partnership with City
of Dallas and the Health and Wellness Alliance for Children. There were 55 participants
who attended the training.

More than 1,100 people have taken Healthy Homes certification courses in Region 6
in the past four years!

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Healthy Child Care

Background

Children spend up to 40 hours a week in child care centers. Across the nation there has
been an overall failure to protect young children from environmental health hazards in
licensed and unlicensed child care and preschools. As many as twenty-two percent of
children who are in childcare spend the day a home-based child care, while more than
forty-nine percent attend in a child care facility.

Nearly seventeen percent of the population are those who identify as Latino or Hispanic. A
higher percentage of Hispanic children (youth under five) are cared for by parents
compared to other racial and ethnic groups. U.S. Census data from 2010 states that thirty-
five percent of children living in poverty are Hispanic. These children are more likely than
their peers to encounter environmental health hazards in their home and child care
settings.1

Results

The CEHN is working to address children's exposures to these environmental health
hazards by hosting Train-the-Trainer (TtT) sessions to educate and support those
responsible for training and providing technical assistance (child care health/nurse
consultants, licensing staff, CCR&R administrators and trainers) to child care providers.
Two TtT trainings were held in FY15; the first was in Austin (February), and the second
was in Dallas (May), reaching a total of 42 child care professionals.

In addition, the funding under this grant provided for the much-needed cost of translating
sixteen fact sheets into Spanish.

The Office of Children s Health Protection provided
funding for a small grant to provide training to
improve children's health in child care facilities. The
' ^	Children's Environmental Health Network (CEHN)

Child Care" was awarded a small grant to Train-the-Trainers in

Eco Healthy Child Care practices in Dallas and Austin.

1 Statements are from the Children's Enviromnental Health Network's 2014 grant proposal.

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Healthy Child Care

Region 6 focused on a second initiative to train child care
providers with a small grant to the Arkansas Department of
Health (ADH). The ADH has been a partner with EPA on lead
based paint

Arkansas Department of Health

	 Under the grant, ADH hosted a Lunch and Learn series to train

childcare providers, Head Start Directors and school nurses in
Central Arkansas and surrounding counties (Pulaski, Jefferson, Saline, Lonoke, Faulkner,
Grant, and Garland Counties). Each session featured a presentation on indoor
environmental issues, such as asthma triggers and lead-based paint. The goals of the
project were to: 1) increase awareness of the relationship between health and the school
environment, 2) develop children's environmental health and asthma partnerships, and 3)
gain a better understanding of the need for such educational initiatives in childcare centers
across the state.

At the conclusion of the six-month initiative, 29 participants had registered and 25 of
those were fully trained. In addition, ADH collaborated with the Clinton Foundation to
present a community event entitled, Bridge to the Future. An environmental village was
setup that featured information on healthy homes, asthma triggers, lead-based paint and
indoor air quality. More than 500 school age children participated in the event.

On Saturday, August 29, 2015 the Arkansas Department of Health in collaboration with
Pulaski Technical College and the University of Arkansas for Medical Sciences hosted an 8-
hour Healthy Homes Practitioner Course for licensed childcare workers. Two hundred and
fifty-six (256) continuing education hours were awarded at the conclusion of the training
and a total of 32 people completed the training.

Arkansas Department of Health Services is an EPA grantee to implement a state program
pursuant to TSCA 402. The overall goals of the workplan include, maintaining the
appropriate infrastructure to successfully administer and enforce the lead-based paint
program, provide training for lead inspectors, conduct inspections of licensed contractors
engaged in lead-based paint activities, and taking appropriate enforcement when needed.
The overall goal is to prevent children being exposed to lead-based paint in pre-1978
homes, daycares, schools, or otherwise defined child-occupied facility.

Results

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The Health and Wellness Alliance for Children

The Region 6 Children's Health Coordinator has been active
for past three years on the county-wide steering committee
for the Health and Wellness Alliance for Children (HWAC), a
non-profit arm of Children's Health hospital in Dallas, and
has co-chaired the Asthma Healthy Physical Environments
working group for a year and a half.

In addition to providing technical assistance to HWAC, the Children's Health Program
sponsored a technical assistance workshop at City Hall last September. There were more
than 40 participants including the Director of the City of Dallas 311 program, city
attorneys, code inspectors, and social workers, respiratory therapists, and registered
nurses from Children's Medical Center. City and Hospital staff spent the day mapping their
respective responsibilities and engaging with each other on where they could connect to
provide safer, healthier environments for kids.

Gina McCarthy Visits Children's Health

In April, EPA Administrator, Gina McCarthy and Region 6 Administrator, Ron Curry visited
Children's Health to see in person, the work they are doing to address pediatric asthma in
Dallas County. They toured the emergency department where some of Dallas' 60,000 kids
with asthma are treated, and met with HWAC staff to learn more about the work they are
doing to address children's health.

M HEALTH & WELLNESS

By p ALLIANCE

¦ FOR CHILDREN

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The Health and Wellness Alliance for Children

Results

The technical training with the City of Dallas kicked off a three-part series, which was
followed by two other training events in FY15 for Dallas code inspectors and city attorneys.
Those two events resulted in an additional 105 city employees trained to protect
children from the environmental risks of household exposures such as lead based paint,
asthma triggers such as mold and pests, and second hand smoke.

The training highlights just one aspect of the partnership between EPA, the HWAC, and the
City of Dallas. The groundwork laid over the past few years has resulted in sustainable
results with city code inspectors and attorneys gaining new knowledge about asthma
triggers—it has helped make the link between children's health and housing.

The HWAC is continuing with additional initiatives such as advocating to update the
Dallas housing code to reflect best practices based on the National Center for Healthy
Housing.

The HWAC has also launched My Asthma Pal, a new app that can be downloaded to help
improve access to basic asthma education. It also helps users manage their asthma
wherever they are. The new app was launched in September. Some of the features include
asthma tips from top medical resources and allow users to:

•	Track asthma medication use and set reminders

•	Share your Asthma Action Plan and Asthma Control Test (ACT) scores with your

•	Manage your asthma symptoms over time and track improvement

For more information on the asthma app, visit www.mvasthmapal.com

For more information on the Health and Wellness Alliance for Children and their ongoing
work on asthma and other chronic childhood illness, visit their website at
http://www.healthandwellnessalliance.com/

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Internal Coordination

The Children's Health program at EPA is driven by Executive Order 13045 - Protection of
Children from Environmental Health Risks and Safety Risks. The Office of Children's Health
Protection, which is located within the Office of the Administrator, has the fundamental goal to
ensure that all EPA actions and programs address the unique vulnerabilities of children. Children
may be more vulnerable to environmental exposures than adults because their bodily systems are
still developing; they eat more, drink more, and breathe more in proportion to their body size;
and their behavior can expose them more to chemicals and organisms. Read the Executive Order
at http://www.gpo.gov/fdsvs/pkg/FR-1997-04-23/pdf/97-10695.pdf

It is therefore essential to ensure that CEH is incorporated in Regional actions. This year,
EPA released the first Strategy for Protecting Children's Environmental Health FY 2015-
2018. In addition to the new task of tracking children's health measures across the

Region, the Children's Health Coordinator continues to work with other program leads
from across the Region. Highlights of efforts include:

•	Coordinate with Regional Science Council and invite a featured speaker to present
on children's health topics during Children's Health Month.

•	Coordinate with External Affairs on press releases, social media posts and internal
articles for staff highlighting CEH initiatives.

•	Coordinate with Tribal Affairs and Environmental Justice to provide talking points
on Tribal calls, and provide program details to stakeholder on the CEH program.

•	Attend periodic meetings and make recommendations to the Enforcement team
who is working on potential Supplemental Environmental Projects (in lieu of
penalties for violations) that may benefit children's health.

•	Coordinate with Superfund and Emergency Response lead for Local Emergency
Planning Committee bulletins for children's health month.

•	Attend periodic meetings with the Lead and Indoor Environments Coordinators to
coordinate on funding options, outreach, and other program priorities.

Indoor Air Quality

In Region 6, the Indoor Air Coordinator manages grants that address the asthma epidemic
and coordinates outreach events focused on managing environmental asthma triggers. In
FY14-15 grants totaling about $60,000 were made to the following organizations:

•	The University of Texas Health Science Center at San Antonio to establish summer
camps to education children diagnosed with asthma about managing their
environments to avoid asthma triggers.

•	Arkansas Department of Health to educate child care providers on indoor
environmental issues such as asthma triggers and lead based paint and to conduct a
community health fair. (Details on page 9)

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Internal Coordination

• Children's Environmental Health Network to fund a Train-the-Trainers program
educating supervisors with the Eco-Healthy Child Care program. (Details on page 8)

Lead Based Paint

EPA's lead based paint program works to prevent childhood exposure to lead, which can
affect almost every organ and system in the human body. Children are especially at risk for
exposure and even low levels can cause behavior and learning problems, lower IQ and
hyperactivity, slowed growth, hearing problems, and anemia. In rare cases, ingestion of
lead can cause seizures, coma and even death. Pregnant women are also at risk. Lead can
cross the placental barrier exposing the fetus. This can result in serious effects to the
mother and developing fetus, including reduced growth of the fetus and premature birth.

EPA makes grants available to states to implement an enforcement program pursuant to
Section 402 of the Toxic Substances Control Act. Under the grants program, states
administer a program to train lead inspectors, conduct inspections of licensed contractors,
and take appropriate enforcement actions. They may also manage a lead certification and
accreditation program under the Repair, Renovate, and Painting Rule. Region 6 currently
has four grants totaling over $1,000,000 to Texas, Oklahoma, Arkansas, and the Cherokee
Nation.

Lead Program Circuit Rider

Making a connection on children's health protection in smaller communities can be
challenging. To address this challenge, Region 6 hired a Senior Environmental Employee
(SEE) to travel around the Region and meet one-on-one with county health and
environmental officials, and to visit with professionals at hospitals, libraries, schools, and
with the general public at local health fairs. This Circuit Rider Initiative is unique in its
approach to reaching out to rural communities about protecting children from
environmental health risks. From these efforts, EPA is making an impact where we might
not otherwise have had any connection.

This year, the Circuit Rider traveled to more than 110 communities. Within those
communities, the SEE visited 82 city/county health or environmental offices, 49 schools
and libraries, 6 clinics, hospitals or health care professionals, and provided information at 6
health fairs or community events. The results of these one-on-one visits and appearances at
community events have raised awareness about children's environmental health to
thousands of people in rural communities in four states.

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Environmental Education

The Children's Health Program works closely with the Environmental Education Program
to get the message out to students about how the environment impacts kid's health.

Student Curriculum

EPA's Office of Children's Health Protection recently released
a student curriculum geared toward ages 9-13. It can be used
not only in the class room, but in extracurricular and after-
school groups. The curriculum teaches students the definition
of environmental health, how to protect themselves and how to
become champions for children's health protection. Lesson plans
are organized around cards that provide actions for teaching: Ask, Do and
Explain with hands-on activities and visual cards.

President's Environmental Youth Award: Fighting Arsenic

In July, EPA announced that eight middle school children from Whiteface, Texas won the
President's Environmental Youth Award (PEYA) for their work to fight arsenic, a naturally
occurring metal and a known carcinogen that can affect children's intellectual function,
among other potential health impacts. The six and seventh graders won the award for their
three year-long campaign to eliminate their catchphrase, Arsenic-It's What's for Dinner.
Groundwater contaminated by arsenic is the main source of drinking water in their
community, Cochran County, Texas. The students led a community research project to
decrease contamination and human exposure to arsenic by conducting field research,
interviews and tested drinking water, wetlands, native plants, and soil in their community.
They discovered that sand drop seed grass is an effective tool in removing arsenic from the
soil and that water drawn from the hot side of the tap had lower levels of arsenic than
water from the cold side. The project led to a reduction in both county and state arsenic
levels. Learn more about the PEYA awards at: www.epa.gov/peya.

EPA's partnership with the Perot Museum of Nature and Science resulted in several events
in FY15, which are described on page 6 highlighting activities during Children's Health
Month. Last year, EPA hosted a SunWise workshop for teachers, and followed up this year
by staffing a booth, during their Teacher's open house. EPA provided information on
SunWise, Clean, Green, and Healthy Schools, and other environmental education programs.
In addition to speaking to several dozen teachers, Regional Environmental Education
Coordinator, Bonita King stated that the following week EPA received 53 follow up calls
for additional information, "That one night has resulted in a multitude of outreach to
educators who are interested in utilizing environmental and nature learning in their
classrooms."

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Webcasts, Social Media, etc.

Face Book and Twitter

This year children's health messages were the focus of numerous Face Book and Twitter
postings. Messages were posted once a month to correspond with children's health events
and during special emphasis months such as Asthma and Allergy Awareness Month,
Children's Health Month, Lead Poisoning Prevention Week, Engineer's Week, Children's
Health Symposium among others. The Children's Health Coordinator was also featured on
Region 6's Face Book page during Women in Science/Women's History Month.

Providing Technical Expertise

Researchers at the Center for Health Policy at Brookings, interviewed the Region 6
Children's Health Coordinator to gain a better understanding of EPA's role with asthma
education and to learn about the resources that are going into community based programs. The
paper, A Case Study in Payment Reform to Support Optimal Pediatric Asthma Care was
published in the spring of 2015 and can be read online.

http://www.brookings.edu/research/papers/2015/04/27-case-studv-pediatric-asthma-farmer
Healthy Homes Blog

The Office of Environmental Justice and Tribal Affairs requested that the Children's Health
Coordinator write a Blog on the successful Healthy Homes training that was hosted by the
Southern Area Health Education Center at New Mexico State University. The blog was
published on EPA's website and re-posted by several online publications including UC
Davis Center for Regional Change, Indian Country Today, and The Center for Health,
Environment, and Justice.

In collaboration with NASA, Region 6 scientist, Dr. Sala
Senkayi and the Director of the Office of Children's
Health Protection, Dr. Ruth Etzel participated on a
panel discussion on climate change impacts on
children's health. They presented during a live
broadcast hosted by NASA at the Goddard Space Center
in Maryland. The panel broadcast was part of EPA's
Earth Day events in April of 2015.

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