There’s been little progress three years after Cleveland’s lead safe ordinance was passed. What will it take to move the needle?

Peeling paint can be seen on homes located in Fairfax, just south of Cleveland Clinic main campus. (Photo by Lee Chilcote)

One of the biggest objections landlords have to Cleveland’s lead safe ordinance is that it is too expensive, according to Rob Fischer. Fischer, an associate professor at the Mandel School of Applied Social Sciences at Case Western Reserve University, is involved in both auditing the city of Cleveland’s progress on lead safety and publishing research about it. To bridge this gap, lead safe advocates are offering incentives such as low-interest loans and grants — but right now, few landlords are taking advantage of them, and progress on the lead safety initiative has been slow.

Cleveland passed a lead safe ordinance in 2019 that would ensure a housing-centered solution to lead. According to the Cleveland Clinic, which pledged $52.5 million toward the Lead Safe Cleveland initiative, Cleveland is at the center of the lead crisis. Lead poisoning rates are nearly four times the national average and children are at greatest risk from exposure. Lead damages the brain and nervous system, impedes growth and development, and causes learning and behavioral problems.

The injury caused by lead can be difficult to see, according to the Cleveland Clinic. Lead poisoning in a developing child may not appear immediately, may develop over time, or may be mistaken for something else.

But scholars looking at the big picture show the harm to be devastating. For instance, a recent study in Lancet Planetary Health attends to the great global cost of lead poisoning beyond childhood, estimating that 5.5 million adults globally died from cardiovascular disease caused by lead. By connecting this to other forms of lead harm in the form of IQ loss and premature mortality, the study estimates $6 trillion as the global cost of lead exposure in 2019.

Rob Fischer recently co-authored an article in Health & Place showing a similar dynamic at play locally. The study not only shows the negative impact lead exposure has on developmental, behavioral, and socio-economic outcomes, but also points to how these downstream effects appear as societal costs: more neuropsychiatric disorders and higher incarceration rates; less tax contributions. It is very expensive to not be lead safe.

A graphic from “Making the case for lead safe housing: Downstream effects of lead exposure on outcomes for children and youth,” an article Rob Fischer co-authored for Health & Place, shows how lead exposure as children can lead to unfavorable outcomes as adults.

What people are missing is that the bigger social costs of not fixing the problem outweigh the up-front costs, Fischer told The Land. “Tracking [lead poisoned] Cleveland kids, you see them involved in every negative civic way later in life: public assistance, homeless services, juvenile court, adult court,” he said. “We’re gonna pay for this. Wouldn’t we be better off if we frontloaded the expense and saved a lot of grief down the line?”

Cleveland faces a health crisis with a housing solution. Making housing lead-safe through painting, and other renovations, is called primary prevention. Secondary prevention, the model Cleveland has used for decades – when science about the dangers of lead exposure was less certain, requires children to be exposed to lead before action is taken. Prevention through safe-housing is the only way to solve the problem because there is no after-the-fact cure.

Despite the crisis, gains have been slow. There are approximately 54,000 properties (that make up 103,000 rental units) in the Cleveland rental universe. The Lead Safe Auditor estimates that to get on track for reaching full compliance by the city’s goal of 2028, 10,000 properties need to be certified during 2023. In the first six months of 2023, there have been only 1,153 applications. Not only is the trend for certification not living up to expectations, it’s going in the wrong direction. In the Lead Safe auditor’s report, one of the important findings was that “Lead safe applications declined 24% in 2nd Quarter 2023 to 490, continuing a concerning four-quarter decline (down from 1,000 per quarter in mid 2022).” These numbers are drawn from the same source data as the Lead Safe Dashboard and can be viewed here.

Lead safe applications for landlords and property owners have fallen 24% in Q2 of 2023, part of a concerning trend. (Graphic from the Lead Safe Dashboard)

Fischer admits the problem but says that Cleveland’s compliance rate is similar to Rochester, New York, which 16 years after passing a lead safe ordinance has achieved 85% compliance with exterior inspections and 95% compliance with interior inspections, according to a recent report. “As we sit here two years after implementing a new civic ordinance, we saw really good early compliance, but now we’ve plateaued a little bit,” he said. “I think the problem is that they (Rochester) never made it to 100% compliance. We have to really be ahead of them to achieve our goals.”

All of this suggests that Cleveland is not where it needs to be — and that the partners and the city are aware of the problem and working to fix it. Unfortunately, there are no easy solutions because the solution involves coordinating disparate partners in a bureaucracy.

“Every day that we don’t get it right, there’s a child at risk of being lead poisoned,” Ayonna Blue Donald, vice president of the Ohio market for Enterprise Community Partners, one of the groups that’s managing the Lead Safe Cleveland Coalition, told The Land. Donald knows Lead Safe Cleveland has not reached its goals, but doesn’t regret aiming high: “Yes, it is true: at times we did set our goals too lofty. But… it is an emergency. This is an emergency to address for our kids.”

Property owners have millions in funding available to them

It has been more than two and half years since Mark McDermott of Enterprise Community Partners spoke optimistically of $80 million in grants and loans available for landlords. “Those resources are open for business,” he said during a City Club of Cleveland forum in April of 2021. “Landlords can right now access the funding that they need. We realize that for lower income mom-and-pop landlords it could well be a challenge,” he said. “We are pretty confident that any landlords who need resources to make their property lead safe, those resources are there. They’re equitable. They’re available, easy to use.”

Of the $80 million in loans and grants mentioned by McDermott, $2.7 million has gone to landlords, according to Enterprise Community Partners. Even more striking, is that the dashboard shows only about 800 applications.

The city of Cleveland’s lead safe law requires residential rental units built before 1978 to get a Lead Safe Certification. To obtain a certification, rental property owners must pass a Lead Clearance conducted by an independent, certified lead safe worker, according to Lead Safe Cleveland. A clearance examination costs $250–500 per unit. If lead is found, getting a property lead safe certified could cost $500–5,000 for interim controls lasting two years, or more for completing a full lead abatement.

Ayonna Blue Donald, Vice President and Market Lead for Enterprise Community Partners, stated that the Lead Safe Cleveland Fund’s approach is unique because private funders raised money to support a city initiative, including the Cleveland Clinic with a $52.5 million investment.

She also says there are a range of reasons why people are not using the money, including trust: “If somebody knocks on your door and says: ‘I have free money for you,’ people will think, ‘Yeah, right,’” said Donald. As a result, new efforts include looping in trusted nonprofit groups such as community development corporations who are more familiar with property owners.

Still, there is a striking disconnect between landlords who say primary prevention is too expensive and the tens of millions of dollars that are not being used. The sense of urgency that one might expect from a health crisis has not made it into the demand for funds, perhaps because the problem has been around so long people have become complacent, landlords lack funds to complete repairs, or they believe the city lacks the enforcement mechanisms to make them comply.

According to materials circulated by Ward 12 Cleveland City Council member Rebecca Maurer, the Lead Safe Home Fund disbursed $6.5 million through the second year. The Lead Safe Home Fund 2.0 now constitutes $111.3 million in funds raised, with $115.1 million projected budget. In addition to loans and grants for landlords, this overarching fund includes programming for training lead safe workers, education, outreach, marketing, lead safe child care, relocation assistance, and Lead Safe Home Fund administrators.

Cleveland’s lead safe approach is uniquely transparent

If private funding is one of the distinguishing features of Cleveland’s lead-safe approach that sets it apart from other cities, transparency is another one.

The main method of transparency is CWRU’s Lead Dashboard. Michael Henderson, a researcher at the Mandel School, sees the city’s willingness to be transparent through the dashboard as “commendable.” In effect, even if the news is not good, it is good that the public has access to the news. In this process, the city is willing to show where it is making progress and where it is faltering, potentially because leaders are aware that moving an entire rental universe towards being lead safe means the public must hold them accountable. The dashboard reports not only on compliance with making properties lead safe, but also on lead testing rates, elevated lead levels in children aged 1–5, and how lead poisoning breaks down by neighborhood and race.

The dashboard includes a tracker of childhood lead exposure. The auditor’s report states that if the coalition is successful, “a decrease in the childhood lead exposure rate in Cleveland will be evident in time. However, in the short term, with a focus on increased screening and testing, the number of children testing positive for lead will likely increase from baseline as more cases are identified.”

Presenters, members of CLASH (including Yvonka Hall, front row, third from right) and members of the Northeast Ohio Black Health Coalition at the Faith and Leaders Lead Poisoning Awareness Luncheon, part of Lead Poisoning Prevention Week. (Photo by Loretta Gray)

How can landlords be motivated to comply?

“No child should ever be lead poisoned” states the opening portal to the Lead Safe Cleveland database. At a Lead Poisoning Prevention Week event in October,  Yvonka Hall, the president of Cleveland Lead Advocates for Safe Housing (CLASH) — a grassroots organization that pushed for the law and is committed to making Cleveland lead safe — stated that given the numerous studies showing the impact of lead poisoning on aggression and negative behaviors, working to prevent lead is urgent because it means working to prevent crime and incarceration: “Before we start criminalizing young people and throwing away the key on them to their lives…we need to start addressing everything we can to keep them from being poisoned in the first place,” she said.

Yet the disconnect with regard to lead safety in Cleveland is the gap between the language of crisis and the ambivalence of many actors. For example, one of the primary conclusions of the lead auditor’s report was that renewals “are not being sought by the majority of previously certified properties (81%), suggesting owner ambivalence to continued compliance.”

Since early in the roll-out, landlords have voiced a range of concerns about the law: lead-safe certification is too expensive and the cost will be passed to tenants; how do we know old properties are dangerous; there is no penalty for non-compliance; the process is slow and unnecessarily bureaucratic; it is hard to clean an apartment while people live there; the larger environment is contaminated with lead, causing the home itself to fail the inspections.

Beyond these voices from the known world of landlords, there is another set of concerns: the Lead Safe Auditor Report notes “38,000 properties had characteristics that suggested that they were being operated as rentals, even though they were not on the City’s rental registry.” Most applications for compliance thus far have come from properties on the rental registry, but there has been “minimal compliance among properties that had not previously complied with the rental registration requirement.” The problem of motivating landlords includes motivating people who are not registered as landlords. Noncompliant properties, notes the Lead Safe Auditor Report, “are likely a very difficult-to-reach population of owners or responsible parties.”

Rob Fischer, associate professor at the Mandel School of Applied Social Sciences at Case Western Reserve University. (Photo courtesy of CWRU)

One of the big problems with compliance is that small landlords are still fearful of government intervention, don’t want to spend money, and don’t trust the city or the program, Fischer said. Up until this point, there has been higher compliance among properties and property owners with big numbers of units. While 13% of properties show compliance, this accounts for 28% of rental units, suggesting that big landlords are complying at a much faster rate than small landlords. That, for Fischer, is a flag that points to the necessity of finding the right mix of carrots and sticks for small operators. Eighty percent of landlords in the city are “mom and pop” operators.

According to the Lead Safe Cleveland auditor’s report, “Properties with more than ten units show the highest rates of compliance (47%)  followed by properties with 6–10 units (35%). Doubles show the lowest compliance rates (10%), followed by 3–5 units (12%).”

“We want all property owners to be good actors,” Fischer said. “For most of them, [it’s] ‘I don’t want to be hassled by the city, I want to have a clean record.’ The hard part is we are asking them not only to submit some paperwork to the city, but asking them to interact with private markets of inspectors and potentially those who do repair work.”

He stated that the process of obtaining funding isn’t always as clear as it could be and some of the money has strings attached. The process can involve delays and frustration for the property owners. “We’ve got to streamline it,” he said.

The auditor’s report suggests that Building & Housing “is well advised to execute a dual approach of engaging and supporting landlords in the application process, along with holding accountable those who have failed to achieve compliance.”

Ayonna Blue Donald states that the Lead Safe Coalition wants to work with landlords, even those who are naysayers to the entire process: “We have a unique opportunity here to influence with carrots and to support landlords. That’s why we’re very willing to listen and shift things.”

A large amount of money has been raised and prevention is urgent. But demand for the money has been low. Money is not the same as a functional system, or a shared vision about the collective benefits of creating a healthy city.

Cleveland Clinic president and CEO, Dr. Tom Mihaljevic, states on the Cleveland Clinic website, “This is not about saving money.” He added, “This is about saving children and saving communities. Lead exposure can cause children serious long-term harm that impacts the rest of their lives. It prevents them from reaching their full potential.”

The surgeon Atul Gawande once stated that “We want the best drugs, the best technologies, the best specialists, but we don’t think too much about how it all comes together … Making systems work is the great task of my generation of physicians and scientists.”

There is a health crisis in Cleveland that is a systems problem. The best drugs can do little for it. The best technologies have little impact. It is not about money, except when it is. It is not working, many say.

To Spencer Wells, an activist with CLASH, “We’re almost at Emperor’s new clothes time.” Wells, a key figure in the petition drive to make lead safety an issue that is taken seriously by the city before the ordinance was passed in 2019, is unimpressed at what powerful entities have done in Cleveland: “I think it’s fair to say that the strategy of getting landlords to voluntarily comply with the Lead Safe Certificate law is on the edge of collapse… the danger is that the elite will walk away from the challenge.” He believes there is a path forward if compliance is taken seriously: “When people realize there’s a penalty for non-compliance, they will comply.”

For more information on how to protect your family from lead poisoning, to get Lead Safe Certification or funding for your home or property, or to find lead safe workers, visit Lead Safe Cleveland Coalition online or call their hotline at 833-601-LEAD (5323).

Actual story can be found at https://thelandcle.org/stories/theres-been-little-progress-three-years-after-clevelands-lead-safe-ordinance-was-passed-what-will-it-take-to-move-the-needle/