U.S. GOVERNMENT PUBLISHING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Publishing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001

20–534 PDF 2017

FLINT WATER CRISIS: IMPACTS AND LESSONS 

LEARNED 

JOINT HEARING 

BEFORE THE

SUBCOMMITTEE ON ENVIRONMENT AND THE 

ECONOMY 

AND THE

SUBCOMMITTEE ON HEALTH 

OF THE

COMMITTEE ON ENERGY AND 

COMMERCE 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED FOURTEENTH CONGRESS 

SECOND SESSION 

APRIL 13, 2016 

Serial No. 114–131 

( 

Printed for the use of the Committee on Energy and Commerce 

energycommerce.house.gov 

COMMITTEE ON ENERGY AND COMMERCE 

FRED UPTON, Michigan 

Chairman 

JOE BARTON, Texas 

Chairman Emeritus 

ED WHITFIELD, Kentucky 

JOHN SHIMKUS, Illinois 

JOSEPH R. PITTS, Pennsylvania 

GREG WALDEN, Oregon 

TIM MURPHY, Pennsylvania 

MICHAEL C. BURGESS, Texas 

MARSHA BLACKBURN, Tennessee 

Vice Chairman 

STEVE SCALISE, Louisiana 

ROBERT E. LATTA, Ohio 

CATHY MCMORRIS RODGERS, Washington 

GREGG HARPER, Mississippi 

LEONARD LANCE, New Jersey 

BRETT GUTHRIE, Kentucky 

PETE OLSON, Texas 

DAVID B. MCKINLEY, West Virginia 

MIKE POMPEO, Kansas 

ADAM KINZINGER, Illinois 

H. MORGAN GRIFFITH, Virginia 

GUS M. BILIRAKIS, Florida 

BILL JOHNSON, Ohio 

BILLY LONG, Missouri 

RENEE L. ELLMERS, North Carolina 

LARRY BUCSHON, Indiana 

BILL FLORES, Texas 

SUSAN W. BROOKS, Indiana 

MARKWAYNE MULLIN, Oklahoma 

RICHARD HUDSON, North Carolina 

CHRIS COLLINS, New York 

KEVIN CRAMER, North Dakota 

FRANK PALLONE, JR., New Jersey 

Ranking Member 

BOBBY L. RUSH, Illinois 

ANNA G. ESHOO, California 

ELIOT L. ENGEL, New York 

GENE GREEN, Texas 

DIANA DEGETTE, Colorado 

LOIS CAPPS, California 

MICHAEL F. DOYLE, Pennsylvania 

JANICE D. SCHAKOWSKY, Illinois 

G.K. BUTTERFIELD, North Carolina 

DORIS O. MATSUI, California 

KATHY CASTOR, Florida 

JOHN P. SARBANES, Maryland 

JERRY MCNERNEY, California 

PETER WELCH, Vermont 

BEN RAY LUJA ́ N, New Mexico 

PAUL TONKO, New York 

JOHN A. YARMUTH, Kentucky 

YVETTE D. CLARKE, New York 

DAVID LOEBSACK, Iowa 

KURT SCHRADER, Oregon 

JOSEPH P. KENNEDY, III, Massachusetts 

TONY CA ́ RDENAS, California 

(II) 

(III) 

SUBCOMMITTEE ON ENVIRONMENT AND THE ECONOMY

JOHN SHIMKUS, Illinois 

Chairman 

GREGG HARPER, Mississippi 

Vice Chairman 

ED WHITFIELD, Kentucky 

JOSEPH R. PITTS, Pennsylvania 

TIM MURPHY, Pennsylvania 

ROBERT E. LATTA, Ohio 

DAVID B. MCKINLEY, West Virginia 

BILL JOHNSON, Ohio 

LARRY BUCSHON, Indiana 

BILL FLORES, Texas 

RICHARD HUDSON, North Carolina 

KEVIN CRAMER, North Dakota 

FRED UPTON, Michigan (ex officio) 

PAUL TONKO, New York 

Ranking Member 

KURT SCHRADER, Oregon 

GENE GREEN, Texas 

DIANA DEGETTE, Colorado 

LOIS CAPPS, California 

MICHAEL F. DOYLE, Pennsylvania 

JERRY MCNERNEY, California 

TONY CA ́ RDENAS, California 

FRANK PALLONE, JR., New Jersey (ex 

officio) 

SUBCOMMITTEE ON HEALTH

JOSEPH R. PITTS, Pennsylvania 

Chairman 

BRETT GUTHRIE, Kentucky 

Vice Chairman 

ED WHITFIELD, Kentucky 

JOHN SHIMKUS, Illinois 

TIM MURPHY, Pennsylvania 

MICHAEL C. BURGESS, Texas 

MARSHA BLACKBURN, Tennessee 

CATHY MCMORRIS RODGERS, Washington 

LEONARD LANCE, New Jersey 

H. MORGAN GRIFFITH, Virginia 

GUS M. BILIRAKIS, Florida 

BILLY LONG, Missouri 

RENEE L. ELLMERS, North Carolina 

LARRY BUCSHON, Indiana 

SUSAN W. BROOKS, Indiana 

CHRIS COLLINS, New York 

JOE BARTON, Texas 

FRED UPTON, Michigan (ex officio) 

GENE GREEN, Texas 

Ranking Member 

ELIOT L. ENGEL, New York 

LOIS CAPPS, California 

JANICE D. SCHAKOWSKY, Illinois 

G.K. BUTTERFIELD, North Carolina 

KATHY CASTOR, Florida 

JOHN P. SARBANES, Maryland 

DORIS O. MATSUI, California 

BEN RAY LUJA ́ N, New Mexico 

KURT SCHRADER, Oregon 

JOSEPH P. KENNEDY, III, Massachusetts 

TONY CA ́ RDENAS, California 

FRANK PALLONE, JR., New Jersey (ex 

officio) 

(V) 

C O N T E N T S 

Page 

Hon. Joseph R. Pitts, a Representative in Congress from the Commonwealth 

of Pennsylvania, opening statement ................................................................... 2 

Prepared statement .......................................................................................... 3 

Hon. Gene Green, a Representative in Congress from the State of Texas, 

opening statement ................................................................................................ 3 

Hon. Fred Upton, a Representative in Congress from the State of Michigan, 

opening statement ................................................................................................ 5 

Prepared statement .......................................................................................... 7 

Hon. Frank Pallone, Jr., a Representative in Congress from the State of 

New Jersey, opening statement .......................................................................... 8 

Prepared statement .......................................................................................... 9 

Hon. Paul Tonko, a Representative in Congress from the State of New York, 

opening statement ................................................................................................ 11 

Hon. John Shimkus, a Representative in Congress from the State of Illinois, 

opening statement ................................................................................................ 13 

Prepared statement .......................................................................................... 13 

WITNESSES

Joel Beauvais, Deputy Assistant Administrator, Office of Water, Environmental Protection Agency .................................................................................... 14 

Prepared statement .......................................................................................... 17 

Answers to submitted questions 1 ................................................................... 181 

Nicole Lurie, M.D., Assistant Secretary for Preparedness and Response, Department of Health and Human Services .......................................................... 19 

Prepared statement .......................................................................................... 21 

Answers to submitted questions 1 ................................................................... 182 

Nick Lyon, Director, Michigan Department of Health and Human Services ..... 33 

Prepared statement .......................................................................................... 36 

Answers to submitted questions ...................................................................... 183 

Keith Creagh, Director, Michigan Department of Environmental Quality ........ 40 

Prepared statement 2 ........................................................................................ 42 

Answers to submitted questions ...................................................................... 201 

Mona Hanna-Attisha, M.D., Assistant Professor of Pediatrics, Michigan State 

University College of Human Medicine, and Director, Pediatric Residency 

Program, Hurley Children’s Hospital ................................................................. 80 

Prepared statement .......................................................................................... 83 

Answers to submitted questions 1 ................................................................... 206 

Joan C. Alker, Executive Director, Georgetown University Center for Children 

and Families ......................................................................................................... 87 

Prepared statement .......................................................................................... 89 

Stephen Estes-Smargiassi, Director of Planning and Sustainability, Massachusetts Water Resources Authority, on Behalf of the American Water 

Works Association ................................................................................................ 95 

Prepared statement .......................................................................................... 97 

Answers to submitted questions ...................................................................... 207 

June Swallow, Administrator, Rhode Island Drinking Water Program, Rhode 

Island Department of Health, and President, Association of State Drinking 

Water Administrators .......................................................................................... 112 

Prepared statement .......................................................................................... 114 

Answers to submitted questions ...................................................................... 214 

1Witness did not answer submitted questions for the record by the time of printing. 

2 Additional material submitted for the record has been retained in committee files and 

also is available at http://docs.house.gov/Committee/Calendar/ByEvent.aspx?EventID=104765. 

Page

VI 

Mae C. Wu, Senior Attorney, Health and Environment Program, Natural 

Resources Defense Council .................................................................................. 117 

Prepared statement .......................................................................................... 119 

Answers to submitted questions 3 ................................................................... 217 

SUBMITTED MATERIAL

Statement of the American Public Works Association by Brian Usher, President, April 13, 2016, submitted by Mr. Green ................................................... 152 

Letter of April 13, 2016, from Richard Hodges, Director, Ohio Department 

of Health, to Mr. Pallone, submitted by Mr. Green .......................................... 156 

Statement of the American Academy of Pediatrics, April 18, 2016, submitted 

by Mr. Green ........................................................................................................ 159 

Resolution of the National Medical Association, ‘‘Lead Contamination in Flint 

Water: Negligence,’’ adopted March 6, 2016, submitted by Mr. Green ........... 176 

Article of April 12, 2016, ‘‘Virginia Tech water study team faces financial 

struggles,’’ by Robby Korth, The Roanoke Times, submitted by Mr. Griffith . 179 

3Witness did not answer submitted questions for the record by the time 

of printing. 

(1) 

FLINT WATER CRISIS: IMPACTS AND LESSONS 

LEARNED 

WEDNESDAY, APRIL 13, 2016 

HOUSE OF REPRESENTATIVES

SUBCOMMITTEE ON ENVIRONMENT AND THE ECONOMY, JOINT WITH THE

SUBCOMMITTEE ON HEALTH, COMMITTEE ON ENERGY AND COMMERCE, Washington, DC. 

The subcommittees met, pursuant to call, at 10:02 a.m., in room 

2123 Rayburn House Office Building, Hon. Joseph R. Pitts (chairman of the Subcommittee on Health) presiding. 

Members present: Representatives Pitts, Shimkus, Guthrie, Harper, Murphy, Burgess, Latta, Lance, McKinley, Griffith, Bilirakis, 

Johnson, Long, Ellmers, Bucshon, Flores, Brooks, Hudson, Collins, 

Upton (ex officio), Engel, Green, Capps, Doyle, Schakowsky, 

Butterfield, Matsui, Castor, Sarbanes, McNerney, Luja ́n, Tonko, 

Schrader, Kennedy, Ca ́ rdenas, and Pallone (ex officio). 

Also present: Representative Kildee. 

Staff present: Gary Andres, Staff Director; Will Batson, Legislative Clerk; Mike Bloomquist, Deputy Staff Director; Rebecca Card, 

Assistant Press Secretary; Karen Christian, General Counsel; Jerry 

Couri, Senior Environmental Policy Advisor; Theresa Gambo, 

Admin/Human Resources; A.T. Johnston, Senior Policy Advisor; 

David McCarthy, Chief Counsel, Environment and the Economy; 

Tim Pataki, Member Services Director; Graham Pittman, Legislative Clerk; Mark Ratner, Policy Advisor to the Chairman; Tina 

Richards, Counsel, Environment; Michelle Rosenberg, GAO 

Detailee, Health; Chris Santini, Policy Coordinator, Oversight and 

Investigations; Chris Sarley, Policy Coordinator, Environment and 

the Economy; Dan Schneider, Press Secretary; Adrianna Simonelli, 

Legislative Associate; Heidi Stirrup, Policy Coordinator, Health; 

Josh Trent, Deputy Chief Counsel; Dylan Vorbach, Deputy Press 

Secretary; Jeff Carroll, Democratic Staff Director; Jacqueline 

Cohen, Democratic Senior Counsel; Timia Crisp, Democratic AAAS 

Fellow; Kyle Fischer, Democratic Health Fellow; Jean Fruci, Democratic Energy and Environment Policy Advisor; Waverly Gordon, 

Democratic Professional Staff Member; Tiffany Guarascio, Democratic Deputy Staff Director and Chief Health Advisor; Rick 

Kessler, Democratic Senior Advisor and Staff Director for Energy 

and the Environment; Una Lee, Democratic Chief Oversight Counsel; Elizabeth Letter, Democratic Professional Staff Member; Dan 

Miller, Democratic Staff Assistant; Rachel Pryor, Democratic 

Health Policy Advisor; Alexander Ratner, Democratic Policy AnaVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00007 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
2 

lyst; Timothy Robinson, Democratic Chief Counsel; Samantha 

Satchell, Democratic Policy Analyst; Matt Schumacher, Democratic 

Press Assistant; and Andrew Souvall, Democratic Director of Communications, Outreach and Member Services. 

Mr. PITTS. The subcommittee will come to order. This is a joint 

hearing between the Subcommittee on Environment and the Economy and the Subcommittee on Health. The Chair will recognize 

himself for an opening statement. 

OPENING STATEMENT OF HON. JOSEPH R. PITTS, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH 

OF PENNSYLVANIA 

Today’s hearing will provide an opportunity for our two subcommittees to examine the issues related to the ongoing drinking 

water crisis and related public health effects in Flint, Michigan. 

Members of the committee already have a basic understanding of 

the situation that led to the high levels of lead discovered in the 

Flint drinking water system and the focus of today’s hearing will 

be how we can best respond to help affected families in Flint and 

how we can best move forward with solutions to ensure this does 

not happen again. Our witnesses today will be able to provide key 

insights on what efforts both the Federal and State Governments 

are undertaking and I look forward to their testimony. 

According to the Mayo Clinic, lead poisoning, quote, can severely 

affect mental and physical development, end quote, and can even 

be fatal at high lives. From a public health standpoint, we will 

want to better understand how the administration has coordinated 

with the State of Michigan to provide technical assistance to State 

and local health departments, including how they helped with case 

management and interventions with children identified with elevated lead blood levels. 

Addressing the long-term health implications, a potential exposure of children to dangerously high levels of lead is no simple fix. 

Some steps have already been taken to attempt to address the serious public health issues in the community. Just last month, the administration announced an expansion of Head Start and Early 

Head Start in Flint, Michigan with a one-time emergency influx of 

$3.6 million for these programs. Additionally, the Centers for Medicare & Medicaid Services, CMS, approved Michigan’s application to 

establish a 5-year Medicaid demonstration, Flint Michigan Section 

1115 demonstration, in response to the public health emergency of 

lead exposure related to the Flint water system. 

The U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children, WIC, is allowing participants to use WIC vouchers for ready-to-feed infant formula, which does not need to be mixed with water. Participants 

can also swap powdered formula for ready-to-feed formula. WIC 

participants are being referred to the local Health Department for 

lead screenings and provided nutrition education on mitigating 

lead absorption through dietary changes. 

These steps should help expand services available to ensure access to needed medical, social, educational, and other services. We 

are eager to hear of other options that may be employed to alleviate the potential impacts lead can have on health. 

3 

I look forward to our hearing today. I thank all of the witnesses 

on both panels for participating in this important hearing. 

[The prepared statement of Mr. Pitts follows:] 

PREPARED STATEMENT OF HON. JOSEPH R. PITTS

Today’s hearing will provide an opportunity for our two subcommittees to examine 

the issues related to the ongoing drinking water crisis and related public health effects in Flint, Michigan. Members of the committee already have a basic understanding of the situation that led to the high levels of lead discovered in the Flint 

drinking water system. The focus of today’s hearing will be how we can best respond 

to help affected families in Flint, and how we can best move forward with solutions 

to ensure this does not happen again. 

Our witnesses today will be able to provide key insights on what efforts both the 

Federal and State Government is undertaking and I look forward to their testimony. 

According to the Mayo Clinic, lead poisoning ‘‘can severely effect mental and physical development’’ and can even be fatal at high levels. From a public health standpoint, we will want to better understand how the administration has coordinated 

with the State of Michigan to provide technical assistance to State and local health 

departments including how they helped with case management and interventions 

with children identified with elevated blood lead levels. 

Addressing the long-term health implications of potential exposure of children to 

dangerously high levels of lead is no simple fix. Some steps have already been taken 

to attempt to address the serious public health issues in the community. 

Just last month, the administration announced an expansion of Head Start and Early Head Start in Flint, Michigan, with a one-time, emergency influx of $3.6 million for these programs. 

Additionally, the Centers for Medicare & Medicaid Services (CMS) approved 

Michigan’s application to establish a 5-year Medicaid demonstration—‘‘Flint Michigan Section 1115 Demonstration’’—in response to the public health emergency of 

lead exposure related to the Flint water system. 

The U.S. Department of Agriculture’s (USDA) Special Supplemental Nutrition 

Program for Women, Infants, and Children (WIC) is allowing participants to use 

WIC vouchers for ready-to-feed infant formula, which does not need to be mixed 

with water. Participants also can swap powdered formula for ready-to-feed formula. 

WIC participants are being referred to the local health department for lead 

screenings and provided nutrition education on mitigating lead absorption through 

dietary changes. 

These steps should help expand services available to ensure access to needed medical, social, educational and other services. We are eager to hear of other options 

that may be employed to alleviate the potential impacts lead can have on health. 

Mr. PITTS. Anyone on our side seeking time? If not, we will go 

back and recognize the ranking member, Mr. Green, 5 minutes for 

an opening statement. 

OPENING STATEMENT OF HON. GENE GREEN, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS 

Mr. GREEN. Thank you, Mr. Chairman. Good morning and I 

thank all of you for being here for this important hearing. The 

drinking water crisis in Flint, Michigan is a national tragedy. It is 

a preventable, man-made disaster that should have been intervened months before it caught the Nation’s attention. Most tragically are the estimated 8,000 children under the age of 6 who were 

exposed to unsafe levels of lead who may need life-long services to 

live fully productive lives. 

Childhood lead poisoning is a tragedy impacting communities 

throughout our United States. The Centers for Disease Control estimates that approximately 500,000 American children under 6 

have blood lead levels above 5 micrograms, the level recommended 

for public health actions to be initiated. Children from low-income 

communities, communities of color, like those in Flint, and commuVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00009 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
4 

nities I have the honor of representing in Houston and Harris 

County, Texas are two to three times more likely to have elevated 

blood levels based on CDC data. No child in America, regardless of 

background or income should be a victim of lead poisoning. 

The City of Houston has been proactive on this issue. Houston 

is one of the six cities to be part of the CDC Child Lead Poisoning 

Prevention Programs with the ambitious goal of eliminating childhood lead poisoning in the city by 2020. In 2013 alone, over 24 children were screened for lead. And since 1996, nearly 3,000 homes 

have been remediated for lead paint. I support these efforts but 

more must be done to ensure that every child is tested for lead and 

all older homes are lead paint free in Houston and across the Nation. Unfortunately, the CDC program was drastically cut in recent 

years from $30 million in 2011 to $15 million last year. Health and 

Human Services working with Congress must ensure that this and 

other similar programs get the resources they need to protect our 

children from lead exposure. 

The recent study conducted by the American Water Works Association estimates that there are 6.1 million lead service lines utilized nationwide, serving 15 to 22 million Americans. These lead 

service lines are greater concentrated in the mid-west and the 

northeast. LSLs are found in every State. My home State of Texas 

is estimated to have 270,000 lead service lines still in use, the 

eighth highest in the country. If we are going to eliminate lead out 

of our drinking water once and for all, our Nation must commit to 

the comprehensive plan to replace lead service lines. This will necessitate coordination between water utilities, cities, States, and 

EPA with a sizeable commitment of resources from the Federal 

Government to support local communities and low-income households, replacing their lead lines. 

I am proud to join my colleague, Representative Paul Tonko, as 

an original co-sponsor of the AQUA Act, which would reauthorize 

the Safe Drinking Water Act for the first time in 13 years and give 

States greater resources to update our Nation’s aging drinking 

water infrastructure by increasing funding for the State revolving 

fund. 

The Safe Drinking Water Act was passed by Congress 4 decades 

ago, to ensure public drinking water supplies throughout the Nation. It is clear today that our Safe Drinking Water Act failed to 

protect the people of Flint and other communities around the country. As a community of jurisdiction, we need to know why. 

Much of the responsibility for the failure, to my peer’s point, is 

the Lead and Copper Rule. The LCR has not seen major revisions 

in 20 years. I am very interested in hearing what EPA has done 

to modernize the Lead and Copper Rule and what revisions the 

public health and water utility experts before us today believe are 

necessary to ensure that our public water systems are lead-free. 

I hope that today’s hearing will bring frank and truthful discussion on these critical issues in public health and that we find common ground in moving forward to ensure that this terrible tragedy 

never hits another great American city. 

Mr. Chairman, I hope our committee will use our jurisdiction to 

further us and do our best to do. 

5 

And I would be glad to yield the remainder of my time to my colleague from North Carolina, Congressman Butterfield. 

Mr. BUTTERFIELD. Thank you, Mr. Green, and I will talk fast. 

On March 4th, members of the Congressional Black Caucus, the 

Congressional Progressive Caucus, and members of the House 

Democratic Leadership traveled to Flint to see the ongoing environmental disaster. I can only describe the frustration and harm to 

the residents of Flint as gut-wrenching. People have lost hope in 

their Government that have failed them at many levels, none more 

so than at the State level under the management of Governor Snyder. I am disappointed that the Governor is not here today to answer for his role and that of his administration in failing to protect 

the well-being of nearly 100,000 Flint residents. 

I understand that this is a hearing on lessons learned from Flint 

but this is not the first time people have been poisoned by their 

water and it will not be the last until we make real investments 

to fix the root of the problem. 

I represent a poor district in North Carolina, which, unfortunately, is no stranger to lead-poisoned water over the last decade. 

Cities of Durham, Greenville, and rural areas in Wayne County 

have all had unsafe drinking water. Levels of contamination in 

Durham exceeded 800 parts per billion. This is unacceptable, 

whether it is in Durham, Greenville, Wayne County, or in Flint, 

Michigan. 

Too often, Mr. Chairman, these problems incur in vulnerable 

communities and our response is too little, too late. Access to clean 

water should not be a luxury. It should be a guarantee. The tragedy in Flint has highlighted one of the key environmental justice 

issues of this generation and it is time to fix this inequity now. 

I thank the witnesses for coming today. I yield back. 

Mr. PITTS. The Chair thanks the gentleman and now recognizes 

the chair of the full committee, Mr. Upton for 5 minutes for an 

opening statement. 

OPENING STATEMENT OF HON. FRED UPTON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MICHIGAN 

Mr. UPTON. Well, thank you, Mr. Chairman. 

You know the tragic situation in Flint has captured the attention 

of the Nation, that is for sure. And the events that unfolded are 

simply unacceptable. And sadly, there are missteps at all levels of 

Government. What happened to Flint and its residents, especially 

the kids, being poisoned in their own home absolutely breaks your 

heart. 

And long after the media leaves Flint and the dust settles, families, real Michigan families will be grappling with this tragedy for 

decades, most likely, lifetimes. That is why today’s hearing is going 

to take a look forward. 

I have said before and I am going to say it again that I am not 

interested in finger-pointing. There has been much of that done already. The focus needs to be on the folks who are impacted, especially the kids, and what we can do to ensure that this does not 

happen again anywhere. 

We are interested today in examining the underlying causes, various public health implications, and potential solutions moving forVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00011 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
6 

ward. And while we can’t rewind the clock to prevent the colossal 

failure of public trust, actions taken by both the State of Michigan 

and the Federal Government are important steps in the right direction. 

The administration and State have coordinated to disseminate 

public health education, provide case management and interventions for kids with elevated blood levels, and have worked to identify vulnerable populations in Flint who may need further targeted 

outreach. 

The Federal Government should work with the State to ensure 

that proper testing and monitoring is indeed taking place. We 

know that early education is a critical factor in combating the effects of lead exposure. In February, HHS awarded grants of 

$250,000 to two health centers in Flint. These funds are being used 

to hire additional personnel, providing more testing, treatment, 

outreach, and education on the lead exposures. HHS has also announced an expansion of Head Start and Early Head Start in Flint 

and a one-time emergency influx of $3.6 million for these programs. 

Thank you. 

In March, CMS also approved Michigan’s application to establish 

a 5-year Medicaid demonstration project in response to the public 

health emergency. Michigan will expand coverage for kids up to 

age 21 and pregnant women with incomes up to and including 400 

percent of the Federal poverty level who were served by the Flint 

water system from April of 2013 through a State-specified date. Additionally, Michigan has indicated that it will implement a State 

program to make available unsubsidized coverage for higher income populations in Flint. 

Here in the House, we also took action when we passed H.R. 

4470, the Safe Drinking Water Act Improved Compliance Act by a 

vote of 416 to 2. This bipartisan solution championed by Flint Congressman Dan Kildee and co-sponsored by the entire Michigan delegation ensures that the public is notified of excessive lead levels 

in the drinking water and also clarifies and improves the process 

of Federal, State, and city officials communicating promptly with 

each other, as they should. Communities across the country, mine 

included, and would note this is this week’s my local paper, earlier 

this week The Herald Palladium, where the headline ‘‘U.S. water 

systems repeatedly exceed Federal standards for lead,’’ all communities are worried about water infrastructure issues. 

And our bipartisan bill, that passed again in the House, specifically calls on EPA to help communities develop a strategic plan for 

dealing with emergencies like this before they happen. 

Today, we expect to learn more from EPA about its plans with 

the Lead and Copper Rule under the Safe Drinking Water Act. We 

are also going to learn from Michigan’s Keith Creagh and Nick 

Lyon on what steps the State and community are taking to get 

Flint water back up to national standards. 

On the second panel, we are going to hear from an association 

of water utilities in association with State drinking water regulators, what lessons that they have learned and what they are 

doing to apply those lessons. 

We are also going to hear from Dr. Mona Hanna-Attisha, Program Director, Pediatric Residency at the Hurley Children’s HosVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00012 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
7 

pital. Dr. Mona, as she is called, provides an important perspective 

on children’s health and I am pleased that she is with us so that 

we can continue to work together. 

It is my hope that this hearing is going to serve as a valuable 

opportunity to hear more about this important work, ideas for further steps that can be taken by the Federal Government and the 

State of Michigan to help the people of Flint and how Congress can 

ensure with confidence that this does not happen again. 

We cannot and we will not forget those in Flint who have been 

impacted by this tragedy. No amount of regrets or words can actually fix what is broken. We need concrete action. 

I yield back. 

[The prepared statement of Mr. Upton follows:] 

PREPARED STATEMENT OF HON. FRED UPTON

The tragic situation in Flint, Michigan, has captured the attention of the Nation. 

The events that unfolded are unacceptable, and sadly there were missteps at all levels of Government. What happened to Flint and its residents, especially the kids 

being poisoned in their own home, absolutely breaks your heart. And long after the 

media leaves Flint and the dust settles—families—real Michigan families—will be 

grappling with this tragedy for decades, indeed lifetimes. 

That’s why today’s hearing will be a look forward. I’ve said before and will say 

again: I am not interested in finger pointing. There has been much of that done already. The focus needs to be on the folks who were impacted—especially the children, and what we can do to ensure this happens never again, anywhere. We are 

interested today in examining the underlying causes, various public health implications, and potential solutions moving forward. 

While we can’t rewind the clock to prevent the colossal failure of public trust, actions taken by both the State of Michigan and Federal Government are important 

steps in the right direction. The administration and State have coordinated to disseminate public health education, provide case management and interventions for 

children with elevated blood lead levels, and have worked to identify vulnerable populations in Flint who may need further, targeted outreach. The Federal Government 

should work with the State to ensure that proper testing and monitoring is taking 

place. 

We know that early education is a critical factor in combating the effects of lead 

exposure. In February HHS awarded grants of $250,000 to two health centers in 

Flint. These funds are being used to hire additional personnel and provide more 

testing, treatment, outreach, and education on the lead exposures. HHS has also announced an expansion of Head Start and Early Head Start in Flint, and a one time, 

emergency influx of $3.6 million for these programs. 

In March CMS also approved Michigan’s application to establish a 5-year Medicaid demonstration project in response to the public health emergency. Michigan 

will expand coverage for children up to age 21 and to pregnant women with incomes 

up to and including 400 percent of the Federal poverty level who were served by 

the Flint water system from April 2014 through a State-specified date. Additionally, 

Michigan has indicated that it will implement a State program to make available 

unsubsidized coverage for higher-income populations in Flint. 

Here in the House we also took action and passed H.R. 4470, the Safe Drinking 

Water Act Improved Compliance Act, by a vote of 416–2. This bipartisan solution, 

championed by Flint Congressman Dan Kildee and co-sponsored by the entire 

Michigan delegation, ensures that the public is notified of excessive lead levels in 

their drinking water, and also clarifies and improves the process of Federal, State, 

and city officials communicating promptly with each other—as they should. Communities across the country, mine included are worried about water infrastructure 

issues. And our bipartisan bill specifically calls on EPA to help communities develop 

a strategic plan for dealing with emergencies like this before they happen. 

Today, we expect to learn more from EPA about its plans with the Lead and Copper Rule under the Safe Drinking Water Act. We will also learn from Michigan’s 

Keith Creagh and Nick Lyons on what steps the State and community are taking 

to get Flint water back up to national standards. On the second panel, we will hear 

from an association of water utilities and an association of State drinking water regulators what lessons they have learned, and what they are doing to apply those lesVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00013 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
8 

sons. We will also hear from Dr. Mona Hanna-Attisha, program director, pediatric 

residency at the Hurley Children’s Hospital. Dr. Mona, as she is called, and I met 

in February, and I’m pleased she is with us today. Dr. Mona provides an important 

perspective on children’s health and how we should be working together moving forward. 

It is my hope this hearing will serve as a valuable opportunity to hear more about 

this important work, ideas for further steps that can be taken by the Federal Government and State of Michigan to help the people of Flint, and how Congress can 

ensure with confidence this never happens again. 

We cannot and we will not forget those in Flint who have been impacted by this 

tragedy. No amount of regrets or words can actually fix what’s broken—we need 

concrete action. 

Mr. PITTS. The Chair thanks the gentleman and now recognizes 

the ranking member of the full committee, Mr. Pallone, 5 minutes 

for an opening statement. 

OPENING STATEMENT OF HON. FRANK PALLONE, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. PALLONE. Thank you, Mr. Chairman and thank you for holding this hearing today. 

This committee’s jurisdiction over public health and the environment makes it uniquely positioned to address the future in Flint 

and I am glad we are beginning that process today. 

I remain extremely concerned about the water and health crisis. 

Flint has been without safe drinking water for far too long. It is 

important that we all recognize that all levels of Government will 

need to invest untold millions, if not billions, to mitigate the damage to Flint residents posed by this man-made disaster. 

This hearing is an opportunity to address how we move forward 

and ensure that anyone impacted has access to support and assistance as long as necessary. We must decide what is needed to fix 

Flint’s infrastructure and address the potential impacts lead contamination may have on Flint’s children, which will take years. 

The people in Flint need a fully functional drinking water system 

that delivers safe water to their homes. We need to take a hard 

look at whether the reestablishment of corrosion control is working 

to prevent further leaching from lead service lines and we need to 

know more about what is required to have those pipes removed and 

replaced. 

There are also significant health needs that must be addressed. 

Flint’s residents, especially the children, will require a suite of 

services, including ongoing testing and monitoring for lead exposure. They will also likely need a range of behavioral health, educational, and social services going forward. Thankfully, our Medicaid program is structured just for emergencies like this one but 

moving forward, our task will be to ensure that every affected child 

in Flint is not only enrolled but also receiving the services they 

need through the Michigan’s Medicaid program. 

Today is also an opportunity to begin to address the problems beyond Flint. For instance, in New Jersey, the Newark School System 

has ordered that water be turned off at 30 schools, due to the presence of lead. Flint reminds us that if we fail to properly invest in 

health and safety, the consequences can be devastating and, in 

many instances, we will need to invest even more resources in reVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00014 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
9 

sponse, if we wait. We must act now to ensure Americans throughout the country do not suffer from these same problems. 

Now, Congress banned the use of lead in new pipes 30 years ago 

but between 3.3 and 10 million older pipes remain in use throughout the country today. Families living in homes connected to these 

pipes all across the country are potentially at risk from lead leaching from these aging pipelines into their plumbing. Children are 

most affected by these aging pipelines and the associated negative 

health effects linked to lead exposure. The CDC estimates that half 

a million U.S. children ages 1 to 5 have blood lead levels that exceed the agency’s guidelines of 5 micrograms per deciliter. As deeply concerning as these statistics are, they understate the problem. 

The current scientific consensus holds that no amount of lead in 

the blood is safe for children. 

It is long past time for a serious conversation in this country 

about the dangerous lack of Federal investment in our drinking 

water infrastructure and in our public health system. The Safe 

Drinking Water Act needs to be strengthened. EPA needs more authority to set health protective standards for all drinking water 

contaminants and we need to invest in our water systems to ensure 

safe drinking water. We also must ensure the necessary resources 

for providing healthcare to monitor and address lead poisoning, as 

well as preventing lead poisoning in the first place. 

So, I want to thank all the members of both subcommittees here 

today for your continued attention on this issue. I look forward to 

hearing from our witnesses about how we can all work together to 

ensure a strong future for the residents of Flint. 

[The prepared statement of Mr. Pallone follows:] 

PREPARED STATEMENT OF HON. FRANK PALLONE, JR. 

Thank you for holding this hearing today. This committee’s jurisdiction over public health and the environment makes us uniquely positioned to address the future 

in Flint, and I am glad we are beginning that process today. 

I remain extremely concerned about this water and health crisis. Flint has been 

without safe drinking water for far too long. It’s important that we all recognize 

that all levels of Government will need to invest untold millions, if not billions, to 

mitigate the damage to Flint residents caused by this man-made disaster. 

This hearing is an opportunity to address how we move forward and ensure that 

anyone impacted has access to support and assistance as long as necessary. We 

must decide what is needed to fix Flint’s infrastructure and address the potential 

impacts lead contamination may have on Flint’s children, which will take years. 

The people in Flint need a fully functional drinking water system that delivers 

safe water to their homes. We need to take a hard look at whether the re-establishment of corrosion control is working to prevent further leaching from lead service 

lines. And, we need to know more about what is required to have those pipes removed and replaced. 

There are also significant health needs that must be addressed. 

Flint’s residents, especially the children, will require a suite of services, including 

ongoing testing and monitoring for lead exposure. They will also likely need a range 

of behavioral health, educational, and social services going forward. Thankfully, our 

Medicaid program is structured just for emergencies like this one; moving forward, 

our task will be to ensure that every affected child in Flint is not only enrolled, but 

also receiving the services they need through Michigan’s Medicaid program. 

Today is also an opportunity to begin to address the problems beyond Flint. For 

instance, in New Jersey, the Newark school system has ordered that water be 

turned off at 30 schools due to the presence of lead. Flint reminds us that if we 

fail to properly invest in health and safety the consequences can be devastating, 

and, in many instances, we will need to invest even more resources in response if 

10 

we wait. We must act now to ensure Americans throughout the country do not suffer from these same problems. 

Congress banned the use of lead in new pipes 30 years ago, but between 3.3 and 

10 million older pipes remain in use throughout the country today. Families living 

in homes connected to these pipes all across the country are potentially at risk from 

lead leaching from these aging pipelines into their plumbing. 

Children are most affected by these aging pipelines and the associated negative 

health effects linked to lead exposure. The CDC estimates that half a million U.S. 

children ages one to five have blood lead levels that exceed the agency’s guidelines 

of 5 micrograms per deciliter. As deeply concerning as these statistics are, they understate the problem. The current scientific consensus holds that no amount of lead 

in the blood is safe for children. 

It is long past time for a serious conversation in this country about the dangerous 

lack of Federal investment in our drinking water infrastructure and in our public 

health system. The Safe Drinking Water Act needs to be strengthened: EPA needs 

more authority to set health protective standards for all drinking water contaminants. And, we need to invest in our water systems to ensure safe drinking water. 

We also must ensure the necessary resources for providing health coverage to monitor and address lead poisoning as well as preventing lead poisoning in the first 

place. 

Thank you to all of the members of both subcommittees here today for your continued attention on this issue. I look forward to hearing from our witnesses about 

how we can all work together to ensure a strong future for the residents of Flint. 

Mr. PALLONE. I would like to yield—I know I have a minute and 

half—half the time to Ms. Matsui and Mrs. Capps. We will start, 

I guess, with Ms. Matsui. 

Ms. MATSUI. Thank you, Mr. Pallone. 

First and foremost, we must do everything we can to support the 

women, children, and families in Flint affected by this public 

health crisis. Contaminated water and lead poisoning were the end 

result of a system that failed the people of Flint but Flint is far 

from the only community at risk. 

Today, we need to ask the hard questions and offer real solutions 

so that the suffering in Flint is not repeated in cities and towns 

across the Nation. The first step is increasing funding for our water 

infrastructure. This infrastructure must be resilient and sustainable because it is also our first line of defense. 

We also need to ensure that our public health infrastructure is 

robust so we can both prevent and respond to crises like those in 

Flint. This means investments in public health, surveillance, prevention and screening, and treatment. I hope today we can learn 

about ways that can support or programs in our local health departments, as well as Medicaid programs to prevent and respond 

to public health crises. 

Thank you, and I yield to Mrs. Capps. 

Mrs. CAPPS. Thank you for yielding. 

You know all people have the right to safe, reliable drinking 

water, no matter where you live. This crisis shines a spotlight on 

our country’s insufficient water systems and potential devastation 

that can result from not investing in our Nation’s most important 

infrastructure. 

The central need for safe access to drinking water is exactly why 

Representative Tonko and I and several others introduced the Assistance Quality and Affordability Act a little over a month ago. 

The bill marks a much-needed start to address the issues facing 

our crumbling drinking water infrastructure and I am happy that 

several components from my Water Infrastructure Resiliency and 

11 

Sustainability Act are among the many important provisions included to help ensure that our water is available and safe. 

But while we could spend our time talking about those, the fact 

is that lack of access to clean water threatens our families’ health 

and our well-being. It compromises our very way of life. So, today’s 

hearing is an important first step in what I hope will be a broader 

conversation on this imminent threat to our public health. It cannot wait. We must act now. 

And I yield back to my colleague. 

Mr. PITTS. The chairman thanks the gentlelady. 

I now recognize the ranking member of the Environment and the 

Economy Subcommittee, Mr. Tonko, 5 minutes for an opening 

statement. 

OPENING STATEMENT OF HON. PAUL TONKO, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK 

Mr. TONKO. Thank you, Mr. Chair, and thank you to our witnesses for being here today for what I believe is a long overdue 

hearing. 

I look forward to hearing what is being done by all levels of Government in response to this tragic and unnecessary crisis. By now, 

the details and time line of events that led to this situation in Flint 

have been well-established but there are still many questions to 

ask and many lessons left to learn. 

There is no safe level of lead in drinking water, yet it exists 

throughout our water systems in pipes, solder, and fixtures. The 

consequences of lead exposure for the people of Flint will be longterm and will require Government assistance in education, public 

health, and mental health services for decades to come. It all affect 

the city’s economy. And this event has lost its residents’ trust in 

Government. So be it for austerity approaches. 

We know the root causes of this catastrophe. I do not want to 

litigate the details that led to this tragedy but I do believe it is a 

clear case of environmental injustice caused by public officials that 

cared more about saving dollars than about serving the health and 

welfare of the people for whom they speak. There is no question 

there were failures and failures of Government. There were delays 

in acknowledging and in serious problems. The evidence and concerns of legitimate experts and public were dismissed. Some causes 

were also structural. 

Flint’s population decline in the past 5 decades has put tremendous stress on the city, on its water system, and on its residents. 

All of these issues are underlined by unaffordable water rates and 

aging infrastructure, which are sadly all too common in our country. Flint should open people’s eyes, especially those in public service that we cannot take safe drinking water for granted. Water supports every life and water supports every job. And so, therefore, our 

drinking water systems cannot and should not be ignored. 

Our systems require investments. That is right, investments to 

upgrade, maintain, and replace basic physical infrastructure to ensure public health. Such investments are basic and cannot be denied for the sake of austerity. At the end of the day, someone will 

pay for our nationwide neglect of drinking water systems. And we 

have seen that paying later, after a crisis, is more expensive than 

12 

investing now. In fact, my engineering community, of which I am 

part, tells me that we pay 10 times more when we wait for the 

break in a line to occur than to have done the preventative therapy. 

We will hear about the steps that must be taken moving forward, 

clarifying and strengthening the Lead and Copper Rule, the risks 

of partial lead line replacement, issues around corrosion control 

and improving our testing procedures. Many of these issues have 

been discussed by the Flint Water Advisory Task Force’s report 

and the National Drinking Water Advisory Council Lead and Copper Rule Working Group’s report. These are important issues but 

I want to be clear that these issues do not end at Flint’s city limits. 

We have been severely underinvesting in our drinking water infrastructure for decades and now we are seeing the dangerous and 

costly consequences. Why are we surprised? 

Removing lead in drinking water should be a national priority 

with a national discussion and it must be done in a comprehensive 

and planned way. Corrosion control treatment will be part of the 

solution but it is not a final answer. 

USA Today has reported that nearly 2,000 water systems across 

all of our 50 States have exceeded the EPA’s lead action level within the past 4 years. That is strictly unacceptable. There are millions of lead pipes across this country, and, given our track record 

for replacement, many lead pipes will remain for decades without 

a more proactive replacement plan. 

We know what we must do. Do we have the courage to go forward? We must improve lead testing, monitoring, and public notice 

to act on risks quickly. We need a focus on protecting vulnerable 

populations. We need to address lead exposure in schools and assist 

low-income homeowners with lead line replacement. And we need 

a sustained and robust commitment to upgrade our water systems 

and remove those lead components. 

The current Federal commitment is simply not good enough. We 

can’t even say we lead by example. We must step up to help States 

and local communities finance these projects. 

A majority of the Democrats on this committee have co-sponsored 

the AQUA Act, which would reauthorize the drinking water SRF 

at Recovery Act levels and beyond. It also makes some much-needed updates to the Safe Drinking Water Act, including support for 

disadvantaged communities and additional emphases on the sustainability and affordability of our water systems. We want to be 

partners in this effort but unless we get serious about addressing 

these bigger issues of deteriorating infrastructure and unaffordable 

drinking water, it is only a matter of time before we are demanding 

another hearing on another preventable tragedy. 

So, I hope that we can count on all members of this committee 

to make sure that the people of Flint, and in particular the children of Flint, get the assistance that they need and that they deserve. And I hope that we will do what is necessary and expand 

the Federal commitment to ensure other communities get the resources that they need to prevent these future tragedies. 

With that, Mr. Chair, I yield back. Let’s do the right thing. 

Mr. PITTS. The Chair thanks the gentleman. 

13 

I now recognize the chair of the Environment and Economy Subcommittee, Mr. Shimkus, for 5 minutes for an opening statement. 

OPENING STATEMENT OF HON. JOHN SHIMKUS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS 

Mr. SHIMKUS. Thank you, Mr. Chairman for recognizing me and 

yielding me this time. 

At one level, I am glad to see that we are looking into the tragedy in Flint, Michigan and, on another, I am saddened and disappointed that it even happened in the first place. 

The drinking water crisis that the residents of Flint, Michigan 

have had to endure has been called a tragedy so much that the 

word loses its meaning. I know there have been concerted efforts 

to assign blame for these problems and other congressional committees have spent trying to look into who caused this or who didn’t 

do enough to stop it. I have decided that there are very few white 

hats in this picture. 

Flint was let down by its Federal and State Government and its 

local officials and the residents there are right to be skeptical. We 

need to look into what is being done to make the situation better, 

delve into what the schedule looks like to restore good drinking 

water to folks, and what the long-term plan is to take care of the 

health and the infrastructure of Flint. Ultimately, we need to ensure coordination, openness, and cooperation between Government 

water utilities and the public so we can feel confidence that the 

work is being done. 

As part of this examination, we should appreciate what changes 

the Environmental Protection Agency is considering as part of its 

long-term revisions to the Lead and Copper Rules. I recognize EPA 

has been getting input from the National Drinking Water Advisory 

Council and others but we should examine what the impact of some 

of those decisions might have on communities. We all want to protect public health but there are a finite amount of resources, Federal, State, local, and private that can be brought to bear to address all issues. We need to prioritize the public health benefits we 

are addressing and getting. We want appropriate attention placed 

on this issue but not at the expense of addressing other pressing 

public issues. 

I want to thank all of our witnesses for joining us today to give 

us their perspective. I want to welcome back Mr. Estes-Smargiassi, 

who testified on lead service lines 6 years ago before this committee. 

Again, I thank you, Mr. Chairman, for the time you have yielded 

to me and I yield back the balance of my time. 

[The prepared statement of Mr. Shimkus follows:] 

PREPARED STATEMENT OF HON. JOHN SHIMKUS

At one level I am glad we are looking into the tragedy in Flint, Michigan, and 

on another one I am saddened and disappointed that it even happened in the first 

place. 

The drinking water crisis that the residents of Flint, Michigan have had to endure 

has been called a tragedy so much that the word loses its meaning. 

I know there have been concerted efforts to assign blame for these problems and 

other congressional committees have spent time trying to look into who caused this 

or didn’t do enough to stop it. I have decided there are very few ‘‘white hats’’ in 

14 

this picture. Flint was let down by its Federal and State Government, and its local 

officials and the residents there are right to be skeptical. 

We need to look into what is being done to make this situation better, delve into 

what the schedule looks like to restore good drinking water to folks, and what the 

long-term plan is to take care of the health and infrastructure of Flint. Ultimately, 

we need to ensure coordination, openness, and cooperation between Government, 

water utilities, and the public fuel confidence in the work being done. 

As part of this examination, we should appreciate what changes the Environmental Protection Agency is considering as part of its Long-Term revisions to the 

Lead and Copper Rule. I recognize EPA has been getting input from the National 

Drinking Water Advisory Council and others, but we should examine what the impact of some of those decisions might have on communities. 

We all want to protect public health, but there are a finite amount of resources— 

Federal, State, and local, and private—that can be brought to bear to address all 

issues. We need to prioritize the public health benefits we are addressing and getting. We want appropriate attention placed on this issue, but not at the expense of 

addressing other pressing public issues. 

I want to thank all our witnesses for joining us today to give us their perspective. 

I want to welcome back Mr. Estes-Smargiassi who testified on lead service lines 6 

years ago before this committee. 

Mr. PITTS. The Chair thanks the gentleman. That concludes the 

opening statements. As usual, all members’ written opening statements will be made a part of the record. 

We will now proceed to our first panel. And I apologize for the 

technical difficulties. I urge members, as they walk down the center aisle, not to bump the wires. It will result in all that cracking 

you are hearing. And the lights on the table do not work. So, at 

4 minutes, I will give you a couple of taps so you know you have 

1 minute left. At 5 minutes, I will do three taps for you to be able 

to wrap-up. 

And I will introduce the first panel in the order of their presentations. Your written statements will be made a part of the record 

but you will each be given 5 minutes to summarize. 

And in the order of their presentations, we have Joel Beauvais, 

Deputy Assistant Administrator for the Office of Water, U.S. Environmental Protection Agency; and then Dr. Nicole Lurie, Assistant 

Secretary for Preparedness and Response, U.S. Department of 

Health and Human Services; Mr. Nick Lyon, Director of Michigan 

Department of Health and Human Services; and Keith Creagh, Director of Michigan Department of Environmental Quality. 

Thank you for coming. We appreciate you coming today and as 

I said, you will each be given 5 minutes to summarize your testimony. And at this point, the Chair recognizes Mr. Beauvais, 5 minutes for his opening statement. 

STATEMENTS OF JOEL BEAUVAIS, DEPUTY ASSISTANT ADMINISTRATOR, OFFICE OF WATER, ENVIRONMENTAL PROTECTION AGENCY; NICOLE LURIE, M.D., ASSISTANT SECRETARY 

FOR PREPAREDNESS AND RESPONSE, DEPARTMENT OF 

HEALTH AND HUMAN SERVICES; NICK LYON, DIRECTOR, 

MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES; AND KEITH CREAGH, DIRECTOR, MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY 

STATEMENT OF JOEL BEAUVAIS 

Mr. BEAUVAIS. Thank you, Chairman Pitts, and good morning to 

you and to Chairman Upton, to Chairman Shimkus, Ranking Member Green, Ranking Member Tonko, and distinguished members of 

15 

the committee. Thank you for the opportunity to testify about 

EPA’s response to the drinking water crisis in Flint, Michigan. 

Under the Safe Drinking Water Act, Congress directed the EPA 

to set national standards to protect public health but assigned primary responsibility to the States to implement these regulations. 

EPA maintains Federal oversight of the States’ drinking water programs. That system, while imperfect, has achieved major improvements in drinking water safety nationwide. The situation in Flint, 

however, underscores the need for urgent and sustained action by 

Federal, State, tribal and local governments, and drinking water 

system owners and operators nationwide to address risks from lead 

in drinking water and to ensure that nothing like this ever happens again. 

As part of the coordinated Federal effort led by the U.S. Department of Health and Human Services, EPA is working closely with 

the State of Michigan and the City of Flint to address the crisis in 

Flint. Since October 2015, EPA’s Flint Safe Drinking Water Task 

Force, composed of agency experts in the areas of corrosion control 

and others, has provided technical assistance to the city and to 

MDEQ on steps needed to re-optimize corrosion control and ensure 

proper lead testing. 

On January 21, 2016, EPA issued an Emergency Order under 

section 1431 of the Safe Drinking Water Act, directing the State of 

Michigan, MDEQ, and the City of Flint to take actions necessary 

to ensure that corrosion control is re-optimized and that the city establishes the capacity to operate its drinking water system in compliance with the requirements of the law. 

EPA is an integral part of the Federal response effort and has 

established a significant presence on the ground, which includes response personnel, scientists, water quality experts, community involvement coordinators, and support staff. In addition to providing 

ongoing technical assistance through the EPA Flint Task Force, 

EPA is conducting a multi-pronged effort to collect and analyze 

drinking water samples taken from around the city to help ensure 

transparency and accountability in assessing the status of Flint’s 

system. Sampling results will continue to be shared with individual 

homeowners and are publicly available on EPA’s Web site. 

EPA has also taken several concrete steps to address systemic 

issues raised during this crisis. EPA’s Administrator McCarthy has 

directed a review of MDEQ’s implementation of the Safe Drinking 

Water Act, has called on EPA’s Inspector General to evaluate 

EPA’s response to the Flint crisis, and issued an agency-wide elevation memo encouraging staff and managers to raise issues of 

public health concern and to assure appropriate and prompt action 

to address such concerns. 

In addition, EPA is working with States that have primacy in 

implementing the Safe Drinking Water Act to strengthen implementation of the Lead and Copper Rule, which covers approximately 68,000 public water systems nationwide. EPA recently sent 

letters to the Governors and drinking water regulatory agency 

heads of every primacy State in the country asking them to work 

with EPA to strengthen implementation of the Rule. That includes 

a series of specific actions to enhance transparency, accountability, 

and communication of timely information to the public. 

16 

In addition, EPA has been actively working on revisions to improve the Lead and Copper Rule. In December 2015, we received 

extensive recommendations on potential revisions from our National Drinking Water Advisory Council, composed of members of 

the general public, State and local agencies, and private groups, as 

well as from other concerned stakeholders. We are carefully evaluating this input and the national experience in implementing the 

current rule, including the events in Flint, to develop proposed improvements. EPA expects to propose revisions to the Rule in 2017 

and will welcome comments robust engagement and comments 

from the public and other interested parties. 

Finally, the situation in Flint highlights the need for broader national action to address our drinking water infrastructure. In many 

areas across our country, that infrastructure is aging and severely 

underfunded, particularly in low-income communities, which may 

have the most difficulty securing traditional funding through rate 

increases or municipal bonds. As EPA continues to work to 

strengthen public health protections through regulatory policy and 

implementation, we also need a serious national conversation about 

how to advance the investments and technologies necessary to continue the delivery of safe drinking water to all American families. 

I thank you for the opportunity to testify today and welcome your 

questions. 

[The prepared statement of Mr. Beauvais follows:] 

17 

18 

19 

Mr. PITTS. The Chair thanks the gentleman and now recognizes 

Dr. Lurie, 5 minutes for opening statements. 

STATEMENT OF NICOLE LURIE 

Dr. LURIE. Thank you Chairman Pitts, Chairman Shimkus, 

Chairman Upton, Ranking Members Green, Tonko, and Pallone. 

Thank you, Mr. Upton, and distinguished members of the committee. I appreciate the opportunity to testify about the water situation in Flint and the Federal Government’s response. 

I am Dr. Nicole Lurie, the Assistant Secretary for Preparedness 

and Response at the Department of Health and Human Services. 

I am also the lead Federal official for the response. And in that 

role, my job is to coordinate and bring the entire Federal family together to deliver resources to help the people in Flint. 

When I was first asked to take on this role, I made the decision 

to base the Federal response in Flint, not in Washington or in Lansing. I established a unified coordination group there to bring Federal, State, and local partners together to assess the situation and 

align resources to support the community. 

Since then, I have been in Flint almost every week meeting with 

community leaders, Government officials and, most importantly, 

residents in Flint to ensure we are doing everything possible. We 

have had up to 110 people working on the ground at any one time, 

including staff from EPA, FEMA, USDA, HUD, HHS, and the Department of Education, as well as hundreds of others working remotely. We have had four major goals: providing safe water, supporting efforts to restore the water system and mitigating the 

health effects of lead exposure. 

I am pleased to report we have made real progress. FEMA has 

provided millions of liters of bottled water and tens of thousands 

of filters and cartridges to residents. Numerous partnerships have 

successfully delivered these commodities door to door and through 

points of distribution and I am confident that Flint residents have 

access to clean water for now. 

As you have heard, EPA is focused on helping the community restore their water system. Our major focus has been understanding 

the extent of the lead exposure and doing everything we can to 

mitigate those effects. My first observation on arriving in Flint was 

that the community was scared, angry, and traumatized. In response, we immediately deployed teams from the U.S. Public 

Health Service to provide psychological first aid and to train others 

in those techniques. Behavioral health remains one of my priorities 

and is one shared by the community. 

In order to fully assess the potential impact of exposure, CDC advised that all children should have the opportunity to be lead tested or retested. There have been many, many testing events across 

the city and what I can tell you is that fewer than one percent of 

children have high blood levels now. But we all know that all children in Flint were exposed to lead at the height of the crisis and 

CDC is completing an independent analysis going back before the 

water switch to the Flint River to further inform our mitigation 

strategies. 

Another focus has been to ensure that all children with elevated 

lead levels receive timely follow-up from a nurse case manager so 

20 

that we can link these kids to important services through their 

medical homes. CDC has provided extra personnel to support the 

State and county in achieving this goal. 

It will also be critical to follow kids over time. We are in the 

process of planning a long-term voluntary registry in collaboration 

with the State, local, and academic partners and this will be critical to the long-term monitoring follow-up of kids with lead effects. 

Beginning early in the response, I began to hear from the community about concerns with [audio malfunction in hearing room]. 

I asked CDC to state in a comprehensive evaluation to see whether 

there might additional substances in the water that could be causing and this investigation is underway. 

We know that a suite of interventions focused on early brain development can help kids overcome many of the harmful effects of 

lead exposure and these include access to healthcare, developmental and behavioral assessments, early childhood education and 

good nutrition. As you heard from Mr. Upton, HHS has approved 

an historic Medicaid expansion covering children through age 21 

and up to 400 percent of the Federal poverty limit or approximately 

15,000 additional children and pregnant women in the Flint area. 

We hope the State can move forward with this important enhancement as soon as possible. 

HHS has also provided an additional $3.6 million in one-time 

emergency funding to Flint’s existing Head Start programs and 

made additional funding available to two community health centers 

to expand access, case management and behavioral health services. 

And the Department of Agriculture is helping the State increase 

community access to foods that help combat the effects of lead in 

this community, which still lacks a full service grocery store. Additionally, this summer, USDA will extend nutrition benefits to an 

additional 15,000 students. 

In closing, this has truly been a whole community whole of Government response. Our progress in Flint has been made possible by 

strong partnership and coordination between Federal, State, and 

local partners. Yet, there is still work to be done to assure the best 

outcomes for Flint families. The Federal Government will continue 

to support Flint’s recovery with the goal of helping its children and 

families lead happy, healthy, and productive lives. Thank you. 

[The prepared statement of Dr. Lurie follows:] 

21 

22 

23 

24 

25 

26 

27 

28 

29 

30 

31 

32 

33 

Mr. PITTS. The Chair thanks the gentlelady and now Mr. Lyon, 

you are recognized for 5 minutes for your opening statement. 

STATEMENT OF NICK LYON 

Mr. LYON. Thank you, Chairmen Pitts and Shimkus, Ranking 

Members Tonko and Green, and members of the subcommittees for 

inviting me to this joint subcommittee hearing to discuss these important issues. I would like to also thank Congressmen Kildee and 

Upton for being here today. 

My priority as Director for Michigan Department of Health and 

Human Services is to ensure a healthy, safe, and stable environment for all of Michigan’s families. I know the people of Flint are 

hurt. I know that they are upset. And I recognize that there is 

anger and mistrust. Rightfully so. Despite the efforts of many dedicated and well-qualified people, both within my department and locally, the citizens deserve better. 

We have initiated an internal review, in addition to the joint investigation being completed by the Office of Auditor General and 

Office of Inspector General. We will address whatever shortcomings 

are identified by these reviews within my department and will 

properly address issues and factors that affected our response. We 

know that we could have done better. 

My heart goes out to the families impacted and that is why I am 

here today, to talk about what Governor Snyder’s administration 

and particularly my department is doing to provide relief to the 

people of Flint and ensure that the necessary services are provided 

in the future. We are now looking forward at what we can do to 

improve the health and quality of not only Flint but for all people 

in Michigan. 

We have already taken steps to restructure areas within our department to better align programs with surveillance and to ensure 

local health issues, such as the ones we are discussing today, are 

quickly elevated for immediate follow-up. For example, we have increased case management for all children with elevated blood lead 

levels in Flint to ensure that their health is immediately being addressed. We have funded additional nurse case managers within 

the Genesee County Health Department to work with families and 

we are aggressively working to increase services in the community. 

We know that outreach and continued care is important. 

And as part of our nurse case management efforts in Flint, we 

are now regularly testing water as a potential source of lead during 

follow-up with families, in addition to considering paint, soil, and 

dust exposures in the home. 

We are also working close with our partners in Medicaid, our 

Medicaid health plans, to increase the number of children in Flint 

tested. While lead testing is required for all children enrolled in 

Medicaid, this is an area we continue to improve upon with our recent rebid in Michigan’s Medicaid Health Plans emphasizing the 

need. We are also working closely with our healthcare providers to 

ensure that all children are screened appropriately. 

In addition, the Flint Water Advisory Task Force has issued a 

comprehensive set of recommendations that we are actively reviewing for implementation. For instance, we know that good nutrition 

works to prevent the absorption of lead into the body. To increase 

34 

access to sources of nutrition foods in Flint, we are working closely 

with the Food Bank of Eastern Michigan to arrange mobile food 

bank deliveries in 23 sites across the city. We are assisting the 

Michigan Department of Education with the coordination and 

placement of nine new nurses in the Flint community and we are 

also adding additional schools to our existing program for adolescent health centers. 

We are developing and coordinating long-term educational and 

behavioral screening tools, services, and supports for the children 

of Flint. We are working with the Genesee Health System and the 

Flint Community Resilience Group to develop and implement mental health first aid to assist the community in their recovery. And 

most recently, we are working to finalize a contract with the Genesee County Community Action Resource Department to replace 

water heaters for residents whose water heaters may have been 

damaged. 

Throughout this emergency, we have greatly appreciated the 

support of our Federal partners. Our department has six Federal 

Centers for Disease Control and Prevention personnel embedded 

within our programs, who continue to work closely with the Genesee County Health Department and the Michigan Department of 

Health and Human Services as part of our efforts. 

Through those resources that we have available to us, we have 

worked closely with our partners in the Agency for Toxic Substances and Disease Registry to create and release a Legionella 

toolkit for healthcare facilities and large buildings to prevent the 

growth of Legionella in water systems. Ultimately, our hope is to 

help other communities in Michigan and across the country learn, 

as we have, how to prepare for and even prevent lead exposure and 

Legionella outbreaks such as the one that occurred in Flint. 

We also appreciate the assistance of our partners at the Centers 

for Medicare & Medicaid and Services who have approved our application to extend Medicaid benefits to pregnant women and children up to the age of 21 up to 400 percent of the Federal poverty 

level who were served by the Flint water system. This waiver will 

ensure access to primary are and provide targeted case management services to coordinate all physical and behavioral health related services for children potentially exposed to lead. 

The Substance Abuse and Mental Health Services Administration is providing technical assistance in many areas, and the 

United States Department of Agriculture has approved our requests to utilize our WIC Program resources to test children for 

lead and enhance our nutritional education efforts. 

In implementing Governor Snyder’s action plan, we are working 

with Dr. Hanna-Attisha and Professor Marc Edwards through the 

Flint Water Interagency Coordinating Committee. 

I want to thank Dr. Mona Hanna-Attisha, who will be testifying 

on the next panel, for bringing this issue to light and for continuing 

every day to help the families and children of Flint. She has been 

an invaluable partner as we deliver on our commitment to provide 

the necessary health care services to these families. 

On behalf of the Snyder administration, I want to assure you 

that we stand committed to fixing this problem for the people of 

35 

Flint and to ensure this does not happen again in Michigan or anywhere else. 

Thank you again for the opportunity to testify and I look forward 

to answering your questions. 

[The prepared statement of Mr. Lyon follows:] 

36 

37 

38 

39 

40 

Mr. PITTS. The Chair thanks the gentleman. 

I know recognize Mr. Creagh for 5 minutes for his opening statement. 

STATEMENT OF KEITH CREAGH 

Mr. CREAGH. Good morning and thank you for the opportunity to 

appear before this committee today. 

I am Keith Creagh and on January 4, 2016 I was appointed to 

be the Interim Director of the Michigan Department of Environmental Quality. When I testified before the House Committee on 

Oversight and Government Reform on February 3, 2016, my testimony described how all levels of Government did nothing together 

to protect the people of Flint, resulting in a water emergency. Since 

that time, Government at all levels has begun working cooperatively to help the people of Flint. I look forward to discussing the 

progress made to provide resources and results for the people of 

Flint, as well as some of the lessons learned. 

One of my first objectives was to implement changes in the culture of the department. We refocused our primary mission to protecting the environment and public health. In reviewing the water 

source switch to the Flint River, we took a technical approach to 

compliance with the Federal Lead and Copper Rule without adequately addressing public concern. One of the first lessons learned 

is that infrastructure changes are complex, especially in aging systems, and regulatory agencies need to engage with the experts and 

the public in a more meaningful way. Much of the progress to date 

has been achieved through the Flint Water Interagency Coordinating Committee. The Coordinating Committee is comprised of 

city, county, and State officials, private entities, and outside experts such as Dr. Marc Edwards and Dr. Mona Hanna-Attisha. The 

objective of the Coordinating Committee is to connect all available 

resources to assist the people of Flint and mitigate the impact of 

lead exposure to the committee. 

Just last Friday, the Coordinating Committee heard presentations on the current status of the Flint water system. The data 

indicates that the water quality is improving and that protective 

coating on the pipes is being restored; however, it is still unstable. 

The information sharing that has occurred as a result of the Coordinating Committee demonstrates a second lesson: in order to rebuild trust, Government at all levels needs to share information in 

order for there to be effective discussions with experts and citizens. 

The Safe Drinking Water Act Improved Compliance Awareness Act, 

passed in February by the House, is a good first step. 

The State of Michigan has appropriated over $68 million to address the water issues in Flint, with another $165 million pending. 

$30 million has been appropriated for the City of Flint to credit 

residents for water used for drinking, cooking and bathing from 

April 2014 through April 2016. The State is paying for the reconnections to the Great Lakes Water Authority to supply finished 

treated drinking water to Flint. $18 million has been set aside to 

provide long-term follow-up care to children. 

The Department if paying for water sampling and testing, residential plumbing assessments and reliability studies. We have established a sentinel water testing program through which over 600 

41 

residents are sampling their water every 2 weeks. The results from 

the past four rounds of sampling show that over 92 percent of the 

households have results at or below 15 parts per billion of lead but, 

again, it shows instability. 

The Department also supported a pilot service line replacement 

program in Flint and, additionally, the State has provided $2 million to the City of Flint for Mayor Weaver’s FAST Start Program 

to remove lead service lines with an additional $25 million in a 

pending supplemental appropriation. 

Moving forward, the Department is committed to supporting the 

City of Flint’s efforts to identify and prioritize replacement of unsafe service lines and other infrastructure to ensure the integrity 

of the drinking water system. 

The third lesson is simply replacing lead pipes alone will not 

solve this problem. Many of the high lead levels come from internal 

fixture that either have lead components, lead solder, or have lead 

particles trapped in faucet aerators. A comprehensive lead education campaign must continue past the immediate emergency. We 

are working with EPA and outside experts to develop guidelines 

that will prohibit partial line replacement and establish replacement priority. 

Furthermore, a long-term strategy needs to be implemented that 

upgrades and maintains an appropriately sized water infrastructure for Flint. 

The fourth lesson is States should treat the Federal rule as a 

floor, not a ceiling. Michigan is proposing to establish a comprehensive Michigan Lead and Copper Rule to ensure necessary public 

health protections that exceed the existing Federal rule. When it 

comes to protecting public health, States cannot wait for EPA’s 

issuance of an updated rules. States must be willing to go above 

and beyond what the Federal Government standards are, whenever 

necessary to ensure public health is protected. 

We will continue to work with the City of Flint regarding its future water needs. We are committed to continuing the collaborative 

process already established with all levels of Government, outside 

experts and citizens to resolve the water emergency. We hope that 

the effective implementation of this approach and the lessons 

learned will prevent the reoccurrence of such emergencies in Michigan and other parts of the country. 

Thank you for the opportunity and I look forward to your questions. 

[The prepared statement of Mr. Creagh follows:] 

42 

43 

44 

45 

46 

[Additional material submitted for the record by Mr. Creagh has 

been retained in committee files and also is available at http:// 

docs.house.gov/Committee/Calendar/ 

ByEvent.aspx?EventID=104765.] 

47 

Mr. PITTS. The Chair thanks the gentleman, thanks each of the 

witnesses for their testimony. 

I will begin the questioning and recognize myself 5 minutes for 

that purpose. 

Dr. Lurie, I will begin with you. Can you talk specifically about 

the CDC Agency for Toxic Substances and Disease Registry response on the ground in Flint? What will their role be moving forward? 

Dr. LURIE. The Agency for Toxic Substances and Disease Research or ATSDR, as it is known, has played the lead role in helping with the analysis of the lead data to date, providing case management services and helping the State and county with those and 

going forward will be instrumental in setting up a registry, as well 

as a strengthened lead program going forward. 

Mr. PITTS. Thank you. Mr. Lyon, what changes are you implementing at the Michigan Department of Health and Human Services that will help reduce lead exposure for Michigan’s children in 

the future? And would it be wise for other States to adopt these 

changes? 

Mr. LYON. I think one of the things we have learned through 

this, and part of the education for all of us is the potential impact 

on these water systems that have the presence of lead. Traditionally, really lead in the past has been a public health success. Over 

the past several decades, the amount of lead in children has decreased drastically with the reduction of lead-based gasoline and 

lead-based paints but we now have to be cognizant that there is a 

new lead danger. As Dr. Lurie has noted and the chairman has 

noted, there is no safe level of lead in the bloodstream. And I think 

we have to be cognizant going forward of water as a potential 

source. 

As part of what we have done specifically, as part of our lead 

abatement program in environmental investigations, we are looking at water in the households in Flint and we are looking at fixtures and aerators and things of that nature as part of the environmental investigation and potentially replacing those items if we believe that is the source of the problem. 

Mr. PITTS. Thank you. Mr. Beauvais, is EPA performing compliance verifications of drinking water systems under the Safe Drinking Water Act? And was there ever a pause in the use of this authority? If so, when and why? 

Mr. BEAUVAIS. EPA exercises its oversight of State drinking 

water programs with primacy through a number of mechanisms 

and it has done that over the years and we are engaged in a specific effort on Lead and Copper Rule oversight right now where regional offices across the country are meeting with every State primacy agency to ensure that there is appropriate attention and resources being given to Lead and Copper Rules oversight that lead 

action level exceedances are being addressed, that corrosion control 

is being implemented where it is supposed to be. 

Mr. PITTS. OK and, Mr. Creagh, I have heard about the many 

testing programs occurring in the City of Flint. And the one I am 

interested in learning more about is the sentinel program. What is 

that? Can you give me some additional information about what it 

is demonstrating? 

48 

Mr. CREAGH. Yes, sir, Mr. Chairman, I can. So, the sentinel point 

was where we, in partnership with EPA, actually identified over 

600 sites throughout the City of Flint looking at a whole variety 

of factors using some R. Mona Hanna-Attisha’s information on age 

of water, where lead service lines were, where various communities 

were. And so every 2 weeks we test those individual homes. They 

have been actually trained on how to take the sample, making sure 

using wide mouth appropriate flow and we collect those and then 

analyze those. And so what that does is it gives us a snapshot, if 

you will, every 2 weeks, of the integrity and viability of a water 

system in Flint. 

Mr. PITTS. And how is the community involved in this? 

Mr. CREAGH. So, as we respond to individuals, we have a community member that has hired a local plumber, that has hired a DEQ 

inspector, and, at times, our Department of Health and Human 

Service or local public health individuals. That is especially true 

when there is high lead levels above 150 parts per billion. We are 

in the house within 2 days. If you are above 100 parts per billion, 

we are in the house within 7 days and if you are above 15 parts 

per billion, we communicate with you and ask you to take another 

sample. 

Mr. PITTS. Thank you. My time has expired. 

The Chair recognizes the ranking member, Mr. Green, 5 minutes 

for questions. 

Mr. GREEN. Thank you, Mr. Chairman. I thank our panel for 

being here. 

The Safe Drinking Water Act is supposed to ensure safe and reliable drinking water for customers of public drinking water systems 

across the United States. Clearly, it failed the citizens of Flint and 

we, in Congress, should be asking why. It seems that the short answer is that because the Lead and Copper Rule or LCR is in serious need of revision. 

Mr. Beauvais, what is the status of the revisions for the LCR and 

when will they be completed? 

Mr. BEAUVAIS. We are actively working on developing proposed 

revisions to the rule. As I mentioned in my testimony this past December, we received extensive recommendations from our National 

Drinking Water Advisory Council, as well as input from a number 

of other concerned stakeholders. So, we are carefully considering 

that input. We will be engaging with stakeholders over the coming 

months to develop a proposed rule and expect to be able to propose 

a rule in 2017. 

Mr. GREEN. How long had that advisory panel been impounded 

to get you the information in December? 

Mr. BEAUVAIS. I believe it was over the course of about a year 

or so. The NDWAC or the National Drinking Water Advisory Council formed a working group to provide specific advice which delivered recommendations to the council in August of last year and 

then the council transmitted those recommendations to the administrator in December. 

Mr. GREEN. Here we are in the middle of April now and you have 

had that information since December. Because of what is happening in Flint I think is just a tip of the issue, is there any way 

that EPA could actually speed up the LCR? 

49 

Mr. BEAUVAIS. We certainly have a sense of urgency about the 

revisions and we also want to make sure that we get them right. 

And in fact, many of the recommendations of the National Drinking Water Advisory Council were developed at a time before Flint 

had really come to light in the national consciousness. So, I think 

stakeholders’ understanding of where we need to go on this has 

evolved somewhat. So, we are working hard on that and we are 

going to get it done as quickly as we can. 

Mr. GREEN. When do you think it will be? Is there an estimated 

time? Because, again, we are almost 4 months into the year. 

Mr. BEAUVAIS. I don’t want to prejudge the process. What we 

have been able to say is that we expect to propose in 2017 and I 

certainly hope that that is as early in 2017 as possible. 

Mr. GREEN. Well, it seems that action levels are not set at levels 

to ensure vulnerable populations are protected. Is that a correct 

statement? 

Mr. BEAUVAIS. I think the specific challenges that occurred in 

Flint have to do with the failure to apply corrosion control as 

should have been done under the existing rule. Nevertheless, we do 

recognize that there is a lot of need for improvement in the rule 

and we are going to be working actively on that. 

In the meantime, we are engaging in very close coordination with 

the States in working to strengthen implementation of the current 

rule and see where States can go beyond the requirements of the 

current rule to improve public health protections. 

Mr. GREEN. How will the LCR revisions ensure health protection 

for children and other vulnerable populations? 

Mr. BEAUVAIS. I am sorry. Could you repeat that? 

Mr. GREEN. How will the LCR revisions ensure health protection 

for children and other vulnerable populations? 

Mr. BEAUVAIS. Well, I think one starting point is the National 

Drinking Water Advisory Council’s recommendation which focus on 

a number of key areas. One of them is to have the revised rule require proactive replacement of lead service lines by utilities, instead of just as a reactive measure. Another proposal is for the 

agency to develop a household action level, which would trigger notifications to public health authorities if household levels are over 

a certain—— 

Mr. GREEN. Well, it seems there is a lot of frustration. The fact 

that exceeding the action level for lead did not actually constitute 

a violation of the Safe Drinking Water Act, the LCR requires corrective action when high lead levels are found but does not penalize 

systems for those initial high lead levels. In other words, the current LCR fails to incentivize protection. 

Do you expect the new LCR revisions to include changes and advise systems to prevent lead contamination, not just a remedy if it 

is found? 

Mr. BEAUVAIS. I do. 

Mr. GREEN. OK. I have a number of series of questions. In February of this year, the Ranking Member Pallone and Congresswoman DeGette and Ranking Member Tonko sent a letter to the 

Michigan Department of Health and Human Services to better understand the role of lead level surveillance in Flint. The DepartVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00055 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
50 

ment answered some but not all of the questions in response dated 

March 11th of 2016. I want to follow-up with some questions. 

Mr. Lyon, it is my understanding you were prepared to answer 

these questions today. Is that correct? 

Mr. LYON. I will do my best, sir, yes. 

Mr. GREEN. OK. In your letter, we asked about July 15th Michigan Health and Human Services memo that observed a spike in 

blood lead levels in the summer of 2014 after the city switched to 

Flint River in the drinking water. However, the Michigan Health 

and Human Services officials originally concluded that this spike 

was seasonal and not related to the water supply. What led the Department to compile the July 15th report? 

Mr. LYON. I received a request from the Executive Officer, the 

Governor’s office, sir. 

Mr. GREEN. Mr. Chairman, I know. I just want—and why did 

Michigan Health and Human Services conclude that the spike was 

not related to the water supply? 

Mr. LYON. Well I think when that initial analysis is done, the 

staff that work for me felt there were seasonal fluctuations within 

the data that drove the changes over that first summer. When they 

compared it prior years, it was within range of years before. And 

obviously, we learned, once Dr. Mona put her information forward, 

we worked with her on her data and were able to later show an 

association of the blood lead increases with the water switch. 

Mr. GREEN. Mr. Chairman, I know I am well over time. I would 

like to submit additional questions, if possible. 

Mr. PITTS. Thank you 

Mr. LYON. And through the chair, sir, we will certainly look at 

your questions and provide a narrative response. Thank you for the 

additional time. 

Mr. PITTS. We will make sure his questions are forwarded to you 

in writing, if you can respond. 

The Chair thanks the gentleman and now recognizes the chair of 

the Environment and the Economy Subcommittee, Mr. Shimkus, 5 

minutes for questions. 

Mr. SHIMKUS. Thank you, Mr. Chairman. 

I want to direct mine to Mr. Creagh. Can you speak to schools, 

day cares, and senior centers in Flint? We have mostly been talking about homes. 

Mr. CREAGH. So, yes, sir, we can. And so we have actually tested 

all the schools in Flint and we have replaced 93 percent of the fixtures. And one of the questions had to do with lead exposures in 

schools in Flint, Michigan. There are no lead service lines going to 

the schools, to the best of our knowledge. It is other types of materials. So, mainly, the exposure happened because of the fixtures 

within those schools. So, we have replaced 93 percent of those. We 

have gone through a number of deep flushings, if you will, for those 

schools, to assure that when kids come back, hopefully after spring 

break, they can once again use that water in those facilities. 

We are not there yet. As we replaced some of the fixtures, we 

found out that there was some plumbing within the schools that 

needed to have some further renovations and so we are working 

very closely with the school superintendent. 

Mr. SHIMKUS. Daycares, senior citizens? 

51 

Mr. CREAGH. Yes, sir, those are certainly on the list and we are 

doing those. I can’t tell you exactly what percentage. I think we are 

about at 46 percent of those. 

Mr. SHIMKUS. So you talked in your opening statement some inconsistencies in the testings across the whole area. And then you 

have also talked about the sentinel program a little bit. 

So, what measures—I mean how are you going to get to a determination when you can make a statement of the water is safe 

again, since there seems to be hot spots and—I mean can you talk 

through that? I mean, I don’t know the answer. I am asking you. 

Mr. CREAGH. Well, the data will drive our decisions. And I appreciate EPA regional administrator Bob Kaplan brought together a 

number of the scientists a week ago Monday to look at the data. 

And the thing that we cannot do is have different interpretation of 

data. We need to be closely aligned because we have promised citizens certain actions, without necessarily having that data support 

those decisions. So, I think what you will see is all of us look at 

the data. 

And the data at this point in time says a couple of things. It says 

that soluble lead is getting better. In other words, there is coating 

in the piping. The particulate lead that gets caught in the aerator 

is problematic. And that is why it is unstable. The data says that 

the filters work and the data say that we need to enlist the help 

of the citizens of Flint to flush their systems thoroughly so that the 

orthophosphates will continue to coat those pipes. 

Mr. SHIMKUS. Can you talk about water bill credits for Flint? 

Mr. CREAGH. Yes, sir. No one should pay for unusable water. And so there is a $30 million credit that is available to refund or credit 

towards the water use between April of 2014 to 2016. About 52 percent of the bill was for drinking, bathing, and cooking. And so, because of the flushing and other things, the residents are afforded 

65 percent. 

We are working with the city. They are trying to perfect the refund and credit mechanism. So, at this point in time, that is in the 

city’s court. 

Mr. SHIMKUS. So, there is a plan but there is a recognizable 

delay? 

Mr. CREAGH. Yes, sir. As the city was going through the records, 

they wanted to make sure they had clarity, transparency, and that 

they could answer the questions as the citizens raised them. 

Mr. SHIMKUS. Let’s talk about the communication between the 

Michigan Department of Environmental Quality and the rest of the 

local, State, and Federal. What have we done—I think from the 

outside, because I am from Illinois, we are watching this unfold. 

Obviously, there is a crisis but the question is how have we improved communication so that we are all moving towards the same 

objective versus pointing fingers at each other? 

Mr. CREAGH. As Dr. Lurie said, one of the ways to improve communication was through the unified command group and I appreciate her leadership in that, so that there was not a difference between State, Federal, and local government. That is number one. 

Number two, Director Lyon and I have a memorandum of understanding or agreement to make sure we share data across program 

areas. Number three, we need to be in the community, so we meet 

52 

in the community every Friday through the Flint Water Interagency Coordinating Committee that I referred to that has both the 

internal and external expertise so we can honestly debate the data. 

And then three is we need to embrace those that raised questions 

and not dismiss. 

Mr. SHIMKUS. Thank you. Mr. Chairman, I know a lot of people 

want to ask questions. I will yield back my time. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the ranking member Mr. Tonko, 5 minutes for 

questions. 

Mr. TONKO. Thank you, Mr. Chair. 

Mr. Beauvais, the most recent EPA Drinking Water Needs As- sessment has estimated that we need $384 billion over the next 20 

years to bring drinking water systems into good working condition. 

The estimated investments needed for those systems has grown 

with each succeeding assessment, indicating that we are falling 

further and further behind. I agree with your statement that need 

a serious discussion about how to deal with this national problem. 

I further believe the funding level for the Drinking Water State Revolving Fund is simply too low to offer States the assistance that 

they truly need to tackle this problem. 

This committee has received testimony and support of my belief 

from representatives of different States and systems both small 

and large. So, I would ask what is your assessment of the States 

and additional Federal funds to reduce the maintenance backlog 

with their drinking waters. What do you believe needs to be done? 

Mr. BEAUVAIS. Well, I think it is clear that we do need increased 

investment in drinking water infrastructure, as well as on the 

clean water infrastructure side and the need surveys point to those 

needs. We are working hard within the levels of resources that we 

have within the State Revolving Funds. We are working closely 

with States to try to find ways to make that money work smarter 

and harder through leveraging and so forth. There is also the opportunity through the Water Infrastructure Finance and Innovation Act. In the President’s budget for fiscal year 2017 there is a 

$20 million request, which could help to leverage additional resources for low-interest loans that could help compliment the SRS. 

So, those are some of the areas in which we are working but 

strongly agree with you that there is a need for more resources and 

work in this area. 

Mr. TONKO. Thank you. And it is obvious that this response in 

Flint is reactive. It is obviously more expensive than a proactive 

program that would prevent emergencies. Do you agree in that assessment? 

Mr. BEAUVAIS. I think there is a common sense response there 

of concern with penny wise but pound foolish policy decisions which 

might save a few dollars in the short-term but, ultimately, have led 

to some very serious expenses and, most importantly, the human 

tragedy that is unfolding in Flint. 

Mr. TONKO. Thank you. And in the case of Flint, I understand 

there are estimates that up to 40 percent of their treated water 

may be leaking from the distribution system. That is not only a 

profound waste of a vital resource, it is economically unsustainable. 

A water utility cannot collect payment on that water but I assume 

53 

they have to charge a rate necessary to cover those losses. That 

problem must be addressed if Flint’s water utility is ever to be able 

to get costs and rates under control. 

What is the estimated investment needed to bring Flint’s drinking water infrastructure up to par? 

Mr. BEAUVAIS. I don’t have precise numbers on what it would 

take to repair the water mains and so forth but that certainly 

would be an expense well beyond what is involved in possible replacement of the lead service lines. 

Mr. TONKO. Yes, I am hearing some very high estimates and 

when I compare that to what is allocated in our SRF, it could take 

up that whole system. Is that your understanding? 

Mr. BEAUVAIS. I don’t have precise figures but that wouldn’t surprise me. 

Mr. TONKO. And am I correct in understanding that the focus 

now is on the lead service lines in Flint’s distribution system? 

Mr. BEAUVAIS. Well, the city has been very focused on replacing 

the lead service lines. I believe that Director Creagh made mention 

of the FAST Start program that the city is engaged in and the city 

has been in dialogue with the State about potential funding for full 

lead service line replacements across the city. 

Mr. TONKO. And Director Creagh, your testimony states that results from recent sampling have shown that over 92 percent of the 

households have lead levels less than 15 parts per billion. That is 

not good enough. But even if water is reliably safe to drink, what 

steps do you believe are necessary to rebuild trust in Government, 

in their Government, and in our water system? 

Mr. CREAGH. As I mentioned, one of the roles of the Flint Water 

Interagency Coordinating Committee is to make sure we are in the 

communities working with the community to build that trust, one. 

Two is that you have to have outside experts and those that are 

trusted in the community part of the solution, like Dr. Mona 

Hanna-Attisha, like Dr. Mark Edwards, Dr. Reynolds, and Dr. Sullivan. So, we try to do that. And then three is we need to perform 

and deliver. 

And so, we are working with the city on reliability studies. We 

are looking at what is the infrastructure needs for the next decade, 

not the last decade. 

Mr. TONKO. I know there has been a big discussion about affordability for programs that speak to drinking water. But I hear a lot 

of avoided costs that, regrettably, are part of the system because 

of austere thinking. 

Can you provide an update on the lead service line replacement 

pilot program? Is there a reliable inventory of lead pipes in Flint? 

Mr. CREAGH. Yes, sir, those are two different questions. The pilot 

program that Retired General—Brigadier General Mike McDaniel 

did on behalf of the city. By the end of this week, they should have 

33 lines out as proof of concept. Those were more than lead service 

lines because galvanized lines act as a sink for lead and that is 

part of the reason for the particulate lead. So, that is a proof of 

concept that he is doing and that should be complete. 

There is then, as I mentioned, $2 million to begin taking out additional lead service lines. They are using the program that the 

54 

Board of Water and Light in Lansing, Michigan used when they replaced their lead service lines. 

Mr. TONKO. And I thank you, Director Creagh. I have taken up 

my available time but there are many questions I have and I will 

submit those to the subcommittees for review for the individuals. 

Mr. PITTS. We will send them to you in writing. 

Mr. TONKO. With that, I yield back. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the chairman of the full committee, Mr. Upton, 

5 minutes for questions. 

Mr. UPTON. Thank you, again, Mr. Chairman. We all have a good 

number of questions. 

The first one that I have, I guess in listening to the response of 

Mr. Beauvais to Mr. Green’s question, if there was one message 

you could send up the chain is we would like to have something 

maybe earlier than 2017. That is a long ways off. And I would like 

to think that maybe there can be a little extra push to try and get 

that so communities can figure out where they need to go. So, 

whether it is a proposed rule or something that can be out there 

that can help, I think that would be important. 

The question that I have I guess for each of you, quickly, is so 

we passed, as I indicated in my opening statement, H.R. 4470 pretty darn quick. I mean Mr. Kildee had some good ideas. We refined 

them a little bit. We had, I thought, some constructive ideas. We 

have worked with Mr. Pallone and the committee staff, who is bipartisan. We didn’t have the hearings. We didn’t have a markup. 

We moved it right to the floor. And I thank again the leadership 

on both sides. We passed it under suspension like that. And of 

course, we are waiting for the Senate to take some action. 

It has now been about 2 months since that happened. So, now 

if you had had this extra 2 months, again, we did this pretty quick, 

what changes would you make? What things have you discovered 

that we might have missed when we moved that bill so quickly out 

of here that we might want to think about, anything? 

Mr. BEAUVAIS. Well, the agency is certainly very grateful for your 

and the committee’s work on providing additional authority for 

prompt public notice for systems where there are lead action level 

exceedances. I don’t have specific suggestions to offer at this moment but we would be more than happy to provide technical assistance. 

Mr. UPTON. That would be great. Because, again, it has languished over in the Senate and, at some point, we are going to, I 

hope, come together. 

Dr. Lurie, I just want to say, too, for the record, you and I have 

met a number of times. We have had a number of conversations. 

We really appreciate what you have done. The directive that you 

had from the President, your weekly trips that are there, you are 

working with all layers of Government. We appreciate your testimony today and what you are trying to do, your expertise. 

But I would be interested in if you have any thoughts in terms 

of what we might have added, knowing that we have been a couple 

months since we passed this in the house. 

Dr. LURIE. You know I think it is a great question. And my first 

observation, overall, is that public health and water are obviously 

55 

tied very closely together. A clear message from this is the disinvestment in the public health infrastructure has consequences. 

And a clear message I think going forward is the importance of 

preventing exposure by a strong early warning surveillance system 

to detect elevated blood levels, stronger surveillance efforts, and 

faster action on the lead mitigation issues. 

Here, moving forward with the registry to track all kids, finding 

kids who might be having trouble and being able to jump on them 

quickly is going to be terribly important. 

Mr. UPTON. So, here is a follow-up question as I watch the clock. 

How many—what percentage of kids in Flint, knowing that this is 

a national story, folks in Flint know about it, how many families, 

how many kids have not been tested in Flint by a percentage? 

Dr. LURIE. You know at the beginning of this crisis—— 

Mr. UPTON. Because I mean—— 

Dr. LURIE [continuing]. And I asked Mr. Lyon to help, about 60 

percent of kids on Medicaid had been tested, although there is a 

universal screening recommendation. With the more recent testing, 

most of the lead was probably out of kids’ systems but it was very 

important for us to find any remaining kids who still had high lead 

levels. Moving forward, testing all kids per the universal screening 

recommendations and getting on those high lead levels within 2 

weeks is going to be critical. 

Mr. UPTON. Mr. Lyon? 

Mr. LYON. She is exactly right. We were approximately 60 percent in our Medicaid program. We instituted some enhanced elevated blood level testing, especially after October first, when this 

occurred. We have tested thousands of children. What we have 

seen is the rate is somewhere below two percent, so we are following up with those children but, as has been indicated—— 

Mr. UPTON. Two percent with higher elevated—with elevated 

lead levels. 

Mr. LYON. Five. 

Mr. UPTON. Five percent, OK. 

Mr. LYON. With that in mind, it doesn’t measure past exposure. 

So, what we have done is we have really taken our focus and said 

that we need to have the services in place that could potentially 

serve any child in Flint because we don’t know what their exposure 

may have been prior to the recent blood testing. 

Mr. UPTON. OK. My time has expired but will prepare similar 

questions for the written record and yield back. Thank you. 

Mr. PITTS. The Chair thanks the gentleman. 

I know recognize the ranking member of the full committee, Mr. 

Pallone, 5 minutes for questions. 

Mr. PALLONE. Thank you, Mr. Chairman. I wanted to ask some 

questions of the panel and I will be a little more specific but my 

major concern, what I hear from our Michigan colleagues is that 

we need to address the infrastructure issue because the fact of the 

matter is that we still have exposure to these lead pipes and shortterm and long-term we need to correct that by having systems in 

place that would allow people to drink the water without having 

to worry about lead. And secondly, we have all these people, particularly children, who have been exposed to lead poisoning and 

56 

something needs to be done to treat them, not only now but also 

in the future. 

Now, I understand that the Governor convened an independent 

group, the Flint Water Advisory Task Force, to review what happened in Flint and offer recommendations for the future and that 

this task force offered a number of recommendations, both shortand long-term, particularly establishing and maintaining a Flint 

Toxic Exposure Registry to include all the adults and children and 

further recommended that all children be offered timely access to 

age appropriate screening, clinical, and follow-up for development 

and behavioral concerns. 

So, thinking about what this task force is trying to do to implement these recommendations, I assume they would try to do that, 

what about the funding? In other words, do you have adequate 

funding to correct the infrastructure both now and in the future so 

that this doesn’t happen again in Flint and to address the health 

concerns that will rise with these adults but particularly children 

who have been exposed? That is what I wanted to know. I want 

to know because we are the committee of jurisdiction. We are not 

appropriators but you know obviously we can influence this. 

I guess I would ask—let me be more specific. Let me start with 

Mr. Lyon. Do you agree that—do you think that the current State 

and Federal budget is adequate to address the public health activities that I mentioned? 

Mr. LYON. I think with this issue especially the investments in 

lead programs nationally has decreased. And I think that has happened at State levels and Federal levels. And I think that is something—that is a priority that should be revisited. We have reviewed 

the science and we see the studies around lead exposure and how 

it impacts children in the near-term, behavioral issues, ADHD, in 

the long-term potential links with interventions with the juvenile 

justice system—— 

Mr. PALLONE. Well, let me ask you this, Mr. Lyon. Do you feel 

right now you have adequate funding at the State and the Federal 

level to address this in Flint, to address both the infrastructure 

needs and the public health concerns? 

Mr. LYON. I would have to defer to Keith on the infrastructure 

needs. What I will tell you is that through the Medicaid waiver 

process and through our partnership with the Federal agencies and 

with the Governor’s commitment to providing State funding as 

well, we are reviewing that. We have dedicated more than $200 

million with State funds. and the Governor is committed to maintaining the fundings to provide these services in the future. 

I also want to, again, thank my Federal partners. CDC has been 

on the ground helping us with many of these investigations. Dr. 

Lurie has been there. Dr. DeSalvo is somebody who has been very 

close to the ground as well to assist our staff there. That has been 

very important. 

But if you are asking long-term what we are doing with some of 

these things, there is always going to be competing public health 

priorities. 

Mr. PALLONE. Well, let me go to Dr. Lurie. So, you are of the 

opinion, if I understand it, that you have adequate State and Federal funds, at this point, to proceed. 

57 

Mr. LYON. For the near-term for what we are looking for. 

Mr. PALLONE. All right. 

Mr. LYON. But I think we are going to revisit. 

Mr. PALLONE. All right, Dr. Lurie, we understand that one of the 

things that Flint teaches us about the consequences of budget cuts 

for public health activities, in other words, a lot of this arose because of budget cuts. So, you know what do you—do you want to 

comment on the same question? Should we be concerned that we 

have inadequate funding to deal with Flint now and in the future, 

so that we don’t have recurrence of Flint problems? 

Dr. LURIE. Well, I very much appreciate the question. And as I 

said, you know disinvestment in the public health infrastructure 

has dire consequences. Maybe not always year one, but it is going 

to come back and bite you, without a doubt. 

Specific to lead and specific to Flint, I think that this Flint situation has shown us that lead in the water is another really important source of lead and the infrastructure issues make us all need 

to pay much more attention to lead. So, I think as Mr. Lyon said, 

it is important to revisit at this point support for the lead programs, particularly with the scope of the CDC. 

Mr. PALLONE. No, I am asking whether or not you think we have 

adequate funding for these programs. 

Dr. LURIE. Right now, I think the program certainly could be 

strengthened. In addition, I think we are really looking at wanting 

to put this registry in place in Flint so that we can both monitor 

kids and learn from the long-run. CDC estimates that establishing 

and maintaining a registry could cost as much as $4 million a year 

or more. 

Mr. PALLONE. So, you think you need additional funds to the 

tune of $4 million a year? 

Dr. LURIE. I think that is their estimation for the cost of the registry. Obviously, the Medicaid expansion, the other things are providing additional resources for the direct care of kids in Flint and 

I would defer to Mr. Lyon for more comprehensive assessment of 

the health and public health needs for Michigan and for Flint, per 

se. 

Mr. PALLONE. Thank you. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the vice chair, Mr. Guthrie, 5 minutes for questions. 

Mr. GUTHRIE. Thank you. Thank you, Mr. Chairman. 

Mr. Creagh, first I want to ask you—it is three questions. I will 

ask it as one question and then get your answer. 

So, what is the status of drinking water in Flint today, particularly in lead concentrations? Is it continuing to improve? And when 

will it be drinkable, without all the caveats and boiling and everything? 

So, what is the status? Is it improving? And when will it be 

drinkable? 

Mr. CREAGH. So, the data tells you that the quality is improving. 

The data tells you it is not yet safe because of the particulate lead. 

And until we go through a comprehensive data analysis in looking 

at where the lead particles are, there is not a date certain. 

Mr. GUTHRIE. I mean is there a rough estimate or time? 

58 

Mr. CREAGH. At this point in time, there is not a rough estimate 

until the system is thoroughly flushed. And that is where we will 

need to have the assistance of Flint citizens to get that accomplished. 

Mr. GUTHRIE. Thanks. Mr. Lyon, I would like to—we are talking 

about spending in public health. And on one of the things I think 

we should have been spending more on public health infrastructure 

as well, particularly infrastructure such as this. States are spending an enormous amount of money. I know my State of Kentucky 

and Medicaid, the growth of Medicaid is crowding out all the other. 

So, we are looking to reform that program to make it more efficient 

and more affordable so that we can spend money on things that 

matter in public health and other aspects. So, I have been focusing 

on Medicaid. 

So, in your written statement, you indicated that Michigan emphasized the need to improve lead testing rates in your recent Medicaid Managed Care Contract. Can you describe what Michigan is 

doing to improve the rate of lead testing, not only in Flint but in 

the entire State? 

Mr. LYON. Yes, sir. So, we have emphasized blood lead testing for 

several years within our Medicaid program but, as we looked at 

many of our public health issues and tried to roll those items up 

into our Medicaid rebid, we are trying to get a more comprehensive 

look at all things that drive health. So, what we are able to do with 

our rebid is build incentives in for the health plans, where if they 

reach certain metrics or certain measurements, then they actually 

can work their way into an incentive pool or a bonus pool. So, that 

is what we do. 

So, we are a strong managed care contract state for Medicaid. 

We believe that that is the effective way to go. We have great 

health plan partners. So, that is who we utilize in trying to do this 

and they then have relationships with physicians. 

What we need to do is circle back to ensure that we are measuring how those health plans are doing with their customers. What 

I would emphasize, public health is for the entire population. So, 

when you are looking at population-based activities, that is broader 

than the Medicaid program. 

Mr. GUTHRIE. Yes and understand my previous comments, I understand that public health is broader than Medicaid. But a lot of 

states are just increasingly spending more and more money on 

Medicaid, which diverts money from broader public health initiatives. There is only X amount of dollars. States can’t print money. 

So my next question was what type of outreach is the state or 

Medicaid health plans doing to encourage families? So, I guess you 

answered that in that you are just giving them target numbers 

that they have to reach and it is really up to the state Medicaid 

plans to make these targets work. Is the state doing other kinds 

of outreach and advertisement and trying to get families to have 

their children tested? 

Mr. LYON. Yes, sir. I am sorry. Thank you for the question. We 

have surveillance programs in place, centrally, and we also have 

some of the money that Dr. Lurie and some of the members we are 

talking about. We target towards our high-risk areas. So, there are 

59 

targeted areas that we really focus on and that is also part of what 

we are looking at. 

Mr. GUTHRIE. All right, thank you. That concludes my questions 

and I yield back. 

Mr. PITTS. The chairman thanks the gentleman. 

I know recognize the gentlelady, Mrs. Capps, 5 minutes for questions. 

Mrs. CAPPS. Thank you, Mr. Chairman and to all of our witnesses for your testimony here today. 

Clearly, what has happened in Flint is a tragedy of incredible 

proportions. While there are many topics I would like to touch on 

as a school nurse, I can’t help but continually go back in my mind 

to focus on the impact of lead on the children of Flint and, frankly, 

in far too many communities around our country. This is a lesson 

for us all. 

I know too well that these environmental and health impacts are 

going to have ripple effects in every aspect of every child’s life affected by it. 

As you know, the CDC’s Childhood Lead Poisoning Prevention 

Program was created to address such issues by funding State 

health departments to screen for children for lead poisoning. Unfortunately, Congress nearly zeroed out funding for this Federal program from 2012 to 2013 and has only partially restored it recently 

to 50 percent of its original levels. These breakdowns, compounded 

by cuts at the State level, deeply affect our Nation’s ability to identify and alert communities of high lead levels. As has been said, 

we are now reaping the results of this neglect at every level of our 

life together, especially in our case at the Federal level, something 

that is not only morally wrong but that will result in tremendous 

long-term effects in our country, not to mention cost. 

For these children and families, the impact of this crisis will be 

life-long and it would only add insult to injury if we add insult to 

injury if we stay on the sidelines and refuse to learn from this tragedy or deem it too hard or too expensive to act. We must think 

critically about the ways we can learn, now that it has happened, 

what went wrong so that our systems can be stronger in the future. 

So, my first question, Mr. Lyon and Mr. Creagh, you have talked 

about this already, what you are doing to strengthen Michigan’s 

blood lead level monitoring programs. But what are the lessons you 

wish we would learn here and considerations we should take into 

account how we learn from you and how we can create or strengthen a national program? 

Mr. LYON. Well, specifically with lead, I believe that stronger 

surveillance is necessary, period. We are more active in surveillance than other areas of infectious diseases and I don’t know if 

this was a Michigan-specific problem but one of the things we have 

done in reaction to this is really ensure that our CLPPP program 

is more aligned with our epidemiologists. That was part of the restructuring that we did and it was critical to correct what we were 

doing. 

I think another sort of overarching piece, and maybe this will 

segue into what Director Creagh will say, is that we have to be cognizant of health in all policies that we create. We talk about health 

in all policies. This is a great example of when a switch was occurVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00065 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
60 

ring or something significant was occurring where we really are 

considering health. And we talked about that generally in communities where there is health disparities but this is something that 

we need to be cognizant of going forward and I think should inform 

both State and Federal policymakers. 

Mr. CREAGH. And if I may, one of the things that we need to 

have is a very targeted and focused program relative to schools. As 

we went through the schools looking at what the infrastructure 

was, it had little to do with lead service lines. It had to do with 

fixtures in schools—— 

Mrs. CAPPS. Crumbling schools. 

Mr. CREAGH. Yes, and so that is one. And then two, as Director 

Lyon said, there needs to be a direct and robust intersect between 

the environmental programs and the public health programs because you cannot run those as siloed programs and we are committed to do that. 

Mrs. CAPPS. Well, thank you. You are pointing out some very 

critical issues. 

You know Flint is a frightening example of the dangers associated with not investing in public health infrastructure and programming across the country. But it is indicative also of a much 

larger program. The CDC and the scientific community have established that no amount of lead in the blood is safe for our children. 

It is estimated that millions of children across our country, not just 

in Flint, are exposed to lead through paint in their homes, through 

lead pipes, and plumbing, and a variety of other ways, particularly 

in older homes and older structures and many older schools. 

Dr. Lurie, I would like to turn to you. Is the agency—and I just 

have a second to get it out if you could respond. Is the agency considering any changes to the Childhood Lead Poisoning Prevention 

Program? How can we improve surveillance mechanisms so we can 

identify in real-time other communities? 

Dr. LURIE. Thank you. I appreciate the question. 

Yes, indeed, the agency is looking very closely at how to 

strengthen surveillance efforts to better detect these kinds of issues 

in the future and Flint has clearly highlighted the importance of 

preventing exposure, having a strong early warning system and 

being able to act on that as well. 

In addition to revising the guidelines for the program going forward, we are also looking at novel approaches such as new ways 

to use health information technology to help with these efforts in 

the future so that we truly have an early warning system and connect on the signals. 

Mrs. CAPPS. I yield back and I hope we can act further on this 

topic. 

Mr. PITTS. The chairman thanks the gentlelady. 

I now recognize the gentleman from Pennsylvania, Dr. Murphy, 

5 minutes for questions. 

Mr. MURPHY. Thank you very much. I want to pick up on some 

of the questions that my colleague from California brought up. 

Dr. Lurie, with regard to these lead levels, as a psychologist, I 

have worked a lot with developmental testing of young children, 

but with these lead levels that you have evaluated and tested, 

61 

what can you expect of the developmental outcome of these lead 

levels that have been present? 

Dr. LURIE. I think that is a really important question and something we focused a lot of our efforts on. What we know is, particularly for very young children, that no lead is good for you but we 

also know that if you do things to stimulate the brain and focus 

on early learning, such as early childhood education, good nutrition, parents reading to their kids, and frequent ongoing behavioral 

and development assessments so that when kids fall off, they can 

be—they can catch up. 

Mr. MURPHY. I understand that part of that. I am just asking 

about the chemical aspect of this level. Again, no lead/copper is 

good, but what I am referencing is so this is a situation where it 

sounds like there was poor corrosion control. And water companies 

are supposed to look for this. Right? Are they supposed to review 

the corrosive levels of water that they are putting into the water 

system? Is that a standard? Does anybody know that, EPA? 

Dr. LURIE. I will ask my EPA colleague to address that. 

Mr. MURPHY. Yes. 

Mr. BEAUVAIS. Yes, systems are supposed to both to be applying 

corrosion control treatment and to be monitoring water quality parameters. 

Mr. MURPHY. And in Flint, they weren’t doing that. 

Mr. BEAUVAIS. That is right. In 2014, when the Flint water system switched from previously purchasing Detroit water, which was 

treated in Detroit and corrosion controlled—— 

Mr. MURPHY. Well someone was violating this. Whether it was 

the EPA wasn’t testing or the community wasn’t testing, someone 

wasn’t following what they should have done. 

Mr. BEAUVAIS. The system did not apply corrosion control after 

they switched to river water. 

Mr. MURPHY. Right, somebody didn’t do what they were supposed to do. I mean clearly know that. 

Is Flint, Michigan the only water system in the country that has 

a problem like this? 

Mr. BEAUVAIS. I think it is fair to say that Flint’s problems are 

quite unique and unusual in the notion of a large system like this 

changing to an untreated water source and failing to provide corrosion control is highly unusual. That being said, it is clear that 

there are challenges with lead service lines and lead levels in many 

systems across the country. 

Mr. MURPHY. So, and testing lead levels in people’s homes is 

something that people are allowed to have, they are allowed to request that, correct? And here it happened that somebody did begin 

to test this out and that became what set this off and we are 

thankful that happened. But across America, I would suspect from 

what you are saying that a lot of communities aren’t routinely testing their lead levels in water. Dr. Lurie, do you know if that is occurring? I will take anybody’s. 

Dr. LURIE. You can speak to the lead levels in water. I can speak 

to the lead levels in blood. 

Mr. BEAUVAIS. OK, in whatever order is preferable. Yes, I mean 

for those systems that are subject to the Lead and Copper Rule, 

62 

they are required to monitor for lead levels in water through tap 

sampling and—— 

Mr. MURPHY. Right but they didn’t. They didn’t. And Dr. Lurie? 

Dr. LURIE. Yes, and, as many people know I think, that Medicaid 

program, in general, has a set of screening requirements precisely 

for this reason, that there is a recommendation that all 1- and 2- 

year-olds be tested. And then there is a recommendation that children 3 and up be tested if they haven’t been tested previously, precisely to detect these issues. 

Mr. MURPHY. Right and I agree. I have seen many a child over 

the years, and I know how important this is. And in my role as 

chairman of Oversight and Investigations, we had company after 

company in front of us: General Motors, Volkswagen, health companies, FDA, people who didn’t do what they were supposed to do. 

Congress puts up these laws, we have regulations. It doesn’t happen. And then companies say, ‘‘Can you bail us out?’’ 

Now, I am very concerned about the people of Flint and we need 

to find a solution for them but I am also concerned about the levels 

across the country. Locally, my elected officials in Allegheny County, Pennsylvania, are still struggling with what the EPA put upon 

years and years and years ago with a consent decree. Well, the constituents in my area and in Mike Doyle’s area, who is also a member of this committee, have been told years ago because the pipes 

that were originally set up that the sanitary sewers and the storm 

overflow go into the same pipes. You have to replace all the pipes 

in the county and the City of Pittsburgh, eventually. It is costing 

these communities billions and billions and billions of dollars. And 

basically, it said you have got to do this; EPA says you have got 

to do it, you have got to do it. 

So the question then becomes here is is this something that 

Flint, Michigan should bear the cost of all these actions or should 

the Federal Government help them out. 

Mr. BEAUVAIS. Well, I think if you are speaking with regard to 

the infrastructure changes that need to happen and are planned in 

Flint, it really is, primarily, a State and local responsibility. The 

assistance that the Federal Government provides, the primary assistance that is available so far is through the State revolving 

funds, which is one available resource, that the State has to fund 

possible infrastructure improvements. There are, of course, ongoing 

discussions, I believe, both in Michigan and here in the U.S. Congress, regarding potential other funding mechanisms. 

Mr. MURPHY. Thank you. 

I recognize I am out of time. Thank you very much, Mr. Chairman. 

Mr. PITTS. The chairman thanks the gentleman and now recognizes the gentlelady from Florida, Ms. Castor for 5 minutes. 

Ms. CASTOR. Thank you, Mr. Chairman, and thank you to the 

panel for being here today. I also want to thank the committee for 

calling this hearing because the Energy and Commerce Committee 

has jurisdiction over the Safe Drinking Water Act, health matters, 

environmental matters and here it is April 2016 and many people 

were wondering where the Energy and Commerce Committee was. 

So, I am glad we finally have this hearing. 

63 

Mr. Lyon, following the April 2014 change of the Flint water 

source, then, in 2015 where families and medical professionals like 

Dr. Hanna-Attisha, who is on the next panel, started to say there 

is lead in the water. People have to stop drinking it. There needs 

to be a coordinated response. At some point after that, Michigan 

asked for a Medicaid waiver for health services for Flint children 

and pregnant women. When did you come together to apply for the 

Medicaid waiver? 

Mr. LYON. Actually, I think we submitted our formal application 

in February, mid-February, approximately. 

Ms. CASTOR. This February. 

Mr. LYON. Yes. 

Ms. CASTOR. And it was, you had been in discussion for a little 

while on that? 

Mr. LYON. Yes, we were discussing the potential with—— 

Ms. CASTOR. And it was granted? 

Mr. LYON. Quickly. I don’t know the exact date but it was—yes. 

Ms. CASTOR. OK, in February? 

Mr. LYON. We applied in February. I am not sure when it was 

actually approved. 

Ms. CASTOR. OK. 

Mr. LYON. But CMS did approve it very quickly. 

Ms. CASTOR. And this Medicaid waiver is a technical term. And 

what it really did is say we need help. We need to make sure that 

the citizens of Flint in the area, children and pregnant women get 

the health services that they need. Can you sketch that out a little 

bit more why you thought that was an important part of the response? 

Mr. LYON. Yes, I think we wanted to extend benefits to children 

and pregnant women in Flint because they are most at risk for the 

impacts of lead exposure. 

Ms. CASTOR. And in fact, low-income communities often are more 

at risk for lead exposure. 

Mr. LYON. I am sorry. What was that? 

Ms. CASTOR. Oftentimes low-income communities are more at 

risk for lead exposure. 

Mr. LYON. Certainly, that is one of the health disparities that we 

look at through our programs is that where there are older homes 

and more lead-based paint in more impoverished areas, that definitely does have an impact on our urban cores, yes. 

Ms. CASTOR. So, as part of that Medicaid waiver, does the State 

receive additional dollars to serve a larger population? 

Mr. LYON. Yes. 

Ms. CASTOR. How much? 

Mr. LYON. I think it is approximately $25 million, total, State 

and Federal. 

Ms. CASTOR. And is there a time line on the waiver and expanded population, treating the expanding population? 

Mr. LYON. The Center for Medicare & Medicaid Services has approved the waiver. We are working with our State legislature to get 

their approval to move forward and those conversations are ongoing. And I hope and anticipate that they will act quickly so that 

we can get this up as quickly as possible. 

64 

Ms. CASTOR. So the Medicaid waiver has been granted by the 

Federal Center for Medicare & Medicaid Services but the State legislature has not put up its share because it is a State-Federal partnership. Is that—— 

Mr. LYON. That is basically correct. What I would say is we have 

to have the authorization and the funding to do this. And we go 

through a budget process every single year, and that takes some 

time. 

So, I think there was a bit of an inkling that this could be done 

as a regular part of the budget and we have asked that they take 

a quicker look at this. 

Ms. CASTOR. So, realistically, when do you think the legislature 

will act and do you think they will act? 

Mr. LYON. I think we will hear quickly. I mean we have been 

having conversations at very high levels with leadership and I have 

been over discussing with them and they understand the importance of doing it. 

Ms. CASTOR. OK, so within the next few months you anticipate? 

Mr. LYON. Oh, yes, yes, yes. 

Ms. CASTOR. OK. So, Michigan has a Medicaid Managed Care 

System. Is that right? You rely upon private plans to provide the 

health services and contract with medical professionals. 

Mr. LYON. The end of that cut out. I am sorry. 

Ms. CASTOR. To contract with medical professionals for the actual 

health services? 

Mr. LYON. Yes. 

Ms. CASTOR. So how do you ensure that children and pregnant 

women are actually being tested? And I think this kind of goes to 

the point of there seems to be a consensus that Flint is going to 

need a registry. But how do you ensure that the residents, the children and pregnant women get the health services they need? Are 

the Medicaid Managed Care companies required to collect data? 

And what else will you need going forward? 

Mr. LYON. Yes, they are required to collect data. We will work 

very closely within the populations they serve. We do outreach with 

the Medicaid health plans. They do outreach to reach out to individuals. It is a capitated model, so they are interested in increasing 

their participation so they have an incentive to enroll people. And 

what I would tell you is it is so important because we have to have 

people identified in the system so that these early interventions 

can occur. 

Dr. Lurie talked quite a bit about education, nutrition is very important, both to stop the absorption but also to ensure that a child 

develops the proper way that they can fight off any potential factors that happen. And the next part of that is having the screening 

in place so that if something is indicated, we can get them the services they need. 

And the most important part of this to me is the link to the medical home or the primary care physician in ensuring that these children and pregnant women are being seen regularly by their providers. And this allows that access to occur. 

Ms. CASTOR. So, in the Medicaid waiver that was granted to 

Michigan that we are waiting on the legislature to act on, does it 

65 

contain specific conditions that require the managed care plans to 

do that screening and testing and data collection? 

Mr. LYON. Yes. As Dr. Lurie mentioned, she mentioned the Federal standards and she could read that right out of our Medicaid 

manual. Ages 1 and 2, and if they haven’t been tested, ages 3 and 

higher. 

Ms. CASTOR. And Michigan’s intent is to ensure that the children 

and pregnant women that get their health services through Medicaid are entered into a registry and are tracked over time? 

Mr. LYON. We are going to track them. That is something that 

anything that we do long-term will have to be well thought out because we haven’t done it before. So, we would work with CDC on 

that. That would be very important. 

The other thing I would note in this situation, too, we have encouraged our health plans to test even younger than 1 because we 

test at 1 and 2 because that is when children begin to be mobile 

and that is when they start interacting with potential—— 

Ms. CASTOR. So but the overall infrastructure on data collection 

and registry is not in place now and that is something you are 

building right now. 

Mr. LYON. We collect data from the health plans but if we are 

looking to do a really robust, all-encompassing tracking system of 

these children long-term, I think it is something that we are going 

to have to work with the CDC and CMS and the local hospitals and 

the local providers to really get that in place, the local behavioral 

health system as well. 

Ms. CASTOR. Thank you very much. 

Mr. LYON. Yes. 

Mr. PITTS. The chairman thanks the gentlelady. 

I now recognize Dr. Burgess, 5 minutes for questions. 

Mr. BURGESS. Thank you, Mr. Chairman, and thanks for having 

the hearing today. Thank you all for being here with us this morning and spending so much time with us. 

I just have a couple of questions and possibly they could go fairly 

quickly. But Mr. Beauvais, let me start with you. 

The Lead and Copper Rule, I didn’t want to oversimplify it but 

to me, as a relative lay person here, it seems like Lead and Copper 

Rule, is the purpose of that to sort of let people know that the 

water supply is OK from these two agents, lead and copper? Does 

it function as an early warning system or does it function or could 

it function as providing a source of comfort to people who are relying on the municipal water that at least Lead and Copper Rule is 

being complied with, so we know we are OK? 

Mr. BEAUVAIS. It needs to, you know the way that Congress 

wrote the Safe Drinking Water Act it required to set standards and 

treatment techniques, in this case, that are feasible. 

Mr. BURGESS. But how does it exist today? I recognize you are 

talking that improvements need to be made. 

Mr. BEAUVAIS. Right. 

Mr. BURGESS. And I appreciate that. 

Mr. BEAUVAIS. But when the rule was written in 1991, the focus 

was on what was the technique that—it is a technology-based 

standard, not a health-based standard. So, it focuses on what levels 

could be achieved by corrosion control, the application of optimal 

66 

corrosion control, techniques across systems. And the action level 

was generated off that. But yes, you are absolutely right that the 

public notice requirements that are in the rule are intended to provide the public with information about how the system is performing. 

Mr. BURGESS. So even with the imperfection of the lead and copper rule as it existed a year and a half ago, should it have signaled 

that there is a problem here? 

Mr. BEAUVAIS. Yes, I think first and foremost to make the switch 

from Detroit water to Flint water required an approval from the 

State. And at that time, the system should have been advised to 

apply corrosion control to the new water source and that was not 

done. 

Mr. BURGESS. And it is your expectation with the improvements 

to the rule that you are anticipating these things will be mitigated. 

Mr. BEAUVAIS. That specific problem we have already issued a 

memorandum clarifying, in case there was any misunderstanding 

for large systems that that is a requirement. 

Mr. BURGESS. What about just sort of the ongoing surveillance 

of my municipal water system back home, do they check it for lead 

and copper? Are they required periodically to do an assessment? 

Mr. BEAUVAIS. They absolutely are. However, the Flint experience has brought to light a number of concerns around sampling 

techniques and approaches and that is something that we are already focusing on. We have already new guidance to States across 

the country asking them to adopt the most protective sampling 

techniques and that is something that we will be looking in the 

course of the rule of revisions. 

Mr. BURGESS. And who checks the checkers to make sure the 

checkers are checking? 

Mr. BEAUVAIS. Right, that is our challenge in this federalist system of—— 

Mr. BURGESS. I check with my municipal water systems, obviously, after this story is on the front page of the newspapers, are 

you doing your job. And they are. And I am grateful for that. The 

numbers are in compliance. 

But then, Mr. Lyon, as I look at the EPA’s map of the City of 

Flint, Michigan and see the dots on the map that are published as 

of April 11th, it is pretty startling. You have got about 60 dots 

equally distributed north and south of the river and only one of 

them is in the zero range. Fortunately, they are not all in the highest range but I am sure they are all in higher ranges than we 

would like to see. So, that is a significant problem, which I assume 

you have got on your radar screen and you are zeroing in on those 

dots that are of the highest intensity. Is that correct? 

Mr. LYON. Yes, Dr. Creagh is. He does the water piece with the 

map that you are referencing. He knows about it. 

Mr. BURGESS. Well, I think it is good that you have made this 

public—— 

Mr. LYON. Yes, we are aware. 

Mr. BURGESS [continuing]. So that people can, not real-time but 

almost real-time, assess it for themselves. 

Mr. Beauvais, let me just ask you because you mentioned in your 

testimony something and I am not familiar with this term, an 

67 

EPA-wide elevation memo was issued. What is an elevation memo? 

I have been on this committee for 11 years, and I haven’t seen that 

term. 

Mr. BEAUVAIS. That is how we refer to a memorandum that was 

issued by Administrator McCarthy to all staff at EPA in January 

of this year, really highlighting the critical importance that in situations where there is an understanding at a staff level in particular 

that public health may be at risk, that staff take the initiative to 

elevate those issues to higher levels of management and that we 

work collectively as managers and leaders across the across the 

agency to ensure that we are creating an environment where that 

happens and is welcomed. 

Mr. BURGESS. Can you share with the subcommittees involved 

the internal memoranda that related to that elevation memo being 

issued? 

Mr. BEAUVAIS. Absolutely. 

Mr. BURGESS. And just finally, there will be an EPA OIG report 

that is generated as a result of all of this. Do you know when that 

is going to be made public? 

Mr. BEAUVAIS. I prefer to let the Office of Inspector General 

speak to the timing of that. 

Mr. BURGESS. Thank you, Mr. Chairman. I will yield back. 

Mr. PITTS. The Chair thanks the gentleman and have a UC request from the ranking member. 

Mr. GREEN. Mr. Chairman, I ask unanimous consent to place 

into the record a statement from the American Public Works Association, the Ohio Department of Health, Director of Health, the 

American Academy of Pediatrics, and also the National Medical Association. I unanimous consent to place it into the record. 

Mr. PITTS. Without objection, so ordered. 

[The information appears at the conclusion of the hearing.] 

Mr. PITTS. The Chair now recognizes Mr. McNerney, 5 minutes 

for questions. 

Mr. MCNERNEY. I thank the Chair. 

One of the important lessons from the tragedy in Flint is the importance of investing, of course in this case it is in corrosion controls, what may seem like a lower priority investment could avoid 

a large public debt in the future. 

Mr. Beauvais, what exactly is corrosion control and are there different types of corrosion control for different water systems? 

Mr. BEAUVAIS. There are different types of corrosion control and 

the application of corrosion control really depends, in significant 

part, on the chemistry of the source water, as well as the configuration of the system. 

So, one common method of protecting against corrosion is the addition of orthophosphate, which is what is being done in the Flint 

system now and that effectively provides a coating on any lead 

service lines or pipes in the system to prevent leaching of lead into 

the water. 

Other techniques involve adjusting the pH of the water to reduce 

corrosion of the system—— 

Mr. MCNERNEY. I realize that Flint is unique. Do we have to 

worry about lead poisonings in other communities because of corrosion of pipes, of lead pipes? 

68 

Mr. BEAUVAIS. In any system that has lead service lines or lead 

premise plumbing, it is important to apply techniques to avoid that 

corrosion and certainly this is a challenge for many communities 

across the country. 

Mr. MCNERNEY. So, is EPA doing anything to incentivize adoption of corrosion control in other communities? 

Mr. BEAUVAIS. Well, in fact, the Lead and Copper Rule requires 

it and so one of the things that we are doing, we recently issued 

a new technical resource to help walk communities through how to 

do corrosion control to update preexisting guidance. And our regional offices, as I mentioned earlier, engaged with every primacy 

State across the country to ensure that they are taking a close look 

at any lead action level exceedances in it. 

Mr. MCNERNEY. And this crisis has caused other communities to 

be more aware of the problem, I take it. 

Mr. BEAUVAIS. Absolutely. There is definitely a strong focus on 

this now and I am sure members of the second panel will also 

speak to that. 

Mr. MCNERNEY. OK, what more could Congress do to encourage 

water systems to make those kind of investments? 

Mr. BEAUVAIS. Well, I think the oversight that Congress is providing and the attention that Congress is helping to bring to the 

issue is certainly helpful. We appreciate any support that we can 

get for our efforts to strengthen implementation of the rule now, 

as we engage with States and water systems across the country. 

And of course, this will be an important element of the Lead and 

Copper Rule revision so, we appreciate the committee’s strong support for moving forward with that. 

Mr. MCNERNEY. Very good. Well, corrosion controls are only one 

part of what the City of Flint needs to do to operate its water systems safely and sustainably. For example, Mr. Creagh, you mentioned that the city is losing large amounts of treated water in its 

distribution system every day. 

Now, being from California, we have a water crisis almost every 

year. So, this is an issue that we care about very deeply, as well 

as contamination. What do you recommend? 

Mr. CREAGH. So, we are working very closely with EPA and the 

city looking at the reliability study, doing hydraulic monitoring, 

doing tracer studies to figure out how long the water is in the system and how best to address those concerns for the community. 

Mr. MCNERNEY. So, there is technology that is good at detecting 

these leaks. 

Mr. CREAGH. Yes, sir. 

Mr. MCNERNEY. OK. Is it pretty expensive to implement that? 

Mr. CREAGH. The monitoring technology I wouldn’t say is the expensive part. The right sizing the infrastructure would be the cost 

concern. 

Mr. MCNERNEY. Thank you. Well, as we look to the future, we 

must invest aggressively in our water infrastructure. I think everybody knows that. But when you do so in a sustainable way, this 

should include incentivizing corrosion controls, water loss audits, 

and other methods to ensure that our water systems can afford 

safe and affordable water well into the future. 

69 

The EPA has committed a year ago to developing health-based 

household action level for lead to help parents, pediatricians, and 

local officials understand the risks to formula-fed infants so that 

they can protect children. Why hasn’t the EPA issued this level 

yet? 

Mr. BEAUVAIS. In fact, that was a recommendation that we had 

just received from the National Drinking Water Advisory Council 

this past December and we are, in fact, actively working on that. 

Mr. MCNERNEY. So, you are not overdue on that recommendation. 

Mr. BEAUVAIS. It really was a recommendation that came in the 

context of the Lead and Copper Rule revisions and we are actively 

working on it. That is a somewhat complex scientific endeavor that 

will require peer review and so forth. 

Mr. MCNERNEY. So, you are not ready to give a commitment as 

to when you are going to release that information, that value. 

Mr. BEAUVAIS. I can’t. I can only say that we are working actively on it and when a product is ready for peer review, that will 

be done. 

Mr. MCNERNEY. All right. Thank you, Mr. Chairman. I yield 

back. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the gentleman from West Virginia, Mr. McKinley, 5 minutes for questions. 

Mr. MCKINLEY. Thank you, Mr. Chairman. 

I have got a couple of questions, Mr. Beauvais, if I could start 

with you on it. Maybe at first you are not going to be able to answer, but if you could get back to me. 

And that is, in your testimony you say there are 68,000 water 

systems in America. I have asked this question of other panels on 

this and no one has gotten back to me. I would like for you to get 

back to me. 

What would be the breakout of communities, let’s just say rural 

communities of 5,000 of fewer out of that 68,000? Could you get 

back to me on that? 

Mr. BEAUVAIS. Absolutely. I think I can probably give you a—— 

Mr. MCKINLEY. You are not going to be able to give me that right 

now but we are looking for some kind of breakdown on the 68,000. 

How many of them are coming? Because in the rural communities, 

often, they are going to be poorer, perhaps, less affluent, perhaps. 

So, they are going to face some other difficulties a we deal with 

this problem. 

I would also like to know from you, if you could, put together 

something that, based on the 1986 Safe Drinking Water Act, the 

number of homes that were constructed prior to 1986. I have got 

to think that that is going to be the majority of homes built in 

America, especially in rural areas that they are going to have older 

homes there that could have internal lead-inducing issues with it. 

So, that leads to the next question of I think you are going to 

answer the question a posit, and that is, our plumbing fixtures, our 

lead solder, our galvanized pipe, just piping in general, our distribution within a house, even if we have the freshest, cleanest 

water coming into the home, aren’t we possibly subjecting the 

70 

homeowners and the people that live in there, the children and all, 

aren’t they going to be subject to higher lead levels as well? 

Mr. BEAUVAIS. Premise plumbing is certainly part of the issue. 

The lead service lines, the laterals that connect the water mains 

to the homes are one big concern but premise plumbing can also 

be as significant. 

Mr. MCKINLEY. OK, I would like to understand more of that significance on that. I often refer to Mildred Schmitt. She is your 

neighbor. She is my neighbor. Mildred Schmitt, when this issue 

was raised, contacted the EPA to find out what do I do. I have 

heard it on Fox News. I have heard it on the news. I have got a 

problem. What am I supposed to do? And she is fortunate enough 

they have the internet, because that is what everyone tells you, you 

are supposed to go to the internet. And she may or may not have 

internet access. But if she does have it, this is what she got was 

this one-inch thick panel of papers that she is 82 years old, and she 

doesn’t know what do with that. So, she is overwhelmed with this. 

This is not a user-friendly system that we have set up for people, 

Mildred Schmitt, to be able to address this problem. She doesn’t 

know whether she has a problem or not. 

And so I am trying to understand—we have known about this 

problem, apparently since 1986 and it goes far beyond Flint. What 

differentiates this lead problem that manufacturers in solder, fixtures, plumbing lines, distribution systems and the like, what differentiates them from all the other settlements and litigation that 

we have had across this country over things? I just was listing 

them: the cigarette manufacturers, $206 billion settlement on that; 

the mesothelioma, the asbestos issue that was $30 billion that the 

manufacturers had to come up with; air bags; thalidomide; Corvair 

auto; ignition switch; engine coolant; breast implants. All of these 

manufacturers have had to step up and take care of this but we 

look over to the manufacturers of a lead-induced system in our 

homes and we are letting them pay no responsibility. 

What differentiates that? Why aren’t they involved in helping out 

the homeowners, whether it is in rural America, rural West Virginia, or elsewhere? What is your response to that? 

Mr. BEAUVAIS. I think it is a very good question. It is not something that I have thought about before but I would be happy to 

give it some thought and get back to you. 

Mr. MCKINLEY. Not that I am trying to get litigation started on 

this but I don’t understand the difference. If these homeowners 

don’t know—Mildred Schmitt doesn’t have two nickels to rub 

against each other and she may be faced with something that could 

cost $5,000 or $10,000 to fix the lead problem in her home. What 

is she supposed to do? She is living on Social Security. 

I think we have a real serious problem here as it relates to 

homeowners. So, I would really like to hear back what some solutions should be. Is this something Governments should step up, or 

is this the manufacturer should take care of it? 

So, I have run out of time, apparently. So, if any of the rest of 

the panel, if you could get back, I would sure like to know which 

direction we want to go in this. OK? 

Thank you very much. 

71 

Mr. PITTS. The chairman thanks the gentleman and now recognizes Mr. Luja ́n, 5 minutes for questions. 

Mr. LUJA ́ N. Thank you very much, Mr. Chairman. 

I have been dismayed by the events that have unfolded in Flint, 

Michigan, which are deeply tragic, because all of these could have 

been prevented. It was all preventable. And that is what I just 

heard from my colleague as well from West Virginia, that is where 

this frustration is coming from. 

And so I also hope that the crisis in Flint serves as a wake-up 

call to all of us in Congress and all across America that public 

health vital programs cannot be cut, that protections that should 

be in place should not be eliminated. 

I am reminded as we are hearing this debate, Mr. Beauvais, that 

there is questions about the standards set with the clean water 

drinking standard. And when there as a breach about a year ago 

in New Mexico and Colorado in the Animas River, it turned orange. 

There were heavy metals flowing through it. And we were told in 

New Mexico that it met the clean water drinking standard. I don’t 

know one of you that would have picked up a glass water out of 

that river that day and put it into your body. We have got to look 

into this stuff because if it is making people sick and killing people, 

we have got to get our hands around it. 

So, with that being said, I am trying to understand what is going 

on in Flint and across the country but it has become apparent that 

there is a lack of good data on where kids are being exposed to 

lead. In my home State of New Mexico, I have become increasingly 

concerned by the risk level for lead exposure faced by many of our 

counties. New Mexico has received 3-year funding from the Centers 

for Disease Control and Prevention for lead poisoning prevention 

programmatic activities. However, just this week, the Associated 

Press analysis of data from the U.S. Environmental Protection 

Agency and the New Mexico Environment Department found that 

20 small water systems across the State of New Mexico have exceeded the Federal lead standard at least once in the last 5 years. 

This is truly alarming. And I know, Dr. Lurie, that you share that 

concern with me. 

Is it true that the Federal Government does not require States 

to submit lead exposure data? 

Dr. LURIE. So, I think as we have been looking at how to 

strengthen lead program, one of the things and improvements we 

have been talking about is publicly posting lead data and obviously 

in a way that provides anonymity for patients but makes clear 

what the levels and issues are. And as we look forward to strengthening the lead program in general, I think we very much look forward to working with Congress on a set of proposals to do that. 

Mr. LUJA ́ N. So, Dr. Lurie, the answer to that question is no, the 

Federal Government does not require States to submit—— 

Dr. LURIE. Does not require States to submit—— 

Mr. LUJA ́ N [continuing]. Lead exposure data. 

Dr. LURIE. No. 

Mr. LUJA ́ N. Do you believe that the variability between State reporting standards makes it difficult for decision-makers to understand the level of lead exposure risk across the country? 

72 

Dr. LURIE. I am not totally sure that I understand your question 

but it does seem as though there needs to be readily understandable, interpretable standardized data that let us all be able to act. 

Mr. LUJA ́ N. That is the essence of the question, Dr. Lurie. It is 

my understanding that there is not a standard for how States even 

report that. That from one jurisdiction to the next, the data that 

is being reported is very different. And so there needs to not only 

be a requirement that this data be sent to the Federal Government, 

there needs to be a standard that is established as well. 

And what steps should be taken to strengthen State and Federal 

programs to screen children for elevated blood levels? 

Dr. LURIE. So, on the part of your question I would really like 

to get back to you on the facts because that is not a level of detail 

that I am familiar with. 

On the State and local level, otherwise, there is a very good Medicaid standard, for example, about screening but I think we also 

know that while there have been vast improvements over the last 

decade or so and we are up to somewhere in the low 60 percents 

for Medicaid screening, we are really looking toward universal 

screening of young children to be sure that we can catch kids with 

lead. And strengthening the surveillance programs and potentially 

even automating some of those systems so that we can have an 

early warning system that is in real-time and is better is a real 

focus of the discussion going forward. 

Mr. LUJA ́ N. I think you just described, Dr. Lurie, why there is 

such an importance with preventative care with screenings and 

with checkups on a regular basis so that we were able to catch as 

much of this as we can as early as we possibly can. 

And then lastly, as my time runs out, Dr. Lurie, I just want to 

appreciate the attention that you brought to the behavioral and 

mental health aspect of this. There are too many people that have 

been traumatized over this and the emotional toil that has been experienced is traumatic. It also brings us back to the importance of 

what needs to be done for mental and behavioral health programs. 

So, thank you very much for your time today for this important 

hearing. 

Mr. Chairman, with that, I yield back the balance of my time. 

Mr. PITTS. The chairman thanks the gentleman. 

I now recognize the gentleman from Virginia, Mr. Griffith, 5 minutes for questions. 

Mr. GRIFFITH. Thank you very much. 

The two witnesses from Michigan referenced Dr. Mark Edwards 

of Virginia Tech. I will ask each of you, it is kind of a yes or no 

except it is not, question and that is, Dr. Mark Edwards hero or 

gadfly troublemaker? We will start with you, Mr. Beauvais. 

Mr. BEAUVAIS. Well, Dr. Mark Edwards, the collaboration between EPA and Dr. Edwards has been extremely useful to us. So, 

he surely is a hero in this. 

Mr. GRIFFITH. Dr. Lurie? 

Dr. LURIE. Similarly, he has been a very important collaborator 

and someone who has also earned the trust of the community in 

important ways for moving forward. 

Mr. GRIFFITH. Mr. Lyon? 

73 

Mr. LYON. Not only would I want to recognize Dr. Edwards for 

his work but I would want to recognize Dr. Hanna-Attisha, who is 

going to testify later. Their independent look at this certainly 

brought us around. So, thank you. 

Mr. GRIFFITH. Mr. Creagh? 

Mr. CREAGH. I would echo Director Lyon to thank both those doctors for providing the leadership to resolve this issue also. 

Mr. GRIFFITH. All right. So, here is the problem. Because he 

dropped everything he was doing, didn’t teach class, in fact in an 

article that appears in the Roanoke Times today, he says he is not 

sure why Virginia Tech still has him on staff because he hadn’t 

taught any classes, hadn’t had time to write grant money, spent 

$250,000 out of their funds, 5 years’ worth of man-hours working 

on this project. They have got a cash flow problem and in fact have 

set up a GoFundMe page, Flint Study VT, trying to raise money 

to offset the work that they have done. 

I ask each of you, do your programs, do your agencies have a 

fund available? And to the folks in Michigan I would say if you 

don’t have a fund available, you have a full-time legislature, if I remember correctly, perhaps a bill ought to be put in to help offset 

or defray some of these costs. 

I don’t know about the other person that you mentioned. She is 

not my constituent. But when I read an article about one of my 

constituents who has done the right thing for another part of the 

country and expended funds that have now put them into a little 

bit of a financial hole, that is what I am looking for. 

So, again, Mr. Beauvais, just because you are at that end of the 

table, if you would start. Are there funds available at the EPA to 

help defray these costs? 

Mr. BEAUVAIS. Well, in fact, we have provided support to some 

of Dr. Edwards’ recent work in Flint. 

Dr. LURIE. I am going to have to look into the kinds of funds that 

are available, although I am not aware that we have received any 

requests for funding. 

Mr. GRIFFITH. I understand. Mr. Lyon, and either one of you can 

speak for Michigan. 

Mr. LYON. I was going to defer. 

Mr. CREAGH. So, I do know that that is a direct conversation 

being held in Michigan to see how we can support Dr. Edwards in 

his research. 

Mr. GRIFFITH. All right, I appreciate that very much. 

Mr. Chairman, if I might, I would ask unanimous consent for 

that article from the Roanoke Times in today’s paper to be submitted to the record. 

Mr. PITTS. Without objection, so ordered. 

[The information appears at the conclusion of the hearing.] 

Mr. GRIFFITH. And let me move on, then, to other newspaper articles that I have read. Miguel Del Toral, according to some recently released emails in an article that I read out of The Detroit 

News back at the end of March, indicated that in an email that 

was released that, at one point in time, he had offered to do more 

tests in Flint, Michigan on his own dime to prove that what he was 

saying up the chain, that there is a problem here, would come out. 

74 

I have to wonder if the EPA has just got too much bureaucracy 

when they can’t even listen to their own people in the field and 

they are offering to do it on their own dime and, instead, they get 

the stiff arm. I know that you didn’t have anything to do with that, 

but Mr. Beauvais, what are we going to do in the future? I mean 

that is what this hearing is about to make sure that when your 

own people are saying there is a problem, they are not just totally 

dismissed and, in fact, he would appear punished. Again, I know 

that is debatable but it appears that he was punished for a short 

period of time. 

Mr. BEAUVAIS. Well first of all, let me just say that Miguel Del 

Toral is an incredibly valued member of EPA’s team, one of the national experts in this area. I am not aware of any punishment of 

him but I—— 

Mr. GRIFFITH. I understand. 

Mr. BEAUVAIS [continuing]. Do think that it is very important 

that concerns that get raised at a staff level be appropriately elevated and get appropriate attention. And that is precisely the point 

of the policy memo that was discussed. 

Mr. GRIFFITH. And I know your position and I am not fussing at 

you but I will tell you in another hearing that I attended, not this 

committee, in regard to this, the mom, the hero mom in this situation was told that he had been dealt with and he disappeared for 

a period of time because he had been dealt with. I consider that 

a form of punishment. The EPA may not consider it that but I do. 

And that is the kind of thing that bothers when we have folks 

saying that we need more money. And I am sure that there is always use for more money but if you just listened to the folks on 

the ground, you could have stopped this problem sooner. And that 

is my concern as a Federal representative talking to the Federal 

representatives of the EPA. You all had a chance. You missed it. 

I am not trying to bust your chops but I want to make sure that 

you all get the system right so when this happens again, because 

the same article in the Roanoke Times says they are looking at 

Philadelphia. 

I yield back, Mr. Chairman. Time is up. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the gentlelady from Illinois, Ms. Schakowsky, 5 

minutes for questions. 

Ms. SCHAKOWSKY. Thank you, Mr. Chairman, for holding this important hearing. 

I was one of a pretty large delegation that went to Flint last 

month. I know Dr. Lurie was part of the—was one of the presenters and was there. I don’t know if I met the others of you when 

the 25 Members led by Leader Pelosi, the Congressional Progressive Caucus, the Congressional Black Caucus for a speak-out, but 

we also had a panel and had an opportunity to see the incredible 

resources that were pulled together at that point to really address 

the problem. And, obviously, nothing is too much for us to do to 

correct this problem. 

And it is not really contained to the City of Flint. There may be 

some particular circumstances, as was mentioned, but cities across 

the country have these aging water systems, these underground infrastructure problems and there could be lead, I know, in Chicago 

75 

because so many kids live in homes with lead paint. The latest 

data we have for the City of Chicago shows that in 2014 approximately 675 children had elevated levels at 10 times the amount but 

I think that is really underestimated. We don’t do a lot of testing. 

So, Dr. Lurie, as a key part of the State’s response, and this has 

been discussed somewhat in Flint, was its application for a Medicaid waiver to extend Medicaid coverage to thousands of children 

and pregnant women in Flint to ensure that our most vulnerable 

receive the comprehensive and ongoing care that they need. And 

thankfully, this waiver was approved. 

The coverage provided through this new Medicaid waiver, which 

also eliminated premiums and cost-sharing and broadened case 

management benefits for all the beneficiaries in Flint is clearly 

going to make a difference in the lives of Flint residents for years 

to come. 

So, I am wondering if you could speak to why Medicaid coverage, 

in particular, was and continues to be such a vital part of the 

broader Federal response in this situation. 

Dr. LURIE. Thank you. I appreciate the question. And as we have 

discussed, one of the situations we had here was that we had all 

kids in Flint exposed to the Flint water system and all kids in Flint 

and families in Flint potentially exposed to very concerning levels 

of lead. Medicaid is the healthcare infrastructure particularly for 

low-income people in this country. It not only provides, however, 

access, to basic healthcare, in this case, Medicaid is a terrific solution because it also can provide through expanded services case 

management, behavioral and developmental services and other 

things like transportation for people who have difficulty getting to 

medical care. 

So if, in fact, we want to get kids into see a primary care provider through their medical home and help them use the services 

that are available to them, often we need case management, transportation services, as well as all the other things we call wraparound services, the developmental behavioral services, the home 

visiting, all of those things that are required to be sure kids get 

what they need. 

Ms. SCHAKOWSKY. So, that is on the list of things that now are 

available. How is it going in Flint? 

Dr. LURIE. So, right now, we are waiting for the State legislature 

to approve the Medicaid expansion so that we can actually get 

those services off the ground. We understand from the State that 

that is coming. And meanwhile, the Center for Medicare & Medicaid Services and all of us are looking at ways to lean forward 

both to monitor uptake but to be really proactive within the community about being sure that people know the services are available and are able to take advantage of them. Many, many community organizations are on the ground poised and ready to get kids 

enrolled. 

Ms. SCHAKOWSKY. So, the legislature in Michigan has to approve 

this. What is the time line there? 

Mr. LYON. Thank you for the question. We are working with 

them, at this point, daily on getting their approval to do this. So, 

it is something that we are working on. It was what I referenced 

a little bit earlier. They were looking, as part of the budget request, 

76 

where it would have taken a little bit longer to get this in place. 

We have asked them to expedite that. And we are ready to implement as well. 

So, there are some technology revisions that will have to happen. 

There are things that have to occur but it should be a pretty quick 

implementation time frame, once we have that off the ground. 

Ms. SCHAKOWSKY. Now, is this administered in the same way or 

funded in the same way that Medicare is with the State match as 

well as the Federal dollars? 

Mr. LYON. The same with Medicaid. It is matched with State dollars, yes. 

Ms. SCHAKOWSKY. So, do you have any expectation on when the 

money can be approved? 

Mr. LYON. I would want to be careful speaking on behalf of the 

State legislature for obvious reasons. But again, I think we have 

an education process we are doing with them. They had a lot of 

other priorities in front of them as well and we have gotten to the 

right people to assure that decisions can be made quickly. 

Ms. SCHAKOWSKY. Thank you. I yield back. Thank you. 

Mr. PITTS. The chairman thanks the gentlelady and now recognizes the gentleman from Florida, Mr. Bilirakis, 5 minutes for 

questions. 

Mr. BILIRAKIS. Thank you, Mr. Chairman, I appreciate it. Thanks 

to the panel for your testimony. 

The first question would be for Mr. Beauvais. I pronounced that 

right, correct? 

Mr. BEAUVAIS. Yes, that is right. 

Mr. BILIRAKIS. OK. You mentioned that the EPA’s role is to 

maintain Federal oversight of the State’s drinking water programs. 

Why, then, didn’t the EPA intervene after numerous violations, including the complete absence of corrosion control treatment by the 

City of Flint that was noted apparently in the June 2015 by Mr. 

Del Toral? Why didn’t the EPA intervene? 

Mr. BEAUVAIS. Well, in fact, the EPA staff were intensively engaged with their State counterparts from the period as soon as 

they—they were initially told that corrosion control was being applied and then later informed that it, in fact, was not being applied. From that point in time, EPA was intensively engaged with 

State counterparts to MDEQ. Ultimately—— 

Mr. BILIRAKIS. When? Can you give me a date on that? 

Mr. BEAUVAIS. EPA was informed in April of 2015 that corrosion 

control was not being applied. A series of engagements ensued. By 

July of 2015, MDEQ had indicated that it would go and ask Flint 

to apply corrosion control. 

Mr. BILIRAKIS. Thank you. The next question, sir. 

There have been Safe Drinking Water Act violations in several 

States, including my home State of Florida. What administrative 

steps has the agency taken to ensure that similar problems that 

may occur across the country are acted upon quickly, of course, and 

do not lead to another public health crisis? 

Mr. BEAUVAIS. Well, we focused on two key actions that are 

closely related to one another. One is that our regional offices are 

engaged with every single State drinking water program that has 

primacy across the country to review all of the data with regard to 

77 

led action level exceedances to ensure that those are being addressed and that corrosion control is being applied where needed 

and that any other steps that need to be taken are taken. 

The second is that we sent letters to every Governor and every 

State drinking water regulatory agency head for the primacy 

States in the country asking them to focus appropriate attention 

and resources on this, asking for a series of concrete steps, both 

with regard to implementation of the rule and increased transparency and accountability in the way that sampling results and 

other information are being provided to the public. 

Mr. BILIRAKIS. Thank you. Next question. 

While lead levels are improving, Flint water still exceeds Federal 

standards and virtually all homes must still be considered at risk. 

Do you have an estimate as to when drinking water in Flint will 

be back in compliance with the Safe Drinking Water standards? 

Mr. BEAUVAIS. I mean I think I would share the view that Director Creagh articulated earlier, which is that I don’t feel that we can 

hazard a guess as to the timing. 

At this point in time, directionally, things are improving and we 

really need to be guided by the data and the experts in assessing 

when we are back to a situation where it is safe to drink. 

Mr. BILIRAKIS. Well, can you get back to us on this one? 

Mr. BEAUVAIS. Absolutely, we are happy to do it. 

Mr. BILIRAKIS. Thank you. 

Experts stress the importance of water use in homes so that the 

orthophosphate and chlorine added to improve the water quality 

that flow through the pipes. Given that many Flint residents are 

hesitant to run their water, and you can’t blame them, whether it 

be for safety or financial reasons, and that there is a growing vacancy in the housing market how will a flushing program be successfully implemented? 

Mr. BEAUVAIS. Well, I want to give Director Creagh and opportunity to respond to this as well. I think that is exactly the challenge that we are now grappling with is both to identify an appropriate protocol and then to develop an approach to make that happen on the ground. And of course I think the question of water bill 

forgiveness is certainly going to be an element of that discussion. 

Mr. BILIRAKIS. Director? 

Mr. CREAGH. I certainly agree with Mr. Beauvais. Our staffs are 

working together to agree upon with Dr. Edwards on an agreed 

upon flushing protocol and then there is high-level conversations 

looking at forgiveness of any of that cost because we do need to 

have the assistance to participate in this effort. 

Mr. BILIRAKIS. Director, I have a question for you. Do you believe 

that those in your agency, appointed or otherwise, had the necessary training and/or certification for managing the city’s drinking 

water system with regard to implementing and enforcing regulations mandated by the Safe Drinking Water Act? 

Mr. CREAGH. I think it goes beyond the technical training of 

staff. And that is one of the reasons why we are exploring apprenticeship programs with the American Water Works Association and 

some of the municipalities so that employees get more hands-on 

training, so they understand what happens inside the plant and 

the results of their actions. 

78 

Mr. BILIRAKIS. Thank you, Mr. Chairman, I yield back. I appreciate it. 

Mr. PITTS. The chairman thanks the gentleman and now recognizes the gentleman from Mississippi, Mr. Harper, 5 minutes for 

questions. 

Mr. HARPER. Thank you, Mr. Chairman, and thanks to each of 

you. And it appears that I am the last person to ask questions. So, 

thank you for being so patient on this. 

Mr. Beauvais, I know that you followed up on some questions 

that Mr. Green had asked earlier and Chairman Upton followed up 

with about the EPA intends to make long-term revisions to the 

Lead and Copper Rule, a question about when. What are the key 

issues for EPA in hammering this out? 

Mr. BEAUVAIS. Well, I think some of the key issues relate to lead 

service line replacements. That is a very, without getting into all 

the gory details, that is a very complex and challenging area because of the way that ownership and control of lead service lines 

works and the expense associated with lead service line replacements. So, that will be one of the key issues to grapple with. 

Another, for example, is the recommendation of the development 

of a household action level that would be used to trigger notification and intervention from public health officials. 

And there is a series of others which I would be happy to outline. 

Mr. HARPER. Sure but thank you very much. 

Does EPA have any concerns about National Drinking Water Advisory Council recommendations? And if so, which ones? 

Mr. BEAUVAIS. I wouldn’t say concerns. I guess what I would say 

is we have also had—we have received recommendations and input 

from a number of other concerned stakeholders. There was a dissenting member of the Council who submitted a separate opinion 

or set of recommendations. And the other thing to mention is just, 

as I was saying earlier, the working group, the Lead and Copper 

Rule Working Group’s recommendations that ultimately came up 

through the council were really developed before the whole experience in Flint came into the national consciousness in the same 

way. So, we are learning a lot on the ground and we are learning 

a lot as we engage across the country and that will also influence 

our thinking on the proposed rule. 

Mr. HARPER. You know you have said there is a lot of data coming in that has got to be evaluated, reevaluated and continuing 

input that is going to go on that. But what is go beyond the requirements? 

Mr. BEAUVAIS. Well, one of the things that we have asked the 

State regulators to look at and drinking water system operators to 

look at is the current rule, for example, doesn’t require public posting of the individual sampling results. Regulators are required to 

report to us the 90th percentile results but we really felt strongly 

that consumers and resident citizens would benefit from having 

that information be made publicly available. So, that is one area. 

And we have provided some information on recommended sampling protocols that are not strictly speaking regulatory requirements of the current rule but we have encouraged people to adopt 

those as more protective. And there is a couple of other areas, as 

well, that we have focused on. 

79 

Mr. HARPER. And Mr. Beauvais, one of the other cities that has 

received some national news is Jackson, Mississippi in my district 

as well. And I know that city officials have been working with EPA 

during this time and we certainly appreciate that assistance. 

In your testimony, you state that Administrator McCarthy’s 

called for an IG investigation to investigate EPA’s response to the 

Flint crisis. Do you know when that IG investigation and report 

will be completed? 

Mr. BEAUVAIS. I think I will have to defer to the Office of Inspector General on the timing of their report. 

Mr. HARPER. Well, on February 29th, the EPA sent a letter to 

ensure water systems were following the lead and copper rule to 

the Mississippi State Department of Health and agencies in each 

State across the country to enforce that rule. In it, EPA asked the 

States to work with public water systems with a priority emphasis 

on large water systems to increase transparency in implementing 

the Lead and Copper Rule by posting that information. 

Any idea why there was an emphasis put on large water systems? Is it just the sheer volume of customers or is it a starting 

point? Explain that. 

Mr. BEAUVAIS. I think something in the nature of triage. This is 

a huge level of effort that needs to be made by State drinking 

water system operators. So, there was an encouragement to start 

with large systems and then kind of work down the stack. We understand there is a number of unique challenges that small systems face and it is important to grapple with those as well. 

Mr. HARPER. I think we all understand the importance of clean 

drinking water and we want to say we appreciate the assistance 

and look forward to a resolution. 

And with that, I yield back. 

Mr. PITTS. The Chair thanks the gentleman. 

At this point, the members’ questions are concluded. We will 

have follow-up questions we will send to you in writing. We ask 

that you please respond promptly to that. 

And so at this point, we are going to take a short break while 

the staff sets up the witness table for our second panel. The subcommittee will stand in recess for 3 minutes. 

[Recess.] 

Mr. PITTS. All right, the time of recess having expired, the subcommittee will reconvene. 

I will ask our second panel to please take their seats and the witness table. I will introduce them in order of their presentations. 

First of all, Dr. Mona Hanna-Attisha, MD, MPH Program Director Pediatric Residency, Hurley Children’s Hospital, Hurley Medical Center, Assistant Professor of Pediatrics, Michigan State University College of Human Medicine. Welcome. 

Second, Joan Alker, Executive Director at the Center for Children and Families, Georgetown University. Welcome. 

Mr. Steve Estes-Smargiassi, Director of Planning and Sustainability, the Massachusetts Water Resources Authority. Welcome. 

June Swallow, President and Administrator, Rhode Island Drinking Water Program, Rhode Island Department of Health. Welcome. 

Finally, Mae Wu, Senior Attorney, Health and Environment Program, Natural Resources Defense Council. 

80 

Thank you for coming, each of you. Your written testimony will 

be made a part of the record. You will each be given 5 minutes to 

summarize your testimony. Our little light system is not working 

so they are on the floor, along with the wires. So be careful, anyone 

walking, not to step on the wires. But at 4 minutes, I will give you 

a couple of taps to give you a signal that you have got 1 minute 

left of your 5-minute testimony and please ask you to wrap it up 

at 5 minutes. 

So, we will start with Dr. Mona. You will be recognized now for 

5 minutes to summarize your testimony. You are recognized. 

STATEMENTS OF MONA HANNA-ATTISHA, M.D., ASSISTANT 

PROFESSOR OF PEDIATRICS, MICHIGAN STATE UNIVERSITY 

COLLEGE OF HUMAN MEDICINE, AND DIRECTOR, PEDIATRIC 

RESIDENCY PROGRAM, HURLEY CHILDREN’S HOSPITAL; 

JOAN C. ALKER, EXECUTIVE DIRECTOR, GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES; STEPHEN 

ESTES-SMARGIASSI, DIRECTOR OF PLANNING AND SUSTAINABILITY, MASSACHUSETTS WATER RESOURCES AUTHORITY, 

ON BEHALF OF THE AMERICAN WATER WORKS ASSOCIATION; JUNE SWALLOW, ADMINISTRATOR, RHODE ISLAND 

DRINKING WATER PROGRAM, RHODE ISLAND DEPARTMENT 

OF HEALTH, AND PRESIDENT, ASSOCIATION OF STATE 

DRINKING WATER ADMINISTRATORS; AND MAE C. WU, SENIOR ATTORNEY, HEALTH AND ENVIRONMENT PROGRAM, 

NATURAL RESOURCES DEFENSE COUNCIL 

STATEMENT OF MONA HANNA-ATTISHA 

Dr. HANNA-ATTISHA. Thank you. Good afternoon. Now, I would 

like to begin by thanking Chairman John Shimkus and Chairman 

Joe Pitts, along with Ranking Member Paul Tonko and Ranking 

Member Gene Green, for the opportunity to testify at today’s joint 

subcommittee hearing on the Flint Water Crisis and most importantly, on the plan to move forward. 

I would also like to thank Chairman Fred Upton from Michigan, 

Ranking Member Frank Pallone, and their respective staff members for their continued interest and work on this issue. 

This is a very important topic and I am pleased these two subcommittees have chosen to devote today’s joint hearing to the public health situation in Flint the and long-term needs of our community. 

It has been said that pediatricians are the ultimate witnesses to 

failed policies. And as a pediatrician in Flint, I can attest to that. 

Our children were failed by every agency that was supposed to protect them. I am not going to go into the details. You know what 

happened with Flint. A lack of corrosion control created a perfect 

storm for lead to leach out from our plumbing into our drinking 

water and into the bodies of our children. There is no safe level of 

lead. Lead is a potent, irreversible neurotoxin that impacts our 

children for decades and generations to come. The treatment for 

lead is to prevent all exposure to lead because there is no magic 

pill for lead. There is no lead antidote. 

So, since we were able to prove that lead was getting into the 

bodies of children, our focus has always been on their tomorrows 

and what are we going to do next for our kids. And we are focused 

81 

on that moving forward. Flint is an incredibly resilient community 

with a proud past and we are hopeful and determined to create an 

even more promising future. Our community is committed to rebuilding and to creating a sanctuary where our children can recover and flourish. We cannot wait to see the potential cognitive 

and behavioral consequences of lead exposure. We must act and we 

must act quickly. 

We are grateful for the State and the Federal support that has 

come in thus far and while these are helpful and appreciated, most 

are, unfortunately, only temporary expansions or increases in funding and will not adequately address the long-term needs of Flint’s 

children. 

On the academic side, Michigan State University and Hurley 

Children’s Hospital have launched something called a Pediatric 

Public Health Initiative. This is our model public health program, 

a center of excellence, almost ground zero on lead, where we hope 

to continue the assessment of what happened to follow these children for decades but, most importantly, to intervene. To intervene 

for these children, which has never been done before and to become 

a model to create benchmarks so that the rest of the Nation can 

learn about what happened in Flint and how we were able to 

change the story and change a trajectory for our children. 

These evidence-based interventions span many domains, most 

importantly, education, nutrition, and health. Because there is no 

medical treatment for lead, the treatment for lead is mitigating the 

impact of lead. Early literacy programs, universal preschools, 

school health services, quality education systems are key for our 

children. Nutrition plays a tremendous role not only for preventing 

ongoing exposure but preventing long-term re-exposure. Lead eventually gets stored in your bones and it can last there for decades. 

When you are stressed or pregnant or have poor nutrition in your 

future, it comes back out of your bones and an cause that 

neurotoxicity all over again. So, that is why nutrition plays a critical role in mitigating this exposure. 

In terms of healthcare, we are grateful for the Medicaid expansion but that only covers our children. The adults were also exposed to lead and many other things in this water, including Legionnaire’s Disease and many skin manifestations. 

So, current efforts at both the State and Federal level efforts— 

our efforts on the academic front are not enough. We need congressional action to address the necessary short- and long-term response. I firmly believe that it is the imperative of public policymakers at all levels of Government, regardless of party or affiliation, to act quickly to address the urgent needs of the Flint community. We need congressional lawmakers to respond to this manmade disaster with the same impetus and robust response as they 

do for any other kind of disaster. Our Nation has never been reluctant to aid victims of hurricanes and floods and tornadoes. 

Short-sighted cost-cutting and willful bureaucratic blindness 

caused the calamity in Flint but it is nothing short of a natural disaster. In addition, the magnitude of this disaster is much worse in 

the long-run. We are not a remote city in a developing world with 

a contaminated water supply. We are a great American city situated in the middle of the Great Lakes, the largest source of fresh 

82 

water in the world, yet we are going on our third year with a contaminated water supply. 

Hopefully you agree that Flint families need our help. And it is 

my hope that our discussion today and with your committee’s interest we will cut through the gridlock and spur significant action by 

Congress to create some legislation. 

Thank you for the opportunity to address the committee today 

and I look forward to your questions. Thank you. 

[The prepared statement of Dr. Hanna-Attisha follows:] 

83 

84 

85 

86 

87 

Mr. PITTS. Thank you for your testimony. 

Ms. Alker, you are recognized for 5 minutes for your summary. 

STATEMENT OF JOAN C. ALKER 

Ms. ALKER. Thank you very much, Chairman Pitts, Ranking 

Member Green, and members of the committee. I am glad to be 

here today, thought the topic is, indeed a sobering one. 

I am not here today to talk about why the Flint crisis happened 

but rather to respond to the committee’s charge of examining lessons learned. This is an especially important exercise for children 

around the country, not just in Flint, because they may, too, be at 

risk of high levels of lead exposure or some of them reside in places 

that are known to have high levels of lead exposure. So, we must 

examine the Flint crisis not only for the children of Flint but for 

children nationwide, especially low-income children, who are at 

greater risk of lead exposure. 

Of course, prevention is the key to ensure that such tragedies do 

not happen again. But sadly, prevention is too late for the children 

of Flint and other children who have already been identified with 

elevated blood lead levels. Policymakers must act immediately to 

ameliorate the harm that has been done. One essential part of this 

response is to ensure that these children have health coverage 

going forward, so that they may access the treatment they need 

now and in the future. 

And while there is so much bad news here, I would like to focus 

the committee’s attention on some good news that emerged from 

this debacle. Governor Snyder, a Republican, and President 

Obama’s administration, a Democrat, were able to come to agreement on a Section 1115 Medicaid waiver very quickly at a time of 

sharp partisan discord, especially on health policy. The waiver relies on the Medicaid program to form the backbone of the State’s 

response to the health crisis for families in Flint. 

The terms and conditions of this waiver include an expansion of 

Medicaid and CHIP for children and pregnant women with incomes 

up to 400 percent of the Federal poverty level who were served by 

the Flint water system until they are age 21. 

This is not the first time that Medicaid has played a vital role 

in our Nation’s response to an emergency. After the terrorist attacks of 9/11, the State of New York also obtained a Section 1115 

waiver to extend Medicaid coverage to additional groups and simplify the application process. 

Following Hurricane Katrina, 15 States, DC, and Puerto Rico 

were granted Section 1115 waivers to provide temporary health 

coverage to those displaced by Katrina. 

Medicaid’s financing structure and the flexibility afforded by the 

waiver process allow for this kind of nimble and comprehensive response in times of crisis. Because Medicaid funding is not capped, 

it is able to respond to unanticipated emergencies, whatever their 

cause. 

For children in situations such as that which has emerged in 

Flint, Medicaid’s comprehensive pediatric benefit, and this is a real 

tongue twister, the Early Periodic Screening Diagnosis and Treatment or EPSDT benefit is essential. The Medicaid statute requires 

coverage of laboratory tests, including lead blood level assessments. 

88 

And once a problem is identified through a screen, the EPSDT benefit requires that treatment must be provided. Children may not be 

charged premiums or copays in the Medicaid program, which can 

be a barrier to needed care. 

These features of Medicaid made it the obvious choice for Governor Snyder to turn to in responding to the crisis in Flint and responding to the health needs of those families. 

But the crisis in Flint creates an opportunity and, indeed, a responsibility to reexamine Medicaid policy with respect to lead more 

broadly and I would like to offer two suggestions for the committee 

to consider. 

Congress should consider ways to improve lead screening rates 

in Medicaid. Despite the requirement to screen for lead in the Medicaid program, screening rates are not where they should be. We 

don’t have great data on this but it looks like for 1- to 2-year-olds 

across the U.S., the screening rate is only about 40 percent. 

States must ultimately be held accountable for low screening 

rates but it is also worth noting that most children in Medicaid in 

Michigan and elsewhere, as has been discussed, are receiving services through managed care. So, ensuring that managed care plans 

are held accountable for improving screening rates would go a long 

way towards ensuring that public health objectives are being met. 

Secondly, I would encourage you to review CMS policy, which allows States to request exemptions from universal screening requirements for lead. As a result of recommendations made by the 

centers for disease control, in 2012, CMS established a process by 

which States can request permission to target lead screenings, 

rather than screen all children in Medicaid. 

Recent events in Flint suggest to me that this option should be 

carefully reviewed and perhaps reconsidered At a minimum, there 

needs to be a more robust public process for States requesting exemptions from universal screening requirements. 

Thanks for inviting me to testify today, and I look forward to 

your questions. 

[The prepared statement of Ms. Alker follows:] 

89 

90 

91 

92 

93 

94 

95 

Mr. PITTS. Thank you. 

Mr. is it Estes-Smargiassi? You are recognized or 5 minutes. 

STATEMENT OF STEPHEN ESTES-SMARGIASSI 

Mr. ESTES-SMARGIASSI. I am here today on behalf of the American Water Works Association. 

What I would like to do today is to discuss how what we already 

knew about the issues of lead in drinking water was underlined 

and emphasized by the events in Flint and some of what we think 

needs to be done going forward. I will do that in part by focusing 

on the recent recommendations of the National Drinking Water Advisory Council, MDWAC. And I would say that the AWWA Water 

Utility Council and its Board of Directors have both voted to support those recommendations. 

I will concentrate on three principle elements of shared responsibility. First, the important role of corrosion control in reducing the 

natural tendency of water to dissolve lead and other metals. Second, that we, as a Nation, must do more to reduce the amount of 

lead-containing materials that are in contact with the water we 

drink, especially the lead service lines connecting our older buildings with the water mains in the street. And third, how water supply and public health professionals can effectively communicate 

about the risks of water—of lead and work with our customers to 

reduce and eliminate those risks. 

Flint should have but did not do corrosion control treatment 

when they switched sources. It was required by the LCR. It is 

sound water treatment practice. It is not clear exactly why they 

didn’t do it. What is clear is that treatment can dramatically reduce the corrosivity of water. In the Boston area, we began monitoring corrosion control treatment in 1996, after careful planning, 

pilot testing, consultation with national experts. We went from 

having some of the highest levels in the Nation, being able to show 

our customers a 90 percent reduction. 

That same success story was repeated across the country, 

prompting the NDWAC to recommend that the requirements and 

guidance for corrosion control treatment be retained as the rule is 

revised and strengthened. The NDWAC specifically recommended 

retaining the current rule requirements to reassess corrosion control if changes to source water and treatment are planned. Even 

before the publicity surrounding Flint, the group underlined this 

existing provision as key to protecting public health. 

The NDWAC called for additional monitoring and the effective 

use of that date to ensure that treatment was being operated in a 

consistent manner and that water systems be required to review 

EPA guidance and update treatment as the science of corrosion 

control advances. 

While the root of the problem in Flint was that corrosion control 

was ignored, it was the fact that perhaps half of the homes still 

had lead services that caused lead exposures to rise so significantly. Estimates are that there are about 6 million lead service 

lines in the U.S. installed a long time ago. They have been gradually replaced but the existing rule has not been effective at mandating substantial reduction. These factors caused NDWAC to recVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00101 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
96 

ommend that over the long-term all lead services should be replaced from the main all the way to the house. 

The NDWAC recognized that a national program of lead service 

line replacement would need to be implemented locally, that each 

water system might have a different approach to dealing with the 

complex issues of identifying lead services, communicating with the 

property owner about the need to replace their portion and dealing 

with issues of cost, access and need of authority. 

The recommendation called for ongoing and regular outreach and 

efforts continue until every last service line is replaced. 

My system just announced $100 million zero-interest loan program our member communities to remove funding as an impediment to progress. Boston just enhanced their incentive program, 

doubling their subsidy to $2,000 and a no-interest repayment period to 48 months. 

The NDWAC also called for improved access to information about 

the location and ownership of lead services. A good example is the 

Boston Web site. Type in an address and up pops a map showing 

lead services. 

AWWA believes in a future with no lead services. In the meantime, we need to do better informing the public. That was a significant failing in Flint, a lack of transparency and a failure to take 

their customers’ complaints seriously. 

The NDWC recommended targeted outreach to consumers with 

lead services and other vulnerable populations be a regular part of 

communication efforts and that the lead data be accessible. They 

also called on EPA to establish a national clearinghouse and Web 

site to provide up-to-date risk information, communication templates for use by water systems, models brochures, videos targeting 

different topics and audiences. AWWA is already providing additional materials for use by its members in their outreach. 

At the MWRA, we believe in transparency. All of our samples, 

collected under the LCR since 1992 are up on our Web site. We believe that public data provides public confidence. 

In summary, making further progress on lead is a shared responsibility. Water systems have made substantial investments in successful corrosion control and the enhancements recommended by 

the NDWAC should help many water systems do even better. As 

a community of professionals, water systems are committed to effective programs to alert our customers if they have lead services, 

to communicate the risk and to work with them to replace them. 

Our State and Federal regulators must exercise responsible oversight and provide useful technical assistance, especially to smaller 

systems. 

We and our partners in the public health community can implement more effective outreach so our customers are informed and 

empowered to make sound decisions about their drinking water. 

Thank you for the opportunity to appear today. 

[The prepared statement of Mr. Estes-Smargiassi follows:] 

97 

98 

99 

100 

101 

102 

103 

104 

105 

106 

107 

108 

109 

110 

111 

112 

Mr. PITTS. The Chair thanks the gentleman. 

Ms. Swallow, you are recognized for 5 minutes. 

STATEMENT OF JUNE SWALLOW 

Ms. SWALLOW. Thank you. 

Good afternoon. My name is June Swallow and I am the Administrator of Rhode Island Department of Health drinking water program and also President of the Association of State Drinking Water 

Administrators. ASDWA represents the women and men in the 50 

States, territories, DC, and the Navajo Nation who are responsible 

for administering the requirements of the Safe Drinking Water Act. 

I also served on the National Drinking Water Advisory Council 

Working Group that recommended long-term changes to the Federal Lead and Copper Rule. Those recommendations were forwarded to the EPA Administrator in December, 2015. 

Today, I will primarily focus on the lessons learned and the path 

forward. 

Flint was something of a perfect storm and we don’t believe there 

are exactly comparable situations in other parts of the country. But 

it did expose vulnerabilities in our collective approach to providing 

safe drinking water and these we very much want to shore up. We 

will learn the lessons of Flint and apply them across the country 

so that we restore peoples’ trust and, most importantly, help ensure safe drinking water for everyone. 

Deputy Assistant Beauvais’ letter to the 50 States provides a 

good overall template for our collective near- and medium-term actions. We want to be sure that water systems are implementing 

and the States are overseeing the current rule optimally and as intended. Where further guidance and clarifications are needed, 

those gaps need to be filled as quickly as possible. 

We will also work with our water systems to go above and beyond what the rule requires, such as transparently sharing information and sample results while working on long-term changes 

that will further solidify some of those above and beyond steps. 

For the long-term, we support the recommendations of the 

NDWAC, the most important of which is to get the lead out, removing entire lead service lines and installing lead-free plumbing components. To accomplish that lofty, but I believe attainable goal, we 

need a national effort across Federal, State, and local players, as 

well as some non-traditional partners, such as the real estate community. 

We also support the other key NDWAC recommendations, including establishing a household action level for lead, setting up a lead 

information clearinghouse, and providing greater overall transparency and timeliness in sharing sampling results with customers. 

We encourage EPA to move the revisions forward as quickly as possible and will actively assist. 

It is not just the lead, though. There are many other challenges. 

We urge the committee, as it considers this matter and possible actions, to be mindful of the fact that implementing the Safe Drinking Water Act is akin to playing three-dimensional chess. The rule 

requirements for the 90-plus regulated contaminants must be met 

all of the time at all of the 155,000 water systems that States oversee, most of which are small. And we, States, EPA, and utilities, 

113 

must also be mindful of a host of new and emerging threats from 

which we need to keep the public safe, such as perfluorinated compounds, hexavalent chromium, perchlorate, and algal toxins, to 

name but a few. 

As critically important as the challenge of addressing lead in 

water is, we may not shift all of our time, attention, and resources; 

thus, creating other vulnerabilities. 

We also need to be mindful of what we call the multi-barrier 

source-to-tap approach to this collective task. To best protect public 

health, the sources of drinking water need to first be protected 

through a variety of other statutes, authorities, and programs, including the authorities provided under the Clean Water Act, as 

well as USDA’s various programs. Sources of surface and groundwater used by water treatment facilities need to be adequately protected from point and non-point sources of pollution. 

We are most successful in our collective efforts when EPA, the 

States, and local Governments work together in partnership, respecting and fulfilling our various roles and responsibilities. States 

remain firmly committed to these partnerships and we believe they 

have been mutually beneficial and essential to protect public 

health. 

Finally, I would like to mention the importance of Support for 

both physical and human infrastructure. You are well aware of the 

issue of aging drinking water infrastructure, including service 

lines, and the costs and challenges of replacement. We appreciate 

the various bills that are seeking to address this need. Managers 

of State drinking water revolving loan fund programs stand ready 

to help in that task. 

But, there is also a human infrastructure shortfall in States of 

which you need to be aware. State drinking water programs need 

far greater support than they receive now. Congressional support 

for the Federal principal appropriation for State drinking water 

programs, the PWSS grant, has been level funded at about $2 million per State for the past decade. To address the increasing responsibilities and assure adequate oversight, at least twice that 

amount is needed for States. 

In summary, we are eager to apply the lessons learned in Flint, 

while being vigilant about all of the other challenges associated 

with providing safe drinking water, in collaboration with our Federal and local partners and with congressional support. 

Thank you for the time to speak to you today. 

[The prepared statement of Ms. Swallow follows:] 

114 

115 

116 

117 

Mr. PITTS. The Chair thanks the gentlelady. 

Ms. Wu, you are recognized for 5 minutes for your summary. 

STATEMENT OF MAE C. WU 

Ms. WU. Thank you. Good afternoon, Chairman Pitts, Ranking 

Member Tonko and members of the subcommittee. I am honored to 

have this opportunity to testify before you today. My name is Mae 

Wu. I am a senior attorney at the Natural Resources Defense 

Council and I am heartened to see the bipartisan concern and support for the struggles of this community. It is a primary role of 

Government to make sure that its citizens have access to safe and 

affordable drinking water and it is failing right now and it is going 

to take bipartisan and a concerted effort to resolve these problems. 

So, I am going to focus my testimony today on three things that 

we need to do. One, we need to fix Flint. Two, we need to fix the 

pipes. And three, we need to fix monitoring. 

So, the first thing we need to do is we need to help the residents 

of Flint. The water infrastructure must be immediately repaired 

and replaced and safe and reliable water must be supplied to them. 

And for those who have been exposed, then the types of interventions that Dr. Hanna-Attisha mentioned also need to be given to 

them. 

The second thing we need to do is we need to fix everyone’s 

pipes. Even the best run system is going to have lead issues, as 

long as lead pipes are in the ground. So, a truck rolling by or construction, any of this stuff could help dislodge lead into the drinking water. 

And so we need an inventory of where all those lead service lines 

are and then we need to get them fully replaced but it is not just 

about lead. The whole infrastructure needs replacing. Leaking 

pipes contribute to bacterial contamination. It wastes a lot of water 

and a lot of money and causes serious property damage. 

So, I am asking on you all to help identify the mechanisms to 

fund this necessary overhaul. 

The third thing we need to do is we need to fix monitoring. One 

of the craziest things about Flint was that Flint had no recorded 

violations of the Lead and Copper Rule. And it is one of the dirty 

little secrets is that there are some utilities that know how to do 

sampling to avoid finding problems. 

The Lead and Copper Rule’s monitoring system is designed to 

target high-risk homes but some of the utilities can employ techniques that defeat the intent of the rule. And so for example, they 

could have homeowners flush the water for 5 to 10 minutes before 

it sits for the 6 hours that are required. They can use the smallernecked bottles, which force the samplers to use a lower flow of 

water, which can also lower the amount of lead that gets captured. 

They can remove the aerators, which have lead particles sometimes 

get lodged in those. And that can also help lower the amount of 

lead that gets collected. 

And there are many more techniques that they can use. It is 

wrong and it needs to stop. And EPA can stop these types of activities as it is revising the Lead and Copper Rule. 

And I really appreciated Mr. Upton’s call for EPA to get the revisions done before 2017. 

118 

But I also wanted to address the NDWAC recommendations that 

have been mentioned several times. As Mr. Beauvais said, because 

Flint has happened, I think that there are more lessons that can 

be learned after the report was given out. And so some of those 

things that should be in the revised rule are a more robust monitoring program that has mandatory and frequent sampling, not voluntary sampling of the tap water in people’s homes and in schools. 

And there should also be a rapid and clear notification to people 

when the samples detect a problem. 

So, on a broader level, when it comes to drinking water, citizens 

have very limited ability in what they can do in the face of the catastrophic failure of the State and local government. Citizens should 

be given the ability to bring suits to enforce the Safe Drinking 

Water Act when there is a substantial and imminent 

endangerment like there was in Flint. Then they wouldn’t have to 

be at the mercy of EPA waiting to see whether EPA is going to act 

and exercise its emergency authority over the States. 

And finally, an important part of the story that I don’t want us 

to forget in Flint, the Flint community is predominately African 

American and it has a high percentage of residents living at or 

below the poverty line or who are working but struggling to make 

ends meet and communities of color all over this country often bear 

the burden of environmental contamination and the resulting 

health problems. 

And so as you are working to identify the funding mechanisms 

to upgrade our drinking water infrastructure, I just urge you to 

find ways to prioritize assistance going to these communities because we don’t want to create a two-tier system, where the wealthy 

get access to clean and safe water and the less wealthy get second 

class water. 

And so I have other recommendations in my testimony for how 

we can protect our drinking water and how doing so can help our 

economy and I would be happy to answer any questions. Thank 

you. 

[The prepared statement of Ms. Wu follows:] 

119 

120 

121 

122 

123 

124 

125 

126 

127 

128 

129 

130 

131 

132 

133 

134 

135 

136 

137 

138 

139 

140 

141 

142 

Mr. PITTS. The Chair thanks the gentlelady. 

That concludes the testimony of Panel 2. We will now go to questioning. I will recognize myself 5 minutes for that purpose, and I 

will begin with you, Dr. Mona. The administration announced $3.6 in Head Start, Early Head 

Start funding for the City of Flint. Can you elaborate on the impact 

this intervention will have on the children exposed to lead and 

their families? 

Dr. HANNA-ATTISHA. Yes, great question. So, education is one of 

the solutions here, and what we do in the 0–5 age range is the 

most important things, and that is where Early Head Start and 

Head Start plays a role. The $3.6 million expands three more classrooms and gives one 

more year of funding. So, it is a temporary thing for a limited number of children. The children most at risk from this exposure are 

the infants and the babies and we need funding for at least 5 to 

10 years to address those exposed children. So, we are grateful for 

that 1 year of funding, but it is not enough. 

Mr. PITTS. Thank you. 

Ms. Alker, thank you for coming to the committee again to share 

your insights on Medicaid waivers. As you noted in your testimony, 

CMS moved quickly to approve a waived expanding Medicaid coverage to children and pregnant women. Your testimony explained 

how children can benefit from early periodic screening and diagnosis and treatment but you didn’t mention how the Flint waiver 

expands coverage to pregnant women and newborns. 

Can you talk a little bit about some of the services, benefits 

available to pregnant women and newborns under the waiver? 

Ms. ALKER. Well, newborns should also be subject to the EPSDT 

benefit that I mentioned. That does provide for comprehensive 

screening and treatment. 

With respect to the pregnant women, I would mention that, and 

I am certainly not an expert, but there were a few ways in which 

the waiver could have been improved in my judgment. And there 

were comments submitted by the American College of Obstetricians 

and Gynecologists with respect to the pregnant women piece, where 

they thought the coverage needed to be little bit more comprehensive and I don’t think those comments were adopted in the final 

waiver. So, that would be something that the committee might 

want to look into. 

Mr. PITTS. Thank you. 

Director Estes-Smargiassi, what lessons have you learned from 

the experience in Flint? 

Mr. ESTES-SMARGIASSI. It is clear that shared responsibility from 

the operators to the plant to the folks who deal with financing, to 

our regulators, to paying attention to citizens is necessary to avoid 

this type of crisis. 

One lesson that I see in this is that we have rules. We need to 

make sure that the rules are paid attention to. We can’t create 

rules that fix every problem. We need to pay attention, as citizens 

and as operators of systems pay attention to what is going on. 

My system, we try and train our operators, train our customer 

service folks that when complaints come in that we take them seriously. If that had happened in Flint, when the water changed colVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00148 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
143 

ors and it was not palatable, folks really investigated what was 

going on, even though bad decisions had been made about corrosion 

control, they might have stopped it earlier. Likewise, if that information had gotten up to the regulators and it was taken seriously. 

So, it is a case where we all need to be vigilant to avoid a crisis. 

Mr. PITTS. Do you have any comments on what Panel 1 said 

about the Lead and Copper Rule? 

Mr. ESTES-SMARGIASSI. Not specifically. I think I would emphasize a couple of things. One, that so long as lead lines are out 

there, there is a risk that some change in treatment—it may be 

that we have a new contaminant that we are worried about and 

we change our treatment—to account for that. And if those lead 

lines are out there, there is a chance that that lead could become 

mobile and end up in the drinking water. Or, if there is a change 

in the source, change in climate, change in weather different circumstances that changes the quality of the source water without 

changing the location of the source, those lead lines could become 

a problem. 

So, as an operator of a system and as a member of the AWWA, 

I kind of look to a long-term view that there aren’t any lead service 

lines out there. Maybe not in 5 years or 10 years, but getting to 

that point of not having lead in contact with the water is a major 

step forward. 

Mr. PITTS. Thank you. 

Administrator Swallow, yesterday EPA announced it had reached 

an agreement with State health officials on environmental exposures and public health. Can you give us some personal examples 

of whether this will enhance coordination or create overlapping 

Federal responses? 

Ms. SWALLOW. I am sorry, I am not familiar with that agreement. 

Mr. PITTS. OK. All right, thank you. My time has expired. 

The Chair recognizes the gentleman, Mr. Tonko, 5 minutes for 

questions. 

Mr. TONKO. Thank you, Mr. Chair. And welcome to our panelists. 

First let me offer a thank you to Dr. Hanna-Attisha for all of 

your work on behalf of the children of Flint. It is so greatly appreciated. And I am also glad we are joined by a number of members 

of the National Drinking Water Advisory Council. 

And Ms. Wu, thank you mentioning other contaminants. 

In my home State of New York, a number of communities are 

dealing with toxic substances in their water systems. This is about 

more than just lead and you made that very clear. But without 

strong Federal support, we cannot incentivize greater response on 

many contaminants to protect public health. 

Ms. Wu, would you agree with my assessment that the Federal 

share of investment has not been adequate to truly carry out our 

goal of reducing public health risks from unsafe drinking water? 

Ms. WU. Yes, I would agree that even more funding needs to go 

to the State revolving fund programs for drinking water and it has 

been woefully underfunded. 

Mr. TONKO. And what role would you site that aging and deteriorating infrastructure plays in that whole outcome? 

144 

Ms. WU. It is a big part of the problem. So, as I mentioned you 

have leaking pipes and if you have pipes that are leaking that happen to be in the same part of the say ditch as like sewer lines, you 

could get bacterial contamination leaking into drinking water and 

that could lead to waterborne disease outbreaks. That is a big part 

of the problem. 

And then there are other issues with contamination that can get 

in through broken water towers and things like that. The big part. 

Mr. TONKO. And I am told that billions of gallons of water lost 

through leaking pipes on any given day. So, it is textiles flowing 

out of those pipes also. 

And Ms. Swallow, you point out in your testimony the importance of maintaining the human infrastructure of our drinking 

water programs. We need to attract and maintain quality people, 

qualified people to operate these systems. We need to ensure that 

system operators have access to ongoing training and certification 

programs to tackle new problems that arise. 

You mentioned the public water system supervision grant program. Will you please expand a bit on the importance of tat funding? 

Ms. SWALLOW. Yes, the public water system supervision grant is 

the primary grant from Congress to the States to implement the 

safe drinking water act. That is our base funding to operate the 

program. It has been level funded for the past 10 years, and that 

has been while we have had a reauthorization of the Safe Drinking 

Water Act. There are quite a lot of more requirements that we are 

implementing among the water systems. 

And the State programs are, essentially, pretty much stretched 

to the breaking point. Our resource needs estimate is that the 

State programs are 41—this is a 2014 estimate—that the drinking 

water programs with the States have a 41 percent shortfall in 

funding, amounting to roughly $308 million. 

Mr. TONKO. Wow. And are there other items or other things we 

can do to support the drinking water workforce that we require? 

Ms. SWALLOW. Yes. Certainly technology improvements help, improvement of the database. The States are in the process, and EPA, 

in doing a major improvement in our data system which will be 

transparent to the public and EPA and, of course, the State programs. So, I think that will help. 

And another thing that is much needed is greater funding of the 

State revolving loan fund programs, so that we can better meet, 

better address the needs both for lead service line replacement and 

all of the other infrastructure improvements that are necessary. 

Mr. TONKO. I would think not focusing on our water infrastructure has also like not provided the attention to the career paths 

that are associated with that work. So, I think by investing we will 

just draw more attention to that career opportunity. 

Administrator, you mentioned the value of using a multi-barrier 

approach for drinking water. It is certainly less costly for water 

utilities if we prevent contaminants from entering their water 

sources. Should we be strengthening source water protection programs? 

Ms. SWALLOW. Yes, we should be strengthening source water protection programs, particularly of the nine-point source pollution vaVerDate Mar 15 2010 10:43 Mar 23, 2017 Jkt 037690 PO 00000 Frm 00150 Fmt 6633 Sfmt 6633 I:\114THCONGRESS\114X131FLINTWATERSCANREQ031717\114X131FLINTWATERPEN
145 

riety. Many States are challenged, especially by a nitrate and phosphorus contamination issues that are leading to nitrate contamination but also cyanotoxins. 

Mr. TONKO. And how are States and water utilities addressing 

this environmental infrastructure issue? 

Ms. SWALLOW. States also have the clean water revolving loan 

fund, which is used to help address this environmental issue. 

Mr. TONKO. OK. 

Ms. SWALLOW. And of course all of the other authorities that are 

environmental program partners. 

Mr. TONKO. OK. I have exhausted my time but I have, Mr. 

Chair, other questions that I will enter into the record, so as to get 

responses to those. 

And with that, I thank our panel and I yield back. 

Mr. PITTS. The Chair thanks the gentleman. We will send you 

those questions in writing, if you will please respond. 

The Chair now recognizes the gentleman from Virginia, Mr. Griffith, 5 minutes for questions. 

Mr. GRIFFITH. Thank you very much, Mr. Chairman. Thank you 

all for being here and waiting through the first panel to get to testify. I do appreciate that. And I do appreciate the testimony that 

you have given here this morning. 

I mentioned in the previous panel that there was an article in 

the Roanoke Times, Roanoke, Virginia, my area, at least the beginning of my area, and in the article that was talking about the Virginia Tech water study team, it said that Edwards said he and 

those involved in the Flint study are gauging interest in doing a 

similar project in Philadelphia. There are some initial similarities 

between Philadelphia and Flint, Edwards said. What do you know 

about it? 

Who wants to tackle it? Does anybody know anything about a 

Philadelphia situation where the initial similarities are there? Do 

you know about other situations? I mean what can we do to be 

aware of these types of things? 

And they went on to mention some other things dealing with 

some private wells and that kind of thing. And obviously, that is 

always going to go on. But do we know of any other major municipal areas that are distressed? 

Dr. HANNA-ATTISHA. I can quickly comment and then I will pass 

it on to the water experts. 

Mr. GRIFFITH. Yes, ma’am. 

Dr. HANNA-ATTISHA. But understanding is that in Philadelphia, 

like in Michigan, they are gaming the sampling. So, they are doing 

maybe pre-flushing or removing aerators or using small wattles. It 

is very easy to manipulate the sampling to detect low levels of lead 

but I will have the others comment as well. 

Mr. GRIFFITH. And I will accept that. So, that gives you some of 

what may be happening and it might be fine; it might not be. 

Now, for those people who might be concerned, wherever they 

might be in the United States, watching this most likely sometime 

in the wee hours of the morning, is there a kit that you can just 

go out and buy and test your own water and follow the instructions? Is that available to the general public? 

Dr. HANNA-ATTISHA. I am not sure. 

146 

Mr. GRIFFITH. No. 

Mr. ESTES-SMARGIASSI. We would not recommend you go to 

Home Depot and pick up a water test there. It will not be very 

helpful. But many utilities do—every State has a list of certified 

labs and many utilities maintain that information for their own 

rate payers to get access to. Some systems provide discounted or 

free water testing, all local decisions. But in any State, anywhere, 

if you were to contact the State Drinking Water Act program, you 

could get a list of labs and for something on the order of $20 to 

$30 or $35, get a sample taken of water in your own home, using 

whatever sample technique to help to understand your own particular problem. 

Mr. GRIFFITH. OK. So, it is—— 

Mr. ESTES-SMARGIASSI. That information is available. 

Mr. GRIFFITH. It is available and you can get a list of the labs 

that might come to your—will they come to your house or you take 

the water yourself and send it? 

Mr. ESTES-SMARGIASSI. Typically, they will mail a sample kit to 

you and then you would return it to them by mail. 

Mr. GRIFFITH. All right. Ms. Wu, go ahead. 

Ms. WU. Well, I was going to mention that I believe there is also 

a group called Healthy Babies, Bright Futures that are doing—that 

have online test kits that you can purchase at whatever price you 

can afford, if your system doesn’t have that available. 

Mr. GRIFFITH. They are listed here as well. And apparently, the 

Virginia Tech water project folks are working on a number of the 

kits that they, Healthy Babies, Bright Futures, has put out. That 

is a nonprofit group but then you still have to get somebody to analyze it. 

Ms. Wu, you indicated that as we go forward, we need to do more 

testing, make it mandatory testing, do it at the schools and the 

homes. Now, would that be done by an agency or would that be 

done by a third party? What do you think would work better? 

Ms. WU. Well, I mean the idea that I had was they would be part 

of the revisions of the Lead and Copper Rule where right now the 

utility is supposed to send people out to do the sampling in the 

homes and the idea would be to keep that. And I mentioned it only 

because in the recommendations from NDWAC that were mentioned, it was talking about more of a customer-initiated voluntary 

program. And so I wanted to make sure that we kept it as a mandatory program for testing. 

Mr. GRIFFITH. OK and I do appreciate that. 

Dr. Hanna—help me. 

Dr. HANNA-ATTISHA. Dr. Mona is fine. 

Mr. GRIFFITH. Dr. Mona. Thank you, I appreciate that. 

I did mention earlier that Dr. Edwards is out a lot of money that 

they expended to bring the team out from Virginia Tech to do the 

research in Flint. The folks from Michigan indicated you had been 

very helpful as well. Are you out substantial funds as well? 

Dr. HANNA-ATTISHA. You know this work doesn’t involve money. 

It is something that is so important that you do and you don’t 

sleep. It is not a 9 to 5 issue. There is no cost. 

You know Dr. Edwards is a hero. You asked that earlier. When 

he heard that Michigan wasn’t listening to its residents and, every 

147 

day that went by, children were being poisoned with lead, he 

packed his minivan with grad students and some slides and he 

came up to bring science to test the water. 

So you know we have all had opportunity costs because of this 

work but this is incredible work and it has been incredibly rewarding. 

Mr. GRIFFITH. Right. And even though they are out of funds, it 

is interesting that you say that because in the article that I didn’t 

mention earlier, he says this was priceless. We will go to our 

graves knowing we stood up for Flint kids when no one else could 

or would. 

Dr. HANNA-ATTISHA. Absolutely. 

Mr. GRIFFITH. And with that, my time is up. I yield back. But 

thank you all very much. 

Mr. PITTS. The Chair thanks the gentleman. 

I know recognize the ranking member, Mr. Green, 5 minutes for 

questions. 

Mr. GREEN. Thank you, Mr. Chairman. 

As I said during the first panel, the Safe Drinking Water Act is 

intended to ensure safe and reliable drinking water for customers 

of public drinking water systems across the United States. Clearly, 

it failed the citizens of Flint. Listening to this panel, it seems like 

it is failing citizens nationwide. Everyone has a role to play in improving the situation—cities, counties, States, the EPA, and Congress. One of the most important things we can do is quickly adopt 

important revisions to the Lead and Copper Rule and those of you 

who were here heard the EPA statement that maybe this summer, 

maybe next year, which is not acceptable when you have something 

like Flint. 

And really, there are a lot of Flints around the country that just 

haven’t been discovered. And that is what I think we need to be 

planning for. 

Ms. Wu, you are a member of the National Drinking Water Advisory Committee, which is playing an important role in LCR revisions. Before the Flint crisis, was there any clear revisions to the 

LCR that were needed? 

Ms. WU. No, not during while everything was happening. But 

just to note that I am not actually on the council anymore. 

Mr. GREEN. OK. 

Ms. WU. My term ended in December of 2014. 

Mr. GREEN. Anybody else have—were there any—I mean obviously, they have been working on it for a few months. 

Ms. SWALLOW. Sure, there were many important pieces in the 

NDWAC recommendations, primarily, get the lead out. Remove the 

lead service lines from the street to the house but also the household lead action level, which is a health guide for individuals in 

their homes when they get their lead results. And the greater 

transparency, so that the public can see the data and also can 

know if they have a lead service line to the best of the knowledge 

of the water system. 

And I guess that is enough for now and Steve can follow-up with 

more. 

148 

Mr. ESTES-SMARGIASSI. So, I was on the working group that 

worked on that. And I would say a number of things in addition 

to what June said. 

One, the group clearly felt that there were opportunities beyond 

the regulatory structure to improve this situation. I will give you 

a couple of examples. Huge frustration among the group, as we discussed the fact that current HUD programs, Housing and Urban 

Development programs, will set up under The Healthy Homes to 

go in and remove lead paint. They might spend $25,000 or $30,000 

in my neighborhood to remove all the lead paint in someone’s 

apartment but they can’t spend a nickel on removing the lead service line. 

So, they will spend all that money, make the house sort of leadfree but not remove the lead service line. So, there are opportunities that aren’t EPA regulatory programs that could make a huge 

differences. 

Other places are in better coordination of communication tools 

between various Federal programs and even at the local level between various parts of organizations. 

Frequently, when we speak to folks who are doing lead education, they don’t talk about water. Folks talk about lead paint, 

they talk about lead dust because those are huge and important 

areas but the person they are dealing with doesn’t get the piece on 

water. 

When we were doing the beginning of our program on corrosion 

control, we were actually initially admonished not to talk about 

water because it would confuse people. And we said no, that is not 

right. We need to talk about all the aspects uniformly, make sure 

that the citizens get all that information. 

So, there is a lot we can do that is outside the regulatory framework. 

Mr. GREEN. Well, and I know we have programs and, like I said 

in the opening statement, the City of Houston has been really aggressive with lead paint on the walls and in dealing with that but, 

again, the galvanized pipes, that was the state of the art over the 

last 50 years, I guess, or so. And what happened in Flint, we see 

that there are ways that that can be eroded. 

Although, my other question is when I first elected to Congress, 

years ago, I was told not to drink the water in DC. I haven’t seen 

those warnings in the last few years so, obviously, we know how 

to fix it. But it is very expensive because you have to replace those 

lines and, obviously, you replace the worst ones first and it takes 

a cooperation between the city government, the State, and the Federal Government to try and do it. And that is why the revolving 

fund is so important to do that. 

But again, it is not just a Flint. It is just Flint fell into it because 

of a decision-making and they didn’t recognize that was a wrong 

decision until it was too late. 

Thank you, Mr. Chairman. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the gentleman from Maryland, Mr. Sarbanes, 5 

minutes for questions. 

Mr. SARBANES. Thank you, Mr. Chairman. I want to thank the 

panel. 

149 

We have heard a lot about the physical consequences on children 

in terms of their physical health from the lead in the water. Most 

of the discussion has been on that and how we address it going forward. But I was hoping, Doctor, maybe you could speak to the psychological impact because I think in the prior panel we heard that 

the recent testing shows maybe only two percent of the children 

now have elevated lead levels but they have going through all 

kinds of testing. 

So, you have the larger context of just heightened anxiety of parents, community leaders, teachers, principals, which obviously 

must be producing some effect. Then, within that, you have got 

testing regimens happening. I don’t know how frequently but it has 

got to be contributing to a sense among these children that something is terribly wrong and they are under siege. So, maybe you 

could speak to that a little bit and kind of what is being done about 

it and what the potential lingering effects of that are going to be. 

Dr. HANNA-ATTISHA. Absolutely. So, the psychological trauma is 

real and I see it every day in the clinic. When a mom brings her 

kid in, there is a look of fear and anxiety and trauma. These are 

families that for 2 years were told everything was OK. Even when 

in their gut they knew that the brown water was not OK, they 

were told it was OK. So, they feel betrayed and traumatized and 

a huge, huge, lack of trust in Government. 

And then there is the fear of the unknown. What is going to happen to my child? All they hear on the news is brain damage, irreversible neurotoxin. They think that their children may be damned 

for generations. 

So, we are actively trying to do reassurance and provide hope. 

Not every kid is going to have every problem but it takes a lot of 

rapport-building and a lot of time. There is definitely the beginning 

of mental health first-aid that is ongoing. Just like in any crisis, 

the American Red Cross and our community mental health is in 

there. There is a crisis line that is set up. Because just that trauma 

and that stress can lead to chronic diseases and more health problems. 

So, of any health issue right now, it is the mental health that 

is most pressing. You talk to a family and after the first sentence, 

they are in tears or they are yelling and rightly so. There is almost 

a sense of a truth and reconciliation process that needs to happen. 

They are so angry and they want to know what happened so that 

they can start healing. It is going to be a long path for healing that 

is going to take decades. 

Mr. SARBANES. Does anyone else want to comment on that to 

mention anything? OK. 

Thanks very much. I yield back the rest of my time. 

Mr. PITTS. The Chair thanks the gentleman. 

We are voting on the floor at this time. The Chair now recognizes 

Mr. Ca ́ rdenas for 5 minutes for questions. 

Mr. CA ́ RDENAS. Thank you very much, Mr. Chairman. I want to 

thank the panel for coming together and also doing the wonderful 

work that you attempt to do and do every single day for everyone. 

So, thank you so much. 

What happened in Flint is atrocious and gut wrenching but today 

we can’t just talk about getting lead out of the water. We need to 

150 

address the future and do what it will take for the children to heal. 

I want to be clear that this scenario was the result of another effort 

to prioritize cuts in Government spending without any regard for 

the protection of the public’s health. In other words, this was a 

cost-saving measure estimated to save only $2.5 million a year, but 

now we are looking at mounting human and economic costs that 

will take decades and hundreds of millions of dollars to address. 

There is a saying that goes water is for life and sanitation is dignity. In Flint, water also stands for dignity. But where is the dignity when children’s futures have been robbed? The Michigan State 

Government’s choices to cut the budget where they did should have 

been made elsewhere, in places where the lives of children would 

not have been put at risk. 

While I know that most of my Republican colleagues continually 

seek to reduce or eliminate Government department by department 

and service by service, we have an obligation to make sure that we 

invest in the lives of children and every American. No American 

child should have to suffer from a manmade disaster. 

This is an atrocity that should not have ever happened. This is 

a reminder that when we are unwilling to invest in people’s safety, 

Flint is going to happen again. The brain does not fall on the EPA 

or the constituents. This dark moment should remind all elected officials that we have a responsibility to do what is right. When an 

idea may not seem popular, it is critical for us to do what is right 

for the wellness and safety of every American so that we never 

have what happens in Flint, Michigan ever happen again. 

Unlike earthquakes, mudslides, and hurricanes, Flint was not a 

national disaster. The Government-appointed commissioner and 

the State of Michigan made this happen. They thought it was appropriate to do something they were warned not to do. The disaster 

was manmade. It was not made out of ignorance. This disaster was 

made out a willfulness to ignore a responsibility to an entire community. 

The brains of the children poisoned with lead will not fully recover. What happened in Flint happens every day in Third World 

countries. It should never happen anywhere in the world, much 

less the United States of America. There were individuals responsible for the community who knew the water wasn’t safe enough 

to drink and yet they did nothing and said nothing. 

Every time we insist on cutting resources from communities, the 

tragedy in Flint is bound to happen over, and over, and over again. 

I want to be clear. What happened in Flint is a disaster that was 

manmade and at the tip of the spear is the Michigan Government, 

its complicity in many levels of Government. So, we need to be willing to do our job to make sure that this never happens again. Because with all due respect, ladies and gentleman, at every level, 

the infrastructure of America is crumbling and we need to address 

these issues. We have a responsibility to be there for the children. 

Let this be a lesson that the $2.5 million a year that the State of 

Michigan wanted to save is now a drop in the bucket of the amount 

we now need to invest due to this manmade disaster. 

Dr. Hanna-Attisha, in your testimony, you observed that the 

State and Federal Government had begun to make an impact in 

Flint through important services offered through Medicaid, Head 

151 

Start, community health centers and WIC. However, as you note, 

most of these are temporary. Correct? 

Dr. HANNA-ATTISHA. Correct. 

Mr. CA ́ RDENAS. Should this be something that we should continue to address for many, many years as these afflicted children 

and families will have these effects for many, many years to come? 

Dr. HANNA-ATTISHA. Absolutely. We have yet to see the longterm investment in our children and in our community. 

Mr. CA ́ RDENAS. Thank you. 

In my closing seconds, I would just like to remind us, finally, let 

me remind our colleagues that when you advocate for billions upon 

billions of dollars in cuts, we will guarantee and put in motion that 

we have failed to prevent the future disasters in America and Flint 

will happen again and again, and again. 

Thank you, Mr. Chairman. I yield back. 

Mr. PITTS. The Chair thanks the gentleman. 

That concludes the questions of the members present. We will 

have follow-up questions. Other members will have written questions. We will send them to you. We ask that you please respond. 

Thank you very much for your expertise, for sharing with us 

today. 

Members are advised there are still 7 minutes left on the clock 

for the vote on the floor. 

I remind members that they have 10 business days to submit 

questions for the record. So, members should submit their questions by the close of business on Wednesday, April 27. 

This is a very, very important issue. We all must have clean, safe 

drinking water. We will work together to accomplish this. Thank 

you very much for all of the testimony and members’ interest on 

this. 

Without objection, the subcommittee hearing is adjourned. 

[Whereupon, at 1:40 p.m., the subcommittees were adjourned.] 

[Material submitted for inclusion in the record follows:] 

152 

153 

154 

155 

156 

157 

158 

159 

160 

161 

162 

163 

164 

165 

166 

167 

168 

169 

170 

171 

172 

173 

174 

175 

176 

177 

178 

179 

180 

181 

182 

183 

184 

185 

186 

187 

188 

189 

190 

191 

192 

193 

194 

195 

196 

197 

198 

199 

200 

201 

202 

203 

204 

205 

206 

207 

208 

209 

210 

211 

212 

213 

214 

215 

216 

217 

Æ