Agenda - Council Work Session - 03/08/2022

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4372 Federal Register/Vol. 87, No. 18/Thursday, January 27, 2022/Rules and Regulations requested further clarification on their include construction of new facilities further guidance clarifying that role.187 Treasury is maintaining this for the purpose of lead remediation. "investments in parks,public plazas, eligible use in the final rule. Recipients should make sure that all and other public outdoor recreation b.Remediation of lead paint or other capital expenditures adhere to the spaces may be responsive to the needs lead hazards.The interim final rule standards and presumptions detailed in of disproportionately impacted included remediation of lead paint or section Capital Expenditures in General communities by promoting healthier other lead hazards as an enumerated Provisions: Other. living environments." eligible use to address health c.Medical facilities.Treasury Public Comment:General:A disparities. received a few comments from significant theme across many public Public Comment:Treasury received recipients seeking to use SURF funds comments was the importance of several comments asking for to build new medical facilities, such as neighborhood environment to health clarification on the eligibility of a hospitals or public health clinics,to and economic outcomes and the particular use that would indirectly serve disproportionately impacted potential connections between address lead pollution. For example, a communities. Given the central role of residence in an underserved commenter requested the ability to fund access to high-quality medical care in neighborhood and disproportionate remedial actions, such as filtration and reducing health disparities and impacts from the pandemic.Many plumbing procedures to help address addressing the root causes that led to commenters highlighted the connection lead pollution. One commenter disproportionate impact COVID-19 between neighborhoods and health requested that private wells be eligible health impacts in certain communities, outcomes,including citing public health for funding to address contamination the final rule recognizes that medical research linking neighborhood traits to with substances such as lead. Other equipment and facilities designed to health outcomes. For example,the CDC commenters requested that Treasury address disparities in public health states that"neighborhoods people live allow replacement of lead pipes as an outcomes are eligible capital in have a major impact on their health eligible use of funds. expenditures. This includes primary and well-being."190 As such,CDC Treasury Response:Recipients may care clinics,hospitals,or integrations of identifies "neighborhoods and built make a broad range of water health services into other settings. environment" as one of five key social infrastructure investments under section Recipients should make sure that all determinants of health 191 and includes 602(c)(1)(d) and 603(c)(1)(d),which can capital expenditures adhere to the "creat[ing] neighborhoods and include lead service line replacement standards and presumptions detailed in environments that promote health and and other activities to identify and section Capital Expenditures in General safety" as one of the agency's goals for remediate lead in water. These uses are Provisions: Other. social determinants of health outcomes. discussed in greater detail in section 2.Housing vouchers and assistance a.Neighborhood features that Water and Sewer Infrastructure of this relocating.In addition to other housing promote improved health and safety Supplemental Information. services,the interim final rule permitted outcomes. Treasury has further determined that a variety of rental assistance approaches Public Comment:Commenters argued several of the services identified by to support low-income households in that neighborhoods impact physical commenters are appropriate responses securing stable,long-term housing, health outcomes in several ways. First, to address health disparities in including housing vouchers,residential some commenters reasoned that the disproportionately impacted counseling,or housing navigation physical environment and amenities in households. These services were eligible a community 192 influence a person's g� assistance to facilitate household moves under the interim final rule and to neighborhoods with high levels of level of physical activity,with features continue to be so under the final rule. economic opportunity and mobility for like parks,recreation facilities,and safe These services include remediation to low-income residents. Examples could sidewalks promoting increased physical address lead-based public health risk include SLFRF-funded analogues to activity that improves health outcomes. factors, outside of lead in water, Section 8 Housing Choice vouchers; Conversely,commenters argued that a including evaluation and remediation of other kinds of rent subsidies,including lack of these features in a neighborhood lead paint, dust, or soil hazards;testing shallow subsidies;and programs to help could dampen physical activity and for blood lead levels;public outreach residents move to areas with higher contribute to health conditions like and education; and emergency levels of economic mobility.189 Treasury obesity that are risk factors for more protection measures, like bottled water did not receive public comments on severe COVID-19 health outcomes. and water filters,in areas with an action these enumerated eligible uses. Second, some commenters also level exceedance for lead in water in Treasury Response:Treasury suggested that access to healthy food in accordance with the Environmental maintains the eligibility of vouchers and a neighborhood impacts health Protection Agency's Lead and Copper relocation assistance in the final rule. outcomes. These commenters reasoned Rule.188 3.Building strong,healthy Further,Treasury had determined that communities through investments in 19Ou.s.Department of Health and Human Services,Neighborhood and Built Environment, certain capital expenditures,including neighborhoods.While the interim final https://health.gov/healthypeople/objectives-and- improvements to existing facilities to rule included a category of enumerated data/browse-objectives/neighborhood-and-built- remediate lead contaminants (e.g., eligible uses for"building stronger environment#citl(last visited November 9,2021). removal of lead paint), are eligible 191 Social determinants of health are"the p ), g communities through investments in conditions in the places where people live,learn, responses,although this does not housing and neighborhoods,"the work,and play that affect a wide range of health examples of services provided generally risks and outcomes."Centers for Disease Control 187 See,e.g.,Centers for Disease Control and focused on housing uses. In response to and Prevention,About Social Determinants of Prevention,Community Health Worker(CHW) questions following release of the Health(SDOH),https://www.cdc.gov/social Toolkit,https://www.cdc.govldhdsp/pubs/toolkits/ determinants/about.html(last visited November 9, chw-toolkit.htm(last visited November 9,2021). interim final rule,Treasury issued 2021). 188 Environmental Protection Agency,40 CFR 192 In public health,this is referred to as"built 141.80(c)(1),https://www.ecfr.gov/current/title-40/ 189 See,e.g.,Opportunity Insights,Creating Moves environment,"or the man-made physical aspects of chapter-I/subchapter-D/part-141/subpart-I/section- To Opportunity(August 2019),https:// a community(e.g.,homes,buildings,streets,open 141.80. opportunityinsights.org/policy/cmto/. spaces,and infrastructure).