RI, Lead Paint, A Systems Approach & Funding

If plaintiff expert witness Patricia Nolan, MD, were a business leader, not the former head of the Rhode Island Department of Health, she might have used the term "systems approach" lots on the stand today in the landmark Rhode Island lead paint trial.

Essentially, from the time she arrived at the Department of Health in 1995 to her retirement in 2005, Dr. Nolan has been reconfiguring the intervention on lead-paint medical problems from stand-alone measures to an integrated systems one.  The results have included a significant decrease in the number of new cases of children with elevated levels of lead in their blood. And, Rhode Island, commented Dr. Nolan, should be "justly proud of its achievements."

The wrench in the system was and still is available/affordable housing that is lead-safe.  With or without the lead issue attached, the housing problem is, of course, national.  And thanks to the real-estate boom, it's gotten much worse.

Applying a systems solution, Dr. Nolan's Department used a variety of tools to loosen up the housing situation and make what became available/affordable also lead-safe.  One was the Lead Hazard Mitigation Act, passed by the Rhode Island Legislature around 2002.  That made incentives available to landlords to rent to low-income people and to address the presence of lead paint before it showed up as a case of elevated level of lead in a child.  Another was community or local outreach versus just state initiatives.  Another has been education about lead hazards.

All well and good.  But everything changes.  The funding for this will change.  The CDC, which has been providing the financing for this intervention by the state through grants, won't be there forever with the money.  The CDC requested the state come up with an exit strategy from this funding source.  That's been called The Elimination Plan.  By 2010, the state has said on the record that its percentage of new cases of elevated blood levels in children will be less than five percent.

As I perceive it, the Rhode Island lead paint trial is about securing the funding to get the state from 2005 to 2010. 

Plaintiff attorney Neil Kelly, who has been questioning Dr. Nolan yesterday and all morning, has been taking the long way around to getting to this funding issue.  Had he, as I blogged last night, gotten in and out faster, he might have scored more points with the jury.

The way I take a reading of the jury is to observe Everyman, the middle-aged gentleman with the great head of white hair.  He seemed very focused early in the testimony, even shaking his head and bending over, perhaps to jot something down in the notebooks provided by the Court. Then he seemed be become restless as the testimony by Dr. Nolan dragged on.

Building a case in court is, I'm convinced, not much different from building the case for a customer/client to buy 100 widgets.  It's primarily about an emotional connection and that begins with respecting the audience's time.