Addressing Energy Usage and Home Health Conditions
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Addressing Energy Usage and Home Health Conditions
ACI Home Performance Conference 2010
Jackie Berger
April 22, 2010
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Session Outline
• Evaluation Overview
• Process Research
• Program Costs and Measures
• On-site Interviews
• Client Pre/Post Survey
• Pre/Post Client Assessment
• Summary and Recommendations
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EVALUATION OVERVIEW
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Evaluation Goals
• Documentation
• Impact measurement
• Recommendations for statewide implementation
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Process Evaluation Research
• Administrative interviews– Ohio Office of Community Services– Cleveland Housing Network, Breathing Association– Partner agencies
• Document review
• Baseline client interviews
• Post treatment client interviews
• On-site client interviews
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Outcome EvaluationResearch• Pre/Post Weatherization Assessment
• Pre/Post Health Assessment
• Pre/Post Client Assessment
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PROCESS RESEARCH
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Logic Model
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Assumptions Activities Immediate OutcomesIntermediate
OutcomesProgram Impacts
Unhealthy homes can aggravate existing medical conditions.
Conduct pre-screening to select vulnerable households for assessment.
Clients with potential for health improvements are identified.
Energy use declines.Clients change behavior to reduce energy usage andimprove health of their homes.Indoor air quality is improved.Clients receive additional social services through referrals.
Clients are able to better afford their energy bills.Clients’ health improves.
Clients need more energy programs due to the use of breathing assistance machines.
Wx decisions can be better prioritized if health impacts are factored in.
Jointly conduct wx & healthy homes assessment.
Wx & healthy homes services are identified.
Relatively small health-related investments can yield large improvements in health.
Jointly deliver wx & healthy homes services.
Clients receive services that improve energy efficiency and health.
Clients do not know how to reduce energy usage and create healthy homes.
Involve and educate the household as a partner.
Clients take actions to reduce energy usage and improve heath.Households will be more invested if they
are involved in the process.
Additional services are available for eligible clients.
Make referrals for services.
Clients receive additional social services.
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Partnerships• Health agencies – state, county, city
• College of nursing
• Diabetes association
• OH State University, Environmental Health
• OH Agency on Aging
• OH Environmental Protection Environmental Education
• Rebuilding Together Central OH
• SERVPRO (fire and water damage cleanup)
• City of Columbus, Department of Development, Emergency Repair Program
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Implementation Challenges
• Model was designed to be sustainable after conclusion of REACH.
• Concept was modest funding that could continue, using a portion of LIHEAP funds.
• Focus– Reprioritization of wx measures.– Funding of key measures to affect health and
safety.
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Implementation Challenges
• Original budget– $500 for home health and energy audits– $1,000 for additional health-related measures– 500 homes served
• HHS approved re-budget– $3,000 average cost– 250 homes served
• Total of 180 homes served in program
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Implementation Challenges
• Joint service delivery– Not intended to be delivered after WAP was
completed.– Requirement for pre-interview helped to
reinforce this.– Each home approached differently.
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Health Issues
• Moisture
• Mold
• Roof leaks
• Plumbing leaks
• Pests
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Services Needed• Plumbing repairs• Repairs to gutters and downspouts• Central air conditioning repaired or replaced• Environmental and mold cleaning• Minor roof repairs• Ventilation• Dehumidifiers• Extermination• Ramps
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PROGRAM COSTS AND MEASURES
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Program Costs
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All REACH Jobs (n=180)
MeanPercentile
25th 50th 75th Labor Costs $2,695 $1,485 $2,198 $3,253Material Costs $1,516 $826 $1,263 $2,021Total REACH Cost $2,629 $1,444 $2,579 $3,547Total Job Cost $4,933 $2,942 $4,404 $6,233
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Air Sealing Measures
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Air Sealing Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Caulking & weather-stripping
139 79% 3% 93% 6% 87 96% 52 61%
Blower door guided air sealing
141 80% 1% 92% 7% 88 97% 53 62%
Non blower door guided air sealing
168 95% 1% 93% 7% 88 97% 80 94%
Duct sealing & repair
110 63% 2% 90% 9% 40 44% 70 82%
Other air sealing work
34 19% 3% 88% 15% 8 9% 26 31%
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Insulation Measures
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Insulation Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Attic 151 86% 1% 93% 7% 78 86% 73 86%Wall 130 74% 0% 94% 7% 83 91% 47 55%Floor 20 11% 5% 80% 15% 7 8% 13 15%Duct 10 6% 0% 90% 0% 4 4% 6 7%Other 15 9% 0% 100% 0% 4 4% 11 13%
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Space Heating Measures
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Space Heating Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACHWA
POth # % # %
Replace 56 32% 4% 64% 32% 31 34% 25 29%Repair 41 23% 5% 78% 12% 8 9% 33 39%Tuned up 79 45% 3% 89% 9% 55 60% 24 28%
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AC Measures
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Air Conditioning Measures
All Jobs
CHN Jobs
BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACHWA
POth # % # %
Window AC 3 2% 0% 0% 67% 3 3% 0 0%Central AC 14 8% 86% 7% 7% 4 4% 10 12%Repair 4 2% 50% 50% 0% 0 0% 4 5%Tuned up 8 5% 75% 13% 0% 2 2% 6 7%Ceiling Fan 11 6% 0% 18% 82% 11 12% 0 0%
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Ventilation Measures
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Ventilation Measures
All Jobs
CHN Jobs
BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Bath 99 56% 73% 16% 11% 87 96% 12 14%Kitchen 34 19% 76% 6% 18% 32 35% 2 24%House 2 1% 0% 50% 50% 1 1% 1 1%Other 27 15% 19% 63% 11% 8 9% 19 22%
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HVAC Accessories
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HVAC Accessories All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure
Installed
# % REACH WAP Oth # % # %Program Thermostat 32 18% 16% 75% 9% 28 31% 4 5%Standard Thermostat 86 49% 5% 63% 31% 55 60% 31 36%Standard Air Filter 62 35% 2% 66% 31% 10 11% 52 61%HEPA Air Filter 91 52% 92% 6% 2% 88 97% 3 4%Other Accessories 31 18% 26% 45% 26% 5 5% 26 31%
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Water Heater Measures
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Water Heater Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACHWA
POth # % # %
Replace 28 16% 7% 54% 39% 8 9% 20 24%Repair 47 27% 2% 87% 9% 23 25% 24 28%Wrap 42 24% 0% 90% 7% 20 22% 22 26%Pipe Insul 85 48% 1% 89% 7% 40 44% 45 53%Temp ↓ 51 29% 0% 92% 8% 44 48% 7 8%Other 9 5% 0% 67% 22% 0 0% 9 11%
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Other Baseload Measures
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Other Baseload Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Indoor Lights 36 20% 0% 6% 94% 21 23% 15 18%Outdoor Lights 31 18% 0% 10% 90% 18 20% 13 15%Refrigerator 24 14% 0% 4% 96% 16 18% 8 9%Other 10 6% 0% 0% 100% 2 2% 8 9%
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Attic/Roof and Repairs
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Attic and Roof All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Attic Vent 98 56% 0% 84% 14% 76 84% 22 26%Roof Repair 26 15% 23% 27% 50% 25 27% 1 1%Chimney Liner 25 14% 16% 64% 16% 17 19% 8 9%
Repairs All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
Repairs # % REACH WAP Oth # % # %Plumbing 56 32% 55% 5% 41% 37 41% 19 22%Sewer 24 14% 29% 17% 54% 21 23% 3 4%Electrical 14 8% 36% 50% 36% 7 8% 7 8%
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Health and Safety Measures
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Health and Safety Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Smoke Alarm 88 50% 2% 14% 86% 82 90% 6 7%CO Monitor 96 55% 7% 85% 7% 89 98% 7 8%Gutter/ Downspout
96 55% 89% 7% 4% 81 89% 15 18%
Grading Lot 67 38% 82% 7% 10% 60 66% 7 8%Stair Repair 12 7% 75% 8% 37% 5 5% 7 8%Bath Bar 5 3% 60% 0% 20% 1 1% 4 5%No Skid Bath 2 1% 0% 100% 0% 2 2% 0 0%
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Health and Safety Measures
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Health and Safety Measures All Jobs CHN Jobs BA Jobs
Measure Installed
FundingMeasure Installed
Measure Installed
# % REACH WAP Oth # % # %Lead 0 0% 0% 0% 0% 0 0% 0 0%Asbestos 3 2% 0% 33% 0% 3 3% 0 0%Poisons 3 2% 33% 67% 0% 2 2% 1 1%Pests 7 4% 100% 0% 0% 1 1% 6 7%Environ Cleaning
124 70% 99% 0% 1% 87 96% 37 44%
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Measure Summary
• Funds leveraged.
• REACH funding of important health and safety measures.
• WAP funding of typical weatherization measures.
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ON SITE INTERVIEWS
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Interviews
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Number of On-Site Interviews
Interview Dates
Cleveland 16 May 18-22Columbus 17 June 15-19Total 33
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Measure Satisfaction
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Satisfaction With Recalled MeasuresMean Percent of Measures With Each Rating
Very Satisfied
Somewhat Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Don’t Know
Cleveland 65% 12% 10% 11% 3%Columbus 74% 13% 7% 2% 3%All Interviews 70% 12% 8% 7% 3%
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Changed Way they Use Home
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Change in the Way the Home is UsedNumber Who Reported at Least One
Change
Mean Number of Changes Reported
Mean Number of Effective
Changes Reported
Cleveland 11 1.3 1.1Columbus 8 1.2 0.5All Clients 19 1.2 0.8
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Reported Changes
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Changes in the Way the Home is UsedNumber of Clients Who Reported the Change
(Unprompted)Cleveland Columbus Total
Use exhaust fans that were provided
3 1 4
Check and adjust for humidity level
3 1 4
Keep home cleaner 3 1 4No longer allow smoking in the home
1 1 2
Change furnace filter 1 0 1
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Changed the Way They Use Energy
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Change in the Way Energy is UsedNumber Who
Reported at Least One Change
Mean Number of Changes Reported
Mean Number of Effective Changes
ReportedCleveland 11 2.1 1.6Columbus 9 0.8 0.6All Clients 20 1.4 1.1
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Reported Changes
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Changes in the Way Energy is UsedNumber of Clients Who Reported the
Change (Unprompted)Cleveland Columbus Total
Lowered winter temperature 5 5 10Turn lights off 7 1 8Increased the summer temperature
1 2 3
Installed CFLs 3 0 3Shorter showers 1 0 1Use timers for television 1 0 1Line dry clothes 1 0 1Discard freezer 1 0 1
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REACH Health Impacts
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Health Impacts of the ProgramNumber Who
Reported Positive Impact
Number Who Reported Negative
ImpactCleveland 8 1Columbus 7 0All Clients 15 1
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REACH Health Impacts
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Health Impacts of the ProgramNumber of Clients Who Reported the
Health Impact (Unprompted)Cleveland Columbus Total
Breathe Better 1 6 7Reduced Hospital Visits 2 2 4Fewer Asthma Attacks 4 0 4Able to Reduce Medication
1 2 3
Fewer Sinus Issues 2 0 2Able to Work More 1 0 1Reduced Doctor Visits 1 0 1
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Program Satisfaction
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Overall Program SatisfactionNumber of Clients With Each Satisfaction Level
Cleveland Columbus TotalVery Satisfied 11 12 23Somewhat Satisfied 2 3 5Somewhat Dissatisfied 1 1 2Very Dissatisfied 1 0 1Don’t Know 1 1 2Total 16 17 33
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On-Site Interview Summary• Program Understanding: Many understood
measures and why they were installed.
• Behavioral Changes: Many reported important changes in the way that they use their home and energy.
• Health Impact: Many perceived that the program had positive impacts on the health.
• Satisfaction: High levels of satisfaction. 39
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CLIENT PRE/POST SURVEY
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Survey Design
• Purpose – assess impact of the program on client health, safety, and comfort.
• Pre survey – conducted prior to any service delivery.
• Post survey – conducted one year later.
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Home Conditions
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Client Behavior
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Mold
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Pests
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Humidity
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Asthma
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Client Pre/Post Survey – AsthmaTreated Clients
(N=93)Untreated Clients
(N=59)Net
ChangePre Post Change Pre Post Change
Has asthma 56% 53% 3 58% 53% 5 -2Asthma – visited doctor
49% 45% 4 53% 47% 6 -2
Asthma – visited emergency room
22% 20% 2 25% 24% 1 1
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Allergies
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Allergies and Bronchitis
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Home Health and Comfort
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Winter Comfort
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Summer Comfort
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Client Pre/Post SurveySummary
• Significant improvements in safety, healthy behaviors, mold, pests, humidity, health, comfort, and winter and summer temperatures.
• Net changes were statistically significant with respect to unsafe home conditions, healthy behaviors, mold, humidity, comfort, winter drafts, and summer home temperature.
• Non-treated had better outcomes with respect to reduced pest poisons in the home, need to use medication for allergies, and need to visit the emergency room for bronchitis.
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PRE/POST CLIENT ASSESSMENT
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Pre/Post Assessment Overview• Providers to collect information about
participant behaviors, home condition, and health at intake and one year later.
• Not collected for all clients.
• Post data only collected for minority.
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Dwelling Condition
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Furnace Filter Changes
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Mold
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Pests
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Winter Comfort
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Summer Comfort
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Air Quality
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Household Member Health
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Household Member Health
Pre Assessment ResultsPost
Assessment Results
BA CHN AllBA with Post
ResultsServices Received
Responses 105 91 196 63 63Excellent 1% 3% 2% 2% 5%Good 20% 12% 16% 21% 22%Satisfactory 45% 30% 38% 48% 48%Unsatisfactory 34% 55% 44% 30% 25%
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Pre/Post Client Assessment Summary • Much of the pre and post assessment data
were missing.
• Results from the pre and post assessment analysis were consistent with the results of the pre and post client survey.
• Positive impacts on home comfort and safety.
• No impact on client health.64
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SUMMARY AND RECOMMENDATIONS
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Accomplishments
• 180 clients received services.
• Allowed agencies to serve underserved households.
• Program coordination and leveraged funds.
• New partnerships.
• Capacity building.
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Findings
• REACH funded health and safety measures and WAP funded weatherization measures.
• Positive impacts on unsafe home conditions, healthy behaviors, mold, humidity, comfort, winter drafts, and summer home temperature.
• No impact on specific health conditions.
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Summary
• WAP can leverage additional funds to provide beneficial health, safety, and comfort impacts for program participants.
• Providers integrated additional health and safety measures into their established WAP procedures.
• Additional measures had a beneficial impact for the clients.
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Recommendations
• Use LIHEAP funding to provide ancillary services to WAP participants.
• Find the most efficient ways to integrate measures with current practices.
• Different models may work better with different agencies’ current procedures.
• New health and safety measures should be implemented in a flexible way, to take advantage of agency partnerships and to create the greatest benefit.
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Contact
Jackie Berger
APPRISE
32 Nassau Street, Suite 200
Princeton, NJ 08540
609-252-8009
www.appriseinc.org
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