MORE ABOUT THE STRATEGY USED IN THIS CASE STUDY Maintaining safe and healthy housing



  • In 2000, 23.6 percent of children in Rochester tested positive for elevated lead blood levels, with 35 percent of children testing positive in several predominantly Black and Hispanic neighborhoods. Renters in housing built before 1978 were at the highest risk for lead exposure. While the city had a rental safety certification program, it lacked an enforcement mechanism.

  • The City and the Coalition to Prevent Lead Poisoning, a local community group, developed the Lead-Based Paint Poisoning Prevention Ordinance, which passed in 2005. The ordinance required regular lead inspections in all rental properties and provided for additional inspections in high-risk neighborhoods. Meanwhile, the City and Monroe County connected landlords to nearly $50 million in local and federal grants to address lead hazards in their units. These efforts contributed to a 83 percent decline in elevated blood levels among children in Monroe County between 1994 and 2011.

  • Keys to the ordinance’s success included the broader community’s leadership in its design, which ensured it addressed the needs of tenants; a focus on data and evidence to build a case for action; proactive education of tenants and landlords after implementation,; collaboration between the City and County governments to secure grants for landlords; and a policy design that increased rental units’ safety in a largely affordable manner, which built broad public support.

  • Challenges the program faced included concerns that the ordinance would harm the housing market and its focus on abatement and not removal of lead paint.

Results and accomplishments


Since the ordinance went into effect in 2005, Rochester has conducted 204,597 unit inspections. Most units were inspected more than once, and were required to be compliant each time.


Between 1994-2011, the share of children under six with elevated blood lead levels in Monroe County dropped by 83% -- a drop 2.4 times faster than New York State and 1.8 times faster than the national rate.


Within 5 years of the ordinance’s enactment, Rochester inspected all 17,951 structures with residential rental dwelling units in “high-risk” areas.

  • A major impact on young children: Between 1994-2011, the share of children under six with elevated blood lead levels in Monroe County dropped by 83%, from roughly 8,000 to fewer than 1,000 -- a drop 2.4 times faster than in New York State and 1.8 times faster than the national rate.
  • Bipartisan, trans-jurisdictional support: The Coalition, with members representing a range of communities, interests, and areas of expertise, secured crucial support and some funding from the largely Democratic elected officials of Rochester and the Republican administration of Monroe County.
  • Modeling success for others: Rochester leaders have provided lead-safety ordinance design and implementation assistance to dozens of jurisdictions across the country, including Cleveland, Syracuse, and Buffalo. The Rochester City School District also passed a Lead Safe School Policy in 2007, which requires annual paint inspections, publication of results, and a formal reporting process for parents or students to file complaints. It is one of only a few school lead policies across the country.
  • Nationally-recognized lead-prevention leader: The U.S. Environmental Protection Agency honored the Coalition with its 2010 Environmental Justice Achievement Award. “With its older housing units and a childhood poverty rate of 38%, one of New York’s highest, Rochester needed to take extraordinary steps to prevent lead poisoning,” said Judith Enck, EPA Regional Administrator. “EPA enthusiastically supports groups like the Coalition to Prevent Lead Poisoning that work to protect the health of their communities.”


What was the challenge?

  • A lead poisoning crisis for Rochester children: In 2000, the citywide childhood lead poisoning rate in Rochester was 23.6%. This was far higher than the average rate in New York State, which itself had the highest state rate in the country.
  • Disproportionate impacts on communities of color: County data revealed that in Rochester, 12 census tracts were at “extreme risk” for lead poisoning. In these neighborhoods, which were predominantly Black and Hispanic, over 35% of screened children had elevated blood lead levels -- more than twenty times the national rate.
  • Health outcomes tied to housing market: Across Rochester, 87% of housing units were built before 1950 (federal law banned lead paint in 1978) and 60% of housing was tenant-occupied, which national research indicates are more likely to have lead hazards.
  • Inadequate rental safety certification processes: Despite the fact that the city’s existing Certificate of Occupancy system banned deteriorated paint, the rule lacked a strong enforcement mechanism, leaving the policy ineffective. A community-run pilot project called Get the Lead Out collected data and stories shedding light on the frequency of exposed lead paint despite the law.
  • Prohibitively expensive full remediation efforts: Rochester leaders, in an effort to evaluate all options to address lead poisoning, commissioned a 2002 Center for Governmental Research report. The report estimated that to remove all lead paint from Rochester rental housing would cost the city and/or owners between $605 million and $5.6 billion. Most leaders in Rochester considered this option too costly and disruptive to the housing market to implement. They therefore began evaluating alternative approaches.

What was the solution?

  • Building on existing city inspection processes: Rochester’s 2005 Lead-Based Paint Poisoning Prevention Ordinance requires rental properties to pass regular lead inspections in order to receive a Certificate of Occupancy. For buildings with more than three units, inspections are conducted every three years; for buildings with two units or less, every six years.
  • Prioritizing the highest risk communities: The ordinance requires all properties in high-risk areas (as determined by annual analysis of blood lead data supplied by Monroe County) to pass both a visual inspection and a more rigorous dust wipe test. The ordinance also includes a provision allowing occupants, community groups, doctors, and others to anonymously request an inspection.
  • Addressing lead hazards: To pass inspections, landlords must ensure lead risks are contained, like deteriorating paint or dust following a renovation. Solutions are often simple, such as replacing lead-painted windows, thorough cleaning, and hiring an EPA-certified inspector to confirm no dust remains that could expose a child to poisoning.
  • Financial support for landlords: The City and County connected landlords with nearly $50 million between 2003 and 2017 to address lead hazards in their units. The funding, which came from HUD Lead-Based Paint Hazard control grants and local programs, allowed property owners to apply for financial support to proactively address lead hazards, such as deteriorating paint and window replacement, and other healthy home interventions, like energy efficiency upgrades and mold and pest remediation.
  • Free inspections, data transparency, and citizen oversight: The law was passed with three accompanying resolutions: a voluntary, free lead inspection program for owner-occupied homes; annual reporting requirements to identify high-risk areas; and a citizen advisory group to oversee implementation and public education campaigns.
  • An ordinance designed by the community: The Coalition to Prevent Lead Poisoning, a group of community activists, educators, researchers, medical professionals, and others, leveraged their diverse skillsets and experiences to help design the ordinance in tandem with city policy staff. Contributions included identifying key blood lead level safety standards and communications strategies with tenants. The Coalition also ran advocacy campaigns before the ordinance passed, and contributed to lead safety public service announcements afterward.

What factors drove success?

  • Identifying an affordable, impactful policy option: By tying lead safety to Certificate of Occupancy inspections, Rochester implemented a policy that incentivizes landlords to maintain units in a lead-safe manner, such as ensuring paint is not deteriorating and that units are thoroughly cleared of any dust following renovations. This approach, in contrast to longer-term and more costly full-scale lead removal (such as removing any walls with lead paint entirely), had a far more mild impact on the housing market and public spending. The result was more robust public support from landlords and tenants alike.
  • Community-led ordinance design: By prioritizing leadership from members of affected communities, the Coalition drafted a policy that comprehensively addressed tenant needs (such as anti-retaliation rules protecting tenants from landlord responses to complaints). This approach also resulted in strong public support from community-based organizations and grassroots organizers, who advocated for the ordinance’s passage and helped to publicize it once it went into effect.
  • Putting data and evidence at the forefront: By leveraging public health data and input from leading subject matter experts during the community organizing process, the Coalition’s evidence-based case to Rochester residents and the City Council for urgent action was especially compelling.
  • Proactive education to tenants and landlords: By investing in and advocating for public lead safety education, the Coalition helped bolster the ordinance’s efficacy after implementation. For instance, through its Lead 101 presentations, the Coalition helped tenants learn how to better maintain lead-safe housing and request inspections; landlords, meanwhile, were made aware of the range of financial resources available (such as HUD grants) to make repairs and subsidize lead-related costs.
  • Collaboration across jurisdictions: The City of Rochester and Monroe County partnered closely to address lead safety issues, with each government represented on Coalition committees. Rochester relied on Monroe County data to define its high-risk neighborhoods, and both jurisdictions leveraged their staff and resources to secure lead remediation grants for landlords.

What were the major obstacles?

  • Complete removal of lead-based paint prohibitively expensive: While Rochester leaders had identified that urgent action to address lead hazards was necessary, estimated costs to make Rochester completely lead-safe (such as by removing and replacing walls with lead paint altogether, rather than painting over them) were between $605 million and $5.6 billion. This cost was prohibitively expensive. As a result, Rochester leaders focused on short-term remediation (such as replacing lead-painted windows and mandating thorough cleaning processes after renovations that could create dust with lead particles in it), regular inspections, and raising public awareness, rather than complete lead removal.
  • Housing market concerns: The law’s passage faced significant pushback from property owners and developers, who argued that costs associated with compliance could prompt some landlords to abandon properties, given their slim profit margins and the area’s depressed housing market. Landlord surveys after the law went into effect indicate this did not occur. There was no quantifiable disruption to the rental market.

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Implementation process

How did leaders confront the problem?

  • School leader identifies lead crisis, galvanizes coalition: After a Rochester elementary school principal finds that 41% of children entering his school had a history of elevated blood lead levels, he organizes a community meeting to discuss solutions. The meetings evolve into the Coalition to Prevent Lead Poisoning.
  • Assessing the community’s needs: With the Coalition raising awareness about the childhood lead poisoning crisis in the area, the Monroe County Department of Public Health commissions the Center for Governmental Research to conduct a needs assessment. The report, which includes a projection that nearly 20,000 Monroe County children will suffer from dangerous levels of blood lead poisoning in the next decade, underscores the urgency of public policy action while acknowledging the area’s extremely limited financial capacity to do so.
  • Convening the community: From its launch, the Coalition prioritizes community-informed solutions. With support from the United Way, the Coalition holds the Community Lead Summit in 2004, bringing together community members, health care providers, educators, lawyers, environmental experts, and local government leaders to identify concrete, actionable steps to reduce lead poisoning quickly.
  • Local leaders commit to finding solutions: At the 2004 Lead Summit, Rochester Mayor William Johnson publicly commits to passing a comprehensive lead safety law before his term ends in 2005. Monroe County Executive Maggie Brooks makes a similar commitment, paving the way for a policy development process that includes an environmental impact statement and dozens of public meetings to gather input.

How was the strategy designed?

  • Frequent inspections for lead-based paint exposure: Full-scale lead-based paint removal (which could include demolition of some units and major renovations to others) was not considered viable due to high costs and the potential for significant housing market disruptions. Instead, Rochester leaders used regular lead inspections within the city’s existing Certificate of Occupancy process as a cost-effective alternative to ensure renters lived in safe conditions. While the approach does not eliminate lead exposure risks entirely, it creates a significant incentive for landlords to ensure their units are maintained in a lead-safe manner. This includes replacing lead-painted windows and undergoing an intensive cleaning and dust-removal process after renovations.
  • Incentivizing lead hazard remediation: While the primary enforcement mechanism for maintaining lead safety is a penalty (revoking a Certificate of Occupancy), city leaders were careful to incorporate positive incentives for landlords to make units more lead-safe as well. For instance, the City of Rochester and Monroe County worked directly with landlords to secure nearly $50 million in federal grant allocations to reimburse them for lead safety renovations (such as replacing lead-painted windows, siding, and porches) and other healthy home interventions, like pest remediation.
  • Prioritizing high-risk areas: The law includes a provision to define high-risk areas based on Monroe County Department of Public Health blood lead data. Such areas are required to undergo a more rigorous dust-wipe test in addition to a visual inspection, increasing the chances for safe housing.
  • Transparency and citizen oversight: Rochester City Council introduced three resolutions to accompany the original ordinance, including an annual reporting and data transparency requirement to identify high-risk areas, a citizen advisory group to oversee implementation and conduct ongoing oversight, and a voluntary free inspection program for owner-occupied homes.
  • Multidisciplinary coalition designs community-informed lead safety ordinance: The Coalition, which brought together community activists, educators, researchers, medical professionals, and philanthropists, combined public health best practices, data analysis, and community insights to draft and refine the ordinance. The Coalition was informed by members of impacted communities, such as through the Get the Lead Out project. For instance, after tenants discussed fear of retaliation from landlords, the Coalition pushed for a specific prohibition of retaliatory action to be written into the lead law.

How was the approach funded?

  • Ordinance implementation: To implement the lead law, the city trained its inspectors to conduct visual and dust-wipe tests for exposed lead-based paint as part of its Certificate of Occupancy process. The additional staff time, administrative needs, and analysis of lead dust wipes cost approximately $600,000 per year.
  • HUD grant funding for lead hazard remediation in 1,400 units: From 2003-2009, Rochester leaders encouraged landlords (through advertising campaigns and informational brochures) to apply for and secure $45 million in U.S. Department of Housing and Urban Development Lead-Based Paint Hazard Control grants. The funding covered short-term lead remediation, like replacing lead-painted windows, in more than 1,200 units. From 2014-2017, meanwhile, the Monroe County Department of Public Health secured another $3.27 million HUD Lead-Based Paint Hazard Control grant, which it used for lead hazard control and repairs in more than 200 units.
  • Reimbursements for lead exposure tests: After securing a one-time grant from a private corporation, the City of Rochester reimbursed landlords a total of $166,500 to conduct 1,665 lead clearance tests in high-risk neighborhoods from 2006-2009. Since then, Monroe County has partially subsidized the lead inspection costs through state lead poisoning prevention funding.
  • Supporting coalition operations: The Coalition’s staff, which at its peak had three salaried employees, was funded by local foundations, governments, and companies. Board members also worked with state elected officials to obtain funding from the state legislature, while office space and administrative services came via host organizations (United Way starting in 2003, before transitioning several years later to Finger Lakes Health Systems Agency).
  • Raising public awareness of lead safety efforts: The Coalition received pro bono PR support, including public service announcements and advocacy campaigns, from a local communications firm for over a decade. This included free advertising on radio, in print, and on TV around the Rochester area, with the donated services valued at $250,000 per year.

How was the plan implemented?

  • Passing the ordinance: After five years of intensive community organizing and policy design led by the Coalition to Prevent Lead Poisoning, Rochester’s City Council passes the Lead-Based Paint Prevention Ordinance in 2005 with strong, vocal public support. It goes into effect the next year.
  • Hiring and training inspectors: Rochester’s Division of Inspections trains inspectors and develops protocols around the newly enhanced inspection process for rental properties. The Division also works to educate landlords about compliance and remediation, while the Coalition engages with tenants, community groups, and others.
  • Ongoing public education on lead safety: Prior to the ordinance’s enactment, in 2004, the Coalition is selected to receive pro bono PR and graphic design support from a local communications firm. This support allows the Coalition to help lead a robust public service announcement campaign to provide tenants and landlords with lead safety information. The Coalition leads public-facing lead safety campaigns for more than a decade using TV, radio, and print advertising.
  • Inspecting thousands of units in year one: Rochester conducts 16,449 deteriorated paint inspections within a year of implementation, including 3,850 in the newly-designated high-risk areas. Within five years, the City of Rochester conducts 58,177 interior visual inspections. Those include all pre-1978 rental units, ensuring that almost all high-risk properties are inspected.

How was the approach measured and refined?

  • Measurable impact as a design principle: Those designing the ordinance, lead by members of the Coalition, prioritized careful data collection and impact evaluations. The ordinance thus included measurable goals within a specified period of time, such as inspecting all high-risk rental units within four years of the law’s enactment.
  • Conducting a needs assessment and evaluating the law: In 2007, the Greater Rochester Health Foundation funded Center for Governmental Research’s evaluation of the first four years of the lead law, finding “that implementation had proceeded as planned with nearly all target units inspected in the first four years, higher than expected inspection passing rates, and no major disruptions of the Rochester housing market.” This came five years after CGR conducted a needs assessment for the region on lead safety and remediation, which had initially helped to prompt action.
  • Annual reporting transparency: One key component of the law is its annual implementation report requirement, which allows both City Council and the public to examine inspections and passing rates over time. Stakeholders review inspection data to inform recommendations for strengthening lead safety standards.
  • Cross-governmental data sharing: In order for the City of Rochester to effectively define high-risk areas, the Monroe County Department of Public Health shares relevant data with the city on elevated blood lead levels in children.
  • Collaboration with experts: To strengthen its proposals, the Coalition engaged with both local and national experts on lead poisoning prevention. The experts conducted data analysis and offered technical assistance to support the Coalition and the City’s ongoing needs during both the policy design and implementation phases.

Results for America would like to thanks Dr. Katrina Smith Korfmacher for her help in completion of this case study, including the use of her book, Bridging Silos: Collaborating for Environmental Health and Justice in Urban Communities.

Photo credit: Communications Bureau, City of Rochester, NY