Efficacy of Voluntary Compliance As a Tool for Healthy Homes Programs

BACKGROUND: Healthy Homes Program framework traditionally employs risk assessment methods and recommends evidence-based interventions for health hazard remediation, emphasizing preventative maintenance. Housing codes and regulations vary by state and do not always compel property owners to take action. Looking beyond traditional regulatory enforcement to reduce in-home health hazards in an urban area with a substantial proportion of children living in poverty, the District of Columbia Department of the Environment Healthy Homes Program launched a voluntary compliance model. Our objective was to evaluate the efficacy of this model.

METHODS: Early in the case management process, a technical assistance report is produced following initial home inspection. This document is provided to both the case and rental property landlord, and details identified health hazards, prescribed steps for remediation, and associated health risks. This initial correspondence with property owner outlines requested timeframe and future steps, such as referral to the Department of Consumer and Regulatory Affairs and the Office of Tenant Advocate. Data from February 2012 through November 2013 were extracted from the Healthy Homes Database and analyzed within Excel and SAS 9.3.  

RESULTS: Among 133 cases enrolled in the District’s Healthy Homes Program during the study period, 78 (59%) were rental properties. More than half of rental properties were in Ward 7 or Ward 8, also home to the highest prevalence of District children living in poverty. Hazard remediation was completed among 47 (63%) rental properties. Landlords voluntarily complied with prescribed remediation steps in 47 (96%) cases.

CONCLUSIONS: These findings suggest that the District’s voluntary compliance model may be a useful tool to facilitate landlord action towards identified home health hazard remediation.   Providing landlords with a time window to take prescribed remediation steps with Healthy Homes Program support and consultation creates a collaborative partnership that fosters timely remediation of health hazards, promoting preventative maintenance.