IPM in Multifamily Housing

Welcoming Residents, Not Pests

I have two quick side notes before I get to today’s post:

• First, I want to give thanks for all the relief efforts that are being made to help those who are struggling in the aftermath of Hurricane Sandy.
• Second, I want to highlight the sample resident newsletter articles that I have posted in the past. Read them all at: http://stoppests.typepad.com/ipminmultifamilyhousing/newsletter-article/. With Thanksgiving fast-approaching, you may want to revisit the first one: “What to do with fat, oil, and grease.”

Now on to the post!

Resident turnover is a fact of life in multifamily housing. Property managers have systems in place for dealing with abandoned units, making apartments ready for rental, and bringing new residents in. Pest management professionals (PMPs), maintenance staff, and property managers must work together to get rid of pests in an empty unit. If left untended, pests may continue to breed, go dormant waiting for the next resident, or move to adjacent homes. In short, you want to get the unit pest-free (as confirmed by monitoring) before putting it back on the market. Do not use total release aerosol foggers and be aware of the laws in your state about who can apply pesticides on your property (even in a vacant unit). 

Today I want to go over options for moving new residents in.

Bed bugs are the motivating factor behind many of the requests I get for help with revising resident move-in procedures. I encourage you to read the applicable notice for your housing portfolio. Each contains specific information about rights and responsibilities.

•   HUD Office of Housing's Notice on Bed Bugs, and
•   HUD Office of Public and Indian Housing Notice on Bed Bugs

Mice and cockroaches are great hitchhikers too, so procedures should focus on allpests, not just bed bugs. A realistic and measurable objective is to have the home pest-free within 3 months of move in. This gives sufficient time for the resident, PMP, and housing management to do their parts. If the effort starts on day-one and the PMP and residents avoid repellent pesticides like foggers, the infestation is unlikely to ever grow or spread to neighboring units. 

It is nearly impossible to prevent pests from coming in the doors, but you can have a system that controls any pest problems and avoids any high-level of infestations in the homes of new residents. I recommend you allocate your time and resources toward monitoring and inspection rather than treating residents’ belongings outside of the home in fear of a few pests dropping onto a hallway floor during transport.

Offer all residents the training they need to use proven, non-chemical control methods like vacuuming with a HEPA filter and good housekeeping. These, along with an IPM program that includes regular monitoring and inspection by trained staff or a PMP should prevent an infestation from getting out of hand.

At a minimum:

1. Have monitors in place for cockroaches and bed bugs before the resident moves in. 
2. At move-in, educate the resident about pests and effective strategies for keeping them at-bay, the pest control policies in place, the monitoring and inspection schedule, and the importance of reporting pest sightings. Give the resident the opportunity to discuss his or her previous experience with pests and offer any recommendations or resources that the housing agency can provide.
   The StopPests residents briefing video and printable resources can help. Set the tone that is so well done on this poster developed by Home Forward in Portland, OR. 
3. After the resident has had a chance to settle in, but within 60 days, conduct a housekeeping inspection. During this inspection, check sticky traps and bed bug monitors and use a flashlight to look for signs of pests. In addition to pest signs, you are looking for pest-conducive-conditions: food, water, and shelter for pests or ways the pests could get in the home.
4. If housekeeping practices do not meet the standard, follow your violation procedures that ideally involve a housekeeping class. If you see early signs of hoarding, reach out to a local service provider.
5. If you see signs of pests, follow IPM: identify, scale response to level of infestation, take control measures, and evaluate the success of the effort through more inspection and monitoring. Mark the home as a focus unit and call a PMP. Have housing staff visit the unit at least every month and allocate time and resources to it until the pests and their evidence is gone. 

Other options that are more time and resource-intensive and may not be necessary/practical:

1. In a legal and sensitive way, ask applicants to self-report that their previous home was infested and offer them available solutions. If they do self-report, at a minimum, recommend the resident vacuums weekly, launders bedding on high heat as part of the move in process, and have a PMP inspect. If deemed necessary, the PMP may treat the unit with pesticides within a week or two of move-in.
2. Encase the residents’ mattress and box spring before bringing it in the building. Use a rip-resistant and snug-fitting encasement on each. Note: the box spring has the most bed bug hiding spots, so it should take priority over the mattress.
3. Steam resident belongings and suspected harborages.
4. Do a whole-unit heat treatment after the resident moves in followed by monitoring and inspection. Note: If done correctly, heat treatments will kill all life stages of both cockroaches and bed bugs.
5. Heat-treat or fumigate (NOT fog) residents’ belongings outside of the building. To me, this seems like a logistical nightmare, but I’ve heard of a few housing authorities that have taken units offline to create a “bug sauna” or have retro-fitted a moving truck to be a heat box.

Controversial topics: disposing of furniture, scent detecting canines and prophylactic pesticide application. You may note the absence of these topics. There are many reasons based on financial burden, efficacy, risk of pesticide exposure, and practicality that I won’t go into here. Each control option has it’s place, but not in a practical standard resident move-in procedure.

Want to share your strategies?
Comment below or join the conversation on StopPests in Housing Facebook page.

StopPests.org—check it out!

I am thrilled to announce that www.StopPests.org got a facelift and is ready to step out into the world!

• Want tips for working with residents? Try some techniques we've learned from housing authorities and use our popular Tenant's Role in IPM video (you can download and burn it to a CD for free). 
• Interested in partnering with your local housing authority? Read how we approach, train, and work with housing authorities.
• Need money or free training? There are pages for funding and training opportunities.
• Got pest problems? View our pest solutions page for tips and suggested resources.

And there's so much more!
Try out the site's robust search function if you're looking for something specific. Popular search terms include "hoarding," "spanish" and "video." 

If you don't find what you need or you have suggestions for improving the site, e-mail me at stoppests@cornell.edu.

Stories from the field—the 2011 National Healthy Homes Conference

Last week I went to Colorado for the first time. What a great place! 

Specifically, I was in Denver at the National Healthy Homes Conference. I spent three days  with people who are making homes healthier—and loving it. Everyone was motivating and inspiring. The resounding message was: each of us has the potential, in our day-to-day work, to make a difference.

The initiatives that stood out to me as being well-represented were asthma, radon, smoke-free, weatherization, and IPM (I may be biased on the last one!).  To see details of the program and contact information of people involved, see the conference website at: http://www.healthyhomesconference.org/. I believe the conference organizers do plan on posting presentations online.

I attended the last Healthy Homes Conference in 2008. In ’08 I remember making the case for IPM as part of a healthy home. Just a few years later, IPM was mentioned in at least one plenary speech! It was great to talk with people at our booth and hear them explain how IPM fits into what they do. Now, more than ever, I believe that an IPM program can be an umbrella under which many other health issues are addressed.

The Northeastern IPM Center had a lot going on at this year’s conference. We had a poster up about the IPM in Multifamily Housing Training program and a booth where attendees could inspect for (dead) bed bugs and get information on IPM. I had the opportunity to talk with a lot of people about this program and met some of you who subscribe to this blog! Even Fox News showed interest: http://www.kdvr.com/news/kdvr-experts-converge-in-denver-to-discuss-healthy-homes-20110620,0,164216.story. Hopefully a few of the connections will result in training at housing authorities in 2012.

We had four speakers sharing their success stories and advice.

1. I spoke about IPM and bed bugs. The bed bug session included about 40 minutes of Q&A. Lots of health inspectors attended who were concerned about bed bugs hitchhiking home with them or getting in their cars. We discussed strategies such as choosing clothing and shoes without cuffs or folds, avoiding upholstered furniture while working in homes, changing into a new set of shoes and clothes before returning home, and laundering items that may have bed bugs on them.

2. One of the property managers who received training in November 2009 spoke about the IPM program at her property. They focused on case management—identifying where the infestations exist through inspection and monitoring and then focusing staff time and resources on these homes or areas. Three of the many strategies she discussed were:

•    To get her maintenance department involved and excited about IPM, she involved them in case management. If a resident’s unit was identified as a focus unit, one maintenance tech was assigned to work with the resident and property manager until the pest (and underlying maintenance) issues were resolved. The tech didn’t have to do all the work, he was just the main contact for the resident. Responsibilities of the PHA, resident, and pest control contractor were defined. This system gave the resident a point of contact, increased communication between all parties, and gave the maintenance tech a feeling of accomplishment when the situation in the home improved.
• One working mother resident had adult children living at home and making messes. The mother couldn’t keep up with housekeeping on her own and couldn’t get her kids to do their part. Repeated failed housekeeping is cause for eviction and the mother was afraid she was going to get evicted because of her kids’ behavior. She and the property manager put their heads together (case management). Rather than only serving the violation notice to the mother (head of household), the property manager created violation notices for the adult children too—detailing what they had to do to keep their mom from getting evicted. These notices got them to cooperate!
• A young working mother was living with pests in a messy home. After having a conversation with her, it became apparent she simply had never been taught how to clean and did not know the expectations for housekeeping. The site’s peer educator (a resident trained to help her peers with housekeeping and pest issues) showed the resident how to clean. Specifically, she used tape to box off a square on the wall, on a counter, on the stove, etc. The peer educator cleaned inside the box—showing the resident. Then she gave the resident a week to make outside the taped area match the inside. Over the course of a few months they worked together and got the entire home organized in a sustainable way—teaching the resident where to let the kids eat, how to keep up with cleaning, etc. The team (including the resident) took before and after pictures. This story was really powerful. The resident and the property manager have both shed tears of joy over the improvement.

3. A PhD from Boston University spoke about the importance of identifying symptoms of mental health and aging so that residents get the help they need both from housing and from health professionals. Her presentation is worth looking at.  Download NHHC _Bratiotis 6.2011

4. The head of maintenance from one of the larger housing authorities trained in 2011 spoke about the benefits his PHA has seen from focusing on the make-ready process for vacant units—getting homes not only pest-free, but pest-proof before the new resident moves in. They no longer paint over frass, grease, old cockroach bait, and old caulking. They clean, repair, and use silicone caulk in the kitchen and bathroom before painting. Their in-house pest management professional places monitors throughout the unit and services or makes recommendations accordingly. A unit is not ready for occupation until the monitors go two nights pest-free. The hardest part of implementing IPM this way was to oversee the maintenance contractors to ensure they did not cut corners when making repairs. Now the word is out that PHA doesn’t tolerate imperfection and they don’t have to make contractors re-do work as much. The bottom line for this PHA is that, although this system costs the maintenance department a lot more right now, it is worth it. They reduced pesticide use by 50%, infestations are down 50%, The pest control cost is down 40%, resident-generated work orders are down, and residents who move into these exceptionally prepared units believe in the PHA’s zero-pest policy. They see the empty monitors in their new home, get IPM training as part of their orientation, and report when they do see a pest.

Note: I do plan on writing case studies for the PHAs who received training and implementation support over the last 3 years.

It was a fantastic week. Not just because of the informative talks, but because of the networking that went on. I want to thank HUD’s Office of Healthy Homes and Lead Hazard Control and USDA’s National Institute of Food and Agriculture for funding this project and allowing us to bring together the PHA staff to share their success stories. And I want to thank the PHA staff for being such wonderful, inspiring ambassadors for IPM!

Hoarding

What pest control topic is hotter than bed bugs right now?

Hoarding!

It’s a reoccurring theme in my work with multifamily housing. In addition to the advice I’ve posted today, I wrote a guidance on IPM in a Hoarded Home ( Download Pest Control in a Hoarded Home ). In it you’ll find information on the risks of working in a hoarded environment, some suggestions for IPM in a hoarded home, and a list of resources on hoarding. I hope you find it useful! If you might work in a hoarding situation, take a look. Some of the hazards to consider may surprise you.

Although most people don’t immediately associate hoarding with pest control, there are a lot of connections. Pests need food, water and shelter. If a resident’s housekeeping is poor and pests get in, the pests will likely set up shop—an infestation in a hoarded home can easily get out of hand. A cluttered home makes inspection hard. A hoarded home, almost impossible.

Property managers usually inspect each unit at least annually for compliance with housekeeping standards, but regardless of the language in a property’s housekeeping standards and lease, there will be residents who don’t comply. I group these people into two categories: those who can’t and those who won’t. This post is about one category of people who can’t—hoarders.

I’ll likely post on how to address other issues that arise when trying to get residents to comply with housekeeping standards. For now I’ll just say that PMPs, maintenance staff, and anyone else working in units should know to report poor housekeeping. Property managers should take action ASAP. Early intervention sends a message property-wide that the development has high standards for cleanliness.

Hoarding, as most property managers at HUD-funded properties know, doesn’t just happen on reality TV. In fact, one researcher said that hoarding is 4 times more prevalent in low-income persons than those making over $20,000 a year. Regardless of why a resident with compulsive hoarding and acquiring behavior comes to reside at a property, they deserve to be treated with respect. Don’t think of a hoarder as nasty, think of him or her as someone needing reasonable accommodation. This may take some acting on your part, but it is critical for building trust from which therapy can proceed.

What defines hoarding?
Hoarding is a complex disorder that is made up of three connected problems: 1) collecting too many items, 2) difficulty getting rid of items, and 3) problems with organization. These problems can lead to significant amounts of clutter which can severely limit the use of living spaces, pose safety and/or health risks, and result in significant distress and/or impairment in day-to-day living.There is a self-diagnosis tool and a wealth of information at the Anxiety Disorders Center.

One of my favorite tools for hoarding is the Clutter Image Rating Scale from the Compulsive Hoarding and Acquiring Workbook. Take a look and you’ll see why I love it…finally a way for to define what we mean by “clutter!” I suggest property managers decide what range on the scale is acceptable for passing housekeeping inspections and take action when a unit falls above this range. This is helpful for all residents. To use it for educational purposes for residents that fail a housekeeping inspection (not just a hoarder):

1. take pictures of the kitchen, bedroom, and living room in the home,
2. print them out,
3. schedule a meeting with the resident outside their home (if possible),
4. have the resident place the pictures you took on the Clutter Image Rating Scale, and
5. have a discussion about what can be done to improve the conditions.

Property managers tell me that this strategy helps the resident see their home more objectively. Once the resident understands the problem, he or she may be more willing to improve. With both hoarders and residents who simply have trouble keeping their house picked up, have them set small measurable goals with deadlines. For example, “By next Monday, I will put all the newspapers piled on the kitchen table that are more than a month old in the recycling bin outside.” Don’t forget to check in and set another goal on the deadline.

I digress…
If left unmanaged, hoarding behavior will get worse over time. Early intervention is the goal. As with pest management, you can’t simply clean out an established problem in one fell swoop and expect it to last. In fact, “clean outs” are detrimental to a hoarder’s therapy and they may refill the space quickly. Managing hoarding behavior will be an ongoing process for the resident, staff, and anyone else you involve. Progress will take time. Patience is important. The goals are to reduce the clutter so that the home is no longer a hazard at the pace that the resident can manage and for the resident to reach a point when he or she can use learned strategies to manage compulsions.

What should you do?
I’ve read some books and talked to some experts, and this seems to be the consensus:

1. Proactively start a hoarding task force that is educated on the topic and is called on when hoarding is reported.
2. Once reported, the health department (stick) and a therapist experienced with hoarding therapy (carrot) visit the resident to work on the problem (see below for more on this analogy). If there is family that can be helpful, call on them too. This group develops relationship and trust before making a dent in the stuff.
3. Over the course of many months or years, the resident gets control of the clutter and learns to manage his or her compulsions. As I mentioned before, the group should set very small measurable goals. Only progress at a speed the hoarder can handle. He or she may need a lot of hand holding at first—patience is key.
4. Once the clutter is managed, someone who has been involved and has the resident’s trust is responsible for checking in so that a relapse can be addressed before the home fills up again. Hoarding can’t be cured.

Who is on a hoarding task force?
Think of people in your area who could help or have authority to enforce codes and standards. Each member learn about the others’ jobs, gets educated on hoarding, and plans out what role he or she will play if a hoarded home is reported.

The sticks in this situation are the consequences of no action or continuing to hoard. Involve the people in your area who have the powers to condemn, evict, and issue a fire code violation. Eviction is the biggest stick and the property management company should wield it wisely—be familiar with the housing court process ahead of time.

The carrot is the support the team offers, therapy, and the benefits of living in a healthy home—having the grand kids visit for example. Even the people who have the stick should be on the team developing a positive relationship with hoarding residents by helping where appropriate—everyone is working towards the same goal of safe, decent, sanitary housing.

 Some or all of the following groups should be on the task force:

• The health department—cares if a home is unfit for human habitation and vector control
• Fire department—cares about fire codes
• Protective services—cares especially when animals, children, or the elderly are involved
• Public works—may be needed for organizing bulk trash pickup
• Pest control—may be needed if pests are present
• Agency on aging
• Housing
• Mental health professional—check www.adaa.org for a local therapist. If there are none in your area involve a social worker familiar with the resident and/or setting.

I wish I had a guaranteed solution for hoarding, but I have done enough research to confidently say that one doesn’t exist. As with pest management, partnerships are key for hoarding management. For those of you going to the Entomological Society of America’s annual meeting, I put together a symposia on partnerships developed for IPM programs. One of the speakers on my panel is hoarding expert, Dr. Christiana Bratiotis. Hope to see you there!