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Libby Community Advisory Group
Meeting Summary

April 10, 2003

Introductions

Gerald Mueller and members of the Libby Community Advisory Group (CAG) introduced themselves. A list of the members and visitors in attendance is attached below as Appendix 1.

Agenda

Mr. Mueller reviewed the following agenda for this meeting:

Public Comment

EPA Report

Jim Christiansen introduced Dr. Aubrey Miller who has taken Chris Weis' toxicologist and science advisor position in EPA Region 8. He then reported on behalf of EPA on the following topics:

Residential and Commercial Cleanups - EPA is continuing winter, indoor-only cleanup. EPA's goal is to have 40 residences/commercial buildings completed by this April 30. Currently four cleanups are underway. The completion rate is about four or five per week. The cleanup cost per residence is in the $30 thousand range and has been dropping as EPA is able to address houses in one area of town. In mid-May, outside cleanups will begin. The indoor cleanups will stop when attics become too hot for the workers who must wear protective clothing. The annual cleanup target is 250 - 300, or about 8 residences per week. Adequate funding for cleanups is available for this year.

Economic Redevelopment Workshop - While EPA is not a economic development agency, provisions of two statutes, the Brown Fields and the Superfund Redevelop laws, provide it with some redevelopment authority. Unfortunately, neither of these statutes is a good fit for Libby. However, when the Stimson plywood mill shut down, EPA decided to convene a redevelop workshop to get local stakeholders together with representatives of other state and federal agencies that might have redevelopment funding. The workshop is scheduled for April 25 and 26. The agenda has not yet been finalized, but it will include addresses by Senator Burns and Congressman Rehberg on Friday, April 25 and by Governor Martz and a motivational speaker on Saturday, April 26. Ads for the workshop will run in local newspapers and on local radio.

CAG Member Question - At the recent meeting of the Technical Advisory Group, we learned that the Libby Superfund site consists of five operable units. Could you clarify what the five are?
Answer - The five include the screening plant site, the export plant site, the mine and mine road, the residential and commercial buildings in Libby, and the City of Troy. We will begin the investigation of the Troy unit next year. The State of Montana will be the lead agency for the Troy site using EPA funding.

CAG Member Question - What is the status of the mine cleanup?
Answer - Because of its isolation, the mine site is a lessor cleanup priority. About $1 million has been allocated in the 2004 budget to begin the investigation of the mine and mine road, including air quality sampling and sampling on USFS and Plum Creek lands.

CAG Member Question - Does EPA need community support to assure the $1 million for the mine investigation?
Answer - I don't think so. We have been keeping our supervisors informed of Libby budget needs.

State Report

Dr. Michael Spence, the Montana State Medical Officer, reported on behalf of the State. He introduced Maggie Bullock, the Administrator of the Health Policy and Services Division, and the three people, Sharon Pesicka, Carol Holoboff, and Laura Wilson, who will be staffing the new asbestos screening facility which the State is opening at 609 Mineral Avenue.

Technical Advisory Group Report

George Keck reported on behalf of the Technical Advisory Group (TAG). As of last Tuesday night's meeting, the TAG has in place its board of directors and executive committee. The TAG will be surveying people in the community for their expertise and experience so that it can form "tiger teams" that will address specific issues and then disband.

CAG Member Question - What is the TAG's purpose and scope?
Answer - The TAG's purpose is to review the cleanup activities at the five operable units described by Jim Christiansen and make recommendations about them. We have obtained a $50 thousand, three year grant which has a 20% local matching requirement. Volunteer time will constitute the matching requirement. Some 28 months are left in the grant period. We receive the grant funds to pay back our expenditures.

CAG Member Question - So the TAG will be reviewing Jim Christiansen's cleanup plans?
Answer - Yes. We will also look at the question of how much cleanup will be enough.

CAG Member Question - What staff will the TAG have?
Answer - We will soon be advertising for two positions, a part time administrator and a technical advisor. We intend to fill these positions by June 1. Anyone interested may apply.

Horinko Letter

Gerald Mueller passed out copies of a letter dated April 1, 2003 from EPA Assistant Administrator Marianne Horinko to Jerry Hersman. (See Appendix 2.) He then read the letter. Sandy Wagner explained that the letter is a reply to the January 16, 2003 letter which she drafted on behalf of the CAG to Montana's Congressional delegation requesting that a public health emergency be declared at Libby. Mr. Hersman had sent a copy of this letter under a cover letter dated February 20, 2003 to EPA Administrator Christine Todd Whitman.

CAG Member Question - Could someone please decipher this letter?
Answer by Jim Christiansen - EPA appears to saying that this is an issue for ATSDR. If EPA had made the declaration, doing so would not have affected ATSDR's independent authority or produced money or facilities for long-term health care.

CAG Member Comment - Maybe we should have been trying harder with HHS.
Response by Dr. Aubrey Miller - We have had a federal and state team working on what is needed for Libby. We have been looking into the programs that HHS delivers. We first conducted a needs assessment and determined that many Libby people do not have health insurance and many have asbestos-related disease. Two years ago we applied for an HHS grant, but were not successful. Dr. Sloan, who has since retired, sheparded another grant to establish a community health center to provide primary health care in Libby. The W.R. Grace Health Plan funds some needed health care. While designating a public health emergency would provide authority to deliver health care, ATSDR does not have the program, funding, or medical expertise to do so. EPA also lacks the medical funding and expertise. Congress could provide the necessary programmatic authority and funding, but it has not done so. At this point the federal and state team does not know what to do. Locally, the Community Health Center, the CARD Clinic, St. John's Lutheran Hospital, and the new state screening facility are providing needed services, but they need to be better integrated to serve sick people as efficiently as possible.

CAG Member Question - What is ATSDR's position on the public health emergency declaration?
Answer by Dan Straughsbaugh - Some weeks ago, I developed with ATSDR management the following talking points regarding the declaration of a public health emergency in Libby. I have not indications that ATSDR has changed its position.

Since November, 1999, ATSDR has worked closely with EPA, the community, and state and Federal agencies to stop exposures to asbestos in Libby and to protect the public health of residents. In support of the community, and to determine the possible health effects from exposure to tremolite asbestos, ATSDR has conducted the largest medical screening program in its history. To date, more than 7,300 people have been screened for lung abnormalities. These public health activities are consistent with ATSDR's statutory authorities.

With regard to the public health emergency clause in section 104 (i) of the 1980 Superfund legislation, public health hospitals have been decommissioned since the mid 19805. Currently, no public health hospitals operate in the U.S. Furthermore, ATSDR does not have the resources to provide health care services as described in 104 (i) of the Superfund legislation; nor is ATSDR authorized to provide health care services to communities.

However, ATSDR has worked proactively with other HHS agencies to support community initiatives regarding access to health care services. To improve access to health care services in Libby, ATSDR has worked with HRSA and SAMHSA to establish a community health clinic and to provide mental health services as well.

Libby has been and will continue to be one of the most important public health sites for ATSDR. ATSDR is capable of conducting all necessary public health activities in Libby without declaring a public health emergency. At this time, neither DHHS nor ATSDR are planning to declare a public health emergency in Libby. The public health agencies will continue to work with EPA, other Federal and state agencies, and the community to prevent exposure to asbestos and protect the health of current and future Libby residents.

CAG Member Comment - We have heard all of this before. Our need for health care is falling through the cracks. We also need to develop a base of information for research.

CAG Member Question - Is the state's screening protocol the same as that of the previous
ATSDR screening?
Answer by Dr. Spence - The screening by the state will be conducted in the same manner as the ATSDR screening. The major difference is an expansion of the ATSDR questionnaire to obtain smoking and respiratory disease history. Also, x-ray's will be read by one rather than three "B" readers.

CAG Member Question - Why are we repeating the screening?
Answer by Dr. Spence - Asbestos-related disease has a latency period. People that previously had negative screens, i.e. that had no indication of disease, may have positive screens in the future. Screening may also pick up other respiratory disease needing treatment.

CAG Member Question - Will there be a charge for people undergoing screening?
Answer by Dr. Spence - No.

CAG Member Comment - To have x-rays evaluated by the CARD Clinic and/or St. John's Hospital will have to fill out a consent form.

CAG Member Comment - We have been studied repeatedly. We need a program for treatment.
Response by Dr. Spence - I agree; we need more therapy.

CAG Member Comment - We need somewhere to go for medical treatment that won't end up costing us our homes.

Response by Dr. Spence - I agree.

CAG Member Question - The change in the number of "B-readers" from three to one is a change in the protocol. Can the state's screening results be combined with those from the ATSDR screening?
Answer by Dr. Spence - As I have previously explained, the change in the number of readers is due to economics. More readers may pick up more false positive readings.

Question by Gerald Mueller - Did any members from Montana's Congressional letter reply to the CAG's January 16, 2003 letter?
Answer - No. Members of our delegation are working on other things such as a medical trust.

CAG Member Comment - The bill introduced by Senator Baucus to establish the medical trust has a cap of $100 thousand per person which is less than the W.R. Grace Plan. Trial lawyers involved in Libby asbestos litigation estimated that treatment may cost $300 to $700 thousand per person.

Audience Member Comment - My husband had cancer and his treatment cost over $250 thousand in six weeks.

CAG Member Comment - In 30 years of working in health care, I have never seen a community come together more than we have in Libby. We have three 501(c)(3) non-profits working together, St. John's Lutheran Hospital, the Community Health Center, and the CARD Clinic, as well as 12-14 local doctors. The three non-profits have volunteer boards of directors that meet at least once and as many as four times per month. Sandy Wagner put in many hours at possible cost to her job to get the Community Health Center grant. The medical community in Libby will continue to work to provide needed health care. Over the last three years, the Hospital put some $1 million into the CARD Clinic, including $750 thousand from W.R. Grace. As of April 1, 2003, the CARD Clinic is an independent entity, but its financing is extremely shaky. We need more help from our federal partners and the Congress. St. John's Lutheran Hospital has a $15 million annual budget, and we write off some $5 million of unpaid charges each year. At the end of the coming year we hope to net $100 thousand to keep the hospital going. We don't turn away anyone needing health care. The CARD Clinic also writes off unpaid expenses. We have to find some source or sources to fund continued medical services.

CAG Member Comment - Those of us afflicted with asbestos disease hope to go into the ground without too much debt.

CAG Member Comment - We need our hospital; it is not fair to bankrupt it.

CAG Member Comment - With the closure of the Stimson plywood mill, St. John's Hospital is Libby's largest private employer.

CAG Member Comment - People forced to leave Libby because of our economic conditions also need medical care. Grant funds are not a stable source to support our medical care; we need something permanent. The public health emergency provisions of CERCLA were drafted for the situation here in Libby. Three things should happen:

1. A public health emergency should be declared.
2. The federal government should contract with someone to fund our medical care.
3. Everyone exposed here should be given a medical card so they can get the treatment they need for the next 80 years.


Response by Audrey Dr. Miller - The situation is frustrating, but we are making some progress. People are working hard for a solution. More work is necessary. We must be careful not to take our frustrations out on each other. Pressure must be put on people outside the community who can help. Libby continues to have political support. People who leave the Libby area should have a medical card. Libby people should not have to crawl to the Hospital for treatment. The public health emergency declaration is a potential program. Make political and agency leaders respond to you as a community. We had a good meeting at the State's new screening facility with Libby health care providers earlier today to discuss how to keep information flowing to support needed activities. We should define data gaps using all of our resources so that we can tell Congress what is needed.

CAG Member Question - Is Assistant Secretary Horinko suggesting that we go back to HHS?
Answer - EPA is not an executing agency for health care delivery. The community should consider taking its requests to the Secretary of Health and Human Services Tommy Thomson.

CAG Member Comment - We have children and other family members who were exposed here, but no longer live here. Hospitals in their communities will not provide them services.

CARD Clinic Report

Pat Cohan reported on behalf of the CARD Clinic on the following topics.

LDC Grant - The CARD Clinic has applied for and received an LDC grant for a research meeting. This is a first step in assembling a data base including out-of-town physicians such as Dr. Whitehouse.

Healthy Community Initiative - The redevelopment conference on April 25 & 26 will include a session on clinical research needed to support health care in Libby.

Genetic and Ethics Conference - A conference on genetics and ethics and asbestos disease will be held in Helena. We need to understand better why disease progresses at different rates in different people. Hopefully, within ten years it should be possible to develop interventions in asbestos-related disease.

CAG Issues

The CAG agreed that the issues it should be addressing include:

  • Monitoring the Superfund cleanup;
  • Funding for long-term asbestos-related health needs; and
• Economic revitalization.

Public & CAG Member Comment

CAG Member Comment - Five of us went to Washington DC to visit with our Congressional Delegation. It is doubtful that we will get money for health treatment from them. In spite of our health needs, Libby's number one priority should be cleanup.

CAG Member Comment - As frustrating as things are, we should recognize how far we have come. I recently attended a conference in Atlanta where I saw that Libby is still in the forefront of our nation's focus on asbestos-related health care. We are still on the radar screen of Secretary Tommy Thomson and the US Surgeon General. We need to continue working hard and persistently with the tools available to us. The heavens are not going to open and rain money on us.

CAG Member Comment - When I found the CERCLA language about the declaration of the public health emergency, I thought that it was designed for our problems here in Libby. I first tried to determine who has the authority to make this declaration. EPA attorney Matt Cohn told me that EPA has the authority. The CAG therefore wrote to EPA asking for the designation. Now EPA appears to be saying that this is an ATSDR issue. ATSDR is saying that it lacks the money. Instead of approaching ATSDR, perhaps we should write to HHS Secretary Thomson to seek the public health care emergency declaration and funding for Libby health care.

Response by Dr. Aubrey Miller - I am not sure that the public health emergency declaration is the best avenue to HHS. This community should define the issues that are not being addressed, your need for specialty health care and a long-term source of funding for asbestos-related hospital care.

CAG Action - After a discussion the CAG agreed that Clinton Maynard, working with any other CAG members wishing to do so, should draft a letter to HHS Secretary Thomson requesting the declaration of a public health emergency in Libby and funding to support a pulmonary specialist and long-term health care. Mr. Maynard agreed to do so and to seek advice from Dr. Aubrey Miller. Mr. Maynard will bring the draft letter to the next CAG meeting.

Next Meeting

The next regular CAG meeting is scheduled for Thursday, May 8, 2003 at 7:00 p.m. in the Ponderosa Room of Libby City Hall.

Appendix 1

CAG Member & Guest Attendance List
April 10, 2003

Members

Group/Organization Represented

Sandy Wagner

Community Health Center/TAG

George Keck

Technical Advisory Group

K.W. Maki

Libby Schools

Rick Palagi

St. John's Lutheran Hospital

Les Skramstad

Alternate for Gayla Benefield

Brad Black

CARD Clinic/County Health Officer

Jim Christiansen

EPA

David F. Latham

The Montanian Newspaper

Gary D. Swenson

Libby Fire Department

Bob Dedrick

Asbestos Victim

Clinton Maynard

Area Asbestos Research Group

Norita Skramstad

Asbestos Victim

Dan Straughsbaugh

ATSDR

Visitors

Group/Organization Represented

Dr. Michael Spence

State Medical Officer

Maggie Bullock

Montana Department of Health and Human Services

Sharon Siska

Asbestos Screening Facility

Carol ?

Laura Wilson

Asbestos Screening Facility

Dr. Aubrey Miller

EPA

Pat Cohan

CARD Clinic

Appendix 2

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON DC, 20460

APR 1 2003

OFFICE OF
SOLID WASTE AND EMERGENCY RESPONSE

Mr. Jerry Hersman
Community Advisory Group
P.O. Box 153
Libby, Montana 59923

Dear Mr. Hersman

Thank you for your letter of February 25, 2003 to Christine Todd Whitman, Administrator of the U.S. Environmental Protection Agency (EPA) concerning the asbestos cleanup in Libby, Montana and issues related to public health emergency provisions found in the Comprehensive Environmental Response, Compensation and Liability Act 1980 as amended
(CERCLA) Administrator Whitman asked that I respond to your letter.

Federal funds made available through the Department of Health and Human Services (HHS) have allowed for the updating of the local hospital facility the operation of the Center for Asbestos Related Disease (CARD) and the Lincoln County Community Health Center. Through a grant to the school district, a data base of school children who may be at risk is being developed. We understand that the funding by HHS provided some additional resources to the people of Libby to help ensure that they get the best care available for the health impacts resulting from this site.

EPA will continue to work with our partners in the Health Resources and Services
Administration (HRSA) of HHS to identify, the best mechanisms available to bring the needed
health care to the community of Libby, Montana. The HHS Office of the Health Resources and Services Administration in Denver, Colorado provides support for the health care facilities in the
State of Montana. The HRSA office in Denver may be contacted at 303-844-7877 or 7864.

As to Public Health Emergency provisions in CERCLA, in the 23-year history of the provision, EPA has never made a determination that a public health or environmental emergency exists to invoke CERCLA?s exception to the general "product" rule; CERCLA See, 104(a)(1)(4).

However, in the part of the statute establishing ATSDR, CERCLA separately provides that
ATSDR may, "in cases of public health emergencies provide medical care and testing to individuals..." CERCLA Sec. 104 (i)(1)(D).

EPA has worked closely with the Department of Health and Human Services (HHS) and ATSDR regarding the health of Libby residents, and have consulted on several occasions
regarding this particular provision of CERCLA. EPA and ATSDR agree that EPA?s decision to invoke the "emergency" provision of 104(a)(1 )(4) to support a removal action, would not pre-determine ATSDR?s independent exercise of authority under CERCLA?s separate "emergency" provisions governing ATSDR, 104(i)(l)(D). At the time the Libby Action Memorandum Amendment was signed in May 2002, ATSDR advised EPA, for reasons unrelated to any perceived nexus between these two provisions, that the substantial health screening and monitoring services being provided to the residents of Libby would not be affected by whether EPA invoked the emergency removal authority.

Thank you for inviting Administrator Whitman to the March 13, 2003, Community Advisory Group meeting. Regrettably, she was not able to attend. Nevertheless, I assure you that the Administrator and I remain fully committed to helping Region 8 achieve a timely, protective cleanup in Libby. As you know, you may continue to get in touch with Jim Christiansen, the EPA Remedial Project Manager for the work being done at Libby, at
303-312-6748.


Sincerely yours,


Marianne Lamont Horinko
Assistant Administrator

Appendix 3

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON D.C. 20460

APR 4 2003
THE ADMINISTRATOR

The Honorable Max Baucus
United States Senate
Washington, DC 20510

Dear Senator Baucus:

Thank you for your letter of February 3, 2003, regarding the Environmental Protection Agency's (EPA) asbestos cleanup in Libby, Montana. I share your concern for the health of Libby residents, and continue to support the cleanup of the Libby site as a top priority.

I appreciate the opportunity to explain EPA?s actions with respect to the question of whether to declare a public health emergency in Libby. Many press accounts have mischaracterized EPA?S position on this matter, as well as EPA?s handling of broader public outreach on vermiculite attic insulation.

The Comprehensive Emergency Response, Compensation and Liability Act (CERCLA) generally prohibits the removal of "product" from a residential structure as part of a removal action, but provides an exception where a health emergency exists. As we have previously discussed, EPA chose not to rely upon CERCLA?s health emergency provision, in part, to minimize the possibility of removal work in Libby being delayed by possible legal challenges to this untested approach. Instead, EPA determined that it has the authority to remove the insulation in Libby based upon more traditional legal authorities because many of the homes contained insulation that was not inspected, packaged, labeled, warranted, regulated, or sold as a commercial "product".

The Agency's decision not to invoke CERCLA?s health emergency provision to remove attic insulation in Libby has no relationship to how EPA communicates potential exposure risk of asbestos-contaminated vermiculite attic insulation to the wider American public. EPA has not changed it long standing guidance to homeowners because we do not have the scientific basis to do so at this time. Until more is known, the best way to safely manage vermiculite attic insulation is to leave it undisturbed or, if necessary, retain the assistance of a professional for removal. To improve communication of EPA?s guidance to a broader audience, EPA will make available to the public a consumer pamphlet that will provide the Agency?s current guidance on how to address vermiculite attic insulation if it is found in the home. Because so much about the risks posed from asbestos-containing vermiculite attic insulation remains unknown, EPA will step up its efforts to research and investigate the potential health effects of asbestos-containing vermiculite products, including a multi-phase study to further evaluate the potential exposure risk from vermiculite attic insulation, so that we can provide more guidance to the public in the future.

Again, thank you for your letter. Please find enclosed detailed responses to your other questions. I appreciate your continued support for the cleanup activities in Libby. If you have any further questions regarding the cleanup or the Agencies activities to evaluate asbestos-contaminated vermiculite, please contact me, or your staff may contact Betsy Henry in the Office of Congressional and Intergovernmental Relations at (202) 564-7222.

Sincerely yours,

Christine Todd Whitman

Enclosure

Libby Community Advisory Group
Meeting Summary
May 8, 2003
Introductions

Gerald Mueller and members of the Libby Community Advisory Group (CAG) introduced themselves. A list of the members and visitors in attendance is attached below as Appendix 1.

Agenda

The CAG agreed to add a presentation by Dr. Putnam first on the agenda. Mr. Mueller then reviewed the following agenda for this meeting:

Presentation by Dr. Elizabeth Putnam

Dr. Putnam, with the University of Montana Center for Environmental Health Sciences, reminded the CAG that she is conducting research into the genetic basis of asbestos disease. She stated that in a previous appearance before the CAG she committed to report to it before releasing results of her research nationally. By analyzing some 200 blood samples from Libby volunteers, Dr. Putnam has found that while an alteration in only one gene has no apparent relation to asbestos disease, a pattern of gene alterations is correlated to a higher risk of asbestos disease or to more severe disease. These results will shortly be released at a conference of the American Thoracic Society in Seattle.

EPA Report

Jim Christiansen and Wendy Thomi reported on behalf of EPA on the following topics:

Residential and Commercial Cleanups - EPA met its 2003 goal of cleaning 40 properties by May 1. The total number of residences/commercial buildings cleanups completed is now 45. The next cleanup targets are 8-10 properties per week or100 additional properties by the end of July. This would bring us to a total of about 165 cleanups by the start of fall. These targets would keep EPA on schedule to meet the goal of 250-300 property cleanups per year. Outdoor cleanups are beginning and the road to the mine is open and contaminated dirt is being moved over it to the mine for disposal. An additional contractor has been hired, Salut, a small business teamed with MARCOR which worked in Libby during the emergency cleanup phase. Currently, Salut is doing restoration at the screening plant site, which is owned by the Parkers. After finishing this work, Salut will be integrated into the residential cleanups. Another three sub-contractors will be added in July.

Landfill - EPA's contract with Lincoln County should be completed in a week, so use of the hazardous waste cell at the landfill should begin soon.

BN Cleanup - With the opening of the landfill hazardous waste cell, BN will begin the cleanup of the rail yard. BN will do the work, and EPA will oversee it and will conduct ambient air sampling. EPA has previously approved BN's cleanup plan. This cleanup should be finished in about three weeks.

High School Track - Resurfacing the high school track will begin in mid-June, shortly after school is out. The new rubberized surface will be installed.

Property Screening - Last summer, about 3,200 properties were screened. EPA did not obtain access to or couldn't make contact with another 400 properties. The screening allows EPA to divide the properties into one of three categories, those definitely in need of cleanup, those not needing cleanup, and those that need additional examination. This year, EPA plans to conduct various sampling activities at a total of 1,800 properties, including attempting to visit the 400 properties it did not obtain access to last year and revisiting some of the previously screened properties. The same general process will be used as last year except that in many cases appointments will be arranged by calling property owners.

Soil Sampling Analytical Methodology - The new method for analyzing soils works well, but its performance review is not yet completed. The performance review will allow confidence in the methodology beyond a shadow of a doubt which is important given possible litigation. EPA expects to begin using the methodology to analyze soil samples about June 1. Analysis of samples collected last year will require about six months and will be completed by the end of this year.

Document Releases - While preparing documents has a lessor priority than the cleanups and sampling, several cleanup-related documents should be released during the next couple of months:

  • The draft containment screening study addendum which overviews the property screening;
    The sampling plans for this summer's remedial investigation work which explain how EPA will sample properties that required additional sampling to determine if cleanup is required;
    The detailed design plan for individual properties, including the pre-design work plan and the design analysis report;
    The response action work plan which will include the details of the interior and exterior cleanups of each house;
    The trigger level and clearance criteria memo which will specify the criteria used to decide on individual property cleanups; and
    The HEPA vacuum cleanup memo. EPA expects to provide several thousand households with a HEPA vacuum to ensure that houses remain clean. The cost of each vacuum will be about $350.

Of these documents, the response action work plan and the trigger level and clearance criteria memo will probably be the most important for Libby people to review.

Cleanup Budget - Mr. Christiansen said that he is less optimistic about the budget situation than a month ago. He has asked for the same level of funding as last year. However, EPA headquarters has asked him to prepare budgets assuming different levels of funding. EPA has requested $150 million for superfund cleanups nationwide, but expects to receive only $50 million. Libby remains a top EPA cleanup priority. Mr. Christiansen has asked for EPA headquarters personnel to come to the next CAG meeting to explain the budget situation.

Economic Redevelopment Workshop - Wendy Thomi reported that the economic development workshop held two weeks ago in Libby was a success as measured by attendee satisfaction. She thanked the local workshop planners.

Fact Sheet - Ms. Thomi also stated that the EPA website includes a summary of activities in Libby since 1999. EPA wants to include in this summary a contact person or persons from Libby. Ms. Thomi will check at the next CAG meeting for a contact volunteer or recommendation.

Audience Member Comment - Regarding outside cleanups, presently, homeowners can go to only one vendor to replace plants. A rose bush from this vendor costs $25, whereas the price at our local discount store is only $3.98. We need access to additional vendors so that we can get a better price; otherwise, we will not be able to replace the plants we lose to the cleanup.
Answer - We are working with the Technical Advisory Group on this problem so that homeowners will have some choices.

CAG Member Question - In the residential cleanups, are any attics being sealed with contaminated insulation left in them?

Answer - EPA's objective is to clean the insulation out of all of the attics. Insulation will be left in attics only if sufficient room is not available to get into them for cleaning. So far, only in one case has attic insulation been sealed in place. A small attic over a garage did not provide sufficient access room. In another house, the EPA contractor considered sealing an attic because of space considerations, but upon further investigation the decision was made that enough access was available to remove the insulation, which is EPA's preference.

CAG Member Question - Last year in an outside cleanup river silt was used to replace contaminated soil. This year, items such as an oil tank on the replacement soil are sinking,. Is any recourse available for the sinking?
Answer - Yes. EPA has specifications for replacement soils to try to avoid problems like this. We will go out and look at this property.

CAG Member Question - Have we reached crunch time with next year's cleanup budget?

Answer - I am getting nervous, but I have not received budget numbers yet. If cuts must be made, I will first cut the 2004 investigation of the mine and then delay investigation of the town of Troy. Cuts beyond the amount allocated for these two investigations will delay cleanup. For every $30 thousand or so in cuts, one property cleanup will have to be postponed.

Audience Member Question - Should the CAG begin to contact officials concerning these pending budget cuts?
Answer - My purpose at this point is merely to warn the CAG of possible budget cuts.

Audience Member Question - Would budget cuts affect the cleanup at the Simpson mill?
Answer - EPA should still be in a position to do the cleanup. The cleanup will address at least three areas. The central maintenance building has vermiculite coming out of the walls. So far, cost estimates indicate little difference between cleaning this building or demolishing it. We are awaiting the decision of the building owner. The plywood dryer also has vermiculite insulation. The third area is the old nursery site which will require cleanup of a large amount of soil.

Audience Member Question - I have two questions about the HEPA vacuum. Will it be tested with Libby asbestos fiber, and what will we have to do dispose of the material which the vacuum captures?
Answer - The HEPA vacuum captures about 99.9% of the particles and hence about the same percentage of the asbestos fibers. The vacuum filter which captures the particles does not need special disposal can just be thrown away with regular trash.

CAG Member Comment - The HEPA vacuum filters are expensive, about $40 a piece.
Response - Once EPA cleans the houses, the homeowners will not need to use HEPA vacuum every day. It need only be used for the polishing touch.

Audience Member Comment -EPA should buy a vacuum and one filter for houses in the cleanups.

Response - That is probably a good idea. EPA will consider providing filters.

CAG Member Comment - When we convinced Governor Martz to use the governor's one time superfund designation, we expected that necessary funding would be forthcoming.
Response - So did I.

Audience Member Comment - During the redevelopment conference, the motivational speaker, Roger Brooks, looked at EPA's Libby brochure and said that, from an economic development perspective, it should be replaced.
Response - EPA's goal is not the same as economic redevelopment. It is important for people to know that there are issues here.

ATSDR Report

Dan Strausbaugh reported on behalf of ATSDR on the following subjects:

Tremolite Asbestos Registry - To develop the Registry, ATSDR reviewed WR Grace and EPA files and identified some 2,000 former WR Grace workers. ATSDR then attempted to contact the workers and their household contacts and reached 781 former workers and 2,214 household contacts who are living and determined that 951 former workers and 551 household contacts are deceased. From these contacts, beginning in fiscal year 2004, ATSDR plans to invite people to participate in the Registry. Eventually, people who qualified for the medical screening who were not workers or their household contacts will also be invited to participate in the Registry.

ATSDR Reports - The report on the combined medical testing has been submitted to an environmental health journal and should be published within two months. The CT study is under peer review and will be published after the review is completed.

MASSA - The Montana Asbestos Screening and Surveillance Activity (MASSA) operated by the State Department of Public Health and Human Services is open at 609 Mineral Avenue and has been operating for one week. As has been discussed at past meetings, MASSA provides free asbestos screening similar to that formerly operated by ATSDR. Individuals who participated in the ATSDR screening in 2000 or 2001 who had negative test results are eligible for rescreening. Other eligible people who did not participate in the past years are also eligible for the MASSA screening. Brochures making this announcement are being circulated around town.

CAG Member Comment - Did you say that the Tremolite Asbestos Registry has been expanded beyond workers and their household contacts to others exposed in Libby?
Response - The initial efforts have concentrated on tracing workers and their household contacts. The Registry will include people who meet the criteria for the ATSDR and MASSA medical screening.

County Report

Karol Spas, the public health nurse for southern Lincoln county, reported on the receipt of a Health Resources and Services Administration (HRSA) grant. She reminded the CAG that Representative Carney in the 2001 Montana Legislature obtained funding for Lincoln County to hire a grant writer to seek funding for asbestos-related health care. The County hired Dennis Alexander and Tracy Velazquez as grant writers, and last fall they wrote a grant to HRSA to fund creation of a network for people with asbestos-related disease. HRSA has awarded a three year grant to Lincoln County, including a total of $133,000 for the first year, $162,000 for the second, and $190,000 for the third. The grant will fund a half-time program director (Ms. Spas) to assist people with asbestos diseases to obtain services from the CARD Clinic, the CORA Program, St. John's Lutheran Hospital, and the Asbestos-Related Health Care Project. The HRSA grant program will act as an entry point for people into available asbestos-related health services from the just listed care providers and to other non-medical community services from churches and youth groups. The grant also includes some money for direct services such as medication and in-home care. In the first year, $50,000 is available for direct services, $60,000 in the second year, and $70,000 in the third year. Ms. Spas said that she would come back to the CAG when the program is operating.

Audience Member Question - Given the limited amount of money available, have you or will you be developing criteria for providing the direct services?
Answer - Yes, we will be developing criteria that will guide allocations for direct services.

Thompson Letter

At its last meeting, the CAG asked Clinton Maynard to draft a letter to US Department of Health and Humans Services Secretary Tommy Thompson requesting a declaration of a public health emergency in Libby. With the assistance of members of the CAG and others in the Libby community, Mr. Maynard drafted the letter included below as Appendix 2.

CAG Action - After discussing whether to postpone action on the letter until the next meeting to allow additional drafting work on the draft, a majority of the CAG members present voted to send Mr. Maynard's draft of the letter to Secretary Thompson with two changes: the words "stop-gap, band-aid" were deleted from the third paragraph; and the words "EPA-established" were deleted from the letter's signature block. A signature page was circulated for members of the CAG and the audience.

Public & CAG Member Comment

There was no additional comment.

Next Meeting

The next regular CAG meeting is scheduled for Thursday, June 12, 2003 in the Ponderosa Room of Libby City Hall. To accommodate a presentation by Dr. Andrij Holian of the University of Montana, the CAG decided that the meeting time will be changed to 5:30 to 7:30 p.m.

Appendix 1

CAG Member & Guest Attendance List
May 8, 2003

Members

Group/Organization Represented

Sandy Wagner

Community Health Center/TAG

George Keck

Technical Advisory Group

K.W. Maki

Libby Schools

Craig French

Montana Department of Environmental Quality

Bob Zimmerman

Cabinet Resource Group

George Bauer

City of Libby

Jim Christiansen

EPA

David F. Latham

The Montanian Newspaper

Ken Hays

Senior Citizens

Bob Dedrick

Asbestos Victim

Clinton Maynard

Area Asbestos Research Group

Norita Skramstad

Asbestos Victim

Dan Straughsbaugh

ATSDR

Wendy Thomi

US EPA

Mike Noble

Asbestos Victim (alternate for Leroy Thom)

Gayla Benefield

Lincoln County Asbestos Victims Relief Organization

Eileen

Carney State Representative 

Visitors

Group/Organization Represented

Dr. Elizabeth Putnam

UM Center for Environmental Health Sciences

Karol Spas

Lincoln County Health Nurse

Appendix 2

May 8, 2003

The Honorable Tommy Thompson
Secretary of United States Department Health and Human Services
200 Independence Avenue, SW.
Washington, D C 20201


Dear Mr. Thompson:

We understand the enormous task that you must be faced with as you engage in your responsibilities of managing the health issues of our great nation. It is with this in mind that we express our deepest appreciation for taking time to understand the magnitude of disaster that has occurred in our small town of Libby, Montana.
As you are probably aware, we are currently the home of our nation?s highest priority superfund site. This is due to the widespread contamination of a most toxic form of mineral fiber, amphibole asbestos. This mineral fiber is a contaminant in the vermiculite that was mined and processed locally for 70 years prior to 1990. The miners and the general population were unaware that they were being exposed to this highly disease-potent, microscopic, toxic substance. Our awareness as a community began three-and-a-half years ago and today we understand that we face a desperate future.
We soon came to realize that our current and former exposed population would require specialized health care and we began to approach our federal government to meet this need, which is expected to last for the next 80-plus years, provided exposures cease. With the assistance of our on-scene federal partners, we have engaged in an exhaustive search to identify a program that would address this need, only to come up with stop-gap, band-aid measures that are unsound and non-comprehensive. Until recently that is, as we have now discovered that within "superfund legislation" exists a solution to this most troubling dilemma. It is clear that the framers of this legislation had the wisdom to provide a solution in the event that a population such as ours had been exposed to toxic substance. CERCLA 9604 (i)(1), provided our nation with the establishment of an agency the Agency for Toxic Substances and Disease Registry (ATSDR), to address problems such as off-setting the impacts of toxic exposure.
Secretary Thompson, we are asking you to declare a "public health emergency" as stated in this legislation, 9604 (i)(1)(D), which would provide healthcare and engage the "all important" government agencies listed, therefore providing a comprehensive, scientific approach to addressing this tragedy.
Exposure presents a grim reality; debilitating lung dysfunction disease (asbestosis), terminal cancer (mesothelioma), cancers of other target organs (that we might survive if detected early enough) and shortened life-span. These devastating impacts of exposure can be decreased through specialized medical therapies and through research that might provide better therapies than exist today. Our immune systems have been compromised, robbing us of our health and these diseases create astronomical medical costs that will leave our families in financial ruin. We are asking that you use your authority to assure the long overdue fairness for our exposed people, to the fullest extent as provided by the law of our land.
In addition, we have come to recognize that this American disaster was not simply due to an oversight. The State of Montana did a full mineral analysis in 1956 and the federal government was aware of the problem, at least by 1979. Much of this toxic exposure was preventable, but due to greed, ineptness, policy failure and apparent corruption, this was allowed to happen to us. Therefore, we respectfully ask that you launch a thorough investigation to identify, and address these problems so that other Americans, who are not as aware as we are today, do not have to endure the plight of Libby, Montana. For those who have died and those who will die as casualties of failure, greed and perceived corruption, accountability and justice must be upheld. If this callous disregard for human life is to be viewed as acceptable, we can be assured that more Americans in the years to come are to meet our same fate.
Please correct this injustice for our nation. Please declare a "public health emergency" for Libby.

Thank you
The EPA-established Libby Community Advisory Group


Photos courtesy of Dudley Dana, Dana Gallery