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New Hampshire Department of Environmental Services

Drinking Water and Groundwater Bureau

June 24, 2019

Request for Proposals

Program Services for Distribution of Filter Pitchers and Filter Cartridges to At-Risk Mothers and Infants

Exposed to Arsenic in Private Water Supply Wells

I. Introduction

The New Hampshire Department of Environmental Services (NHDES) is requesting proposals for services

related to the attached Funding Proposal, “Filter Pitchers to Protect New Hampshire’s Most Vulnerable

Populations from Arsenic in Drinking Water from Private Wells.” NHDES anticipates a single contract to

cover all of the contracted services described in this RFP and in the attached Funding Proposal, including

material development, training and technical assistance, project implementation, and program

evaluation. The cost of water sampling bottles, water sample analysis, pitchers, replacement filter

cartridges, coupons for obtaining additional filter cartridges, and shipping of those materials to the

Contractor will be borne directly by NHDES, and will not be required to be included in the amount of the

subject contract, as detailed in the “Cost and Time” section on page 4 of this RFP.

II. Background

This RFP is for the services of the “Contractor” as described as Phase 1 in the attached Funding Proposal.

NHDES will convene and coordinate the Project Advisory Committee (PAC) and will work directly with

the filter pitcher vendor to obtain filter pitchers and have them delivered to the Contractor. The New

Hampshire Drinking Water and Groundwater Advisory Commission (the Commission) which administers

the Drinking Water and Groundwater Trust Fund, has approved funding for this project. Additional

background information on the Trust Fund is available in its “2019 Award Plan”

(https://www4.des.state.nh.us/nh-dwg-trust/wp-content/uploads/2019/04/2019-DWGTF-Award-Plan-

Adopted-4-16-2019.pdf).

III. Scope of Work

This scope of work covers Phase 1 – project period of approximately 66 months (five years as described

in the Funding Proposal plus six months to complete evaluation and report writing). Funding is available

for all of Phase 1.

In Year 1, the Contractor will be responsible for the following:

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1. Finalizing the project design, with input from the PAC.

2. Developing an evaluation and performance measurement plan for the pilot stage, subject to

approval by NHDES and the PAC.

3. Developing (1) education, notification, and training materials, and consent and information-

sharing forms (for WIC clinic staff and project participants) and (2) procedures in consultation

with NHDES, the PAC, and WIC program directors. The Contractor will provide a project-

identifying sticker to be applied to filter pitchers used in the project; the design of the sticker

will be provided by NHDES. Respondents should address how they will meet the needs of non-

English speaking participants.

4. Developing a data management system to accommodate the data management needs of the

project. The system will enable the Contractor to track and report at a minimum the “data

elements” listed in “Figure 1: Project Flow Chart for Phase 1” in the Funding Proposal. In

addition, the data management system will allow the Contractor to track and report measures

identified in the evaluation and performance measurement plan.

5. Conducting “Stage 1” pilot project resulting in the participation (use of filter pitchers) by

approximately 50 pregnant women in a subset of Supplemental Nutrition Program for Women,

Infants and Children (WIC) clinics. This includes training and orientation of WIC clinic staff,

assembling and providing water test kits (bottle, instructions, and pre-paid mailer) to WIC clinic

staff, coordinating the notification and interpretation of test results to testing participants in

coordination with the Public Health Laboratory, and packaging and shipping of filter pitchers

(with instructions and project sticker) and replacement filters to pitcher-using participants.

Enrollment of women in the pilot stage will continue until enough women are enrolled (testing

participants) and have had their water tested to result in 50 women qualifying for filter pitchers

(water testing above 5 ppb arsenic). Enrollment will end when approximately 50 pitcher-using

participants have been enrolled. Contractor may need to store up to 50 pitchers and 50

replacement cartridges at any time during the project. See “Anticipated contractor

responsibilities” in attached Funding Proposal.

6. Following up periodically (at least quarterly is anticipated) with pitcher-using participants to

support pitcher use and gather information regarding pitcher use and any issues involving use of

pitchers.

7. Evaluating and making adjustments to project design, materials, etc. This may involve

substantial changes such as including additional water test parameters such as lead. Any

substantial change would require approval from NHDES, the PAC, and the Commission.

8. Submitting quarterly reports to NHDES describing progress, identifying problems and proposing

short-term changes if indicated, and summarizing “data elements.”

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9. Reporting results of the pilot stage and recommended changes to the PAC in writing and in a

meeting.

In Years 2 and 3 the Contractor will be responsible for the following:

1. Developing an evaluation and performance measurement plan for the remainder of the project,

subject to approval by NHDES and the PAC.

2. Training all client-contact personnel in participating WIC clinics. Respondents should describe

the number of sessions and format(s) – in-person, webinar, etc. Following initial training

sessions, providing individual telephone- or web-based training to any new WIC clinic staff.

3. Supporting WIC clinic staff by phone and supplying them with water testing kits during the 24-

month enrollment period, during which all eligible women (pregnant, using private wells) will be

offered enrollment. Holding follow-up training sessions or conference calls if needed.

4. Coordinating the communication of test results to testing participants.

5. Shipping filter pitchers and replacement cartridges to each pitcher-using participant for 24

months.

6. Supporting pitcher-using participants for 24 months each by phone, text message, and online,

including periodic contact with all pitcher-using participants to gather relevant information.

7. At the completion of each pitcher-using participant’s 24-month participation period, conducting

a wrap-up interview or survey and providing coupons for a free 12-month supply of filter

cartridges.

8. Submitting quarterly reports to NHDES.

In years 4 and 5 the Contractor will be responsible for the following:

1. Continuing to support pitcher-using participants through the end of each participant’s 24-month

participation period, conducting wrap-up interview or survey, and providing coupons for free

filter cartridges.

2. Submitting quarterly reports to NHDES.

Following the completion of 24 months of follow-up with all pitcher-using participants, the Contractor

shall prepare a final report, including a summary of all project activities and results, evaluation of the

project, and recommendations for scaling up the project to a larger population of pregnant women. The

Contractor will also present findings to the PAC in person. At this time funding for scaling up the project

beyond the 66-month project period has not been sought.

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IV. Proposal Format

Each proposal shall include the following information:

Methodology: A description of methods to be used in accomplishing each task to be performed in each

year. This should include tasks such as developing materials, training WIC clinic staff, storing and

shipping pitchers and replacement cartridges, providing phone/text/online support to participants,

capturing and managing data, and project management and evaluation.

Qualifications and Staffing Plan: A description of the technical qualifications, relevant training, and

experience of each staff member who will perform work on the project, as well as the title of each staff

member for this project.

Cost and Time: A breakdown of the cost and staff time required to complete each task associated with

the project. The total amount of the contract is expected to be no more than $194,550, including all

Contractor expenses (staff time, materials not provided by NHDES, travel, etc.). The table below breaks

out each line item from the “Estimated Total 5-Year Project Costs” (Table 1) in the attached Funding

Proposal (p 7) into costs included in the Contract and costs borne directly by NHDES. The budget

includes $150,000 for the Contractor’s services and expenses plus $31,440 (524 participants x 6

packages x $10) for the Contractor’s cost to ship pitchers and replacement cartridges to participants and

$13,110 for the Contractor to provide return postage for testing participants to return water samples to

the Public Health Laboratory (1,748 testing participants x 1.5 samples each x $5). NHDES will bear the

cost of sample bottles and analysis at $15 per sample. The Contractor’s cost of sample shipping and

NHDES’s cost of sample analysis assumes that testing participants will relocate on average 0.5 times

during the project.

Item Total Project Cost Contract NHDES

Pitchers & filters $130,838 $31,440 $99,398

Testing $52,440 $13,110 $39,330

Contractor $150,000 $150,000

Total $333,278 $194,550 $138,728

Previous Work: Descriptions of the respondent’s previous work relevant to the proposed project as an

organization; or Contractor support of relevant work.

V. Additional Information

Respondents are responsible for understanding the scope of work as described herein and in the

Funding Proposal. The successful candidate will be expected to enter into a standard State of New

Hampshire contract or grant agreement and meet applicable requirements for recipients of state

contracts or grants. The successful candidate may be invited to participate in a kickoff event with senior

elected officials, state agency officials, and the media to publicize the project.

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VI. Evaluation and Award Criteria

NHDES and the PAC will evaluate the proposals submitted based on the following criteria:

Understanding of services to be provided under this contract 20%

Demonstrated understanding of the population served and issues and challenges related to private well testing and the adoption of protective behaviors such as the use of filter pitchers

20%

Adequacy of description of approach, including approach to addressing a variety of circumstances (e.g., participant loses test kit, fails to mail water sample, loses pitcher, does not receive a pitcher or cartridge shipment, etc.)

20%

Qualifications, skills and experience of staff 20%

Ability and commitment to complete the project within 66 months of starting, assuming a start date of January 1, 2020

10%

Cost and ability to leverage Contract funds 10%

VII. Proposal Submittal

One hard copy and one electronic copy of the proposal should be submitted no later than 8:00 AM EST

September 3, 2019 to:

Paul Susca N.H. Department of Environmental Services 29 Hazen Dr, PO Box 95 Concord NH 03302-0095 Paul.susca@des.nh.gov

Following review of the proposals, NHDES might require one or more high-scoring respondents to meet with the PAC to present their proposal(s) and answer questions before final selection of the Contractor.

VIII. Questions

All inquiries or expressions of interest related to this RFP should be made to Paul Susca at the email

address above or (603) 271-7061. Interested parties may by July 8, 2019 request a conference call. If

any party requests such a call, all interested parties will be invited, and the call would take place around

July 15, 2019.

IX. Attachment:

Filter Pitchers to Protect New Hampshire’s Most Vulnerable Populations from Arsenic in Drinking Water

from Private Wells - Funding Proposal submitted to New Hampshire Drinking Water and Groundwater

Advisory Commission, June 3, 2019

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Filter Pitchers to Protect New Hampshire’s Most Vulnerable Populations from Arsenic

in Drinking Water from Private Wells

Funding Proposal

submitted to New Hampshire Drinking Water and Groundwater Advisory Commission

New Hampshire Department of Environmental Services (NHDES)

in cooperation with New Hampshire Department of Health and Human Services (NHDHHS)

June 3, 2019

Summary

Almost half of New Hampshire residents use private wells for their water supply at home, and about

30% of those wells have naturally occurring arsenic levels above the health-based 5-parts-per-billion

(ppb) limit proposed by NHDES. In light of recent information concerning the elevated risk that even

low-level arsenic exposure poses of adverse birth outcomes, infections during the first year of life, and

gestational diabetes, of greatest concern are pregnant women and their young children, particularly

those who cannot afford to test their water and install a treatment system. For an estimated total

project cost of $333, 278, the project will test approximately 1,750 private drinking water wells for

arsenic and provide protection to the estimated 524 pregnant women and their young children drinking

water with elevated arsenic for up to three years ($212 per family per year).

NHDES, in cooperation with NHDHHS and the state’s network of WIC clinics, proposes to provide

effective (verified by NHDES) filter pitchers to an estimated 524 low-income pregnant women using

private wells with elevated arsenic, and to provide follow-up support, including a 36-month supply of

replacement filter cartridges. The project is designed to (1) establish a sustained practice among those

young families of using filter pitchers and replacing filter cartridges as needed, while (2) generating

valuable information regarding the effectiveness of this approach to reducing exposure to contaminated

drinking water and (3) reinforcing a public information initiative regarding the use of certain verified

filter pitchers as an affordable means of treating drinking water from private wells, particularly for

pregnant women.

Identification of Problem

In New Hampshire, arsenic is commonly found at levels in private well water that are harmful to children

and mothers. Arsenic is a naturally occurring contaminant that is found in excess of the 5 ppb limit

proposed by NHDES in approximately 30% of private wells in the state. Research conducted in New

Hampshire and elsewhere has found that exposure to arsenic at levels above 5 ppb in water from

private wells during pregnancy increases the incidence of adverse birth outcomes, gestational diabetes

in mothers, and infections during the first year of life. Several studies also suggest a link between low-

dose arsenic exposure and childhood intelligence. (The following information is excerpted from NHDES’

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Review of the Drinking Water Maximum Contaminant Level (MCL) and Ambient Groundwater Quality

Standard (AGQS) for Arsenic, December 2018, R-WD-18-20.)

Adverse birth outcomes and early-life infections

The New Hampshire Birth Cohort Study conducted by the Geisel School of Medicine at Dartmouth has

relatively recently found connections between low levels of arsenic exposure from water and food, and

adverse birth outcomes and infections in infants and gestational diabetes in mothers. Unlike the

majority of epidemiological studies on arsenic exposure, the study explores exposures at levels common

in New Hampshire. Researchers analyzed 706 mother-infant pairs exposed to arsenic through drinking

water (median 0.5 ppb, interquartile range 0.1 – 2.7 ppb) and diet. They measured urinary arsenic from

each mother and compared it to the birth weight of her baby, adjusting for maternal pre-pregnancy

weight. The researchers found that higher levels of arsenic in the mother’s urine during her second

trimester were associated with decreased head circumference at birth. They also found associations

between arsenic exposure and decreased birth weight and length. In another component of the New

Hampshire Birth Cohort Study, in-utero arsenic exposure in a group of 412 mothers whose drinking

water arsenic averaged 4.6 ppb (interquartile range 3.1 ppb) was also associated with a higher risk of

infection during their babies’ first year of life, particularly infections requiring medical treatment, and

with diarrhea and respiratory symptoms. Finally, among 1,151 women in the New Hampshire Birth

Cohort Study with an average drinking water arsenic concentration of 4.2 ppb (90% were below 10 ppb),

each 5 ppb increase in home well water was associated with a 10% increase in the odds of gestational

diabetes.

Childhood intelligence

In a study of 272 children in grades 3 through 5 from three Maine school districts published in 2014,

researchers at Columbia University and the University of New Hampshire found, “Compared to those

with [drinking water arsenic (WAs)] < 5 μg/L, exposure to WAs ≥ 5 μg/L was associated with reductions

of approximately 5–6 points in both Full Scale IQ (p < 0.01) and most Index scores (Perceptual

Reasoning, Working Memory, Verbal Comprehension, all p’s < 0.05). . . The magnitudes of these

associations are similar to those observed with modest increases in blood lead, an established risk factor

for diminished IQ.” The mean drinking water arsenic concentration in the overall group was 9.9 ppb;

roughly half were < 5 ppb. The Maine study is not alone; the researchers noted that this study, “gives

confidence to the generalizability of findings from our [2004] work in Bangladesh, where we also

observed a steep drop in intelligence scores in the very low range of [drinking water arsenic]

concentrations.” That study observed a 3.8-point drop in IQ between drinking water at 0 ppb and 10

ppb.

Surveys have indicated that the major barriers to testing and treating water from private wells are cost

and inconvenience.

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Project Overview

This project is designed to address both the cost and inconvenience barriers to preventing harmful in-

utero and early-life exposure to arsenic in a highly vulnerable target group: low-income pregnant

women served by clinics supported by USDA’s Special Supplemental Nutrition Program - Women, Infants

and Children (WIC) through NHDHHS. Participation will be voluntary on the part of the women. The

project will provide free testing of private well water for arsenic. For those women whose drinking

water tests above 5 ppb, they will be provided free filter pitchers that have been shown to be effective

at removing arsenic. NHDES has identified two brands of filter pitchers that perform well in removing

arsenic and is evaluating them to determine which is best suited for this project. Participation in the

project will include replacement filter cartridges (shipped to participants) for 24 months, followed by

coupons for an additional 12-month supply for participants who complete a wrap-up survey or

interview.

The ideal outcome of the project is that after three years of using filter pitchers, including one year of

obtaining their own free replacement cartridges, participants will understand the importance of

knowing what is in their drinking water, see the value in treating their water, and continue to use the

pitchers at their own expense.

Although this project is focused on a specific group of individuals, NHDES and NHDHHS recognize the

outreach opportunity this project will provide to inform people throughout New Hampshire about the

importance of understanding what may be in their water and showing them that there are simple and

inexpensive methods to improve their own water quality. Therefore, in parallel with this project,

NHDES, NHDHHS, and their partners will promote the use of filter pitchers by all pregnant women and

families with young children using private wells (as indicated by water test results) as a short-term

measure that should be followed up with installation of a fixed treatment system. No funding is being

sought from the Trust Fund for the outreach effort.

The goal of the outreach in conjunction with the proposed free pitcher distribution project is to

establish water testing and the proper use of filter pitchers or other treatment systems where

appropriate as the standard for pregnant women in New Hampshire consuming private well water.

The filter pitcher distribution component is intended to address the initial cost and behavioral barrier for

low-income women by providing free pitchers and replacement filter cartridges - delivered - for two

years, followed by free access to replacement filter cartridges for an additional year as an incentive for

completing an end-of-project survey or interview.

Project Description

1. NHDES will engage a contractor with expertise in public health who is qualified to work directly

with WIC clinics and their staff (frontline staff and nutritionists) and who will educate pregnant

women about the project.

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2. To qualify for this project, pregnant women must live in a home where private well water is the

water supply source. WIC clinic staff will voluntarily enroll women in any stage of pregnancy in

this project and obtain written consent from participants to participate in the project and

allowing the contractor to contact the participant. (See flow chart on page 9.)

3. Eligible participants (pregnant women using private wells) who choose to participate will receive

a pre-paid water sampling kit – labeled so as to be identified by the NHDHHS Public Health

Laboratory as belonging to this project - and instructions at their WIC appointment while

pregnant. (During subsequent visits to a WIC clinic, clinic staff will ask pregnant women who

have previously been screened whether their address has changed. Pregnant women who have

moved to a new address with a private well will be provided a new water test kit.)

4. After collecting the water sample at home, each participant will mail (postage prepaid) the

sample to the Public Health Laboratory, where it will be analyzed and results sent to the

participant and the contractor.

5. The contractor will contact the participant directly to provide an interpretation of the test result

and if the arsenic level is elevated (above 5 ppb) confirm that a filter pitcher kit will be shipped.

If the sample has an elevated level of arsenic, the contractor will ship a filter pitcher kit directly

to the participant. The kit will include instructions, a filter pitcher, a replacement filter cartridge,

and a sticker that will identify the pitcher as being provided by the Drinking Water and

Groundwater Trust Fund, NHDES, and NHDHHS to reduce the level of arsenic in drinking water

when used according to directions (including cartridge replacement).

6. The contractor will follow up with participants to;

a. answer questions,

b. provide education,

c. provide additional replacement cartridges,

d. provide encouragement and support in use of the pitcher, and

e. gather data on the participant’s use of the pitcher.

Participants whose water test results do not indicate elevated arsenic will be contacted to make

sure they understand their test results and contact will end at that point, unless they report at a

subsequent WIC clinic visit that they have moved.

Phases of this Project and Follow-on Project

This project is the first phase of an initiative to establish water testing and the proper use of filter

pitchers and other treatment systems where appropriate as the standard for pregnant women in New

Hampshire consuming private well water.

Phase 1 (Proposed project – $333,278) – five years, running in parallel with outreach effort by NHDES,

NHDHHS, and others, consists of a pilot stage followed by a full-scale stage including all eligible women

in all WIC clinics. The steps involved in both the pilot and the full-scale stage are described in the flow

chart on page 9.

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10. Establish Project Advisory Committee (see below).

11. Engage contractor and WIC clinics.

12. Contractor develops education and training materials and logistics in consultation with

Project Advisory Committee.

13. Stage 1: Pilot project with approximately 50 pregnant women in a subset of WIC clinics.

Enrollment of women in the pilot stage will continue until enough women are enrolled and

have had their water tested to result in 50 women qualifying for filter pitchers (water testing

above 5 ppb), but no longer than 12 months.

14. Evaluate and make adjustments to project design, materials, etc. This may involve

substantial changes such as including additional water test parameters such as lead. Any

substantial change would require approval from the Drinking Water and Groundwater

Advisory Commission.

15. Stage 2: Extend project to all WIC clinics, enrolling all eligible pregnant women over a two-

year period.

16. Complete contact with each participant after 24 months of participation.

17. NHDES, NHDHHS, Project Advisory Committee, and contractor evaluate project and make

recommendations regarding the design of a possible future project (Phase 2).

Phase 2 (future project – no funding requested at this time)

The proposed project (Phase 1) will yield valuable information regarding the public health benefit of

distributing filter pitchers to pregnant women, as well as information regarding the effectiveness of

various aspects of how the distribution is done. Possible components of a follow-up project, based on

results of Phase 1, might include:

1. Scale up the project further to provide free filter pitcher kits to qualified pregnant women

and families with young children in Federally Qualified Health Clinics and Community Health

Centers.

2. Provide coupons for free or low-cost replacement filter cartridges to all income-qualified

families with young children.

Population included in the Project

New Hampshire’s WIC program serves approximately 1,900 pregnant women per year. This project

would offer enrollment to WIC clinic clients using private wells who are or become pregnant during a 24-

month period. To qualify for this project, pregnant women would live in a home where private well

water is the water supply source. The calculations used to estimate of the potential participation are

shown below.

Pregnant women served by WIC clinics over a 24-month period: 3,800

Those using private wells: 46 percent (statewide average) of 3,800: 1,748

Those having arsenic above 5 ppb: 30 percent (statewide average) of 1,748: 524

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Up to approximately 524 women will receive filter pitchers and replacement cartridges for 24 months

and coupons for a 12-month supply of cartridges.

Impact

In addition to the approximately 524 low-income women-infant pairs who along with their families

would have substantially reduced arsenic exposure for two years through the use of filters delivered at

no cost to the participant, this project is expected to have the following impact:

Some families will continue to use filter pitchers, obtaining free replacement cartridges using

coupons for a third year, and thereafter at their own cost. These families will continue to

benefit from reduced arsenic consumption, reducing the risks of childhood cognitive

impairment, cancer (primarily lung and bladder) later in life, and other adverse health effects.

NHDES, NHDHHS, and its partners will obtain valuable information regarding (1) the behavior of

participants with respect to water testing and treatment, (2) the obstacles to increased adoption

of protective behavior, and (3) development of effective ways to address those obstacles and

scale the project up beyond the WIC clinics.

Some private well users who do not participate in the project will adopt the use of high-

performing filter pitchers or other appropriate exposure-reduction measures as a result of

learning about the project through the media and through each project partner’s outreach and

education efforts. No funding is being sought from the Trust Fund for this ongoing outreach and

education effort.

Valuable data will be captured to allow for a better understanding about the practice of testing

and treatment when barriers are removed or addressed; data could inform and build support

for future initiatives to promote and cover testing among other populations within the state,

and potentially through different funding mechanisms (e.g., alternative grant funds, health

insurance coverage, etc.).

Estimate of Project Costs

The following estimate of project costs does not include NHDES, NHDHHS, and project partner staff

time, for which funding is not being sought from the Trust Fund.

NHDHHS time includes WIC program staff. The NH WIC Program Director and NH WIC Nutrition Services

Manager will be the lead contacts for working with the NH WIC Program local agencies. They will

provide guidance and feedback to the Project contractor for working with the local agency or agencies in

the pilot period as well as statewide rollout (Stage 2 of Phase 1). Both the WIC Program Director and

Nutrition Services Manger will provide time to the project through regular monthly meetings with local

agency staff, Project Advisory Committee (see page 8) meetings, document review and collaboration on

project quality improvement changes. It is estimated that the Program Director and Nutrition Services

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Manager will each spend approximately two hours per month on the project ($125/month for 60

months = $7,500).

In addition to state agency staff, local agency WIC nutritionists will also provide time to this project

through screening, counseling and follow-up on water testing. It is estimated that each nutritionist will

spend approximately five minutes with each pregnant woman, screening and educating on water source

and providing test kits (1,852 pregnant women per year @ 5 minutes each = 9,260 minutes; 154 hours

@ $19 = $2,932). This is an in-kind component of the project cost, for which funding is not being sought

from the Trust Fund.

Finally, the time of Project Advisory Committee members is an in-kind component for which funding is

not being sought from the Trust Fund.

Table 1: Estimated Total 5-Year Project Costs - Funding Request

Item Cost

Pitchers & filters* ($250 per family x 524 families) $130,838

Testing** ($20 per test x 1,748 participants x 1.5) $52,440

Contractor (5 years) $150,000

Total $333,278

*NHDES is currently evaluating two models of pitchers; this estimate is based on the higher cost of the

two models, including replacement cartridges. Depending on the product selected, the cost may be

lower than indicated here.

**Represents NH Public Health Laboratory’s fee for arsenic ($15), plus packaging and shipping of

samples to the Laboratory. Number of participants is multiplied by 1.5 because it is assumed that 50%

of participants will move once, on average, during pregnancy.

Cost Effectiveness

This project represents a cost-effective way to provide treated drinking water to the target population.

Costs per family are indicated below.

Table 2: Costs per family

Cost per family for filter pitchers and replacement cartridges for three years: $130,838 / 524 $250

Cost per family filtered, including all project costs (pitchers, filters, testing, and contractor) averaged over all families receiving filter pitchers: $333,278 / 524

$636

Annual cost per family filtered, including all project costs: $636 / 3 $212

Cost per family participating (testing water) including all project costs: $333,278 / 1,748 $191

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For comparison, an alternative to providing filter pitchers would be providing bottled water. For

emergency water supplies in areas with contaminated water in 2018, NHDES contracted with a vendor

at $42.50/month or $510 per year per family for 60 gallons/month (2 gallons/day) delivered.

Project Advisory Committee

Before issuing a request for proposals (RFP), NHDES would convene a Project Advisory Committee,

inviting the participation of the following programs and organizations:

- NHDHHS Division of Public Health Services (DPHS)

o Bureau of Population Health and Community Services

Chronic Disease Prevention & Screening Section

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Maternal and Child Health Program

o Bureau of Public Health Laboratories ,Biomonitoring Program

- NHDHHS, Division of Medicaid Services

- NHDES – Drinking Water and Groundwater Bureau

- NHDES – MtBE Remediation Bureau

- NH Department of Administrative Services, Wellness Program

- WIC clinic directors

- Dartmouth Toxic Metals Superfund Research Program and/or Children's Environmental Health

and Disease Prevention Research Center at Dartmouth

The role of the Project Advisory Committee would be to advise NHDES in RFP development, contractor

selection, and project management; coordinate outreach efforts to complement the project with private

well testing and treatment messages targeted at a broader audience; and to assist in designing the

follow-on work and developing recommendations for the future.

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Figure 1: Project Flow Chart for Phase 1 (pilot and full-scale). See text for additional details. (Source: DPHS)

Anticipated contractor responsibilities

Develop detailed project protocol and printed materials (including intake and consent form) and

online education materials, to include online video instruction on taking water sample, using

and cleaning filter pitcher, and replacing cartridges.

Create a system to manage data associated with the project.

Assemble postage-prepaid test kits using bottles supplied by Public Health Laboratory.

Choose pilot WIC clinic(s) based on data.

Train pilot WIC clinic staff and provide them with all necessary materials.

Conduct pilot involving 50 participants for 12 months.

Analyze data and participation feedback from pilot study. Revise project details as necessary.

Train all participating WIC clinic staff and provide with all necessary print materials and supplies.

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Anticipated contractor responsibilities (continued)

Scale up to all WIC clinics for 24 months of enrollment. Follow up with those participants for 24

months each.

Provide phone support to WIC clinic staff and participants.

Contact participants by phone or text message when they received water test report from

Laboratory. Interpret results. Confirm mailing address.

Ship pitcher kit, replacement cartridges and education materials to qualified participants.

Follow-up contact with participants at 3, 6, 9, 12, 18 and 24 months. Participants will receive

replacement cartridges only if they respond to follow-ups.

Keep records regarding participants, provided by WIC clinics, Laboratory, and direct contact with

participants.

Notify WIC clinics regarding which participants have received pitcher kits.

Conduct periodic and end-of-project survey of participants.

Provide participants with end-of-project 12-month supply of coupons for filter cartridges as

incentive for completing end-of-project survey/interview.

Protect confidentiality of participants.

Anticipated role of WIC clinic staff

Maintain a supply of test kits and other project materials provided by contractor.

Screen all pregnant women to determine their eligibility. (Contractor will develop protocol in

consultation with NHDES including questions to determine whether the potential participant’s

water supply is a private well.)

Provide project-specific information about arsenic in drinking water to pregnant women who

screen positive for using private wells, including intake and consent form to participate.

Recheck private well-use status of all pregnant women if they have moved since previous clinic

visit at all prenatal WIC visits.

Obtain participant signature on consent form when receiving test kit. Participant will consent to

taking water sample, mailing it to Laboratory, follow-up phone conversations with contractor,

use of pitcher, use of replacement filter cartridges to be provided, and participation in surveys.

Obtain contact information for clients in a form that can be easily shared with contractor (on

intake and consent form).

Provide water test kits, instructions and fact sheet to eligible participants.

Anticipated role of NHDHHS Public Health Laboratory

Enter into information-sharing agreements with NHDES, contractor, and WIC agencies.

Provide coded (prepaid) test bottles to contractor.

Work with NHDES and contractor on report format to be used in this project. Report will

include contractor phone support number.

Charge NHDES for analyses performed on samples returned in coded bottles.