City Report Finds Health Dept. Problems

A 50-page report from the City of Milwaukee Health Department examines the city’s Childhood Lead Poisoning Prevention Program. Released Thursday afternoon, the report gives a frank assessment of the successes and challenges of the program that the department itself bills as “deficient.”

Buried on page 31 of the report is the admission that from 2015 to 2017, of the 32 children that received chelation therapy, a special medical procedure for those that record dangerous blood lead levels of 45 micrograms per deciliter or above, two were released to homes that were never investigated or abated. Remediation steps have since been taken by the department.

Of the 320 homes that were supposed to have received an environmental investigation during that period to determine the source of lead, the city has so far found no records that 30 of them were ever investigated. Even in cases where an electronic record exists, 119 homes lack a paper record that an assessment was initiated. The report notes that this portion of the investigation is still ongoing. Mayor Tom Barrett said that the primary belief is that this is a matter of “inadequate documentation.” Investigations are required by the state when blood lead levels are recorded at 20 micrograms per deciliter or above.

An audit of the 519 cases of children testing positive for elevated blood lead levels of 20 micrograms per deciliter or above from 2015 to 2017 found 26 cases that the department flagged for additional follow-up. Action on those cases is underway.

The report comes after Barrett made the announcement January 12th that Health Commissioner Bevan K. Baker resigned and that his administration had recently become aware of serious issues with the program. The city has sent over 6,000 letters to potentially affected families, with 134 calls from families and 47 clinic visits occurring as a result. The Common Council opened an investigation into the matter and held a four-hour-long hearing on January 17th. A subsequent hearing on the matter is expected later this week.

The city receives approximately 3,000 annual cases from health care providers that show blood lead levels above five micrograms per deciliter in Milwaukee children. Lead in the bloodstream can affect the development of the brain and nervous system. Children under the age of six and pregnant women are particularly vulnerable.

“In most cases on the home visits, lead paint is the issue. So this is primarily a lead paint issue when we make these assessments and in fact, it is primarily a lead paint issue when we are dealing with children with elevated blood lead levels,” said Barrett.

The report indicates the city has made great strides in reducing the number of children testing positive for elevated blood lead levels, dropping from 31.9 percent of tested children under six years of age having a level of 10 micrograms per deciliter or above in 1997 to 3.3 percent in 2017. However, the report shows that progress has basically been flat since 2013. During this period of stagnation, the number of full-time employees assigned to the program has been cut nearly in half to 20 due to a decline in funding.

Funding for the program, much of which comes from federal and state grants, has declined substantially in recent years. Barrett said the program had a budget of approximately $6 million in 2009, while the 2018 budget is barely over $3 million, largely due to less money received in federal grants, and declining shared revenue from the state. Barrett said the city must now grapple with its severely constrained revenue sources to find ways to fund the program locally if grant funding levels don’t increase.

The report recommends a series of program improvements ranging from implementing a new records system and creating a frequent audit schedule to filling open positions, modifying job descriptions and streamlining the chain of command in the Health Department. The report recommends a number of changes to how the program itself is administered.

A series of graphs and charts in the report show that elevated blood lead levels are most commonly found in the city’s most impoverished zip codes, including 53205, 53206, 53208, 53210, 53212 and 53215. Those zip codes include many of the city’s oldest homes, most of which were at some point painted with lead paint and also have lead laterals.

At a Monday evening press conference, Barrett acknowledged that a personnel investigation is still underway. He said “there have been some percussions,” before declining to comment further, citing the advice of the City Attorney’s office.

At the press conference, the mayor pledged to continue to inform the public “as quickly as possible,” as more information becomes available.

The report was submitted to the Mayor and Common Council Monday by Health Department Director of Disease Control and Environmental Health Angela Hagy.

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