Milwaukee,  get the lead out

Milwaukee Water Commons holds its annual We Are Water events at Bradford beach. The organization has been working on the lead problem for the past two years. 

Photo: Courtesy Milwaukee Water Commons

Get the lead out of the city.

On this, there’s wide agreement in Milwaukee among community activists, healthcare professionals, government agents, whistleblowers, watchdogs and elected officials.

Apparently, though, that common goal was not shared by the Milwaukee Health Department.

Both Milwaukee’s mayor and its common council are mobilizing in light of the bombshell news last month that the MHD did not notify families whose children tested positive for elevated lead levels. That led to the Jan. 11 departure of Health Commissioner Bevan Baker, an angry mayor and a newly resolute council.

Mayor Tom Barrett, announcing that he’d asked for Baker’s resignation, cited mismanagement at MHD that left him deeply disturbed and angry. At a news conference Jan. 29, the mayor said he expected more from the department and residents expected more.

On Feb. 6, the Milwaukee Common Council elected to issue a request for proposals to conduct an independent review of the MHD.

The council also voted for Dr. Patricia McManus, president and CEO of the Black Health Coalition, as interim commissioner of MHD after earlier signaling its opposition to Barrett’s choice — the mayor withdrew the appointment Feb. 5.

The votes followed the release Jan. 29 of a 54-page report detailing MHD’s failures and insufficiencies.

Among the report’s findings:

• For the period 2015–17, families of 6,022 children should have received letters from the MHD regarding elevated blood lead levels and recommendations for future testing but electronic records document only 1,500 letters sent.

• During the audit, multiple cases in which children tested for elevated blood lead levels were flagged and require outreach and more follow-up.

• The most severe cases of elevated blood lead levels require chelation therapy, which involves removing lead from the body. From 2015-17, 32 children Milwaukee children received the therapy. “It is imperative that children receiving therapy return to a lead-safe home environment and MHD is responsible for assuring that. In at least two cases during 2015–17, that was not assured,” the report said.

Barrett, at the news conference, said, “There were two children, at least two children we know of that were allowed to return to a home that we had not tested to make sure it was lead-free.”

The report details how underfunding, low morale, high turnover, insufficient training and poor record keeping in the department factored in the failures.

Unfolding crisis — and a gag order

After a spotlight fell in 2014 on Flint, Michigan — where government cost-cutting measures led to tainted drinking water containing lead and other toxins — the Guardian newspaper published an investigative report that caught the attention of citizen activists in Milwaukee.

At least 33 cities in 17 U.S. states used “water testing cheats” that can conceal dangerous levels of lead, it said. And 21 cities, including Milwaukee, used the same water testing methods that prompted criminal charges in the Flint crisis.

In Milwaukee, more than 74,000 properties have active lead service lines — and 93 percent of those properties are residential.

The effects are clear.

In 2016, “the Wisconsin Council on Children and Families released their analysis of the rate of lead poisoning among children in Wisconsin, which the report says is nearly equal to Flint. … In Wisconsin, 4.6 percent of children under the age of 6 who were tested had lead poisoning; Flint, Michigan’s rate was 4.9 percent. The analysis further found that a disproportionate number of African-American children had lead poisoning,” according to U.S. Rep. Gwen Moore, D-Milwaukee.

Groups such as the Freshwater for Life Action Coalition demanded attention to the Guardian’s report and other evidence of a crisis in Milwaukee.

Outlets such as KINGFISHmke/Milwaukee’s Independent Voice repeatedly amplified the concerns and, Dec. 28, former MHD employee Benjamin James wrote an email to the mayor and all 15 alderpersons, warning about a hostile work environment and problems in the lead prevention program.

But at the city health department, as the common council learned in mid-January, there was a gag order preventing staff from communicating with elected officials without authorization from the health commissioner or operations administrator.

News of the gag order — now rescinded — set off a new wave of outrage and questions.

‘Scrutiny and accountability’

The common council responded to developments Jan. 12 with a “new day” declaration to act.

The joint statement was signed by all 15 council members: Alds. Ashanti Hamilton, Cavalier Johnson, Nik Kovac, Robert Bauman, James A. Bohl, Milele A. Coggs, Khalif J. Rainey, Robert G. Donovan, Chantia Lewis, Michael J. Murphy, Mark A. Borkowski, Jose G. Perez, Terry L. Witkowski, Tony Zielinski and Russell W. Stamper II.

“Today,” the declaration stated, “members of the Common Council learned that officers of the Milwaukee Health Department failed to ensure adequate notification of thousands of families whose children tested positive for elevated lead levels in their blood. This is an egregious public health failure that was in direct noncompliance with procedures put forth by Common Council resolution.

“We will move forward to hold the executive branch accountable for this very serious failure and we will investigate in-depth to determine what processes, procedures or other matters, if any, have been ignored, not complied with, or have been mishandled by the Health Department. The protection of our children must remain our highest priority. Our review of this matter will be handled with a seriousness appropriate to a failure of this magnitude.

“This marks a new day in the Common Council’s dealings with this administration with regard to policy, in general and with appointments, in particular. We will exercise a new level of scrutiny and we will demand a new level of accountability.”

The new level of scrutiny and accountability fueled the council’s rejection of Barrett’s choice of Paul Nannis for interim health commissioner. Nannis ran the department for a decade and later, under Baker’s management, Nannis’ company received more than $500,000 in MHD contracts. A council committee voted against the 120-day appointment Jan. 25 and the full council voted for McManus’ appointment Feb. 6.

“We made it clear we did not want someone part of the good old boy network, not someone intimately connected,” said Zielinski, a 2020 mayoral candidate who represents the 14th District. “We firmly believe on the council that we are going to have to turn that department around.”

But he and other council members also want a full independent review of the health department.

“These problems have been percolating for years,” said Zielinski.

‘No sense of urgency’

Last July, Zielinski, co-chair of the Milwaukee Nutrition and Lead/Hunger Task Force, offered a transparency resolution to direct MHD to issue a news release to inform at-risk populations of the risks of lead exposure in city drinking water, the availability of inexpensive filters, and the importance of getting tested.

At the time, the alderman said, “I offered this resolution because our own health department is not doing enough to inform people about lead in water and the need for water filters. I am especially concerned for infants who rely on … formula and their mothers, who might unknowingly expose them to lead. The health department has failed our community by ignoring evidence-based research from the lead in water problems from both Washington, D.C., and Flint, Michigan.”

Zielinski’s resolution was adopted in November 2017 and signed by the mayor Dec. 6, 2017, but had not been acted on when council members issued their own notice Jan. 31.

“There’s no sense of urgency in that department,” Zielinski said.

The points in the council’s notice:

• Women of the childbearing ages of 15–45 and children — including infants and children up to age 6 — should drink water and eat foods prepared from only lead-free sources.

• A water filter certified to remove lead should be used in homes with lead service laterals, lead pipes and fixtures. Look for water filters labeled NSF/ANSI Standard 53, which reduce risk of exposure.

• Previous instructions from MHD to “flush” or run water for several minutes before testing for lead are ineffective for protecting residents’ health.

What’s next?

Short-term responses to the MHD failures include:

• Zielinski wants every city water bill to include information about lead risks and safety.

• Bauman wants a mandate for the city to replace lead service lines to residential properties that the city owns due to delinquent taxes. 

• And there’s the independent audit of MHD.

“The ball has been dropped and the public has the right to have it picked up by an outside investigator,” stated Stamper, who represents the 15th District. “As the inconsistencies and the lack of transparency mounts, questions that have been raised won’t be answered by those who have already let us down.”

More solutions — 60 proposals — are listed in the “Assessment of Operations and Recommendations for Corrective Action” report released Jan. 29 and ordered by the mayor, who reviewed the findings during a news conference that evening.

Corrective actions include reorganizing staff and consolidating the program’s operations into one office building, implementing a new data system, creating a single environmental health program, reestablishing relationships with healthcare providers and community partners, looking for new funding sources, expanding education and outreach, and revising the process to ensure children who undergo therapy return to lead-safe homes.

Council members expect more solutions to come from the independent review, which could begin at the end of February.

“All options — including fundamental restructuring of the Milwaukee Health Department — are on the table as the council moves forward,” stated Perez, who represents the 12th District. “No structure, no process and no person should consider themselves exempt from scrutiny in the case of a failure this fundamental. The investigation is only beginning.”

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