Poison: City at Risk Prevention Program is in Disarray
October 27, 2004
By OSHRAT CARMIEL , Courant
A Hartford lead inspector stood outside a home in the city's North
End, his mission clear: get inside and trace the source of lead
that poisoned a 3-year-old who lived there. No one was home to
let him in, the inspector, Ken Eliason, noted on the young patient's
"Will have to wait for next child to get poisoned there,''
he wrote after his visit in March.
No one else at that Pliny Street home has been poisoned since.
But a few blocks away, at 285 Martin Str., lead poison did
infiltrate twice. Two years after the health department concluded
that the lead inside that home had severely poisoned a young
child, a second child moved into the same apartment and was poisoned,
according to case files. Though the department had ordered the
owner to clean up the lead hazard after the first child got sick,
the case stalled and the home's doors and windowsills remained
a hazard of leaden dust.
The city's lead poison prevention
program is in disarray. Even the city health
and human services director agrees.
In Hartford, where officials estimate that at least 65 percent
of the housing stock contains lead paint -- and, consequently,
lead hazards that may cause learning disabilities and lower IQs
in young children -- the unit of the health department charged
with managing the problem has not functioned properly for almost
The lead unit is late to conduct lead inspections, slow to issue
citations and once it does either, fails to follow up -- in part
because records have not been entered properly into a computer,
if they have been entered at all.
Eliason, who had been the unit's only inspector for months,
is 74 years old, has a habit of falling asleep on the job, and
once backed a city car into a home
he was inspecting, personnel and accident records show.
The lead unit recently lost a $2.9 million grant from the federal
Department of Housing and Urban Development that the city had
relied on for the last four years. The grant, which was to help
building owners pay for costly lead remediation, was simply not
renewed. HUD officials decline to say why, but they note that
the grant program is competitive.
At the same time, Connecticut's Department of Public Health,
which gives the city money to help
with case management, wrote a sharp rebuke of the city's childhood
lead prevention efforts.
Its June 2004 audit found that the city's transient
lead staff was not entering all poison cases
into a computer and was misfiling the charts of children who
had been lead poisoned, including mixing up documents from separate
files. Generally, the audit found, the city health
department had no system by which to track a lead poisoned child;
to make sure that the child was receiving treatment; and to ensure
that the home of the poisoned child was being cleansed of lead
-- or that its owner, if necessary, was being prosecuted in court.
" Hartford has definitely got issues,'' said Lisa Stapleton,
program director of Connecticut Parents United for a Lead Safe
Environment. Her group works with the health department to provide
shelter and counseling to city families
with lead poisoned children.
"Families are falling in the gaps because there's such a lag
time,'' Stapleton said. "A lot of kids are getting poisoned
off of the same house that has been cited previously. That's
what we're finding.''
Ramon Rojano, the city's health and
human services director, said he thought initially that the lead
unit was doing well. It had published a bilingual children's
book about lead poisoning called "Henry and Fred Learn about
Lead.'' And in a letter to Rojano in May, HUD had praised the
unit for abating lead in city homes
and educating the public about lead hazards.
After the state audit in June, he concedes the unit is failing.
"I think we need total reconstructive surgery,'' Rojano said.
"We need to reset it completely.''
A former city employee who had knowledge
of the program was annoyed enough to send HUD a "whistleblower''
letter that echoed some of the things the state audit found wrong
with the program.
Staffing is chief among the critics' concerns. Exactly who served
on the lead team this year is a question with a moving target
of an answer, depending on whom one asks and when. At one point,
said an employee familiar with the unit, the health department
submitted to HUD a photo of staff at an office birthday party
as evidence that the lead team was thriving.
But the state's audit showed that when it came to living up
to its basic mandate -- which demands an investigation of all
cases of extremely high blood lead levels -- the lead unit of
the city health department had not
been doing its job for almost a year.
Rojano, who assumed his title when the city's health
and human services departments merged into one last year, put
part of the blame on inheriting a new department that had lost
a combined 33 employees. In January, the department's "lead
program coordinator'' moved to another city department.
Rojano hired a new lead coordinator just this month, after the
position had been vacant for 10 months. He also submitted a plan
to the state on how he plans to fix the problems found in the
Saying he was "depressed'' when he learned of HUD's decision
not to renew the lead abatement grant, he has asked HUD for a
full accounting of what went wrong. But he is also joining a
Washington-based lobbying group in challenging the wisdom of
how HUD awarded its grants this year.
"Lead for me is a real major concern,'' Rojano said. "I'm
a child psychologist; I know what a particle of lead can do to
the brain. It's a civil rights issue for me.''
Lead is a potentially toxic metal, and is commonly found in
soil and in paint that coats homes built before 1978. Young children
who live in those homes are especially vulnerable to lead exposure
since they are more likely to eat crumbling paint chips and put
their hands, with lead dust on them, into their mouths.
Though adults also can be poisoned by lead, it is much more
serious when it happens to children under 6 years old. Since
the brain has not completely developed at that age, lead poisoning
can cause learning disabilities, attention deficit disorders
and lowered IQs.
So speed is critical when it comes to treating children with
high levels of lead in their blood.
"Kids who live in the city and don't
have a lot of resources, they have enough problems in their life,''
said Susan Sarvay, medical coordinator at the Hartford Regional
Lead Treatment Center. "They don't need to be intellectually
compromised from an early age. They don't need another issue.''
State law even sets a timeline for lead investigations: When
a child in Hartford takes a blood test that shows lead levels
to be 20 micrograms per deciliter or higher, the city health
department is notified and has five days to respond. The city's job
is to conduct an "epidemiological investigation'' -- essentially
detective work to figure out where the child was exposed to lead.
Once the lead unit traces the source of the lead, the department
should contact the owner of the home within two days and send
the owner a notice that there is lead there, advocates say. The
owner has 15 days to file a plan to correct the lead problem,
and the department has 15 days to approve it. The HUD grant the
department relied on was used to help defray the costs of such
In some cases, the Hartford department took more than a month
to do the initial investigation, advocates say. The state audit
says the records the department keeps offer few clues: When the
auditors randomly looked at 14 new cases of child poisoning,
they found computer records showing that all were responded to
on the same day.
Eliason, one of the department's lead inspectors, is responsible
for conducting initial investigations. He said that such probes
can take time, given that the family could have moved, or someone
isn't home when they said they would be.
"They don't stay in one place very long,'' he said. "If I'm
a couple of days late, it's almost impossible to find the mom.''
In some cases, the child's home is found to be free of lead
-- and so the lead inspector is obligated to inspect every other
place where the child spends time.
Though Eliason declined to discuss it, his personnel file shows
a checkered work history that may not lend itself to speed. Supervisors
have documented many cases of him sleeping at his desk, sleeping
while manning the phones at the department's environmental health
division, and possibly sleeping in a city car,
Officials transferred him to handle rodent inspections, but
returned him to lead inspections after he filed an age discrimination
complaint with the state.
A second lead inspector who left the department has returned
to his job as well.
Rojano's corrective plan to the state promises better record
keeping and case management in coming months. The clerk responsible
for entering data into the lead poisoning system took a computer
tutorial last week, he said, that will help the department's
ability to track its cases.
"We're on Gilligan's Island,'' Rojano said of the lead program.
"We have to build the world.''
Reprinted with permission of the Hartford Courant.
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