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Lead Poison: City at Risk
Prevention Program is in Disarray

October 27, 2004
By OSHRAT CARMIEL , Courant Staff Writer

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 case file.

"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 a year.

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 audit.

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 cleanups.

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, records show.

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. To view other stories on this topic, search the Hartford Courant Archives at http://www.courant.com/archives.
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