Health news Health & Medical News Baltimore goes from lead paint cleanup leader to 'in the red'

Story Photo: Baltimore goes from lead paint cleanup leader to 'in the red'
Baltimore goes from lead paint cleanup leader to 'in the red'

Joe Pawley says he's fighting to save his children's future, and he's feeling very alone right now.

During routine testing last summer, his 2-year-old son, Aaron, was found to have a dangerous level of lead in his blood, and city health workers found the toxic metal in the paint on the window sills, baseboards and walls of the Pawleys' rowhouse in Southwest Baltimore.

The family sought help from the city Health Department to hire a contractor to remove or cover the deteriorating lead paint, which could cause lifelong learning and behavioral problems for their three young children. The agency has federal funds for such work. But their application was rejected, Pawley says, and he's not sure why.

"If you can't get the city to come out here and help out a homeowner or somebody who has lead, I think the city don't really care," he said, as Aaron and another son, 22-month-old Joshua, scampered about. A box of wet wipes sat on the television, for scrubbing his youngsters' hands of any lead dust they might pick up and put in their mouths.

The Pawleys are one of hundreds of families in Baltimore struggling to protect young children from the lead paint that lurks in older homes. Over the years, the city has helped thousands like them, using tens of millions of dollars in federal funds. Its efforts put the city at the forefront of the nation's campaign to reduce lead paint hazards.

But now, the federal tap has been shut off. Problems with the city's program to treat lead paint in homes caused the U.S. Department of Housing and Urban Development to declare the local health agency ineligible for new grants.

"How do you go from being a model all these years and then suddenly have your money taken away? That's the open question," said Rebecca Morley, executive director of the National Center for Healthy Housing, a Columbia-based nonprofit that works on lead paint and other housing issues.
According to HUD documents and interviews, the city has been struggling for years, since shortly after it received its most recent grant, of $3.9 million in 2007. The Health Department was chronically behind in fixing enough houses to meet its goal, and by last summer had done just 141 of the 364 it had pledged to do by January of this year. It also had fallen "extremely behind," in a HUD official's words, in lining up homes to work on.

The cutoff has left city officials scrambling to shift the lead-paint effort to Baltimore Housing, which handles other federal grants to weatherize and rehabilitate homes, and to scrape together local and state money to keep the work going. HUD officials, meanwhile, have raised concerns about how the grant was handled and are poring over the city Health Department's records to see if all of it was spent appropriately on reducing lead paint hazards.

The federal cutoff surprised many, because Baltimore has long been praised as a leader among the nation's cities in trying to protect its children from the scourge of lead poisoning.

In the early 1990s, as the federal government began to pour money into tackling what many belatedly realized was a nationwide epidemic, Baltimore's abatement program was lauded by the bureaucrats in Washington who wrote the checks. Since 1993, they have funneled more than $33 million to the city in eight grants ranging from $2 million to $6 million.

"We were actually ranked No. 1," recalls Scott Rifkin, who was chief of lead abatement for the city Health Department in 1994. Baltimore was fixing lead-paint hazards in more homes than any other city at the time, he said.

But in the years since then, Baltimore's reputation for leadership in the struggle has been tarnished, at least in the eyes of federal housing officials. The city Health Department went from No. 1 to falling "in the red," making it ineligible to apply for new lead hazard reduction grants from HUD, the main source of funding for the costly work of repairing homes with flaking, chipping, lead-based paint.

While the city's difficulties might be news to some, the Health Department has been struggling for years to fix enough lead-riddled houses to meet the goals of its grants, and there were multiple warnings before HUD stepped in last fall, according to interviews and records provided by federal officials and others.

Within months of the most recent grant, given in 2007, Baltimore health officials were failing to treat enough homes and meet other benchmarks, HUD officials said.

"They've had performance difficulties the entire time," said Michelle Miller, programs director for HUD's Office of Healthy Homes and Lead Hazard Control.

City health officials say they got off to a slow start in part because they were trying to complete the work called for under prior grants totaling $6.7 million that HUD had given Baltimore in 2004 and 2005. The lead-abatement work on those had been handled at first by Healthy Start, a nonprofit that had been the Health Department's partner in the effort since the 1990s.

But by 2007, city health officials say, the arrangement was no longer working well and the pace of work was too slow. HUD had also downgraded the city's performance as the 2005 grant was winding up, slipping from a cautionary "yellow" to unsatisfactory "red" under the federal agency's stoplight-colored rating system. So the city Health Department moved to shift all of the contracting in-house about the time it applied for $3.9 million more in 2007.

In the new grant, the 364 homes the Health Department was promising to fix equaled the number done with the two previous grants combined, work which hadn't been finished yet. By last fall, when HUD finally deemed the city a "high risk" of not fulfilling the terms of its grant, the Health Department had completed work on only 212 homes.

"It was difficult to catch up on all those grants and meet the ambitious benchmarks that had been set," said Olivia D. Farrow, the city's deputy health commissioner.

City health officials say it was tough as well to find families and homes eligible for help under the terms of the federal grant. Funds could be spent only on homes in which low-income families with children 6 or younger lived, for instance, or where the dwellings would be offered for rent to such families.

"These grants are challenging, more challenging than they appear," said Dr. Joshua M. Sharfstein, who was city health commissioner from December 2005 through March 2009 and is now state secretary of health and mental hygiene. "Doing $10,000 of lead abatement on a house that needs $200,000 in repairs is not an option under the grant."

Other cities and states that have received federal lead paint grants have struggled to fulfill the terms. Maryland's Department of Housing and Community Development completed 162 homes, just over half the 300 it had pledged to do, under a $3 million grant it received in 2003 to help counties and small cities around the state. The state had to return part of the unused funds.

"It's not unusual," said Morley, head of the National Center for Healthy Housing. "It's just more unusual in this case because Baltimore has always been deemed such a leader."

But others say the program's difficulties were largely self-inflicted. City health officials were "not paying attention to the knitting," said Ruth Ann Norton, executive director of the Coalition to End Childhood Lead Poisoning, a Baltimore-based nonprofit that works in cities across the country.

Although well-intentioned and able in many respects, the management and staff of the lead program in the Health Department did not pay sufficient attention to the "fundamentals," of marketing the help it could provide and of engaging the low-income community it was trying to serve, Norton said. Key people there lacked training in rehabilitating housing and in how to manage the grants, she said.

"There was always a sense of 'we got it, and we don't need help,'" said Norton, whose group also received a $2 million HUD grant for lead abatement and other repairs.

Last April, far behind in fixing homes, city health officials asked HUD to give them six more months to catch up. But federal officials say they were reluctant to grant an extension without a showing by the city that it was picking up the pace. Instead, according to HUD's Miller, the Health Department had reported doing fewer homes with each three-month update it provided. In August, federal officials denied the city's request for more time.

City officials appealed to Sen. Barbara A. Mikulski, a Maryland Democrat who sits on the Appropriations subcommittee that reviews HUD's budget.

In a brief letter to Mikulski, Madeleine A. Shea, then Baltimore's deputy health commissioner, acknowledged that her agency had been "underperforming" in the grant's early years. But everything was in place now, Shea asserted, and an extra six months would enable the city to "exceed all goals."

Mikulski forwarded the plea to HUD Secretary Shaun Donovan and asked him to give "appropriate consideration" to the city's request and have his staff report back to her office.

Nearly a month later, a HUD official replied, writing that not only would the city agency not get an extension, but because of its chronically poor track record, it was getting extra federal scrutiny and could be cut off from future funding. But the HUD letter held out the prospect that the city might still be able to get an extension if it could finish fixing 60 more houses by the end of September and line up another 90 to work on.

But when the end of September came, HUD officials say, the city could not document that it had done that.

Federal officials began monitoring the Health Department's work more closely. Miller said she asked to review files on homes ready to be treated, and found only six out of 10 or 11 had the necessary paperwork showing that inspections had found lead-paint hazards and that the work to be done was appropriate.

The Maryland Department of Housing and Community Development, meanwhile, tried to step into the looming funding gap by partnering with the city Health Department in an application in October for a new grant from HUD, which was preparing to dole out $127 million at the beginning of this year.

The joint application touted the Maryland agency's "expertise in management of federal grants, program management and monitoring" and said the state had been working with the city in administering its current grant. With another $4.5 million, the state and city pledged, they would fix 260 lead-tainted houses in Baltimore a less ambitious goal than the one for the city's then-floundering effort.

HUD did not even consider the application submitted last fall by the state and city, however, because the state failed to include a required form in the voluminous grant application, then failed to sign it after being prompted to send it. Under HUD rules, the form had to be signed for the application to be considered valid. By the time the missing signature was noticed, the deadline for fixing it had passed.

Meanwhile, HUD began paying visits to Baltimore and poring over the Health Department's files. In a "monitoring report" written in late December it found that the Health Department was not routinely documenting that occupants of homes were eligible for federal aid and that some federal dollars were spent removing lead paint that wasn't a hazard because it wasn't deteriorating. "In many instances, the components addressed did not even contain lead-based paint," the report said.

City officials insist that whatever the problems they had with HUD, their work under the grants was a success, with the proof being the continued decline in the number of children in Baltimore with lead poisoning.

And they say those who received the city's help are grateful. At the request of the Health Department, David Hare contacted The Baltimore Sun to say that the lead-abatement work went smoothly on the 80-year-old home in Hamilton that he and his wife, young son and newborn daughter had moved into.

"I had no problems with it," said Hare, 38, a city employee. "To be honest with you, that's the reason I bought in the city."

But others felt left out.

Linette Putty, 52, said she applied for a lead paint grant from the Health Department but backed out after feeling jerked around. Her daughters are grown, but she babysits their young children in her Northeast Baltimore home, and she discovered that it had lead paint in the windows and kitchen door, and that there was lead dust in the carpet.

"Everything went smoothly until [the Health Department] got to a point where the work was to be done," she said. At that point, she said, she was informed she would have to put up $780 of her own money for the work. She said she couldn't afford that on her disability income, so she withdrew her application.

She has since arranged with the lead poisoning coalition to do the work, she said, and she'll only have to put up $195 for a building permit.

Health Department spokesman Brian Schleter declined to respond to inquiries about individual cases.

Joe Pawley, meanwhile, determined to tackle his home's lead paint problems himself something experts advise against without proper training. But with his son Aaron's blood test indicating that he'd been poisoned, Pawley felt he had to do something. So he scraped and repainted a portion of the living room wall. He washes the leaded baseboards weekly. The lead levels in his son's blood have come down, but he's still planning to replace the leaded windowsills soon.

As of Jan. 1, the city reported treating a total of 292 units under the grant still well short of the 364 pledged. HUD officials say they're checking to validate the figure.

The city's lead program will move to the Housing Department as of April 1. Without the HUD grant, the agency says it has about $1.5 million to use for lead paint work.

Housing officials have not yet come up with a target for lead abatements this year, said Ken Strong, assistant commissioner for green, healthy and sustainable homes.

The stakes are high. Though the number of lead-poisoned children in the city has declined by 84 percent in the past decade, there were still 347 in 2009, according to state figures.

And while the city's program has remediated the lead-paint hazard in 2,500 houses, the 2000 Census tallied 47,000 in Baltimore built before 1950, when lead paint was routinely used. The Health Department has a backlog of 525 homes citywide where children have tested positive for lead poisoning, and peeling, flaking paint has yet to be removed or covered. Though nearly half are vacant and boarded up, the rest are not.

"We desperately need to have funds available," said Patricia McLaine, an assistant professor of nursing at the University of Maryland and a member of the state's Lead Poisoning Prevention Commission. "We still have poisoned children."

Source: By Timothy B. Wheeler and Scott Calvert, The Baltimore Sun

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