Svgalbertian [Public domain], via Wikimedia Commons

April 15, 2019; Milwaukee Journal Sentinel

It is good news that Milwaukee has, after a five-year lapse, regained a 5-year, $5 million federal Healthy Start grant to reduce the incidence of infant mortality. Still, not everyone is happy with the way city leaders managed the process.

In Milwaukee, black infants are three times more likely to die than their white counterparts. But the granting of the new award to the Children’s Hospital of Wisconsin has become a source of friction rather than cause for celebration.

Although the city will now have the grant, community relations were strained by the way city health officials guided the proposal process. According to the Journal Sentinel, “Milwaukee Health Services, the second-largest community health center in the city, and three African American groups said [their] proposal to run the Healthy Start program was undercut by the city’s new health commissioner when she encouraged Children’s Hospital of Wisconsin to also apply for the grant.”

Originally, a coalition known as the Milwaukee African American Perinatal Health Collaborative (MAAPHC), which included Milwaukee Health Services, the African American Breastfeeding Network, My Father’s House, and Black Health Coalition of Wisconsin, as well as UW-Milwaukee’s Zilber School of Public Health, had the city’s support. But Milwaukee’s health commissioner, Jeanette Kowalik, said she had concerns about how the Collaborative was proposing to staff their program and encouraged Children’s to submit a competing application. From her perspective, bringing the program back to her city was more important than keeping community organizations happy. “My intention for all of this was about bringing Healthy Start back to Milwaukee to prevent black infant mortality. Period. And at the end of the day, it’s back in the community.”

Dr. Tito Izard, president and chief executive officer of Milwaukee Health Services, contends that the coalition was bypassed. “We had a competitive grant, and we were undermined….The only way the City of Milwaukee is going to be able to solve its historical problems and distrust of each other is for a true collaborative to be established.”

City Alderman Tony Zielinski sides with Izard in a statement from his office. “In effect, Commissioner Kowalik chose to cut out the African American coalition and instead have the city be the grantseeker,” Zielinski writes. He adds, “When Dr. Izard—someone who is widely respected in the community and who rarely speaks publicly about such matters—calls out Commissioner Kowalik on this grant process (crying foul), I am convinced that something improper might have occurred that deserves public scrutiny. It seems without question that the Commissioner decided to undercut a coalition centered on the unique health needs of the African American community.”

At a Monday news conference called after it was learned that the grant had been given to Children’s Hospital, Izard expressed strong unhappiness with the way the city had intervened:

Everybody has to work together, and that’s what we were trying to develop—a true collaborative, but from the grassroots, not from the institutions. The institutions cannot create the collaborative. The people have to create the collaborative. And that’s the same mistake that the city continues to do over and over again. If it’s not implicit bias, then why is it?

Kowalik dismisses Izard’s concerns. She believes the group was more concerned about supporting their designated project manager than ensuring that the city won the grant dollars. Kowalik told Izard multiple times that the plan to hire Patricia McManus of the Black Health Coalition of Wisconsin as project director was a mistake. “He dismissed me. He said, ‘That’s what you think, but we still are going to go this way.’” Adding to the drama is the fact that McManus had been the city’s health commissioner before Kowalik assumed the position.

Milwaukee now has secured a grant to support its efforts to reduce infant mortality. Those efforts will need real partnerships with community organizations and will need to be supported within all the city’s neighborhoods. Kowalik recognizes this, telling the Journal Sentinel “that Children’s will have to work with community groups for the grant to be successful. And she is unapologetic. ‘As much energy is going into dragging me, we need to be put energy into the implementation of the grant.’” But given the political acrimony, generating community buy-in may not be easy.—Martin Levine