Attach to the Suspension Document Dated 12/11/2017
March 19, 2018

Written in Response to Suspension Notice dated 1211112017- Lisa M. Lien

Lisa M. Lien, have been an employee with the City of Milwaukee Health Department for 26 years
and have received only positive performance reviews and never had any prior disciplinary actions,
this statement is in rebuttal of a disciplinary action dated 12/11/2017.

Within my 26?year tenure at the City of Milwaukee Health Department have had several roles
including; Staff DevelOpment Coordinator, Staff Development Manager, Building Manager, Assistant
Director of Nursing, Director of Nursing and, as of November 2009, the Home Environmental Health
Program Manager.

The Home Environmental Health (HEH) Program is a strong outcome-based program, at no time was
the Lead Program mismanaged, rather the Lead Program was maintained and developed under my
supervision; have hired exceptionally competent employees, obtained numerous million-dollar
grants, participated in several internal and external audits, represented and presented to the
community. The Program was operational and managing despite the lack of administration

One issue appears to be Administration?s complete lack of understanding about the grant
requirements and grant implementation within the Health Department. More disturbing even than
that, is management?s lack of interest in learning about the grant requirements and their operation
within the Health Department, including failure to ever discuss such information with me. This refusal
to learn about the grants and their operation has, of course, resulted in unjustified discipline against
me, but much more important, it is impacting the grants themselves and the public safety.

To understand the inaccuracy of the written suspension, it is first necessary to understand the grant
terms, how they have been operating for the last several years, the HUD knowledge and approval of
implementation, and the continued successful awards of HUD Lead Abatement grants, which is now
being placed in jeopardy as a result of management?s action.

Federal Housing and Urban Development (HUD) grants are announced and eligible cities, counties
and states are able to apply. The City of Milwaukee Lead Program has been successfully awarded
HUD funding for the last 20 years, under my tenure with the Program we have received over $10.5
million dollars in lead abatement funding. In order for an applicant to be awarded HUD funding, the
grant application requires documentation of program capacity, relevant organizational experience,
information and data demonstrating need, soundness of approach of work practices, and program
evaluations. Upon award, HUD will perform program audits and reviews along with analysis of the
quarterly reports that are submitted by grantees. Department administration, which is the Health
Commissioner for the Milwaukee Health Department, receives a quarterly HUD response report
regarding the program?s performance to date. The submitted grant defines the terms, operations and
implementation practices and objectives. The current 2014 and 2016 HUD grants were administered
as written by our program and approved by HUD.

MHD Administration specifically reviews and signs off on grant submission, program/grant operation
reviews and all formal documents received from HUD as well as on my personal performance review.
Since 2009, management has consistently rated both my work on the grants and the performance of
the grant program itself with approval.

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Attach to the Suspension Document Dated 12/11/2017 -

Implementing a grant program requires adequate and knowledgeable staff. Administration
(Commissioner Bevan Baker, Angela Hagy and Sandy Rotar) and the MHD Human Resource
Program (Lori Hoffmann and Tanz Robertson) transferred staff into the Lead Abatement Program,
one staff member as recently as October 2017, which would not have been done if at any time the
program was mismanaged. Staff were transferred from other MHD programs into the Lead Program,
yet hiring Lead Risk Assessors was seemingly impossible.
. Human Resource Analyst Lori Hoffmann transferred a probationary Public Health Nurse to
the program in July of 2017.
. Human Resources Manager Tanz Robertson transferred an Office Assistant Paula Olsen
to the program in October of 2017.

In June of 2017 a new Division Director, Angela Hagy, became the new manager due to Paul
retirement. Paul was a supportive manager that created and fostered a
supportive team environment within the Health Department?s challenging organizational culture based
on his keen interest and knowledge of the grant requirements and the program operation. Paul
attended the Program?s all-staff meetings and updated staff on current issues and often engaged
them, requesting their thoughts, concerns and ideas. Angela?s management style was quite different;
she did not meet with the Lead Program staff at all or even with me, as the Home Environmental
Health Program Manager. Further, she often sent authoritarian-type, strong directive emails, often
based upon inaccurate or false information. Her management style is hostile and harassing??
complete opposite of my own and Paul?s administrative style but similar to Commissioner Baker?s
leadership style. However, much more troubling than her style is that she has shown little willingness
or interest in learning about the grant requirements or the program?s experience and rationale for the
day-to-day lead program operations.

I believe that Hagy was notified by the MHD Budget Director David Piedt, that some Housing and
Urban Development (HUD) dollars were likely to be returned to HUD and there was potentially a
decrease in housing unit lead abatement production. Instead of meeting with the Lead Program, and
myself specifically, she and the Commissioner inaccurately concluded the situation to be a (the
current) ?crisis?. At no time was I asked by Hagy or the Commissioner for clarification or resolution.

I had reported to the Human Resource Director Barbara Henry numerous times, warning that our
Lead Abatement grants would be in jeopardy if staffing issues were not addressed in an emergent
manner. I had conveyed to Hagy in operational meetings, June-November 2017 that it was imperative
that Lead Risk Assessors be hired. MHD Administration was aware that for the past 2 years staffing
of inspectors was at 50% (due to retirements and management?s failure to fill the positions) and the
second issue was the failure of the City of Milwaukee Housing Authority (HACM) to expend their
complete $400,000 budget that was specifically allocated to our grant program, which impacted the
overall grant?s unexpended dollars. Hagy never followed up to offer suggestions or supportive
feedback, nor offered a summary of any concerns and seemed only interested in blame, but not
understanding or saving the grant program or assisting the children in Milwaukee who are most
affected by lead.

If Hagy had read the 2014 and 2016 HUD Lead Abatement grants that were provided to her or if she
would have talked with me about the program grants and any concerns she had, she would have had
the knowledge and history of the MHD Lead Program and understood the complexity of implementing
million-dollar lead abatement grants. However, she chose not to do either.

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Attach to the Suspension Document Dated 12/11/2017

On November 15, 2017 I was placed on an Administrative Leave. On December 10, 2017, I received
a 10? day disciplinary suspension based on 8 issues. The Suspension issues came only after?the-fact,
after I had already been placed on Administrative Leave. Below, are my responses to the disciplinary
suspension Ietter?s specific allegations. Not only is the language offensive and disparaging, it is
inaccurate and untrue. Below in bold are the accurate and honest responses to the items identified
by Hagy which are set forth in italics:

0 Issue 1: Lisa was ineffective in her performance.

Lisa has failed to assure training is being consistently and effectively provided to nursing staff.
Despite being a prior director of nursing, a written nursing orientation curriculum does not exist.
A check off procedure for determining independent operation for nursing home visiting in lead
does not exist. it is not clear what training the last two nurses hired into lead were provided. it
is critical that nurses be provided sufficient training to do their duties and without a written
training plan and a checkoff procedure it is impossible to assure that is done. The lead
program lacks both which an effective manager would see as being integral to their program.

Nursing Training (Issue #1 is Inaccurate): Response. The assignment of orientation of new
nurses is an assigned duty and responsibility of the Public Health Nursing Coordinator-
Margot Manassa. There is also a?D'i'rector of?Nursing, Tiffany Barta, whose job is to provide
oversight, on-boarding and orientation of nurses. Barta coincidentally provided the mentoring
and orientation for the current Public Health Nurse Coordinator, Margot Manassa. Margot had
trained two nurses prior to the newest nurse- and both were exceptional in their duties. Even
though Barta had met with the Lead Program nursing staff, at no time was there feedback
from the Director of Nursing (Tiffany Barta) to myself, the Program Manager. She was remiss
in her duties as a Nursing Director to assure communication with the Manager if there were
questions or concerns.

In short, these duties were part of the responsibilities assigned to the Director of Nursing and
to the Public Health Nurse Coordinator, not to me as the Home Environmental Health Program
Manager. Nevertheless, had any issues been called to my attention, I would have stepped
right in to assist with resolution of any deficiencies. Unfortunately, Hagy did not discuss this
matter with my prior to placing me on Suspension.

. Issue 2: Lisa was insubordinate and inefficient in her performance.

She was instructed via email on May 30?? of 2017 as well as verbally by the DCEH Division
Director to have one on one meetings with her staff on at least a basis to provide
routine couching and mentoring associated with employee performance management and
employee performance review. As of November 171?h of 2017 Lisa had failed to comply with that
work rule. She instead relied on staff to just pop in to her office if they had an issue. Only staff,
and should not be relied on for ongoing coaching and mentoring and establishing a dialogue to
serve as the basis for performance review. This demonstrates a lack knowledge of basic
management principals.

Bi check in meeting (Issue #2 is Inaccurate). There was no insubordination or

inefficient performance for coachinglmentoring staff. While Hagy discussed management

style with me, she did not direct that I change my methods for which I had been rated highly

on my performance reviews. There was no ?work rule? or directive given on the style of

communication with staff. I provided a less rigid, more informal, communication process that

was more efficient and obtained good results from subordinates. was available 24/7 for staff
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Attach to the Suspension Document Dated 12/11f2017

and had many informal and formal discussions with each staff person, relative to daily work
activities, work load, and often specific cases. The ?5 min check in? was started in January;
staff did not care for the format, relaying that it felt forced rather than timely or specific to
current matters. My management style was more of the open-door policy which was more
supportive and conducive to the environment and culture of the program. I did meet and have
communication interactions with all of my staff in fact more frequently than 
Additionally, scheduled Program meetings were held approximately that included all
staff who were working in the Lead Program. The team communication model that 
implemented for the Lead Program not only was supported by the former Director Paul B.'but
also similar in style to how he communicated and supported his management team. Hagy had
not criticized nor directed me to change this team meeting model.

In short, there was no insubordination since I was never directed to change my management
method. Indeed, Hagy did not even criticize my management performance to me until I read
what she wrote on my Suspension after the fact.

0 Issue 3: Lisa failed to follow department policy.
MHD policy requires graphics/public information officer to review and approve all forms and
flyers. Numerous forms and flye'rswere created and/or modi?ed for 'u'se'by?the lead program in-
violation of the department?s graphics/communication policy.

Graphic policies (Issue 3 is INACCURATE). Graphic policies were followed as required per
policy. The Graphics area provided an editable version of our program outreach flyer so we
could make minor updates- which was utilized to update program contact numbers/names. All
program educational materials were developed by Graphic and reviewed and updated by
Graphics. No one ever discussed any issues about the materials. If they had, they would have
learned that the Graphic policy was followed with the Graphics area.

In short, the Graphics policy was followed. The material was pro-approved by the Graphics
area which allowed minor updates, as has been long-standing practice.

- Issue 4: Lisa has been incompetent or inefficient in her performance. Lisa violated provisions
of the State Statute/Administrative Rule. Lisa failed to follow DCEH policy and procedures. As
a health department who contracts with the Wisconsin Department of Health, under Wisconsin
State Statute 254.166, the City of Milwaukee Health Department upon noti?cation of a report of
child under the age of 6 with single? elevated blood lead level (EBLL) of 20 ug/dL or two
venous biood lead level of 15ug/dL taken 90 days apart is obligated to perform a thorough
environmental investigation of the child?s dwelling of premises in order to attempt to identify the
source of the lead. All cases whether capillary or venous 20 and above per MHD protocol
should be assigned to PHN coordinator assure follow up testing occurred, for 2017 only 39%
were assigned a PHN in STELLAR. 133 cases year to date were new reports of lead poisoning
though no PHN follow or environmental testing was done on 48 of them in violation of
administrative rule. Furthermore on multiple occasions children undergoing chelation were
released to return to environments that were not lead safe. Over the past two years it appears
that overall case management suffered under an ineffective PHN coordinator, but it appears
that Lisa did not have the proper quality assurance processes in place to identify these failings.
She failed to provide oversite and assure adequate span of control of the programs to which
she was charged.

Attach to the Suspension Document Dated Hill/2017

Elevated Blood Lead follow-up (Issue #4 is INACCURATE). All required follow up for reported
lead tests were completed per program guidelines. Informational letters were sent to
parents/guardians of Milwaukee children who had a lead test result'5 and greater, at a level of
outreach and early intervention home visits were conducted by Alva Goldberg,
Health Service Assistant and at levels greater that 20 venous a Public Health Nurse and Lead
Risk Assessor conducted visits to the address to assess for lead hazards and provide health
information and developmental screening for the child. The CDC WI DHS database; STELLAR
software system was the repository for all lead results, with data entered daily by office staff.
STELLAR is (has been) in the process of being replaced by a new software system
from the United States Center for Disease Control Due to the age of the STELLAR
software and the IT server incompatibility, the STELLAR database would ?go down? several
times per week/month. In addition, STELLAR has limited data reporting availability. Although
MHD management and the State of Wisconsin Childhood Lead Poisoning Prevention Program
was well aware of the software deficiency no attempt was made, to my knowledge, to address
the current system rather for the past 3 years sole focus was put into the replacement system
although loss of data could put residents at risk.

All children with a reported lead level above 5ugldL received a letter notifying the
Tparentlg'uardian of- the resu'lt and ?when the child'shouldi-be- re-teste-d. The letter was
automatically generated by STELLAR and the enclosures included program centact
information and educational materials ?Protecting Your Child from Lead?, a nutritional
pamphlet and the program flyer with information on lead abatement was enclosed and mailed
to the child?s guardian.

 

In short, the alleged statement is false and should be redacted.

Issue 5 Lisa has been incompetent and inefficient in her performance. Lisa violated provisions of

the State Statute/Administrative Rule.
Lisa modified EBLL process placing herself in role supervising investigations of lead poisoned
children. Lisa did not delegate the day to day oversight of lead risk assessors to the field
supervisor (Rich Gaeta) as written in his job description. As the technical expert over lead Lisa
was required to be well versed in the requirements of DHS 163 which is the main
administrative rule governing lead, and should have known the transfer of supervision from a
manager required to have lead risk assessor licensure (the field supervisor) to one that does
not prosses it, is not permitted under administrative rule. Lisa failed to update either job
description to reflect the change and she failed to obtain easily over her tenure in her position.

Elevated Blood Lead Supervision (Issue #5 is INACCURATE). This is inaccurate and
demonstrates a complete lack of knowledge from Hagy on the role and responsibility of a WI
DHS Certified Lead Risk Assessor As the manager, I did not act or assume the role of

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Attach to the Suspension Document Dated 12/11/2017

the LRA- rather I oversaw the administrative process and completion of files. Any consultation
needed by Lead Risk Assessors for items/questions outside of my scope of knowledge were
provided by the Program?s Lead Risk Field Supervisor. Lead Risk Assessors are trained and
certified by the State of Wisconsin. All lead hazard investigations, monitoring and clearances
occur under the WI DHS license of the investigating Lead Risk Assessor.

In short, management did not discuss the delegation of duties or the role of the state training
and certification with me so they would understand the separate functions. I was neither
incompetent nor inefficient?in fact quite the opposite.

. Issue 6: Lisa has failed to comply with city or departmental work rules. Lisa was inefficient in
her performance of her work.

Lisa engaged in negotiations with a vendor regarding providing outreach for obtaining lead
abatement applications. Lisa engaged in discussions with the vendor for months shaping the
scope of work and discussing what type of collaboration would be possible. After the details of
the contract had been negotiated between Lisa and the vendor, Lisa presented the contract to
the Division Director as if Lisa was approached out of the blue by the vendor with this

opportunity; The Division Director turned the opportunity o?o?Wn, as many other?community"
organizations could provide the same service and the cost per application $3000 for 15
completed applications or $200 per application was not cost effective. The vendor, with the
understanding that this was sure thing, wrote an angry letter to the Commissioner and the
Mayor. When asked initially to provide all documentation with the vendor Lisa provided only
two recent emails. The true level of the negotiations/interaction between Lisa and the vendor
was only determined through an email request. When confronted with the fact that we
email contracted her previous statements, Lisa did indicate that further assistance was
provided.

Lisa failed to disclose requested information when asked. Lisa admitted to having previous
relationships with the vendor and assisted her in revising bids in order to be selected. When asked
for the documentation, partial documentation was rendered. This violates department ethics policy
and also increases management?s lack of confidence in her integrity. This acted in embarrassment
for the city as when the deal wasn?t implemented the vendor sent an letter to the Mayor.

Community Vendor (Issue #6 is INACCURATE). Ideally all Vendors and contracts are reviewed
by the City?s Procurement Department, However any one time contact under $5,000 may be
approved by the Program Manager and MHD Budget Manager and this policy has been
routinely followed in the past. For example, in 2013, the Home Environmental Health Program
worked with Southside Organizing Committee to perform outreach in the community
about the hazards of lead in older homes and also assist in translation services of non-
English speaking property owners, this was a successful partnership. The particular
community vendor/organization referred to was necessitated as a means to generate
knowledge of our program and abatement applications on the near North side of the City,
53206 area, an area where the applications for lead abatement were declining. This agency is
familiar with the Milwaukee Health Department and the previous Division Manager was aware
and well versed on the organization. In any case, the Budget and Accounting Manager, David
Pied, approved this one-time invoice. There was along standing relationship with this agency
and years of emails/communications have occurred. Dialogue specific to the development of

Attach to the Suspension Document Dated 12/11/2017
an appropriate invoice was provided to the agency and emails specific to the proposed work
activity were provided to Hagy.

In short, the overall City policy has a long-standing exception for one-time contracts under
$5,000. In addition, Budget and Accounting Manager, David Pied, approved this one-time
invoice. Unfortunately, again, Hagy appears to have a disregard for the truth, as she did not
investigate the facts, let alone discuss this issue with me so that she could learn the nuances
of the policy. At no time did she ever inform me of any change in the long-standing policy
which I followed.

Issue 7: Lisa was ineffective in her performance. Lisa violated City Ordinance. Lisa violated

department/city policy.
?Doing Business with the Lead Program? is form that the lead program updated as recently as
spring 2016, but has been around in various iterations according to staff for at least 10 years.
The lead program has required all contractors to sign the agreement prior to receiving
abatement contracts. Prior versions of the form are found in the lead risk assessor manual
which is provided to each new risk assessor upon hire. The form prohibits contractors from
grieving disputes with the lead program to outside parties, and levied a fee for failed
performance (dust wipes). The amount of the fee was increased to 250 per'Wip?'sometiine in
2016. When asked about the form, Lisa denied all the knowledge of it, though she referred to a
complaint she got from a contractor that made reference to it. Lisa agreed that prohibition of
grieving complaints outside of the lead program was inappropriate. She was not aware that
legal process to promulgate fees had to be through contracts or through ordinance. She said
the fee was just something Rich, Ben and Rose came up with, she didn?t know exactly when it
was changed but she had not been involved in it. She had no part in the decision, and there
was no justification as to the amount or to the increase.

This demonstrates a complete lack of depth of knowledge of the program to which she is charged
with oversight. The form was in the program manual which she was charged with updating and
maintaining. The fees were charged to contractors. The contractors were displeased when they
were charged for failures, it seems highly unlikely Lisa was unaware of its existence or provisions.
it only took a few weeks after a contractor had my information before he provided me the form and
complained about the content. When previous complaints did surface Lisa should have
immediately launched an in-depth review of the practice. At best it shows incompetence, lack of
technical expertise and lack of managerial oversight of her staff, at worst it shows willful violations
of city ordinance/city processes and may result in yet undetermined financial liability to the city.

?Doing Business with the Lead Program? (Issue #7 is ?Doing Business with
the Lead Program? was a document put in place to provide guidance to Lead Abatement
Contractors working with the HEH program. The failure to pass dust wipe clearances indicates
that a hazard remains and likely is due to the contractor?s poor lead-safe workmanship and
post abatement clean-up, this lead dust hazard could poison children. The fee associated with
dust wipe failures has been in place for almost a decade, as a way to encourage contractors to
be more thorough and diligent in their post?abatement cleaning. I did respond to Hagy about
the failure fee, but was unclear on the exact date of implementation. The practice of instituting
a fee for dust-wipe failure was documented in the program?s HUD grant submission and was
clearly outlined in the 2014 and 2016 HUD grant narratives that were provided to Hagy. HUD
administration was also aware of the practice and discussed and supported this initiative as
recent as at their on-site successful audit of the MHD Lead Abatement Program in July 2016.
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Attach to the SuSpension Document Dated 12/11/2017

In short, it is unclear whether Hagy intentionally made inaccurate conclusions, or whether she
merely did not understand the process or terminology since she has no lead experience, but I
am well-aware and closely follow the grant?s long-standing HUD-approved policy.

Issue 8: Lisa has been incompetent or inefficient in her performance.

The number of housing units abated has generally shown a downward trend that is
independent of overall program funding. The number units abated for 2017 through 12/8 is
329, down by more than an average of 100 units from three years ago. From 2008-2012, 600-
800+ units per year were done. Driving results is one of the key competencies of this position,
and is was not achieved.

Decline in the Number of Housing Units Abated (Issue 8 is INACCURATE). Administration,
Commissioner Baker, Sandy Rotar, Barbara Henry were all notified in early 2016 and made
aware that the program was operating at a 50% staffing level due to retirements, resignations
and promotions and numerous requests and follow-up was made to them by me to ?ll these
open grant funded positions and get the lead program up to minimum necessary staffing
ieveis; Not only were the positions ieft unfilled, but no one in administration demonstrated
urgency or responded with awareness that filling the vacancies was upmost priority.

Units cannot be assessed for hazards or monitored and cleared without an inspector- this is
the role/job duty of the Lead Risk Assessors. With 50% fewer Lead Risk Assessors, it is
logical that there would be 50% fewer unit completions.

In short, this accusation is ?passing the buck? and lacks the operational knowledge that as a
Program Manager my job was to notify my Manager and Human Resources, which I did
repeatedly. Unfortunately, my position DOES NOT have the authority to directly hire staff.
Numerous communications were made to HR to inquire on the location of a Lead Risk
Assessor hiring list with the unfortunate response from HR that my request was in process.
Numerous ?Notification of Vacancy? documents were sent to HR stressing the importance and
requesting that they be expedited, only to wait months for any type of reply.

I am extremely concerned that without a history in childhood lead poisoning, it is apparent that Hagy
has taken things out of context and is unaware of past practice and program implementation history.
Fueling this lack of knowledge is a reluctance, even refusal to talk to the Program Director (me) or the
Manager (Richard Gaeta) regarding the lead HUD grants and the lead program. The program has
gone from a National Leader in lead abatement to now having a tarnished reputation-
inaccurate, all in and due to Hagy?s 6- month tenure- putting future funding in jeOpardy. It is
extremely unfortunate that there was no transparency, no communication or support from Hagy if she
had questions or concerns

In summary, it is clear that MHD Administration was more focused on using me as a scapegoat than
safeguarding our Milwaukee children against lead hazards. Commissioner Bevan Baker, Sandy
Rotar, and Barbara Henry were notified and aware of the results of staffing vacancies and failed to
assume any responsibility, instead unethically directly sole blame and fault on my leadership of the
program.

Attach to the Suspension Document Dated 12/11/2017

The suspension document appears to be a narrative contrived by Hagy to support defamation of my
professional character to shift and protect MHD Administration of their role, responsibility and failure
to assure the resources needed by the Lead Abatement Program.

The City of Milwaukee Childhood Lead Poisoning Prevention Lead Abatement Program has been
awarded HUD Lead Hazard Reduction grants for 20 years and leads the nation in the number of
housing units abated. have successfully overseen the award-winning program for nearly a decade.
Having knowledgeable and experienced program leaders, Lead Risk Assessors, outreach staff,
nursing and in-house laboratory analysis capacity makes Milwaukee?s Lead Abatement program
special and unique. it is this comprehensive program that has successfully and continuously been
awarded HUD grant dollars and accolades and has served Milwaukee?s children well, given the 50%
staffing level the City of Milwaukee has seen fit to provide to the program.

As a 26-year Milwaukee Health Department employee, I believe the Disciplinary Suspension
document should be removed from my file and that the suspension is representative of the harassing
and unethical environment of the Health Department, the lack of transparency and management
support for a long standing successful program, and the focus on scapegoating, rather than working
to enhance programs for the public welfare. Putting me out on a long-term Administrative Leave,
turning that into a Suspension, bringing me back, and now-this we'ekiagain putting *me out on another 
Administrative Leave only harms Milwaukee?s children and puts our HUD grants at risk. I contribute
worth and value to the Department; I believe the entire narrative on the suspension document from
Hagy is inaccurate, slanderous, and an erroneous statement of my professional character and work
ethic.

Most important, I have spent my career safeguarding the children of the City of Milwaukee, just to be
the scapegoat while the City places the HUD funding at risk.

Respectfully Submitted,
Lisa M. Lien