Health Commissioner Kowalik uses Infant Mortality grant as pawn against African American Collaboration

How does being an American Descendant of Slavery affect your pregnancy, birth outcome and first year of your child's life? That is the question asked by the Milwaukee African American Perinatal Health Collaborative (M.A.A.P.H.C.). Dr. Patricia McManus, President & CEO of the Black Health Coalition of Wisconsin and physician, Tito Izard, M.D., President and CEO for Milwaukee Health Services, Inc. have studied and evaluated this critical issue for decades.

According to Dr. McManus, "over the past 3 years, Milwaukee has seen a worsening of African American infant mortality despite hospitals and universities working downstream to save mothers and babies. We wanted to work upstream, in the community with the families, to prevent poor birth outcomes before they happen."

So, when Dr. McManus became aware that a federal grant notice of funding opportunity was announced to address this topic, she thought that this would be a great opportunity to collaborate. "Not just any collaboration but one that would incorporate and be led by the population most impacted, those organizations primarily focused on caring for African American families." Joy Tapper, Executive Director for the Milwaukee Health Care Partnership, inquired and reiterated public support from the healthcare consortium. After discussions, Children's Hospital of Wisconsin, who was originally considering applying for the grant, agreed to withdraw their consideration and lend their support for this "unified one Milwaukee application" approach. Everyone publicly agreed when the notice was released, so the collaborative work began.

"MHSI was asked to be the fiscal agent for the collaborative because of our expertise with managing federal grants, our 'One Stop shop' comprehensive primary care services and our close connectivity to the community", said Dr. Izard. Other core members of the collaborative included: the African-American Breastfeeding Network, Zilber School of Public Health, the city of Milwaukee Health Department and subsequently, My Father's House, Inc. "This was going to be great, this was a dream come true," said Dr Izard. Many of us have worked together in different committees around the city but this would be the first time a true community collaborative was created emphasizing African American self-determination, leadership development and grassroots capacity building.

During the city of Milwaukee's transition between Dr. McManus as interim health commissioner and the appointment of Dr. Jeanette Kowalik as the new incoming health commissioner, the two agreed that MHSI, as a Federally Qualified Health Center for funding purposes, would be the perfect agency to build the collaborative around. Unfortunately, somewhere along the way, either the mayor's office or the new health commissioner decided to no longer support the Milwaukee Health Care Partnership's recommended unified application idea.

The result, Health Commissioner Kowalik's actions violated the trust of the Collaborative in which she originally unanimously supported. Commissioner Kowalik was more interested in garnering grant money than respecting the collaborative process. "Money won't solve African American infant mortality, people will. Some of the people with whom, the Commissioner has little regard," said Dr. Izard. Most importantly though, Health Commissioner Kowalik ultimately was wrong in her analysis and assessment of the M.A.A.P.H.C. She didn't believe the Collaborative would be funded. "Those are actions of someone who behaves with implicit bias or contempt," Izard said.  

 If the mayor's commissioner acted with contempt and conspired against this African American community collaborative, when did Mayor Barrett decide to support his employee?  That is an answer the M.A.A.P.H.C. demands to know. According to a Children's Hospital administrator, after they had already agreed to support the Collaborative, they received requests from the Heath Commissioner, Mayor Barrett's office and the State all requesting CHW to reconsider applying because of unsubstantiated accusations leveraged against the M.A.A.P.H.C. "No one from Children's administration bothered to call me directly to discuss any alleged concerns," said Dr. Izard.

 They all accepted the commissioner's accusations as fact without questioning. That's what concerned me the most. How do you defend yourself when the judgement has already been rendered? Subsequently, Children's Hospital of Wisconsin has apologized for their presumption, but the damage has already been done. 

In the end, the Milwaukee African American Perinatal Health Collaborative's federal score was 96 out of 100. Lower scores nationally have been awarded.  According to our notification from the granting agency, "...your application was not approved because your service area either partially or fully overlapped with a higher scoring applicant serving the same area." Commissioner Kowalik had previously informed Dr. Izard that the Children's Hospital of Wisconsin application that she highly encouraged to reconsider was a regional application (Milwaukee, Racine & Kenosha) and "would not compete with the Collaboratives' application." This statement by the Health Commissioner apparently was false.

We just want to know is the health commissioner operating on behalf of the mayor or is she defying his wishes? Clearly there was something that the health commissioner said that made CHW decide that they would rather want to compete than to collaborate. "They're not talking", Izard said. Where is the transparency, where is the justice? These institutions constantly say that they support system change but in end they stay the same. If we measure progress along a continuum, reinforcing the status quo maintains control within the existing majority lead organizations. Adjustments of a few degrees here or there won't make any difference in outcomes. American Descendants of Slavery (A.D.O.S) live within a calcified crisis on the periphery of that continuum. True change will require personal ownership, accountability, commitment and sacrifice; all of which were integrated into the community collaborative. 

This grant specifically is about addressing African American infant mortality. How is it that not a single representative of the FQHC's, black physicians, Black Nurses Association, Black Health Coalition of Wisconsin, Black fatherhood collaboratives, or Cream City Medical Society was at the table when Children's decided to compete against this African American collaborative? We asked Children's to come to the table with us, but their administration declined. "These are our dying babies, mourning mothers and fathers who need to be supported that we're talking about," said Albert Holmes President & CEO for My Father's House, Inc.-a local agency dedicated to building strong and responsible fathers that better the lives of children and families. "This is not how you collaborate. We deserve the right to be heard and we deserve the right to know what the mayor's office said to change Children's position from supporter to competitor."

We want a community meeting with Mayor Barrett, Commissioner Kowalik, Common Council President Hamilton and Peggy Troy, President & CEO of Children's Hospital of Wisconsin.