A city health building that was cited last year by the Baltimore Office of the Inspector General for unsanitary and substandard working conditions still has problems that workers say could be inhibiting patient care.
Photos obtained by The Baltimore Banner taken earlier this month of the Druid Sexual Health Clinic facility in West Baltimore’s Druid Heights neighborhood show holes in the ceiling, trash accumulation outside the building, and used needles scattered around the property. Workers at the site, employed by the city health department and Johns Hopkins, said they fear the building’s poor condition may discourage patients from coming to get tested for sexually transmitted infections.
As part of our Better Baltimore series, which asks readers for feedback about what’s going well in the region and what stands to be improved, we spoke to clinic staff who lamented the state of their workplace. Union representatives said the site serves as a symptom of a much larger disease: the deterioration of aging city buildings.
“We’re finding this to be an issue throughout city facilities,” said Antoinette M. Ryan-Johnson, president of the City Union of Baltimore. “It is more deeply rooted than just this one building — the infrastructure is very old in Baltimore City, which causes problems for our members.”
Members of the American Federation of State, County and Municipal Employees Local 44 and the City Union of Baltimore work at the clinic. Ryan-Johnson, who represents about 2,300 CUB members, said the complaints about city workplaces range from mold and asbestos to water leaks and mice and other pests. Temperature control issues, she said, have caused members to be dismissed from offices in the hot summer months.
“We need facilities to be up to par and not dangerous for members,” Ryan-Johnson said. “A large portion of [members] can’t work from home.”
Such is the case for the sexual health clinic employees, where the staff not only give STI tests but also provide diagnosis and treatment services, including for people living with HIV.
Isabel Mercedes Cumming, Baltimore’s inspector general, detailed the clinic’s decrepit state in an investigative report synopsis published last September. In it, she reported that the clinic’s condition not only proved insufficient for workers, but also resulted in the waste and tainting of medical supplies due to a faulty air conditioning system.
Property records show that the 27,000-square-foot facility was built in 1960 and is currently valued at more than $2.3 million.
During a site visit in December 2020, Cumming reported finding rodents, insects, malfunctioning doors, temperature control issues and other maintenance concerns. Employees told her that the inability to regulate the temperature caused interruptions to the rapid testing of patients for sexually transmitted infections. In addition to causing waste, this may have violated Maryland state code that mandates “proper public health testing,” Cumming wrote.
Some of the rodents and insects found in the building during the site tour were dead, Cumming added, causing a “foul odor.”
The report also detailed broken ceiling tiles, a basement water leak, and an unsecured and damaged access door.
Employees said the city addressed some of the problems outlined in the report, but others have since cropped up. One employee said a new air conditioning unit was installed but doesn’t work well and leaks all over the floor.
“It’s really a disgrace … because we mostly see poor Black people, and there’s no thought being put into how the building looks,” one employee told The Baltimore Banner, asking to remain anonymous out of fear of retribution from their employer. “If you didn’t know it was a health department building, you would call the health department.”
Publicly available planning documents show the budget dedicated to upgrading and maintaining city buildings is extremely limited. City planning officials said the city owns much more real estate than it can maintain.
The Department of General Services, which oversees the Druid Sexual Health Clinic and several other properties, including the Baltimore Convention Center and City Hall, estimates needing $70 million to keep its existing buildings maintained. The last budget allocated just 14% of that total for facilities management, according to the head of the planning department.
“The City could get closer to a goal of adequate investment either by increasing the amount of funding for maintaining public buildings or reducing the number of buildings in its portfolio,” Director Chris Ryer wrote in a March 2021 staff report covering fiscal years 2022 to 2027.
Without “dramatic increases” to the budget — which also covers such items as the response to the coronavirus pandemic, education and policing — the city should “strategically dispose” of its real estate, Ryer wrote. He pointed to the increasing viability of remote work as a potential solution to the maintenance backlog.
Representatives from the Department of General Services did not respond to requests for comment.
Workers at the sexual health clinic said modest improvements have been made at the site. The Department of Public Works has since agreed to pick up trash at the site twice a week, Cumming wrote in the report, which could help prevent rodent infestations. She also said the city had installed a gate around the parking lot to discourage illegal trash dumping.
She noted that the health and safety concerns also potentially violated federal Occupational Health and Safety Administration regulations and the memorandums of understanding the city has with its labor unions.
Regular and accessible STI testing is especially crucial in Baltimore, which has the highest rates of chlamydia, gonorrhea and primary and secondary syphilis in the state, according to 2019 figures from the Maryland Department of Health. City residents also account for nearly a third of the state’s congenital syphilis cases, which doubled in the state from 2016 to 2019.
Workers at the clinic said the site serves as a community anchor for surrounding neighborhoods and an accessible place for essential health services. A former employee, who asked not to be identified out of fear of retribution from his current employer, said he thought the facility’s condition didn’t match the level of care clinicians were providing patients.
The Baltimore City Health Department did not make health commissioner Dr. Letitia Dzirasa available to comment on the status of the building. In a written response to the OIG report last year, Dzirasa said that the department was aware of the concerns raised by staff and had constant contact with the city’s Department of General Services to address the problems.
“The building is old, deteriorating and not up to code,” Dzirasa said in her response. She said the property needed a full heating, ventilation and air conditioning replacement, and the agency had allocated $150,000 in the fiscal year 2022 capital improvement program budget for a partial system upgrade. The building also had an open work order to address a leaky roof, Dzirasa wrote, which was put on hold until after the HVAC project was completed.
She said the test kits that had expired due to the building’s heat problems could have “fiscal implications” for the agency, but were being used for staff training purposes to ensure they didn’t go to waste. She also acknowledged the difficulties with pest control services and said a janitorial subcontractor had refused to dispose of the dead rodents, claiming it was outside of their scope of responsibility.
Current building employees said the gate added to prevent trespassing and trash dumping is not always closed. They also said a fruit fly infestation has consumed attention in recent weeks.
“There are ebbs and flow in consistent terribleness,” one employee said. “I thought it was telling that in a city with an astronomic STD rate, this is not really being addressed at all.”
In Dzirasa’s response to the inspector general’s report, she said the city agency was drafting a proposal to receive federal COVID-19 relief funds, with options for full renovation or the purchase of a new building. She also said a request would be made for more capital improvement program funds for the city.
City officials said that request was denied.
Of the $80 million in federal COVID-19 relief aid the health agency received, none of it is earmarked for the clinic, Baltimore City Health Department spokesman Arinze Ifekauche said. The department is working through a “needs assessment” to “ultimately decide whether it is best to renovate or relocate,” he said. He declined to specify where the funds for renovation or relocation would come from.
Ryan-Johnson said several members have undergone OSHA training to better understand what they should expect from their workplaces. She said an inspection at the clinic planned for this summer will help determine whether to file a grievance.
“Working conditions of our members — city employees — have to be addressed,” she said. “We’re trying to teach our workers how to be safe, but the city also needs to provide safe and healthy work environments for them.”