The Washington PostDemocracy Dies in Darkness

Washington’s worst case of lead poisoning in decades happened in a home sanctioned by housing officials

Crystal Luster plays with her 2-year-old daughter, Heavenz, who is being treated for lead poisoning at Children's National Medical Center in Washington. (Linda Davidson/The Washington Post)

Another morning in the motel room, and there were more appointments to attend to. Today it wouldn't be the blood tests, which weeks before had established Heavenz Luster's lead levels as higher than anything seen in Washington in decades, or another injection to remove that lead — she had already had 18 — or another cognitive evaluation or visit to a nearby CVS pharmacy for more medication. Today it would be the behavioral therapists. Her parents, who silently watched the 2-year-old babble and stare at nothing, would finally know the severity of her brain damage.

“Are you taking her?” Crystal asked her husband, Robin, as she pulled on clothes for the appointment. “Did you want to take her out in the cold?”

“I thought it was like she needed to go,” he said.

“She actually doesn’t have to go to this meeting,” she said. “I think it’s better not to take her.”

These are the choices that have dominated the Lusters' livesevery day since late November, when they learned that Heavenzhad suffered severe lead poisoning after the family was placed in a house under a new city program for the homeless known as Targeted Affordable Housing. The D.C. housing office had inspected and approved the house before the Lusters moved in.

The tragedy exposes key weaknesses in federal guidelines followed by the District and other cities to ensure safe housing for homeless families, especially those with young children, according to interviews with five housing advocates and experts. Instead of specifically testing for lead or asthma-inducing mold, D.C. inspectors following the guidelines visually check for peeling paint and deteriorating conditions.

To help a property pass an inspection, some landlords simply apply a fresh coat of paint and “it looks good for one day,” said Kathy Zeisel of the Children’s Law Center. “If there’s moisture, it starts peeling right away.”

The city and the landlord, Ngozi Azoroh, blame each other for what happened to Heavenz.

D.C. officials said that it was Azoroh’s responsibility to keep the house free of lead hazards, not the city’s.

“Every D.C. resident deserves a safe and healthy place to live, period,” said Joaquin McPeek, an official with the Office of the Deputy Mayor, who spoke on behalf of the D.C. Housing Authority. He added that overall, cases of lead poisoning have decreased across the city. “We must remain vigilant in holding bad actors accountable who threaten this goal.”

Officials with multiple agencies did not respond to questions about whether inspections were thorough enough or whether the standards required reform.

Azoroh, through an attorney, said he didn’t know that lead was in the home he bought in 2008, and when it passed the inspection, he assumed it was safe.

“The inspectors didn’t say that anything was wrong, and he believed he had complied with their regulations,” said his attorney, Leslie Perry. “. . . The renters, they had a walk-through of the property, and if they had any issues, they could have told the inspectors who could have told Section 8 or D.C. housing.”

The case comes at a particularly critical time for the District, which is struggling to find enough housing for the surging number of homeless families in a city where many of the available homes were built decades ago.

Other jurisdictions with aging housing, including Rochester, N.Y., Rhode Island, and Maryland, where a scourge of lead paint poisoning in Baltimore left thousands of residents permanently damaged, go beyond guidelines established by the U.S. Department of Housing and Urban Development and require lead testing before families move into older rentals.

“There are certainly deficiencies [in housing inspections] that need improvement,” said Ruth Ann Norton, president of ­Baltimore’s Green & Healthy Homes Initiative and one of the nation’s foremost experts on lead-poisoning prevention. “We started in Maryland with visual inspections and came to the conclusion that . . . you need to add lead dust-clearance testing.”

Heavenz’s development regressed within three months of the Lusters moving into a home on Emerson Street NW. She stopped interacting with her family, withdrawing into a world her parents couldn’t penetrate, and in late November, doctors tested her for lead.

The result: 120 micrograms of lead per deciliter of blood, which, according to the District’s Department of Energy and Environment, is the highest level in the city in at least 20 years. Inspectors searching for lead soon confirmed lead dust and paint chips were widespread throughout the home — on the doors and the windowsills, in the bathtub and kitchen.

“You almost never hear of those levels anymore in this country, even in Flint,” said Daniel Levy, an assistant professor of pediatrics at Johns Hopkins University who has treated scores of children with lead poisoning. No amount of lead in the blood is safe, but doctors believe anything higher than 5 micrograms can cripple a child’s cognitive development.

“Once you’re lead-poisoned, you’re lead-poisoned for life,” Levy added. “. . . It’s not a death sentence, necessarily, but it doesn’t bode well for this kid’s future.”

Heavenz’s parents, who spend their days wondering what that future will look like, now watched as Heavenz spilled her breakfast across the floor of a city-funded motel room where they were living.

Crystal sighed, and Robin shook his head, saying, “She’s throwing everything on the floor.”

He told his son to watch Heavenz, put on his coat and motioned to his wife.

“We need to get out of here while she’s quiet, Crystal,” he said. “I’m going downstairs before she notices I’m gone.” Crystal took another look at her daughter, picked up her purse and followed her husband out the door for an appointment to learn what to do about Heavenz.

Maintaining hope

She always looked for the positive in every situation, and now as Crystal left with her husband, she tried to convince herself that it wouldn’t be so bad. The doctors had told her that Heavenz would be in “a fog” as the treatment sponged lead from her system, and it was too early to know the lead’s effect. It profoundly damages some, she was told, and leaves others with near-perfect acuity. So even after she read the lead inspectors’ report — and learned that some of the highest levels had been in Heavenz’s room — she maintained hope. Maybe Heavenz would be one of the lucky ones.

If so, it would be the first break the family has gotten in as long as she can remember. She met Robin four years ago, when she was a beautician, and together they moved from Kansas City to Washington after Robin found what appeared to be a high-paying job on Craigslist that turned out to be a scam. It would be months before he found a job at a Goodwill in Arlington, Va., but by then they were already living in the shelter and had lost the family truck, a Chevy Tahoe, which had broken down along the side of the road.

They now rode a city bus after using $3.50 of the $487 remaining in their savings to purchase two tickets. It stopped in front of the Metro station on Georgia Avenue NW, and Robin told Crystal that “this is our stop here,” and Crystal found herself thinking how difficult it has become attending all of these appointments while looking for a place to live.

“Forced into another situation you don’t want to be in,” she said, walking into the station.

More and more that seemed to Crystal how her life has been going. When Robin couldn’t find a job in early 2014, they moved into a homeless shelter, something they had never done. Then the city found them several houses through Rapid Rehousing, a D.C. Department of Human Services program that offers temporary housing and currently shelters 1,456 homeless families, a 23 percent increase over last January. But those houses, which the Lusters felt they had to take, were in some of the city’s roughest neighborhoods. Then Crystal was diagnosed with cancer, and they were chosen for a new program, this one called Targeted Affordable Housing, which shelters 17 families. It provides long-term housing vouchers through the D.C. Housing Authority to people whose needs exceed the services provided in Rapid Rehousing.

And so, from house to house, one agency to another, one program to the next, the Lusters migrated over three years, one more homeless family run through a housing bureaucracy that advocates say has grown so unwieldy and balkanized that families can be lost in the shuffle.

“The net result of so many different layers is that . . . it multiplies the different places where there can be a breakdown or a mistake can happen,” said Max Tipping, a lawyer with Washington Legal Clinic for the Homeless. “If there are four or five layers of bureaucracy, there are four or five places where something can go wrong.”

In July, the District’s Department of Human Services asked the Housing Authority to check out a house on Emerson Street NW, which had been built in 1923 and, according to city records, had a history of peeling paint. It was cited for it in May 2014 and in February last year — when it was also shown to have moisture — and again during that July inspection, city officials say, when the walls weren’t “freshly painted.” Two days later, an inspector returned, and Azoroh had made the repairs, and the Lusters moved in with Heavenz.

And now six months after that, her parents approached an office building in Columbia Heights, a few minutes late for their appointment.

Coming to terms

The therapist slid the evaluation report to Robin and Crystal, and they paged through a list of their daughter’s behaviors to which they were quickly becoming accustomed: “Does not respond to her name . . . does not point and has no words . . . will scream really loud for no reason . . . rocks from side to side . . . very anxious . . . cognitive development is delayed . . . gross motor development is delayed . . . falls below the range for typically developing children.”

Robin slowly shook his head, and the therapist asked, “Is she helping take care of herself?”

“No,” Robin said quietly. “She isn’t doing any of that.”

“Sometimes kids, especially kids who have lead poisoning, it takes them longer to reach their goal.”

“But they might still do it?” he asked. “Eventually?”

He had been staying up late in the weeks before, when Heavenz’s screaming would make sleep impossible, looking at videos of lead-poisoned kids on YouTube, and what he saw terrified him. Kids who can’t be controlled. Kids attacking their parents. Kids who grow into adults who can’t read.

“As she gets older, can it go up more?” he asked of her cognitive function. “Is this where she is going to be?”

“I’m not sure,” the therapist said. “With therapy, most children do greatly improve.”

“Even with lead poisoning?” he asked. “I read you can’t really change it, reverse it.”

“You can’t reverse it, but you can help her learn some of these things,” the therapist said.

“She may just not learn at the pace we’re used to seeing,” Crystal said hopefully.

“I’m just trying to imagine her at 16, biting me,” Robin added, ignoring what his wife said. “I’m serious. I’ve watched the videos.”

He looked down at the report again saying where a toddler should be.

“She’s not doing a lot of these things,” he said.

“Every kid is different,” the therapist said.

There was a long silence. The therapist gave the couple a list of things they could do to help Heavenz develop, set a schedule of weekly therapy appointments, and they thanked her for the help. Back out in the cold, they walked to the Metro station, and Crystal said she felt optimistic about working with Heavenz. She could get better, Crystal said, and Robin didn’t respond.

But first, they had another few dollars to spend, another train to catch and another line to wait through at the Virginia Williams Family Resource Center for the homeless on Rhode Island Avenue NE, where they would tell another city case worker they were living in a motel and needed help finding a house, one, they would emphasize this time, that was free of lead.