Grace Under Fire

February 15, 2006 - Injury Free Coalition for Kids of Baltimore

One morning in December 2003, David Nichols arrived in the pediatric intensive care unit to find the team assembled at the bedside of a an 11-year-old boy. He had been burned so severely that although he was African American, he appeared to be white. His body was bloated to two or three times its normal size, his face so swollen that the PICU team, unable to get a breathing tube into his mouth, was performing an emergency tracheotomy. The next day the boy died, as did his younger brother. Both had been trapped in a burning row house. Their power had been shut off, and the family had resorted to lighting the home with candles. The candles ignited the window curtains; the entire house went up in flames.

These boys were not the only children to die at Hopkins Hospital from burns sustained in homes where power was disconnected and open flames were in use. From April 2003 through October 2004, the Johns Hopkins Children’s Center, which had recently become the regional referral site for pediatric burn victims, had 34 admissions for flame injuries. Five were associated with power shutoffs. Three of those ended in death.

It was the case of the two brothers, though, that prompted Nichols to act. He had discovered that the boys’ mother, unable to pay the utility bill, was in the process of applying for energy assistance when the power was disconnected. A professor of anesthesiology/critical care medicine, as well as vice dean for education and an attending physician in the PICU for 25 years, Nichols would later tell state legislators: “Although I’ve seen children die in the course of my career and witnessed the grief felt by their parents, the circumstances surrounding these cases wouldn’t permit me to simply move on to the next pressing matter. Such unnecessary suffering has to stop.”

To try to stop it, he organized a grass-roots task force. It represented an unusual confluence of people from throughout Johns Hopkins. Among them were physicians Lewis Romer and Rick Redett; nurse practitioner Susan Ziegfeld, pediatric trauma coordinator at the Children’s Center; Hopkins Medicine vice president and general counsel Joanne Pollak; social worker Ben Selassie; and public affairs and government relations staff.

Three children died in this house in the 2400 block of East Madison Street, just six blocks from Hopkins Hospital. Their mission: to prevent burn injuries or deaths in young children following power shutoffs for nonpayment. It was deemed so important that Pollak authorized hiring outside counsel to help the task force through the process.

But first, Heather Barthel, assistant director for state government affairs, would spend hours explaining policy and regulatory issues to fellow committee members. Just as they wanted utility companies to know what happened to burn victims treated here, the task force had to understand utility regulations and how to advocate for change.

The Hopkins team sparred with utility companies, government officials, the Public Service Commission and the Office of Home Energy Programs. For 18 months, they dealt with bureaucracy and for-profit interests to plead their case. They beseeched utility companies to offer longer grace periods and payment plans for unpaid energy bills. “Our goal was to make them think long and hard before turning off a family’s power,” says Barthel.

Meanwhile, Selassie, administrator for Hopkins’ Injury-Free Coalition for Kids, and a corps of volunteers launched a sweeping community outreach program, sponsoring fire-safety fairs in East Baltimore, distributing brochures on how to get help with utility bills, and running classes for parents to help them keep children out of harm’s way.

In November, the task force’s efforts paid off. Gov. Robert Ehrlich and the Public Service Commission announced a settlement to provide more help for families with young children facing power shutoffs. Building on the Energy Assistance Program Act, signed into law last April after the task force’s initial efforts, the amended agreement now offers expanded hours for energy-assistance inquiries, an extended payment plan and a 55-day grace period.

This winter, with soaring energy costs and house fires breaking out in poor neighborhoods, the task force’s efforts seem especially critical. But their work is not over yet. “While we now have a formal plan,” says Nichols, “all our partners must remain vigilant to ensure it is enacted. We owe it to the children and families of Maryland.

—Judy Minkove


Mahseeyahu Ben Selassie, MSW, MPH, ACSW, LCSW
Phone: 443-287-2026