Nearly one in five Baltimore sanitation workers did not have city health insurance, according to an inspector general report published Tuesday. One worker learned they were uninsured when they were hospitalized.

Some 136 workers within the city’s Department of Public Works’ Bureau of Solid Waste were eligible for health insurance but said they did not know and/or did not receive notice they were eligible for credit for waiving their insurance, according to Inspector General Isabel Mercedes Cumming.

Those employees make up about 18% of the bureau’s 741 workers. That number includes people who had waived their insurance to use outside providers.

Investigators spoke to 46 of the 136 who were affected, according to Cumming. Two learned they were within the time window of starting their city employment to sign up for health insurance. And only two people knew about their eligibility for a credit waiver, which can be either $650 or $2,500 depending on their eligibility, per an agreement between the city and AFSCME Local 44, a union representing DPW workers.

A city spokesperson said the 18% figure that the inspector general reported was “misleading,” saying those employees may have foregone their city health insurance for a variety of reasons, including opting for outside providers.

“The assertion that the city somehow failed one-fifth of its solid waste workforce in this instance is inaccurate and misleading,” a city statement said. “All city employees eligible for insurance are officially offered it and the city communicates that in a variety of ways. We have submitted our official response clarifying this with the OIG.”

Cumming said the investigation began when her office reviewed Workday, the city’s internal human resources system.

“I was surprised that nearly a fifth of all solid waste workers didn’t have insurance, considering how dangerous their jobs are,” she said in an interview. “That’s when I knew there was a major communication breakdown. We have second-chance workers, but we’re not giving them tools to succeed. The city has failed them.”

In a response memo, the city’s HR director Quinton Herbert and DPW director Khalil Zaied said only 4.6% of eligible employees across the city’s workforce of nearly 13,000 elected to not sign up for benefits. Some 523 city employees receive waiver credits; 80 of those employees are in AFSCME Local 44.

“That said, we acknowledge the anecdotal information related to the challenges faced by (solid waste) employees in DPW accessing and enrolling in the City’s employee benefits program. Our commitment to supporting all employees in their benefits enrollment is paramount and we take these concerns seriously,” Herbert and Zaied wrote.

The two directors said city agencies would communicate more with eligible workers. The city also will hold an informational session Oct. 21 at the Middle Branch Aquatic Center to help eligible workers during the open enrollment period sign up for benefits.

Public Works has been under scrutiny since the summer, after sanitation worker Ronald Silver II died on the job from hyperthermia, and the OIG released two reports about the agency’s failure to provide workers with adequate cooling provisions, such as ice and air conditioning, and kept toilet paper and Gatorade behind locked doors.

The city has since contracted with a law firm known for opposing heat-related regulations to review workplace conditions within the department. Deputy DPW director Richard Luna said last month he would leave his job Thursday.