Health district revamp up in the air

Spokane Regional Health District board members remain undecided about whether to restructure the agency in the wake of the firing of health officer Dr. Kim Thorburn.

In the four months since Thorburn’s contract was terminated, board members have questioned state health leaders, surveyed employees and reviewed an urgent recommendation by the region’s doctors to retain a single strong, professional public health official.

So far, though, they’re no closer to choosing whether to keep the current system, in which the health officer is also the agency’s chief administrator, or whether to divide the post into two jobs, said Brad Stark, a board member heading a committee charged with making a recommendation.

“There’s obviously pros and cons to both,” Stark said Friday.

Stark is hoping a public forum scheduled for Thursday evening will help shape a decision and allow the health board to start seeking candidates in April.

“I think we’ll be closer after this Thursday,” Stark said Friday. “I think the public forum will be really enlightening.”

At issue is leadership of Washington’s third-largest public health agency, with 250 employees, a $22 million annual budget and responsibility for a region that encompasses a half-million people.

Surveys this month of 10 top-level managers and 125 front-line staffers showed that employees are evenly divided over whether to revamp the health district.

About 42 percent of employees favored retaining the current structure, in which the health district administrator reports to the health officer and both are supervised by the health board.

Nearly 47 percent advocated splitting the position into two equally powerful posts. Less than 10 percent of staffers chose an arrangement in which the health officer reported to the administrator.

Several employees responding to the anonymous survey urged health board members to choose a structure that keeps public health as its primary focus.

“The medical officer needs to be the person in charge – not an administrator,” one employee wrote. “The M.D. needs to have the authority to deal with epidemics, making medical decisions and so forth without being second-guessed by a non-medical person who can overturn a medical decision.”

That was the same view expressed by the Spokane County Medical Association, whose members include about 80 percent of the region’s doctors.

In a letter to board of health members, the association urged board members not to split the structure of the agency.

“We don’t want to dilute the influence of the health officer,” said Dr. Brian Seppi, president of the group.

Medical society members are also concerned that board members won’t be able to attract a high-quality candidate to the post, both because of the diminished responsibility and the likelihood of lower pay. Even Thorburn’s $125,000 annual salary was low for similar posts in Washington and nationwide, Seppi said.

State health officials, however, have noted that several of Washington’s nearly three dozen health departments and health districts operate successfully under structures that include separate health officers and administrators.

“The decision is up to you,” said Joan Brewster, state director of public health systems planning and development.

Health board members decided to reconsider the structure of the agency after firing Thorburn in November, citing longstanding communication problems.

At least a few staffers criticized that decision in their survey comments.

“It is a shame we lost Dr. Kim,” wrote one. “She sure seems to be what we are now seeking.”