Board to decide Thursday if non-doctor may lead Spokane Regional Health District

To better mirror other counties in Washington state, the Spokane Regional Health District is deciding whether to change the governance structure and put an administrator in charge rather than a doctor.

On Thursday, the Board of Health will vote on an amendment to the bylaws that would make that change.

A physician has been in charge of the district since it was established as an agency in 1970. But when previous health officer Dr. Joel McCullough stepped down in December, the board began looking outside the county to see how other districts handled health district administration.

“We talked to a lot of folks,” said board member and Spokane County Commissioner Shelly O’Quinn. “It was a lot of homework, but because of that, that’s why we feel comfortable.”

In the proposed structure, there would still be a health officer, but that person would no longer report directly to the board, as was the case in the past. Instead, a board-appointed administrator would fill that role. The board would be in charge of hiring and firing the administrator as well as the health officer.

Board members said an increasing number of counties in Washington are moving to this structure, and many already follow it because it allows someone versed in business and administration to handle those types of issues. Meanwhile, the health officer can focus on health issues.

“Almost all counties do it the way we’re moving to,” said board member Breann Beggs. “It’s the trend.”

Previously, language in the bylaws was unclear about the range of power the administrator would have. During last month’s meeting, Beggs, who also sits on the Spokane City Council, was worried the administrator would be able to fire a health officer without any oversight.

Beggs also had concerns about ethical issues that could arise. In the past, the health officer had final decision-making power, while the administrator reported to that person. Under the new proposal, the doctor would report to the administrator, Beggs said.

“Essentially, my concern is not with any particular person,” he said. “But when there comes to be a tough decision, and you’re balancing medical issues with other issues, I want the doctor to have that medical experience nailed in their brain.”

Kim Thorburn, who served as the district’s health officer from 1997 to 2006, shares Beggs’ concern. She says the trend of rearranging leadership to an administrator makes sense from a logistical standpoint, but that health districts are losing the medical background and expertise that only a doctor can provide.

“I think it’s really too bad,” she said. “I just think having that in leadership, at least in some portions of our state, is really, really important. Losing that tradition will lose something for local public health in Spokane and in the state of Washington.”

The board was ready to vote on the amendment to the bylaws in last month’s meeting, but an amendment added at the last minute pushed the decision back to Thursday. The addition to the bylaws, championed by Beggs, made it the board’s responsibility to handle personnel issues regarding the health officer, not the administrator’s.

“I wanted to make sure the public health officer was insulated from any kind of politics in making the medical decision the department needs to make,” Beggs said. “I made sure the administrator couldn’t just fire the doctor.”