The final roster for the new Spokane Regional Health District Board of Health is nearly set, and a medical doctor isn’t slated to be on it.
On Tuesday, the four existing Board of Health members nominated a naturopathic doctor, a former member of President Donald Trump’s administration and a homeless outreach coordinator for three of the board’s four vacancies. The Spokane County commissioners are scheduled to formally appoint the three on Feb. 8 during their 2 p.m. meeting.
The Board of Health is choosing new members to comply with a law the Washington Legislature passed in 2021.
That law seeks to depoliticize health boards by diversifying their makeup and mandating representation from medical experts. During the COVID-19 pandemic, health boards have made critical public health decisions, even though they’re mostly run by politicians without medical expertise. Under the new law, health boards must have an equal number of elected and unelected members.
Alycia Policani was nominated as the health board’s medical provider and public health representative. She’s a licensed naturopathic doctor and president at Evergreen Naturopathic. Policani holds a doctorate in naturopathic medicine from the National University of Natural Medicine in Portland. Her appointment could be controversial given that a handful of candidates with medical doctorates or graduate degrees in public health applied to serve on the board.
Christopher Patterson was nominated as the board’s consumer of public health representative. Patterson served as a regional administrator for the U.S. Department of Housing and Urban Development under former President Donald Trump. He founded BreakThrough Inc., which operates residential programs for kids and young adults with behavioral or developmental challenges in the state. He currently works as the community solutions adviser at Washington Trust Bank.
Charlie Duranona was nominated as the board’s community stakeholder representative. Duranona, a disabled Navy veteran, is an outreach specialist for homeless veterans at the Department of Veterans Affairs in Spokane and has worked previously as a veterans liaison and Wounded Warrior Program fellow in Rep. Cathy McMorris Rodgers’ office for two years.
How did we get here?
State Rep. Marcus Riccelli, a Spokane Democrat, wrote the legislation that forced the commissioners to restructure the health board.
And now he is criticizing how the commissioners have complied with the law. He said he’s specifically frustrated with their decision to shrink the board, which he described as a move to consolidate power.
“I think that was purposeful and in a way to kind of try to exert control, against the spirit of being more inclusive,” he said.
The commissioners have said they opted for a smaller board because the county funds the health district and because the commissioners represent all county residents.
The health board used to have 12 members. Spokane had three seats and Spokane Valley had two. Those five dedicated seats are gone.
The new eight-member board includes the three commissioners and one individual to represent all of the county’s cities. The commissioners tapped Millwood Mayor Kevin Freeman for that role.
In addition to the commissioners and Freeman, the new board will include four unelected representatives from categories outlined in Riccelli’s law. The commissioners are tasked with picking three of those four and decided to include Freeman in the selection process.
The American Indian Health Commission appoints one representative.
Every board needs at least one of the following: a medical provider and public health representative, a community stakeholder and an individual with personal experience using public health services – ideally someone from a historically marginalized or underrepresented community.
What the candidates said
Each candidate had 20 to 25 minutes to answer the same set of 10 questions. None of the questions were about the COVID-19 pandemic, masks or vaccines.
When asked about the greatest issues facing the health district – besides the pandemic – Policani listed diabetes, cancer, obesity and heart disease.
She said she wants to address health inequities within Spokane County and work to provide equal health care access to all. Policani, whose father was an immigrant, was raised by a single mother and told board members she knew what it was like to need services like WIC. She would apply what she does in her practice to her work on the board, she said.
“I am trained to focus on cause and prevention and apply the treatment to the individual, and I believe that’s a beneficial approach to apply to the Spokane community as a whole,” Policani said.
She did not respond to an interview request left at her practice, Evergreen Naturopathic.
Duranona is a first-generation Cuban American from Miami, who served in the Navy and became disabled during his service. He said the biggest issues facing the health district are mental health and suicide prevention, the opioid crisis and poverty and homelessness.
Duranona hopes that his background in social and public health, in the Navy and as a Hispanic man in Spokane will be an asset on the board.
As for the present pandemic, Duranona said in an interview that listening to the subject-matter experts and following the guidelines is important. He said he is fully vaccinated, and when it comes to the health district promoting vaccines, he said the science is telling.
“The sciences states that vaccines are working,” he said. He stopped short of supporting mandates but added that education is an important role the health district can play in the future.
Patterson noted that he grew up in the foster care system in Spokane. He said during his interview that homelessness, mental health and addiction are the top three public health issues facing the district.
“We won’t start to move the dial until we address those issues,” he said.
Patterson, who worked at HUD during the Trump administration and also in the health and social services field, said the two agencies’ missions go together. He said the health district should be supporting families during the pandemic, including making sure students stay in school.
When asked whether the health district should be promoting COVID vaccinations to families and children, he said families will have to make that determination on their own. Patterson would not disclose his COVID-19 vaccination status.
Board members did not deliberate their decisions on Duranona and Pattersons’ nominations, and both of their nominations passed unanimously.
Disagreement over alternative medicine
The commissioners and Freeman spent roughly six combined hours Monday and Tuesday interviewing candidates for the three vacancies.
Monday’s interviews were all for the public health and medical provider category. When the four existing health board members started discussing their favorites, Freeman made clear he had different preferences.
Freeman wanted either a medical doctor or a public health expert on the board. He specifically wanted either Dr. Monica Blykowski-May or Denise Smart to have a seat at the table.
Blykowski-May has a medical doctorate from the University of Washington and spent 26 years as a family practice physician, mostly at MultiCare’s Rockwood Clinic. She also serves on the board of the Washington State Medical Association.
Smart is a professor and associate dean of nursing at Washington State University. She has a doctorate degree in public health from Loma Linda University and more than four decades of experience as a nurse.
Freeman ultimately nominated Policani along with the three commissioners – making her nomination unanimous – but only did so after acknowledging none of his top candidates had a chance of being selected.
Spokane County Commissioner Mary Kuney said Blykowski-May was her first choice, but commissioners Josh Kerns and Al French mostly leaned toward naturopathic doctors through the selection and interview process.
French didn’t shy away from his preference of candidates with backgrounds in naturopathic medicine. He asked Kuney, Kerns and Freeman whether the interview panel could ask health board candidates to state their opinions “with regard to naturopaths and/or alternative medical approaches as we deal with community health.” They agreed, and the question was posed to candidates in all three categories.
French explained Monday that someone close to him has health issues that haven’t been fully resolved with traditional medicine.
“Now they are in a partnership between traditional medicine and naturopaths to find a cure and a path forward,” French said.
French said someone with a naturopathic background would bring a valuable perspective to the new board.
“Traditional medicine has not got all the answers, and I wanted to get a broader perspective,” French said.
“We’ve got a lot of people at the health district that have got excellent medical credentials,” French added, “What we don’t have are naturopaths.”
Editor’s note: This article was changed on Feb. 7, 2022 to correct Dr. Monica Blykowski-May’s title on the Washington State Medical Association Board of Trustees.
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