Guest blog: The Question of the Norwood Health Dept.
Norwood City Council, Ward 2
October 12, 2008
The chronology of events, from my perspective, relating to the current question regarding the Norwood Health Department:
In May of this year, Health Commissioner Donna Laake submitted her resignation to the Mayor of Norwood and the Norwood Board of Health. In response, the Norwood Board of Health immediately began conducting a search for a replacement.
On July 17, Norwood Safety/Service Director Joseph Geers sent a letter to Hamilton County Public Health (HCPH) asking for an estimate of what HCPH would charge to provide certain services currently being provided by our own Norwood Health Department. At the time, neither Norwood City Council nor the Norwood Board of Health was either consulted or informed of this request for an estimate.
On July 30, the HCPH director Timothy Ingram sent a letter in response with an initial estimate.
On August 13, the Safety/Service Director sent a letter to Norwood City Council to advise Council that “I have been in discussion with the Hamilton County Health District regarding their services.” This is the first time Council has been made aware of the Administration’s interest in contracting with HCPH.
On August 18th an article in the Cincinnati Enquirer stated that “the Norwood Health Commission has suspended its search for a replacement for Laake.... There's been no decision about whether an interim health commissioner will be appointed.” Upon reading this I sent an email to Gary Arthur, President pro-tem of the Norwood Board of Health asking for confirmation of the report that the search for a new Health Commissioner had indeed been suspended. To that point, Council had not been informed of such a move. That same day Mr. Arthur responded via email:
“The search for the new Health Commissioner HAS NOT been suspended, unless it was done without my knowledge. My suggestion to the Health Commission when I left for vacation was to move forward as planned. I asked Mayor Williams to schedule the next round of interviews at his earliest convenience so we could have a candidate to present to council by the end of August. I was contacted by the Enquirer and played phone tag and never had the opportunity to give them any information regarding either the search or outsourcing any of the services we provide for our citizens. The Health Commission is NOT considering any option other than to continue the Health Department with a new Commissioner. We believe it would not be in the best interest of Norwood to contract any services with Hamilton County, Cincinnati or any other Health Department. My understanding is Norwood City Council is reviewing these options.
I would suggest that we move forward with the selection process. If Dr. Perrino is in agreement, I believe we can work with him as an interim director until we can agree on a new Commissioner. I am sure that if we all work together in a timely manner, we can bring this to an agreeable conclusion.”
Despite Mr. Arthur’s statement “Norwood City Council is reviewing these options,” there had been no action on Council to that point in response to the letter from the Safety/Service Director.
On August 29th Gary Arthur suspended the search for a new Health Commissioner after the Board had narrowed the field down to three finalists. In his email to the Mayor, Mr. Arthur stated: “We would like to be included in any future discussions relating to the future of the Health Department. It is important for the Health Department and the City of Norwood as well, that we keep an open dialogue during this discussion process. If this had been a consideration in the past, much of this confusion could have been eliminated.”
On September 25th the Director and Assistant Director of HCPH were invited to make a presentation at a meeting of the Norwood City Council Committee of the Whole. The estimate provided by HCPH had raised several questions as to how many of the services currently offered by the Norwood Health Department could be adequately met by HCPH. The Committee meeting was called to help address those questions. In addition to the presentation by HCPH, the meeting featured comments from over two dozen citizens including the former Health Commissioner, the current interim Health Commissioner.
At the conclusion of the Committee of the Whole meeting, I requested that a report be submitted by the Committee affirming City Council’s support for the continued operation of the Norwood Health Department and that Council encourage the Board of Health to renew their search for a new Health Commissioner. Lacking the support of the majority of Council for the resolution, and in accordance with the rules of Council, I submitted the document as a Minority Report with the signatures of myself and Councilperson Gabbard.
On Friday of this week I received my Council packet containing the agenda and discovered that the minority report I had submitted was not included on the agenda for Tuesday’s meeting. I inquired with the Secretary of the Clerk of Council’s office and was told that the report had been submitted to the Law Department. No reason was given.
In my conversation with the Assistant Law Director, I was told that the Chair of the Committee of the Whole had submitted the report with a note attached asking for an opinion on the question of if it were possible to have a minority report when there was no majority report submitted. In my conversation with the Assistant Law Director, I was told that the Law Department’s response was to simply provide the Committee Chair with a copy of the rules of Council, a portion of which he read to me over the phone.
I also sent an email to the Chair of the Committee of the Whole asking for an explanation as to why the minority report was not included on the agenda.
The relevant section in the rules of Council is item #4 under the section regarding Council Committees. It states:
“Every committee shall report in writing and every report shall be signed by not less than a majority of the committee except: A minority member may prepare in writing a special report.”
As of this writing I am waiting for a response from the Chair of the Committee of the Whole to my request for an explanation as to why the report was not included on the agenda. I have asked the Assistant Law Director to provide a written response to my question. I have also sent an email to the Norwood Law Director asking to speak to him on the matter.
Where I stand on the issue.
At this point, I remain of the opinion that the City should continue to operate our own health department. This opinion is based on several points:
A detailed comparison of the services currently provided by the Norwood Health Department and those offered by Hamilton County Public Health have convinced me that contracting with the HCPH will result in a significant reduction in both the quality and quantity of services offered to our population.
The numerous phone calls and other communications I’ve received and other discussions I’ve had with Norwood citizens have revealed an overwhelming preference among the citizenry for maintaining the operation of our own health department.
This preference was also clearly on display at the September 25th Committee of the Whole meeting when over two dozen individuals addressed the committee. All of whom expressed their support for the continued funding of the department. Of particular interest and influence were several individuals who described the many ways the services and individuals of the Health Department had made a significant difference in helping them deal with a variety of health-related issues.
In this time of economic uncertainty, it is more important than ever that our local government, that level of government which is closest to the needs of the community, be empowered to provide the most comprehensive level of safety and security possible.
I understand the motivation on the part of the Mayor to pursue this question. Norwood operates on a razor thin margin between needed services and available revenues. And I fully support any effort to look for ways to make our government more efficient and effective.
However, based on the poor communications coming from the Administration and the lack of concrete action taken by the Administration in the past four months since they first decided to address the issue of the Health Department, I am concerned that their unwillingness to move forward in a timely and responsible manner is seriously effecting the delivery of important services by the Health Department.
We are at a point at the end of the year when important reports need to be filed and applications for grants need to be completed and processed. Lacking a full-time Health Commissioner at this critical stage of the department’s operations increases the risk that funding and oversight will be lacking and that important services and operations will deteriorate.
I am concerned that so little has been done to move the discussion forward. To my knowledge, since the recent Committee of the Whole meeting, there has been no follow-up with Hamilton County Public Health to further refine what was universally acknowledged to be an entirely inadequate estimate. No public meetings have been scheduled to gain further input from department heads or citizens. No committees have met to discuss options and next steps.
Indeed, since the time of her notice of resignation, Council has still not been officially informed of the Health Commissioner’s action or made aware of her letter. Nor were we at any time consulted on the plan to ask HCPH for an estimate or on the administration’s efforts to stop the search for a new Health Commissioner.
Council is not alone in being left in the dark regarding the future of the health Department. With the resignation of the Health Commissioner, the Norwood Board of Health immediately began the process of searching for a replacement. At no time, however, did the Health Commission receive any communication, official or otherwise, from the Administration as to their interest in pursuing an alternative provider of health department-related services. This, despite the fact that the Mayor is “President of the Board of Health by virtue of office.”
Only after the Board of Health had narrowed its search to three viable candidates and was preparing to choose a new Commissioner did its members hear, via a second-hand RUMOR, that the Administration was considering an alternative provider of health department-related services.
The only official communication between the Administration and the Norwood Health Commission regarding the Administration’s interest in pursuing an alternative provider of health department-related services was in a response to a communication from President Pro-tem of the Norwood Board of Health to the Mayor seeking to confirm the rumor.
Why didn’t the Mayor, at the first moment of contemplating such an action, approach the full Council or one of its committees such as Safety, Police and Fire or Finance and Audit to discuss this issue? Why didn’t he approach his fellow members of the Norwood Board of Health to gain insight and perspective on such a proposal? By his own admission during the Committee of the Whole meeting on September 25, the Mayor lacks expertise in the area of public health. Why then did he proceed to instruct the Safety/Service Director to seek an estimate from Hamilton County Public Health that, by everyone’s admission, does not come anywhere close to presenting a true “apples-to-apples” comparison of services and costs?
The unfortunate conclusion to be drawn from the above observations is that the Administration has little interest in hearing the views of those outside their immediate circle on this important issue. They have not consulted Council. They have not consulted the Norwood Board of Health. They did not consult the former Health Commissioner in the time between her announcement and her final day at the Department. Nor have they communicated their intentions to Norwood Citizens.
Simply put, I am concerned that the Administration has already made up its mind and is not interested to having a full and open discussion of the issue.
Even if we had the time and the cooperation of the Administration, I have serious doubts as to whether Hamilton County Public Health could provide the level of service that would match that currently provided by the Norwood Health Department.
In his letter to Council, the Safety/Service Director states “we could transfer some duties to the Building Department when it comes to inspections.” It is my belief that to do so would risk placing onerous operational and financial burdens on existing City departments that are already stretched to the limits of their capacities or that we would be forced to hire extra personnel, thus effectively negating most, if not all of the presumed financial benefits of contracting out to the County.
And finally, by moving our services to Hamilton County Public Health, an entity wherein we would be one of 44 communities served, I feel that we will lose valuable insight into unique local needs that have, in the past, helped drive the acquisition of grants that have been so helpful in serving our diverse population.
There is an organizing principle with its roots in Catholic social teaching known as subsidiarity. It states that matters ought to be handled by the smallest, lowest or least centralized competent authority. The Oxford English Dictionary defines subsidiarity as the idea that a central authority should have a subsidiary function, performing only those tasks which cannot be performed effectively at a more immediate or local level. This strikes me as a perfect example of the principal of subsidiarity.
All of which is why I am calling on Council to re-affirm their support for the Norwood Health Department by pledging to continue funding the department for the foreseeable future and to encourage the Board of Health to continue their search for a suitable replacement for the position of Heath Commissioner.
Update: Monday, October 13, 10:31 a.m.