Just as the Board of Health took steps this week to ice out Health Director Tisha Dowe, the El Paso County Board of Commissioners is poised to bounce the only medical doctor from the board that helps oversee a vast array of health services to the county's half-million residents.
Amid declarations that the Health Department is engaging in socialized medicine, commissioners are maneuvering to oust emergency room physician Dr. Jack Dillon from serving a second, five-year term and replace him with Robert Sanford, a presently out-of-work businessman who admittedly does not know much about the county's Department of Health.
If commissioners decide to appoint Sanford, it will be the first time in decades, if ever, that a medical doctor has not served on the Board of Health, said Dr. John Muth, the former county Health Department director who sits on the board of the El Paso County Medical Society. The 700-member Medical Society strongly endorsed Dillon for another term.
In a separate move on Monday, the remaining four members of the Board of Health -- who oversee the Health Department and are all appointed by the Board of County Commissioners -- voted in closed session to place Dowe, the director of the Health Department since 1999, on administrative leave for 10 days. No explanation was given for their decision, and Dowe was reportedly told to clean out her office and was escorted from the building.
The Health Department's deputy director, Rosemary Bakes-Martin, said that shortly before the closed session convened, she was asked whether she would agree to be the acting director.
Bakes-Martin said she is unaware of the reasons for Dowe's administrative leave, and hopes the director will be reinstated. "My concern is for the Health Department right now, and my role is to keep the department going," she said.
Bad blood between the Health Department and the county commissioners is not new. Four years ago, elected officials attempted a takeover of the department altogether but ultimately abandoned the effort. The Health Department is state-mandated and receives funding from local, state and federal sources. It currently operates with a $16 million budget, with programs ranging from restaurant inspections to child immunizations to the monitoring of infectious diseases.
In recent months Commission Chairman Tom Huffman has emerged as a vocal critic of the department and many of its services.
This week, Huffman confirmed he believes that the programs currently offered or funded through the Health Department -- many of which are designed to assist low-income and indigent residents -- constitute socialized medicine.
It is not the government's role, Huffman insisted, to ensure all citizens have access to health care.
However, during his interview seeking a second term on the Board of Health, Dr. Dillon pointed out to commissioners that ensuring health care access to everyone -- whether they can afford it or not -- is not just a philosophical position but a legal mandate.
Federal law requires that people, even if they cannot afford health care, are able to receive treatment. If immunization and pre-natal programs are not readily available, Dillon pointed out, then patients are forced to seek treatment from emergency room services -- whether it be for a sprained ankle or an advanced pregnancy in which a woman without health insurance has not seen a doctor.
"The goal of the Health Department is to ensure the health of the community," Dillon said. "I would like to make sure we keep this a healthy, pleasant place to work and live. That is what keeps us strong and makes people want to live here."
During his interview, Dillon also noted that the Health Department should also step up efforts to address disaster preparedness and the possibilities of bioterrorist emergencies.
Violating the guidelines
However, last Thursday, four of five county commissioners indicated strong support for dumping Dillon and appointing Sanford, a former chief operating officer for a defense contracting company who has been out of work since October.
The commissioners' choice violates the county's own guidelines outlining the qualifications necessary for the volunteer Health Board position, which state, "Applicants should possess knowledge of, and be concerned with the wide range of health issues within the community."
During his interview, when asked by Commissioner Ed Jones whether he knew anything about the Health Department, Sanford responded, "I've read a bit, but to tell you the truth, not a lot."
Jones subsequently made the motion to appoint Sanford, though the commissioner did not express his rationale for why he believes Sanford is the best candidate. Nor did Sanford submit a letter to the county explaining why he is even interested in the job.
This week, Huffman indicated that he prefers Sanford because, "I like his business qualifications. He's sat on boards where money didn't come out of the sky."
The five other applicants to the Board of Health, including Dr. Dillon, have all had extensive experience in the health field and at least three hold masters degrees in public administration.
In its letter of support for Dillon, the El Paso County Medical Society underscored their support of Dillon, and that "having a physician on the Board is of utmost importance and a logical choice."
"We have a long history of cooperation and respect between the local Health Department and the practicing physicians of our county," the Society wrote. "We encourage you to continue support of this tradition."
The lone dissenter, Commissioner Jeri Howells, said she believes it makes sense for a medical doctor to continue serving, both as a counterbalance to the health director and for his health expertise.
In addition, Howells offered strong criticism of the direction her colleagues are taking. "I think they have started down a path that I, as a commissioner, don't agree with," she said.
"[Dillon] has done a good job. Unless there's a glaring reason, out of respect for the time that appointees put in, we should reappoint them to a second term."
The commissioners will revisit Sanford's appointment on Feb. 21. The Board of Health is scheduled to review Dowe's tenure the following day.