Burke Health, Social Services boards lose independent authority

In front of a standing-room only crowd of nearly 100, the 4-1 vote, with commissioner Johnnie Carswell the lone dissenter, came after a marathon public hearing in which a parade of speakers — 15 in all, among them a number of health and social services professionals — addressed the board, all of them asking commissioners to delay the decision until more information could be gathered.

In addition, both the health and DSS boards had previously passed resolutions asking the commissioners to slow down the process as well, but to no avail. 

Commission Chair Jeff Brittain said recently the board has informally discussed the topic for at least a dozen years, and it acted quickly Tuesday after the comments ended. Commissioner Phil Smith moved to approve the change. Smith, Brittain, Scott Mulwee, and Randy Burns voted in favor.

The commission board room was filled to overflowing by the time Burke County Manager Brian Epley began to explain the plan to bring health and social services under the same structural umbrella as the rest of the county’s departments.

“I do think the transition could potentially increase efficiency, and being vertically aligned operationally I think provides a better pathway for communication,” Epley said. 

Epley said since state law changed in 2012 and began allowing counties to bring the boards under commission control, 42 counties in the state have altered the traditional model like the one Burke previously employed and which had been in place for more than a century.

The day-to-day operations of both departments would not change, Epley said, and both boards would still be able to impact policy decisions, thereby retaining a measure of autonomy. 

Although both boards were technically dissolved Tuesday, all members of both were immediately reappointed. Health Director Danny Scalise and DSS Director Korey Fisher-Wellman will remain in those posts and retain all their current responsibilities and authority in matters like budgets and personnel decisions.

“This board is very appreciative to the work that has gone on with the board of health and the board of social services,” said Commission Chair Jeff Brittain just prior to the vote. “And the consideration of this item is in no way an indication of a dissatisfaction to any of that work. That work has been great.”

In the weeks leading up to the hearing, opponents of the move have voiced their concerns about handing public health policy decisions to an elected body and taking them out of the hands of health professionals who sit on the boards.

That was a common refrain again Tuesday as the speakers took their turns at the podium. Some of them also took exception to the fact the county announced the public hearing 30 days in advance, the minimum amount of time state statutes require.

Dr. Anthony Frank, vice chair of the board of health, cited the masking and vaccination policies that emerged during the COVID-19 pandemic as examples of how politics can affect public health policy, although those mandates came from the Governor’s office and not from county health departments.

Rob Nelson said more time was needed, and added, “Quite frankly, if you decide to move forward today, it seems insane.” 

Pastor Paul Carlson said public health policy decisions shouldn’t be based on politics.

“Politics, especially partisan politics, has no business in public health,” Carlson said. “I never want a political party making decisions for my health, my family’s health, or my community’s health.”

Health professional Artie McKesson-Logan said she was uncomfortable leaving decisions to the commissioners, “a responsibility that you are not qualified to assume.”

Some speakers pointed out Burke is one of only two health departments in the state to achieve national accreditation and has emerged as a leader in fighting the opioid crisis by utilizing pharmaceutical settlement funds.

“Why fix something that’s not really broken?” Allison Calloway asked.

Wednesday morning, health board chair Isaac Crouch, who spoke first Tuesday and has been a vocal critic of the decision, said he was still trying to process what happened.

“I’m struggling to think of a more anti-democratic display of power from county government or any of our local governments,” Crouch said. “I’m still processing that, because it’s pretty bizarre.

“I have a deep appreciation for everyone who came out. I was overwhelmed by the support everyone showed for the work of social services and the health department. The directors, the employees, and the good stuff they’ve been doing in our county.”

Crouch said he’s still weighing his options but has no immediate plans to step down. He said several health and DSS board members have indicated to him they have a lot to think about as well.