Resignations are decimating the ranks of the Dallas County Board of Health and the Dallas Public Health Department (DCPH), and the fastest-growing county in the state appears to have the fastest-shrinking public health department.
The five-member Dallas County Board of Health, which oversees the operation of the DCPH Department, has had three resignations in the last month, including board chair Sandra Christensen and members Cynthia Swanson and Dr. Cheryl Standing, the board’s state-mandated physican.
The health board’s senior members are now Dallas County Supervisor Kim Chapman, who took a seat on the board five months ago, and Monty Button of Adel, a four-month member. The supervisors approved Tuesday morning the appointment of Dr. Joshua Kindt of Waukee, a pediatrician at Mercy Clinics.
At the same time, the Dallas County Public Health Department (DCPH) is losing staff members as quickly as the health board is losing directors. Two key staff members, DCPH Department Director Kelli Vallinga and Population Health Administrator Jennifer Walters, tendered their resignations this month, and June saw the resignation of two other agency staff members, Community Health Coordinator Beth Frailey and longtime Public Health Nurse Stephanie Birt.
These DCPH departures are just the latest losses in a department that has shrunk by more than half — from about 17 employees to seven — since Nov. 1, 2017, when the department ceased offering home health nursing services. One year ago, there were four regsitered nurses on the DCPH staff, and now there is one RN.
Amid the resignations, the Board of Health met Tuesday evening at the Dallas County Human Services Campus, with Christensen and Swanson making their final appearances as directors.
Among the board’s first orders of business was the promotion of Suzanne Hegarty, DCPH Department office and finance administrator, to the position of interim department director. The additional duties come with a pay increase of $1,250 a month. The board estimated it would take three to six months to hire a permanent director.
Hegarty then delivered the monthly department report to the board, a duty normally falling to the DCPH director. She addressed the matter of the resignations.
“I’ve had multiple staff reporting, asking as to why the agency director and board of health members are resigning,” Hegarty said.
She said staff members have reported hearing rumors “from contacts both within and outside of the county” about an impending audit of the department, but Hegarty said nothing is expected but a “fairly routine” audit by Iowa Medicaid and the U.S. Centers for Medicare and Medicaid Services that has yet to be scheduled.
“As soon as I know more information and/or the date, I will pass that along,” Hegarty said, “but I wanted to let you know that I have staff that are hearing things and concerned about things, and it’s not been something that we have dealt with yet.”
The resigning board members did not address the reasons for their resignations during the meeting. Asked afterward, they did not cite any specific reasons.
“It’s just time to do it,” Christensen said. She has served on the Dallas County Board of Health for 10 years. “I’ve really appreciated and enjoyed the agency, but I’m just ready for someone else to take the chair,” she said.
Swanson had no comment. She recently began her second three-year term on the board.
Also attending the Tuesday meeting of the health board were Dallas County Environmental Health Director Ted Trewin, DCPH Community Health Coordinator Abigail Chihak, Dallas County Human Resources Director Erin Freeman and Dallas County Attorney Wayne Reisetter.
Public attendees included Heather Bombei, regional community health consultant with the Iowa Department of Public Health, and representatives from Polk County’s Visiting Nurse Services of Iowa, which now contracts with DCPH to provide maternal child health services in Dallas County, and Broadlawns Medical Center, which administers Dallas and Polk counties’ Women, Infants and Children program, a federally funded nutrition program for children up to the age of 5 and for women who are pregnant, postpartum or breastfeeding and who meet eligibility guidelines.
Several DCPH staff members also attended.
Hegarty said she is ready for the extra work the interim directorship will bring, even if she is not prepared to commit to 80-hour work weeks.
“You guys have asked in the past couple of meetings for basically an agency overhaul,” she said to the board, “which I think is going to probably fall to me to do in the next few months to at least get that started. Even if it’s not completed, that’s a lot of work on top of the job that I’m already doing.”
While the DCPH Department has recently withdrawn from providing home nursing care and maternal child health home visits, a number of essential public health services remain to be delivered, including communicable disease surveillance and investigation, immunization services, emergency preparedness activities and community health needs assessment and health improvement planning. The department’s health navigation function is also growing in importance.
In this era of privatizing public services and seeking market-based solutions to social and human needs, the mission of the Dallas County Public Health Department and the commitment of the Dallas County Board of Supervisors to supporting that mission appears to be in transition.
