State lawmakers are looking at easing the public health credentials required for the state’s health department head, as they consider accommodating a new agency leader whose background is largely in business management.
The move has elicited concern from Utah’s largest physicians organization and some state legislators, who say the middle of a pandemic is a time for more — not less — public health knowledge in positions of power.
“We need expertise and experience now more than ever to tackle this pandemic and protect the health of the public,” Rep. Suzanne Harrison, a Draper Democrat and physician, said in a written statement. “It makes no sense to me to NOT have medical doctors and public health experts in leadership — after all, it is the Department of HEALTH.”
In a Monday meeting with state lawmakers, Saunders acknowledged that he’s spent most of his career as an organizational behavior specialist in the private sector before joining the state’s health department in 2015 as a management consultant.
Traditionally, the head of state’s health department has been a physician, although state law doesn’t require a medical degree for the position and a handful of agency leaders have had a different background. However, a nonphysician must have a master’s degree of public health or public administration or have at least seven years of professional experience in public health, with at least five of those in a senior level administrative position, according to the law.
The legislation, SB6006, slated for consideration in this week’s special session would also give Saunders the ability to choose a nonphysician as deputy director of the healthy department. Currently, if the executive director is not a medical doctor, the agency’s second-in-command must be one.
In an interview Tuesday, Christensen argued that the ability to practice medicine isn’t essential for the health department’s executive director, whose job calls for managing a budget and overseeing staff.
“Someone pointed out to me that in hospitals, we don’t assign doctors to be the hospital administrator,” the North Ogden Republican said. “We assign administrators.”
But that’s not a one-to-one comparison, said Michelle McOmber, chief executive officer for the Utah Medical Association (UMA). In a hospital, an administrator relies on a board of physicians for the medical knowledge integral to operating the health facility, she said.
Similarly, it’s important to keep medical experts in high ranking positions within the state’s health department, she said.
“They’re changing the qualifications for the executive director — fine,” McOmber said of Christensen’s bill. “But then in that case, they need to leave a deputy director as a physician.”
McOmber said she’s hopeful her group can work with lawmakers to find a resolution.
Christensen chalks up UMA’s reservations to an interest in protecting its turf.
“If it says ‘health’ in [the title], they want a doctor to be in charge of it,” he said of UMA.
McOmber said the accusation is unfair and she believes UMA is making a reasonable request for medical experts in leadership positions at the health department.
Rep. Ray Ward, another medical doctor serving in the Utah Legislature, said he’s open to Christensen’s proposal, given the difficulty of finding a health department leader who checks all the boxes — a physician, a public health expert and a talented administrator and communicator.
“I would say it’s close to impossible to find all three of those skill sets in the same human being,” said Ward, R-Bountiful.
To make sure there’s at least one high-ranking health official to fill each of these roles, Ward said he’d be in favor of allowing the executive director to name up to two deputies.
Saunders had been working as Burton’s chief deputy during the pandemic and took over as interim executive director of the health department on Aug. 1, he told a legislative subcommittee Monday. Miner is serving as the agency’s chief medical adviser.
If Christensen’s bill passes, putting a physician in an advisory role at the health department would satisfy the statutory requirement for a medical doctor in the agency’s upper ranks.
In response to questions about his qualifications, Saunders said his education is in organizational behavior and that he spent 25 years working in the private sector — in retail, manufacturing, construction and information technology. Five years ago, he joined the health department to improve performance in Medicaid services and rose through the ranks to become an organizational expert for the entire agency, he said.
“So your actual training and experience in public health itself is limited?” Rep. Jennifer Dailey-Provost, D-Salt Lake City, asked Saunders during the subcommittee meeting.
“Yeah, the public health is just over the last five years,” Saunders replied.