According to state statute (RCW 70.05.045), "The local health officer, acting under the direction of the local board of health..." and "each local board of health shall have supervision over all matters pertaining to the preservation and health of the people within its jurisdiction..." (As the law clearly states, the board is not advisory -- but supervisory.) The law continues to state that, "the public health officer acts as the executive secretary to, and administrative officer for the Board of Health."
In upholding this public trust, the board must confidently know that not only are public health matters communicated to the board and general public, but that the administrative functions of the health district are being addressed as well. For example, the health district utilizes tax dollars, oversees personnel, regulates businesses and assumes some liability in carrying out its functions. The board and health officer cannot focus entirely on only one aspect of the district's mission and downplay the significance of others (as specified by state law). The only way for the board to uphold its responsibilities is through open and frequent communication with the health officer.
While employment law greatly limits the type and specificity of information that the board can release, it has been widely published that the board took a vote of no confidence two years ago when Dr. Thorburn engaged in a sarcastic exchange of e-mails with board member Kate McCaslin and refused to provide McCaslin with information that she had requested.
Shortly thereafter, several board members met with Dr. Thorburn individually to discuss the dynamic of her relationship with the board, their desires for information and how to improve communication. However, instead of addressing these concerns, Dr. Thorburn frequently took a defensive and adversarial stance in communicating with the board.
One year ago, and consistent with her employment contract, the health district conducted a performance evaluation of Dr. Thorburn. While she scored higher with staff and some members of the community, she received poor scores from the board, reflecting a continued lack of communication.
Prior to releasing the results to the entire board, the executive committee of the board met with Dr. Thorburn to review the strengths and weaknesses reflected in the evaluation. Dr. Thorburn was asked to consider the results and be prepared to present ideas on how to improve communication with the board. Unfortunately, Dr. Thorburn chose to utilize that time to blame the shortcomings of certain health district staff for the problems.
Any employer understands what it is like to have an employee who is technically doing his or her job, but makes it difficult for other parts of the organization to achieve their goals. Such employers have the choice of continuing or terminating the relationship with the employee.
In this case, the Board of Health has invested nearly two years in attempting to improve the relationship with Dr. Thorburn. It has been very clear about requesting information on a number of public health topics and providing direction on others. But during that same time, Dr. Thorburn has been quoted in the media claiming that the board was "disengaged" and repeatedly inferred that the board didn't care about public health. This summer she was quoted in the Spokesman-Review (July 26, 2006) as saying she doesn't try to work with the board anymore.
Every relationship requires the participation of both parties. When one party gives up, the opposite party has no choice other than to consider it as "irreconcilable differences" and move on.
The Board of Health is now looking for a new direction and a relationship with the health officer that includes the free flow of information. It also includes confidently knowing that the board, through its health officer, is fulfilling its responsibilities under the law and upholding the public's trust in operating the administrative side of a government agency along with advancing the best interests of public health.
Todd Mielke is a Spokane County Commissioner and Chairman of the Spokane Regional Health District Board. Mary Verner is a Spokane City Councilwoman and Vice-Chair of the Spokane Regional Health District Board.