EDITORIAL: County needs two full-time top health leaders

FresnoAugust 16, 2013 

Fresno County Administrative Officer John Navarrette stands to get a $35,000 annual raise after the Board of Supervisors approved pay hikes at its Tuesday, Jan. 14, 2014 meeting.

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The Fresno County proposal to have two top health officials is a classic example of doing the right thing the wrong way.

On Tuesday, the Board of Supervisors will consider reversing a cost-cutting decision made eight years ago: the consolidation of the county's health officer and health director's positions.

This is an idea that we endorse. Our county of 950,000 residents, many of them poor, faces myriad health issues and more complex health challenges than many other counties in California.

For example, the bowl-shaped topography of our region contributes to some of the nation's worst air pollution and the debilitating -- sometimes deadly -- consequences. This combination of poverty and poor air quality has resulted in high rates of chronic disease and asthma.

In addition, the county must also implement its components of the Affordable Care Act, a challenging task for any county.

The problem, as we see it, is that the proposal going to the supervisors would make the newly created health officer a part-time job. As reported by The Bee's Barbara Anderson on Saturday, the plan is to assign the health officer duties to a county employee who is a licensed physician and bump the doctor's pay 10% for the additional responsibilities.

This is simply unacceptable in a county with so many pressing health concerns such as tuberculosis, obesity, sexually transmitted diseases, drug and alcohol addiction, poor inmate health and psychiatric care, and Valley fever. According to state health officials, Fresno County had 475 diagnosed cases of Valley fever last year.

The health officer should be a full-time position.

County Administrative Officer John Navarrette counters that Dr. Edward Moreno, who wore both hats until he resigned in May, spent most of his time directing the public health department. Navarrette further says that the county has doctors who specialize in tuberculosis, immunizations and early childhood care, and they report to the public health director.

But that is just the budget juggler in Navarrette talking -- a voice reflecting the wishes of his bosses, the supervisors who believe the county's overriding public policy should be putting farmers and themselves first.

Dr. David Hadden, the county coroner, knows the demands of trying to be an effective part-time health officer. Between 1997 and 2003, he served as both coroner and health officer when the health director was a stand-alone position.

Hadden told Anderson that county public health officers have many more responsibilities than signing death certificates: "There is a misunderstanding or lack of appreciation for what a health officer does."

The supervisors can take a step in the right direction by splitting the heath director and health officer positions. They should then take the bigger step of making them both full time.

County residents deserve nothing less.

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