A year after its director was plucked into the service of the state, the Allegheny County Health Department remains without a long-term leader.
The Board of Health and new County Executive Sara Innamorato have just begun an effort to fill what a spokesperson called “a vital position for the administration.”
“The director and the [board] have broad responsibilities that range from infant mortality and the opioid epidemic to air pollution and food safety,” wrote Abigail Gardner, the county’s communications director, in an email to PublicSource. “Leading the Health Department is highly technical and process-oriented work,” requiring understanding of law and regulations and “a massive amount of genuine public engagement.”
Unclear at this point is the public’s role in the selection process. Gardner wrote that “it is likely that there is some kind of piece of the process that will involve public input.”
At its Jan. 17 quarterly meeting, the Board of Health did not discuss plans to choose a director, and Acting Director Patrick Dowd declined comment.
Some advocacy organizations are setting out their expectations up front.
On Dec. 7, a coalition of 35 organizations and 37 individuals under the banner of the Equitable and Just Greater Pittsburgh Network petitioned the county to prioritize health disparities and social determinants of well-being in its choice of a new director.
“The Health Director’s role and the Health Department affect so many aspects of people’s lives,” said Jason Beery, director of the network, convened by UrbanKind Institute, a Pittsburgh-based “think-and-do tank.” A new director would likely want to be involved in issues including air quality, housing health and the county’s development of a climate action plan, he said, so it’s important to hire someone “with certain qualities that we think would best address some of the complex health challenges and health outcomes that affect all of our communities and municipalities.”
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Important department, leadership vacuum
Debra Bogen served as the county’s health director from early March 2020, as the pandemic shutdown loomed, until January 2023, when Gov. Josh Shapiro announced her nomination as state secretary of health. Bogen serves as the acting secretary because Republican lawmakers’ concerns have prevented state Senate confirmation. Dowd, the acting director, is a former Pittsburgh City Council member with a doctorate in history.
The 300-person department’s responsibilities include:
- Monitoring air quality, enforcing emissions regulations and allocating the Clean Air Fund
- Inspecting restaurants and otherwise enforcing food safety measures
- Enforcing housing health rules
- Striving to curb violence, overdoses and other causes of death
- Preparing the public for health emergencies like the pandemic.
The director is technically chosen by the nine-member Board of Health. Eight members continue to serve despite expired terms. The slots are some of many that Innamorato can use to shape the county bureaucracy after 12 years of former Executive Rich Fitzgerald making appointments. Gardner did not provide a timeline for reappointing or replacing members, or for hiring a director.
“We look forward to continuing to dig in with them and understand the expertise the board could use going forward to meet the moment or urgent public health needs,” Gardner wrote.
At its meeting, the board reelected as its chair Lee Harrison, a physician and epidemiology professor at the University of Pittsburgh. He has served on the board since 2001, was last reappointed in 2017 and has continued though his term expired in 2020.
‘Hard to get information’
Innamorato’s transition team has posted the health director position on its job opportunities website, indicating that it wants candidates for the $270,000-a-year position who:
- Will focus on racial and economic health disparities
- Has experience making “a measurable impact” on community health
- Is ready to support marginalized communities
- Can craft “an inclusive strategy” to fill vacancies in the department
- Will partner with governmental organizations, nonprofits and businesses to address health challenges.
A medical doctorate is “highly desirable,” according to the posting, though a candidate with a doctorate in public health may be considered.
In its letter to the Board of Health, the Equitable and Just Greater Pittsburgh Network called for a health director conversant in the social determinants of health — the effects that economic, environmental, political, social and cultural factors have on well-being.
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The letter also noted the longstanding disparities in health care in the county, some of which improved in recent decades but many of which remain stark.
The local health system’s failure to bring Black residents’ life expectancy and chronic disease rates in line with those of white residents was magnified by the COVID-19 pandemic. The department pledged to work on closing gaps in care driven by racism and the lack of culturally appropriate health access in announcing a five-year plan a year ago.
A new director should also have experience in policy implementation and commit to transparency, openness, accountability, accessibility, cultural humility, collaboration and public participation in budgeting, according to the letter.
“It’s been hard to get information out from [the Health Department] in the past, and considering it is a department focused on public health, it feels like a lot of that information needs to be made public, and there needs to be clarity on why the department is making certain decisions,” said Beery in an interview with PublicSource. He also outlined the network’s views during the public comment portion of the board meeting.
The four-year-old network has never weighed in on a personnel decision before, according to Beery. Member groups would like to see some kind of public input process, potentially including representatives of underrepresented communities, areas burdened by pollution or other health threats and groups directly affected by health policy.
The network has not yet received a response to its letter, which was sent to the department, the Board of Health members and several Innamorato transition team chairs.
Beery said that a thorough and prompt process would be ideal, but added that the network is not trying to be antagonistic. “There is an amount of grace that we would show any new person in this kind of executive role,” he said.
Less patient was Clairton resident Kim Meachem, speaking at the board meeting as the department moves toward issuing a new operating permit for U.S. Steel’s Clairton Coke Works.
“We are sick and tired of coming before this panel to tell you the same story over and over and over again,” she said, “and not seeing any results.”
Charlie Wolfson is PublicSource’s local government reporter and a Report for America corps member. He can be reached at charlie@publicsource.org or on Twitter @chwolfson.
Rich Lord is the managing editor at PublicSource and can be reached at rich@publicsource.org.
The Jewish Healthcare Foundation has contributed funding to PublicSource’s healthcare reporting.
