Wednesday’s St. Joseph County Board of Health meeting agenda lists some ordinary business matters, but it also contains a situation that might be unprecedented.
The health department is notifying the board that seven staff members are resigning.
Leaving the department are Cassy White, director of health equity, epidemiology and data; White’s assistant director, Taylor Coats; Harry Gilbride, public health emergency coordinator; Sally Dixon, maternal and infant health coordinator; and three community health workers: Tracina Chism-Fikes, Savannah Hardy and Clara Davis.
Several of the individuals tell WVPE that they’re leaving because of harassment and a toxic work environment they say has been created by Republican county council members Amy Drake and Dan Schaetzle, who took office in January.
Especially troubling and bizarre has been Drake’s opposition to any grant opportunity or programming plans that include the word “equity,” says Cassy White, the director of health equity, epidemiology and data. She joined the health department in 2018.
“All I wanted to do was to be able to do public health and community health,” White said. “Health equity is public health. It was constantly, over the last five to six months, it’s been running around, trying to gather information for a board member or a council member but never with any justification for what that information was needed for. It became difficult to come to work every day because you never knew what the new thing was going to be.”
Sally Dixon is a registered nurse who had worked in labor and delivery before pausing her career years ago to be a stay-at-home mom. She joined the health department in 2015 and used a state grant to create a Fetal Infant Mortality Review team. The purpose was to identify factors that lead to fetal and infant mortality, which has been a bigger problem in the county than in most others in Indiana.
And Indiana historically has been among the 10 worst states for infant mortality. In the county, fetal and infant deaths have hit people of color and people in poverty harder than the general population.
The program works to inform mothers about everything from enrolling in Medicaid and the importance of prenatal care, to safe sleeping positions for babies.
In 2016 the death rate for black infants was four times the rate of white infants. It’s now come down to about two or three times the rate, which is partly due to Indiana’s expanded access to Medicaid in recent years.
“And that’s where this whole concept of equity comes in that we’re hearing so much about,” Dixon said.
As an example, Dixon recalled how the health department had some sponsorship money left over from a conference it put on last year on fetal and infant mortality. The department wanted to use the money this year to continue interviewing women whose fetuses were lost during pregnancy or whose babies died after delivery.
But Drake objected, saying she didn’t know if the conference sponsors would approve. She wanted the money instead given to the Women’s Care Center.
After that, the health board's attorney advised her to no longer use the word “equity” and “racial disparities” but it was still OK to say “socioeconomic disparities.”
“I object to this,” Dixon said. “I mean, I’ve been doing this since 2016. These aren’t controversial words, despite efforts to make them so. I said, I can’t do my job without talking about this. It’s not all I talk about. I talk about all these different things.”
Tracina Chism-Fikes, one of the exiting community health workers, is quitting after starting in March 2022. She says politics have overridden public health under the now Republican-controlled council.
Chism-Fikes said Drake lead the other Republicans on the council to vote down the appropriation of that leftover conference money.
“That affected my job because if I can’t meet people where they are, and how to help them, that’s not beneficial,” Chism-Fikes said. “That’s not going to be helpful whatsoever. And if they can do it to one program, they can do it to any program. And to see that that’s what had started to happen, I couldn’t stay.”
Harry Gilbride came to the department in 2020. He had a passion for helping people who are experiencing homelessness. He worked to control the spread of COVID-19 among that population during the height of the pandemic.
Gilbride also grew tired of the what he saw as the “politicization” of public health by Drake and Schaetzle, along with others on the far right. His final straw came as a result of his involvement in a permanent supportive housing project he was developing with South Bend Heritage Foundation, Oaklawn and the city of South Bend.
Gilbride said he was asked by the team to sign memoranda of understanding calling for South Bend Heritage to partner with Oaklawn and the Corporation for Supportive Housing for the development.
He said the health board’s attorney advised him commissioners would need to sign the documents also, and he shouldn’t ask them to do so.
“So it was pretty clear to me where the wind was going on that,” Gilbride said. “I’m here to improve the lives and the health outcomes of the most vulnerable and it just didn’t seem like this was going to be a space that is very conducive to that anymore.”
Taylor Coats, assistant director of health equity, epidemiology and data, has been the most vocal of the resigning staff. She spoke out at a recent Board of Health meeting, saying Drake had harassed her and created a hostile work environment.
Coats was hired by the department in April 2021. When she began, her title was simply “licensed clinical social worker.” But then-county health officer Dr. Bob Einterz gave her more responsibilities, to the point she was leading teams of community health workers who, she says, were making a big difference in helping the county’s poorest residents learn about resources they could tap to improve their health.
Coats, White and Einterz wrote a grant to the Centers for Disease Control that funded eight new community health workers who focused on helping people avoid COVID-19 by focusing on improving their health.
“Anybody in the community could ask for help and our community health workers would respond and provide them resources that would help alleviate whatever issue they were dealing with,” Coats said. “Everything from food insecurity to housing to transportation, day care, educational assistance, that sort of thing. And so our team really helped address a lot of different things that can make people sick or can impact their well-being and their life.”
For a while, it was her dream job.
“It was amazing,” she said. “I could not have been happier with the job that I had. I loved it underneath Dr. Einterz. I had always wanted to do macro- social work, and it was a position that I could only have dreamed of being able to do. I was leading a team of people who were changing the lives of a lot of people in our community.
“We have community members who don’t have any electricity, who in the middle of the summer, elderly women and men, who can’t have any air-conditioning or fans to keep them cool, who will die of heat stroke if not given assistance.”
But Coats says Drake was questioning everything she did, scrutinizing her funding sources, and delaying the work, to the point that she started to become physically ill from anxiety. She was on family medical leave for a month before her resignation.
“Any day I would get an email of, hey, we need you to show us all of the documentation about this. Hey you need to prove XYZ now. Hey you need to do this. Or conversations from the health officer. Hey they’re asking about you again. Hey just so you know, this is a conversation they’re having with XYZ. It just wasn’t worth it.”
Neither Drake nor Schaetzle responded to WVPE’s request for comment for this story.
