The St. Clair County Board of Commissioners voted 4 to 2 to effectively eliminate the Medical Health Officer Role filled by Dr. Annette Mercatante.

The vote restructured the leadership of the St. Clair County Health Department into two separate jobs. Mercatante stated that she will not be applying for either position.

The Health Department’s most recent temporary mask mandate for schools had vocal opposition at recent county board meetings.

Commissioner Jeff Bohm, who voted to restructure the position, said that Mercatante was not fired, but that the county is aligning its structure to the structure of the majority of other counties in the state.

Commissioner Dave Rushing, another yes vote, expressed that his main issue was with the issuing of an unenforceable mask mandate without consultation with the board and felt that the orders were unconstitutional.

Commissioner Jorja Baldwin, who voted no on the proposal condemned the decision, referring to it as neither fiscally nor organizationally responsible and said that less “nuclear” options were available.

County Commissioner Lisa Beedon, the other no vote, called Mercatante an asset to this community.

From County Commissioner Jorja Baldwin:

“The vote to split the health department director into two positions is not fiscally or organizationally responsible.

If the goal of some board members was to remove Dr. Mercatante for issuing a mandate after we’d adopted a resolution opposing federal mandates, then the motion should have been to terminate her contract early. While I am not a proponent of mandates in this climate, especially with the vaccine being so readily available for those who choose to get it, Dr. Mercatante was within her legal authority to issue them. The Board does not have the standing to intimidate, pressure or terminate a person for exercising their lawfully provided authority, even if they don’t agree with them. A commissioner and a department head not being on the same page is a communication issue, normally handled by HR through the county administration. Much of this may have been avoided had we been more involved, but because of her exemplary service over the last decade, we trusted her and her team to make the right calls as she’s done for so long. We all failed on various levels by not taking the time to build a relationship with Dr. Mercatante and her team. Dr. Mercatante needed to lean on her Health Advisory Board, as well. These are lessons learned the hard way over the past 6 months. 

The public health act, regardless of the department’s structure, gives the authority to only the health officer. Nowhere in the act does it call for joint authority in decision making. Currently, Dr. Mercatante does speak with her department, and in the case of the mask mandate, various school representatives, prior to making a decision. So, a team approach is already happening within the current combined position.

We could have first considered an extension of the contract to create a realistic succession plan to best protect our community who utilizes the SCCHD for their primary, prenatal, teen, etc. care and ensure we’re being good stewards of the budget. Attempts to come to an understanding with the health department and the Health Advisory Board were not made by anyone, but could have been during the transition to a new health officer. Hindsight is 20/20, but less nuclear options were available. 

A common concern we heard was that the health department was being run by an unelected bureaucrat for what some deemed too large a salary. This proposed structure will now involve two unelected bureaucrats: a part-time medical director stating at $123 an hour for a minimum of 16 hours per week, and a full-time local health officer with an annual salary of $120,000. State law requires very specific qualifications related to board certifications and a public health masters degree and experience. I am concerned we will have difficulty recruiting quality, qualified candidates. I am concerned that the initial proposed wages will not be nearly enough, and the $28,000 currently estimated as the increase will grow exponentially. I am concerned that we are going from 24/7 medical coverage to 16 hours per week medical coverage. The unintended consequences of this decision in relation to employee morale, or the loss of additional staff also weighs heavily. Therefore, to me, this solution adds increased costs for less service, and still the authority to issue mandates falls on a single, unelected county employee, which really isn’t a solution at all. 

Unless, of course, this issue was more personal than organizational and the only intent was to remove Dr. Mercatante. In that case, some would consider the problem solved.”

From County Commissioner Lisa Beedon:

“I voted no on splitting the position because Dr. Mercatante is an asset to this community and losing her in this role is a loss for the county. Despite anyone’s opinions on a single issue, she has had a profound impact on the overall success of public health in St. Clair County. She has proven to be collaborative, bringing issues like healthcare disparities, to the forefront so that they can be properly addressed. She has been intentional about inclusion and diversity, ensuring those who are underrepresented are represented and have their voices heard.”

From County Commissioner Jeff Bohm:

“We are looking at splitting the position back to 2 positions.. Out of 54 counties there are only 2 counties that have our model.  The current health director is not being fired.  She will have the opportunity to apply if so desired. We feel the 2 positions could better serve the citizens of Saint Clair County. If we are unable to do this we would look to maintain is the current position.”

From Dr. Annette Mercatante:

“While I’m disappointed in the BOC’s decision, I want the residents of this county to know that no matter what happens, the staff at the Health Department remains committed to prioritizing the health and safety of our community. We will do everything possible to ensure that the essential services we offer stay intact throughout any transition”.

She continued “One of the more difficult parts of this situation has been explaining these decisions to my dedicated staff, all of whom have worked tirelessly during incredibly difficult circumstances. I’m proud of the work we have done together to serve this community. It has been the honor of my life to serve as St. Clair County Medical Health Officer for the past 13 years.”

From a Phone Interview with County Commissioner Dave Rushing:

Rushing said that the Health Department put in a health order with no intention of enforcement. Hundreds of people expressed concerns about the order. Rushing mentioned “separate but equal” legal clauses that cannot discriminate between vaccinated and unvaccinated for health orders. He felt that the health department orders were unconstitutional.

Rushing recognized that Dr. Mercatante has done some good things for the county, but took exception with orders with no intent to enforce and referenced the removal of orders after the Michigan legislature threatened removal of funding if mandates stayed in place. Rushing said that this was mishandled.

Rushing said, “If this was actually to protect the children, we should have enforcing.” He went on to say, “I don’t think you should put mandates in place unless you’re going to enforce it.”

Rushing emphasized problems with poor communication from Dr. Mercatante, particularly with issues that he felt violated the Michigan constitution. He also feels that the federal government cannot require masking on buses as it does not have that authority.

Rushing said, “At no point do I want to obstruct a Health Director or Homeland Security Director’s job.” When asked when he thought it was appropriate for a Health Director to consult with the Board of Commissioners, he said he thought it was necessary when it affected a large population in the county.

When asked if he thought the new two positions would be hard to fill, Rushing said, “No one is irreplaceable.” He had no concerns about filling the jobs and said that a 16 hour per week job for $100,000 shouldn’t be hard to fill. He said that the two-position model is in the best interest of the county and that two people will converse with each other to put the best policies in place and neither will have sole authority. 

Reporting for WGRT – Jennie McClelland