VICKSBURG - Which is more important to your average Mississippian?
(A) The organizational chart of the Mississippi Department of Health.
(B) Assurance that the kitchen of the restaurant where the family ate last night isn't crawling with vermin.
Most would say (B), but you'd never know that by listening to some voices in the Legislature and seeing some media reports about the MDH, which is at a crossroads. By June 30, the agency will get a pat on the back, a makeover or face extinction at the hands of the Legislature. So far, discussions and reporting have tended to focus on the personalities involved instead of the awesome responsibilities assigned to 2,100 rank-and-file employees.
It must really rankle Sen. Alan Nunnelee, R-Tupelo, chairman of the Public Health and Welfare Committee, to see such a crucial discussion degenerate into who's in and who's out, akin to an episode of "Survivor."
Legislating is a part-time job in Mississippi, but Nunnelee has been at his chairmanship full-time, given that the MDH "sunsets" this summer unless given new life by the Legislature. Nunnelee has been gathering information, holding hearings and speaking out about the MDH - and becoming increasingly aggravated about members of the state Board of Health, the "autonomous appointive board" that hired Dr. Brian Amy as MDH director and seems almost indifferent to legislative inquiries.
Last fall, Nunnelee told The Clarion-Ledger that board members had said "there's not a problem" at MDH and that "they've never talked to an employee who had a problem." In placing the blame at the feet of Amy, whom Nunnelee says "has to go," the senator added he'd found plenty of employees willing to talk about agency dysfunctionality.
Problems range from morale, generally, to underreporting West Nile viral infections and spending money allocated for one purpose on something entirely different. Insider deals and wink-and-nod contracts are also part of the picture.
Objectively, Mississippi is the No. 1 state or close to No. 1 in infant deaths, obesity, failure by pregnant women to seek prenatal care, hypertension and undiagnosed cancers of myriad types because people don't undergo screenings or have regular checkups.
Objectively, a state consistently rated as a most unhealthy place to live would respond with the most aggressive and professional public health programs possible. No muss. No fuss.
Yet what we get is, "Who does this Nunnelee guy think he is?" We get lawmakers and reporters focused on Nunnelee being a Republican and his counterpart in the House, Public Health and Human Services Chairman Steve Holland of Plantersville, being a Democrat.
No need to be naive. Turf considerations are real. They're part of everything. Amy, who has impeccable training and credentials, was hired in 2002 by Board of Health members and given a six-year contract. They'd have to admit error and, under terms of his deal, find "cause" to fire him. Democrats in the House and Senate don't like Republican Gov. Haley Barbour, who would gain de facto control of the MDH if lawmakers gridlock and the agency is not reauthorized. Everybody wants to be a winner. No one wants to be a loser.
But wouldn't it be keen if everybody took a step back and considered how good it would be to have aggressive, empowered and tightly focused public health officials out there serving as advocates for the people of Mississippi? A top-notch public health service could make one heck of a difference in this state.
By the way, in the last year, 1,377 places serving food - hospitals, nursing homes, public restaurants, day cares, personal care homes and prisons - were given failing scores by MDH inspectors, including due to evidence of vermin infestation.
In almost every one of those cases, there was no fine, no penalty and no direct notice to the public. Operators were allowed to keep their permits on a promise to do better.
Food service inspection is just one of more than a dozen vital functions of MDH. Water quality, licensure in some medical and non-medical fields and certification of all sorts of institutions are up to the MDH. Public education and awareness programs are another function, as are health screenings and planning and preparing for disaster-related health crises.
It's safe to say Mississippians, fully aware of the need, would be justified in having high expectations for the performance of their public health agency. It would be great to hear more talk about that, and less of all the usual dithering. After all, if a roach is doing the backstroke in your soup, it's not likely you'll call the waiter over to discuss the state chain of regulatory command.
