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M I N U T E S SOUTHERN NEVADA DISTRICT BOARD OF HEALTH CHIEF HEALTH OFFICER SUCCESSION COMMITTEE MEETING 400 Shadow Lane, Suite 206 Las Vegas, Nevada 89106 EPI Conference Room Thursday, 1:00 P.M. Chair Tim Jones called the meeting of the Chief Health Officer Succession Committee to order at 1:10 p.m. Annette L. Bradley, Esq., Legal Counsel confirmed the meeting had been noticed in accordance with Nevada s Open Meeting Law and that a quorum was present. Committee Members Present: Tim Jones Bob Beers Frank Nemec, MD Mary Beth Scow Lois Tarkanian Chair, At-Large Member, Regulated Business / Industry Councilmember, City of Las Vegas At-Large Member, Physician Commissioner, Clark County Councilmember, City of Las Vegas Committee Members Not Present: Susan Crowley At-Large Member, Environmental Specialist Rod Woodbury Councilmember, City of Boulder City Other Board Members Present: Michael Collins, RN Alternate At-Large Member, Registered Nurse (in audience) Legal Counsel: Annette L. Bradley, Esq. Staff: Bob Gunnoe Diana Lindquist Public Attendance: Norine Clark Lorraine Oliver Amanda Oliver Human Resources Administrator Recording Secretary SNHD SNHD Self P.O. Box 3902, Las Vegas, NV 89127 / 702.759.1000 / fax 702.759.1412 / www.southernnevadahealthdistrict.org

Southern Nevada District Board of Health Page 2 of 5 II. PUBLIC COMMENT Public comment is a period devoted to comments by the general public on items listed on the Agenda. All comments are limited to five (5) minutes. Chair Jones asked if anyone wished to address the committee pertaining to items listed on the Agenda. Norine Clark She questioned the agenda as to why the Health District would be recruiting nationally for a Chief Health Officer (CHO) when Dr. Middaugh, as Interim CHO, would be working with Dr. Coleman, Director of Community Health, to have Dr. Coleman step into the CHO position. She would like the Board to take this into consideration so employees may have some stability. She complimented both Dr. Middaugh and Dr. Coleman. Chair Jones stated we owe it to the community and to the Health District to open up the CHO recruitment to all possibilities whether it is with existing staff or nationwide search. Ms. Clark suggested that the new CHO have public health experience in addition to being a physician. Lorraine Oliver Commented on their appreciation of Dr. Middaugh meeting with them and feels the responsiveness of administration and the morale of the employees have improved since Dr. Middaugh became the Interim CHO. The Health District now has a presence in North Las Vegas. Michael Collins, RN, Board of Health Alternate At-Large Member, Registered Nurse Wants the Board to consider Dr. Tom Coleman as a candidate for the CHO position as he has experience within the community and the Health District and is very well credentialed. Hearing no one else, the Chair closed this Public Comment portion of the meeting. III. ADOPTION OF THE OCTOBER 4, 2012 AGENDA Chair Jones called for a motion to adopt the agenda for the meeting as presented. A motion was made by Member Scow to adopt the Southern Nevada District Board of Health Chief Health Officer Succession Committee meeting agenda; seconded by Member Nemec and carried unanimously. IV. REPORT / DISCUSSION / ACTION A. Discuss Past Recruitment History for Chief Health Officer Position Bob Gunnoe, Human Resources Administrator, stated that there have been only three CHO s at the Southern Nevada Health District, formerly known as Clark County Health District. Dr. Otto Ravenholt was the first. He started in 1963 and served over 30 years. Dr. Donald Kwalick served as the Assistant CHO prior to becoming the CHO. Dr. Ravenholt promoted Dr. Kwalick to replace him when he decided to retire. Dr. Kwalick served as the Health District s second CHO from 1998 until 2007. At that time, there was no official recruitment process beyond local posting and entertaining of candidates that responded to that posting. Dr. Lawrence Sands became the third CHO. Dr. Sands came to the Health District from Maricopa County and served as the Director of Community Health prior to becoming the CHO. The recruitment for the Director of Community Health was a national search in which Dr. Sands was a candidate. Both Dr. Kwalick and Dr. Sands were internal appointments. A national search had been conducted and interviews held prior to appointing Dr. Sands as CHO. Mr. Gunnoe mentioned that when

Southern Nevada District Board of Health Page 3 of 5 the national recruitment was held for Director of Community Health, it was considered that this position would become the CHO replacement when Dr. Kwalick retired. A national recruitment agency was used for the recruitment of the Director of Community Health position, which was CPS of California. B. Review, Discuss, and Approve a Professional Recruitment Agency and Terms of Engagement; and take any action deemed appropriate Chair Jones suggested that, since there is a possibility there may be a change in terms of the Health District s structure as a result of the upcoming legislative session, consideration should be given to postponing hiring a professional recruitment agency, members of the Committee should have a discussion with Dr. Middaugh and Dr. Coleman to determine their interest in the position, and determine Dr. Middaugh s ability and willingness to continue as CHO through the Legislative session. Annette Bradley stated that regardless of the outcome of the Legislative session regarding restructuring of the Health District, the Health District would still need a CHO and recommended the Committee move forward with its recruitment process parallel with the other issues identified. Member Nemec felt it would be in the Health District s best interests to take a proactive stance and proceed with having a CHO and that the CHO should have a masters in public health or other advanced administrative degree. The Committee discussed the potential that, as a result of the Legislative session, the CHO job description may change to reflect a division between administrative and medical duties. Chair Jones stated this model may not be the best for the Health District. Member Beers expressed he would rather hold off on the CHO recruitment not so much for the legislative clarity, but for the Health District to analyze its inside applicants to avoid expending money on the recruiting agency. Member Scow stated the Health District could start identifying the qualifications and laying the groundwork it wants in a CHO. Member Nemec suggested the CHO recruitment reflect that the position is subject to Legislative change of the scope and responsibilities. Chair Jones mentioned that NALBOH (National Association of Local Boards of Health) would be a good resource for helping with the CHO position statement. There was discussion on the recruitment agencies and it was noted that the last recruitment agency used by the Health District for a national search was done by CPS for the Director of Community Health. The Health District s Human Resources Administrator was directed to come up with the CHO job specifications, see what resources the Health District can utilize with NALBOH, and pass this by the stakeholders such as the Nevada Resort Association. C. Determine Next Steps for Chief Health Officer Succession Committee and Approve Recommendation to the Full Board Member Beers suggested a preliminary search be done and information gathered from a variety of sources, such as with NALBOH, regarding the CHO job description and present this to the full Board and solicit their input. The CHO Succession Committee can then meet a week after the full Board of Health meeting to discuss search firms and the rest of the recruitment process. Chair Jones asked the Committee members if the current structure of the Health District is the most effective for the Health District, or is a change to an administrative officer plus a medical officer more effective going forward. If that change is more effective, how would the Health District go about getting that up to the Legislature? Member Nemec suggested that if this position was endorsed by the Board of Health, the Legislature may approve and facilitate that. Chair Jones felt because of the work complexity, it would make the most sense to have two people, one with medical background and one with administrative background. Mr. Gunnoe

Southern Nevada District Board of Health Page 4 of 5 commented that Dr. Middaugh had suggested there be an Assistant CHO or Chief of Staff that would be subordinate to the CHO. Chair Jones suggested that through the NALBOH group, the Health District can look at different management models other communities use. Member Beers stated that these model comparisons may have been discussed at the 2005 Legislative session and that it might be helpful for the Health District to request from the Legislative Counsel Bureau any research they did comparing public health agency management models at the time the qualifications for a CHO were last amended. Member Beers suggested that once we receive this documentation and information, the Health District may provide it to the chairs of the Legislative health committees. The following motion was made by Member Beers, seconded by Member Tarkanian and carried unanimously to: 1. Tim Jones and Mary Beth Scow to discuss with Dr. Middaugh his interest in continuing as CHO during the course of the search. 2. Have legal counsel place a public records request to the Legislative Counsel Bureau regarding research pertaining to comparing public health agency management models at the time they revised NRS 439.368 that changed the qualifications of the CHO. 3. Bob Gunnoe, Human Resources Administrator, will update the candidate specifications for creating the best candidate profile. 4. Place an item on the next Board of Health agenda on October 25, 2012 for the Chief Health Officer Succession Committee to update the full Board on the state of action of the CHO selection and solicit input from the full Board regarding organization structure of the CHO position. 5. The Chief Health Officer Succession Committee to meet one week following the October 25, 2012 full Board of Health meeting. V. PUBLIC COMMENT Public comment is a period devoted to comments by the general public, if any, and discussion of those comments, about matters relevant to the Board s jurisdiction will be held. Chair Jones asked if anyone wished to address the committee. Michael Collins, RN Commented that Dr. Kwalick and Dr. Mary Guinan were both CHO s at the State, they worked under a CHO and administrator, and there were significant problems working under this type model. He asked the Committee members if they were aware of any bill drafts currently in place to affect this process. Member Beers mentioned that at this time, bill draft requests just have a vague one or two sentence description. The body of the bill, which is what the Health District needs, is absent. He was not aware of any placeholders. Norine Clark thanked the Committee and Board for their support during the Health District s transition. She really appreciates the Board taking their time to listen to employees concerns and offered their support to the Board. Chair Jones asked if anyone else wished to address the committee. Hearing no one, he closed the Public Comment portion of the meeting.

Southern Nevada District Board of Health Page 5 of 5 VI. ADJOURNMENT There being no further business to come before the Committee, Chair Jones adjourned the meeting at 2:10 p.m. Respectfully Submitted, Timothy Jones, Chair /dkl