Interview Applicant(s) for Assistant Health Officer position
Dr. Sands: Good morning.
Chair Fairchild: Good morning, sir. I don’t know how everyone wants to perhaps do this. If everyone wants ask a question, or would you like to have Dr. Sands just kind of do an overview, what is the Board’s, or committee’s . . .
Dr. Kwalick: Madam Chair, you all received Dr. Sands’ application and his CV, etc.?
Chair Fairchild: Mr. Jones?
Member Crowley: I think we all gave them back to …
Various members: We gave them back.
Angus MacEachern: I’ve got them.
Member Hardy: If I can while they’re being passed out?
Chair Fairchild: Please, Dr. Hardy.
Member Hardy: I think we were under the impression we were going to have some questions that were going to be common threads through this whole process so we could like we were being consistent with what we were doing and I don’t know if we’d had those generated or not.
Chair Fairchild: Angus, were you able to develop those for us?
Angus MacEachern: Excuse me, ma’am?
Chair Fairchild: Were you able to develop a list of questions for us?
Angus MacEachern: When we only had one applicant, the word I received was that we were just going to do a general interview. I’ve got the applications out for you. Many times we start by asking a person why he wants the job.
(Laughter)
Angus MacEachern: . . . as a starting point.
Chair Fairchild: A Reader’s Digest Condensed Version of why you’d like this position.
Dr. Sands: Well, sure. Well as most of you may know, I’ve been here almost two years as the Director of Community Health. I came here originally from after having a public health career in Arizona for about seventeen years, and looking back I’ve been very happy with the decision to come here. There’s certainly a lot of opportunity to do a lot of work in public health here in Nevada, and particularly in Southern Nevada. I have enjoyed my time here with the health district and have found it to be a, you know, special place, very unique, I think compared to some of the other places I’ve worked in terms of, you know, its involvement in the community and its role in the community and particularly, you know, how it’s very much a very important part of the viability of the community. And I like being part of the, part of an enterprise like that. I’ve, in the two years I’ve had a chance to learn about the health district, not just in terms of learning my job, but learning about the community, learning how the health district works, and being able to understand the dynamics of what makes the community run and how the health district plays an important part in helping to maintain, as I said, the viability and the overall infrastructure of the community. And I see by stepping up to take the Assistant Health Officer position, it gives me a chance to be able to work in a much more expanded way in the community, and be able to serve the health district and potentially also be considered as a candidate for Dr. Kwalick’s successor.
Chair Fairchild: If you had one professional goal and one personal for the District, what would they be?
Dr. Sands: I think professional goal for the District would be to look at, to build on the success of the District, and to develop its image and, you know, its role in the community as in terms of building that support, and building on the support in the community and making it, having it being very much connected to all the different elements of the community that help to make this, Southern Nevada, a wonderful place to live. I think with internally, I think one of the things, I’d like a goal would be to continue to improve, you know, how we communicate, not just with our external partners, but also with staff so that we, how we’re keeping everybody informed about how the District operates, what some of the issues are facing the District, and how, the role we play in the community as, showing that everybody’s on the same page so that we all can work together as a team here in the District to make this a good place to work, but also to provide the maximum benefit to the community.
My personal goal is really to continue to grow as a professional and continue to take on leadership role of being able to have an impact on the health of the population. That’s one of the reasons I went into public health and left private practice. It was, you know, quite rewarding to be able, you know, to see patients one-on-one individually, but soon in my career I began wanting to have a little bit, ability to have more impact. And I think by working in public health you get the chance to apply what you know in medicine to the overall health of the population and that’s something that I found in my career to be the most satisfying to me.
(Comment) Very good.
Chair Fairchild: Mr. Jones?
Member Jones: Could you maybe give us an example of one program or process that you got initiated with the public health services here and you put together the overview of the mission and how it became such a success with that?
Dr. Sands: Well, a number of different areas. The first charge I had was to create a new division. And in doing that, pulling together the team for that division, creating some and cohesiveness between the different programs that up to that point had worked together in various ways, but never really kind of saw themselves as, you know, I think a cohesive team. Developing a mission, a vision, a strategic plan that has come to be very useful with the initiative we have right now with Knowledge Capital Alliance with the strategic planning process that we have. When that started, we had something in our division that we could start building on to, you know, as far as help us lead that process. So that’s one area.
The other is that I’ve been able to initiate some partnerships internally as well as externally. We’ve developed the Disease Prevention Control and Advisory Committee that is, has a role in our public health preparedness program in terms of bringing, identifying expert in the community at different levels, both medicine, different, different levels of medicine, science different aspects of the community so we have this kind of “brain trust” so that when we do get into situations with the community where we may have to issue guidance or actually give directives that really may change medical practice or how we do things in the community, that it’s coming not just from the health district but it’s coming from the peers in the community, so that we can all stand together and say this is how we’re going to do business or how we’re going to respond as a medical community to a particular issue. And that’s been put in place. We’ve met a couple time; we’re going to continue to meet into the new year as well.
And then last I would say is that one of the things I identified early on, the health district has been very good to me in supporting me going to an institute in Chicago back in my home medical school, back in Chicago where they’re looking to develop osteopathic medical educators and provide training. And so I was given that opportunity to do that, and in doing my project for that, one of the things I identified is that we had a lot of training going on here of health professionals. And as well as that there was increasing demand for the different health professional programs to use the health district as a training site; but we didn’t have any kind of infrastructure in place – it kind of just kind of happened in different ways. And so what I did was I initiated the Academic Affairs Committee where we developed a process of how we, you know, register students, track them and how we make sure when they’re coming into our facility that they’re meeting our requirements as well as that they’re also going to provide something back to us as much as, well you know, as we’re able to give them what they need to meet their academic needs.
Member Jones: Thank you.
Chair Fairchild: Dr. Hardy?
Member Hardy: I’m just absorbing it all. As I look at your qualifications and everything that you’ve been involved with, I appreciate the experience you’ve had and coming to a new position, and then going to another position, and then going to another position, I think the goals question and what you’ve done is very apropos. The transition. How do you see the transition happening and how would you like to see it happen? What would you like to see that process become in specific ways?
Dr. Sands: Are you talking about the transition from my current position …
Dr. Hardy: From where you are to assistant to successor. What would facilitate that transition so that staff could say, yes you not only have the vision, but you have the wherewithal to accomplish that?
Dr. Sands: Right. I think what I would like to see is, you know, certainly Dr. Kwalick and I identifying some particular areas where, above and beyond what in the areas where I should be, could be initiating work in above and beyond what I’ve already have done that would again help with moving the health district forward, as well as the same time prepare me for having even more knowledge or experience in the workings of the health district, and as well as the, working with the community. I think one of the things that, I think, would help with the transition is to meet with certain key people in the community that a health officer would have to able to have a relationships with and would be having interactions with on a regular basis and certainly represent, key people who represent areas of the community where it’s important for the health district to have partnerships and have a, you know, strategic alliance in that vein. And then the other, I’d say, is to continue looking at developing, using the opportunity of the strategic planning process as a way to be able to help with that transition, because whoever takes, you know, moves up to that position is going to be left with having to use that strategic plan and to see that it comes to reality, and I think the part that I would like to see is, to see how that gets, see that process gets well integrated into the District and how we it gets used as a tool not just by staff, but by management so that it’s not just something on paper, that it is something that we really do use as kind of our compass so that to help develop the health district into the future.
Dr. Hardy: Thank you.
Chair Fairchild: Ms. Crowley?
Member Crowley: I’m doing the same thing; I’m absorbing all of this and taking it in.
Chair Fairchild: OK.
Member Crowley: No questions.
Chair Fairchild: Dr. Christensen?
Member Christensen: You’ve lived here for two years?
Dr. Sands: Mm-hmm.
Member Christensen: What’s your passion?
Dr. Sands: What’s my…
Member Christensen: What do you want to fix, given unlimited resources? Where do you see your future problems and what’s your passion that you need to fix?
Dr. Sands: Passion, need to fix. (Sigh). One of my passions, and this goes back to my, you know, experience in the areas where I’ve had success before is looking at the childhood immunization issue, and that is something that, and it’s not just about protecting children against vaccine preventable disease, I mean it’s certainly, that is the immediate outcome that we’re looking to achieve. But also, it’s, it gets so tied into how we deliver preventive services to children and as well as others in the community that it’s, there’s been a lot of good research into it and we, you can show good associations that children who aren’t getting their immunizations probably aren’t getting other preventive services. And by that token, moving that on, you know, if we’re not able to provide preventive ser…, see the children get preventive services, then what are we doing for preventive services for other members of our population? And so I think that, you know, that’s something that I’d certainly would like to be able to focus in on just for those reasons alone to, again, to look at using that as a model how we work together with, you know, the medical community and others in the, other partners in the community, how do we deliver, ensure that preventive services are getting delivered, both to children, but others in the community so that it’s an integral part of how we deliver care and how we all work together. So there is that emphasis on prevention and that there’s a higher level of emphasis on prevention than there is now because certainly, this is true in a lot of, most places in the country, is that, you know, a lot of the emphasis is still is on acute care and I think by raising that awareness and really focusing on a single issue, like childhood immunizations as a leading indicator of preventive services that we can do a lot to create more of that emphasis on preventive services.
Member Christensen: The ILM report says that we’re killing hundreds of thousands of people. There’s a couple campaigns out there that hundred thousands lives leapfrog, things like that. How does that fit into public health?
Dr. Sands: In terms of…coming…we’re killing hundred thousands…oh, you mean as far as patient safety?
Member Christensen: Acute care and safety.
Dr. Sands: Absolutely. OK. Acute care. I mean that certainly is a concern with, again, of public health, cause that again is another form of prevention in looking at how, you know, how can we work with our partners in the community to ensure not only are people getting preventive care and getting the health care they need, but making sure the care is delivered efficiently and safely. And certainly I think one of the areas that the health district has, works with very closely and has a big impact, is through the emergency medical services area which is one the, you know, one of the main goals of that, of our program is to ensure that people get the care they need, they get effective care and they get it safely. And that whole process that we use with the Medical Advisory Board, and you just saw this morning that, you know, the Trauma Advisory Board and the Trauma Medical Advisory Committee, Audit Committee, is that’s working towards trying to, you know, play a role into reduce errors and improve patient care and safety overall. So I’d say that there are ways for us if you use that as a model, there certainly is a role for us to be playing in that.
Chair Fairchild: Any questions? Any other questions?
Member Christensen: We’ve got time if we keep going.
Chair Fairchild: Mr. Empey?
Member Empey: Dr. Sands, I’m going to ask you a very hard question and then you can talk to Dr. Kwalick. I’ve given him very front, hard questions, decisions. He and I have been working together for twenty-five years. And my background goes back forty-seven years . . .
Dr. Kwalick: Seems like twenty-five.
(Laughter)
Member Empey: . . . about forty-seven years. As you well now, this is a very large and exciting city and community . . .
Dr. Sands: Mm-hmm.
Member Empey: If we have a bio-disaster, how you gonna use the staff?
Dr. Sands: Well, first of all, I mean, as you’re aware, we do have plans in place. They’re constantly being developed and tested and then, you know, re-developed. Staffing is a big concern that I don’t think any health agency has, will have enough of staff to be able to, to be able to respond in, just with that staff that they have. And I think that the role that we’re going to require everybody here in the District to play some role in responding to, in a bioterrorism event. A lot of times the role is going to be more in terms of leading others into intervention, strategies, countermeasures that we design and put into place. And so that’s how I see, you know, we’re going to use a lot of our staff is, you know, is more in that terms of being able to work together, help to pull together the operations or interventions, and the countermeasures, but also having to organize people, other people in the community to help with the implementation and delivery of those countermeasures.
Member Empey: You’re going to make some decisions that people are not going to like.
Dr. Sands: That’s correct. I mean, and again that’s one of the reasons why we developed the Disease Prevention Control and Advisory Committee, so not so much as, you know, again, the idea of having that kind of shield, but it’s more for that, you know, that there are going to be some decisions that are going to have to be made together with other partners in the community so it’s, so the decisions come out, say for example closing schools in a pandemic. That that’s something that we’ve talked with the school district about that, you know, that’s a decision that is going, probably should be made together with the school district, the health district and probably some of the, you know, municipalities as well, because that’s going to have a big impact on, you know, operations throughout the county, and so we all to be able to go into that together understanding, you know, what, why that’s being done, why that needs to be done, and how we’re going to be looking at the impacts of that.
Member Empey: Thank you.
Chair Fairchild: Mr. Vigilante?
Member Vigilante: In reference to the hotel/casino industry . . . and the relationship to be built other than put aside the regulations set forth. What goals or possible programs or participation would you consider in having the relationship grow together other than just a regulations set forth? Have you thought about that?
Dr. Sands: Yes. It’s, I think we’ve been doing a lot of work in that. I mean, one area is certainly with preparedness and that we’ve already initiated, as you know, several processes to work with the casinos so that they can operate as dispensing sites in an emergency so that, you know, it will help both us be able to achieve our goals, as well as the goals of the casinos. Again, it gets back into that whole thing where, all you know, in an emergency of bioterrorism event I mean, we’re all going to have to respond together as a community. So, exercising together, planning together is ways that we bring everybody together so we’re all clear about how we’re all going to operate during those times, and identify where we need to develop a formal relationship, formal relationships. Like right now, we’re working the formal relationships with the casinos to, so they can serve as dispensing sites and perhaps as alternate care sites of some kind or another. So going from there to the other is that in getting back to having an emphasis on prevention services, I think the other with the casino/resort community and employers in general, but the casino/resort community is a major, the major employer, is to work together on workplace health promotion and chronic disease prevention/health promotion-type activities because certainly there’s a lot of resources we have here, even though, you know, we do have a limited staff, they’ve been able to accomplish quite a bit with the resources they’ve had and develop tools and programs that we, you know, that can certainly be adapted and delivered in the workplace settings. And that’s in fact one of the areas that we’re, you know, looking to move more into with our chronic disease/health promotion program as we go into the future.
Member Vigilante: Thank you.
Chair Fairchild: Mrs. Toney?
Member Toney: My question, and I don’t think, it’s not intended to be the same as Dr. Christensen, but my question would be what challenges, and I’m sure there will be several so maybe you can think about the two challenges that you would be faced with and how you would handle that.
Dr. Sands: Two challenges, you mean here in the District?
Member Toney: Yeah, you’ve been here, what, for a couple of years?
Dr. Sands: Couple years, right. I think, well, you know, I’ll give you two, the challenges. Certainly one is funding . . .
Member Toney: Excuse me?
Dr. Sands: Funding. Funding is always a problem with all organizations, but particularly with public health organizations, that one of the areas is funding is that, to be sure that we’re getting, I think that Southern Nevada is getting its fair share of federal grant dollars that come through the State, because certainly having the largest part of the population down here and having much of the economic engine for this State, it’s important that, you know, you know, both the scale and the size of the issues that we have are much greater. But also it requires that we have need, can have the resources that match the scale of work that that we’re expected to do to control things like S, sexually transmitted diseases, and to see that kids get immunized, and make sure that we’re able to care for patients, people who have tuberculosis, as well as, you know, be able to prepare for pandemics and so forth. So that’s certainly one of the areas that is going to have to be addressed on a number of fronts both at the federal, you know, working with our federal partners but also with our state partners, and also with the other local health authorities. And that’s something that we’ve experienced in the past year, working with the local health, other local health authorities to address that, how to say it, to be sure that, to assure that there’s equitable allocation of funding within the State when funds come into the State for different public health activities. And the other is, is also to see that, to work with the Assembly, with legislature to see that public health does get the resources it needs to do the job that, you know, we’re that expected to do to protect citizens of Nevada here, particularly in Southern Nevada.
So, you know, that’s one and the other one, again, is, I think the other challenge is just the shortage of health care professionals, and just health care resources in the state, not just Southern Nevada. I think that definitely, particularly as a new person, you know, has a family and, you know, you have to seek health care sometimes, it’s, I’ve had personal experience with understand, to bring me to the understanding of that. We just don’t have enough people to meet the demand. I think, you know, we have, people get good health care when they’re able to get it by and large, but they don’t, there just isn’t enough of it. So, and I think that shades everything that we do, it makes, it just adds just another, increases the barriers that people have to getting care, and also increase our barriers to being able to initiate different programs because people are just overloaded, and there’s also, you know, even just maintaining a workforce here at the health district sometimes, you know, we have difficulties in making sure that we have enough trained professionals to do the work that needs to be done.
Member Toney: Thanks.
Chair Fairchild: Ms. Mattocks?
Member Mattocks: If I were to go out to the staff that report to you or that work closely with you, and ask them about your management and leadership style what would they tell me?
Dr. Sands: I think they would tell you that I’m, work from a team management approach; that my focus is to try to put together the team, promote leadership among the staff, to, you know, give them direction. There’s definitely times that I have my ideas of how things should be done, or could be done, but, you know, I try to give people enough room to innovate, because that’s a key part of what, you know, we try to strive for in our division, and my experience has always been usually the best question to ask people, well how would you like to do this? Because usually people pretty much come up with some very good ideas and in particularly since, you know, they’re the ones that are going to have implement it or direct it in working the front lines, that they, you know, usually best know what’s going to work at the front lines. I, you know, I think my job is to make sure that, you know, they have the support they need to get, to do their job. So I’d say that. You know, I try to bring some humor to work, to the job, that, you know, that everything’s not so, you know, so deadly serious; but, you know, I think it’s okay to have fun at, you know, your job, but you also have to stay focused on, you know, why you’re here and on the mission. And, I, we, I think people say that I’m dedicated, you know, that I work hard. I try to, you know, put in the time that needs to be put in to get, to see, to get the job done. And to make sure that, again, that people get the support they need so that they can get their work done.
Member Mattocks: Thank you very much.
Chair Fairchild: Are there any further questions? Very good. Dr. Sands, thank you so much for your time.
Dr. Sands: Thank you.
