Sacramento County Health Services Director Dr. Peter Beilenson is stepping down from his post Dec. 22 after just over two years in the position.
As the county launches a nationwide search to fill his place, grassroots organizations are calling for transparency and inclusion in the hiring process. And those who provide health care to low-income people and communities of color say whoever steps into the role needs to be ready to tackle both the worsening COVID-19 crisis and long-standing racial inequities in health care.
“I really think it’s time that we have a little more diversity in that position,” said Britta Guerrero, executive director of the Sacramento Native American Health Center. “The health issues the county director is focused on disproportionately affect people of color, and it would be really wonderful if someone understood the folks who are seeking services at the county and how to identify with those communities.”
The county created the Director of Health Services position during a structural reorganization in 2018. Their personnel services department says there’s only been one person besides Beilenson in the position — an interim director whose ethnicity is listed as Asian or Pacific Islander.
Last month, Beilenson faced criticism for referring to Asian people as “yellow folks” during a board of supervisors meeting. Beilenson says his departure is not related to that debacle or to the stress of the job, but to multiple family emergencies.
The county board of supervisors recently passed a resolution acknowledging racism as a public health crisis.
COVID-19 rates in Sacramento are highest among Native Hawaiian/Pacific Islander, Hispanic, Black and American Indian/Alaska Native residents respectively. Experts say that’s due to a combination of factors: people of color are more likely to hold essential jobs that can’t be done remotely, more likely to live in close quarters with other family members and less likely to have access to regular medical care than white people.
On Tuesday Dec. 8, community organizers urged county residents to call or email the County Board of Supervisors to demand an equitable hiring process for Beilenson’s replacement and multiple other staff positions that are open right now.
The People’s Budget Sacramento, a grassroots group that’s been pushing to divert public funding away from law enforcement and toward social services, posted on Instagram that they’d like to see Beilenson’s role filled by Dr. Olivia Kasirye, the county's current public health officer.
“Dr. K is extremely qualified and competent,” said Courtney Hanson, an organizer with the People’s Budget. “Unfortunately as a county we do not have a history of acknowledging and uplifting the leadership of people of color and Black women and it’s about time that we do that.”
A county health officer oversees health programs such as communicable disease surveillance, chronic disease prevention and health education, according to the county. They report to the health services director, who fulfills more administrative duties such as obtaining program approval, making budget recommendations and maintaining relationships with county supervisors and state and federal officials.
The county is currently in the process of appointing an interim health services director before Beilenson’s final day, and says it “may not be in the best interest of residents” to have Kasirye leave her current position during the pandemic, but that they are “considering all options for filling both the interim and permanent position.”
CapRadio asked health leaders from different communities what sort of person they’d like to see fill Beilenson’s position, and what issues county health officials should prioritize going forward.
Flojaune Cofer, senior director of policy for Public Health Advocates
Public Health Advocates Senior Director of Policy Flojaune Cofer
“We’re in the middle of a huge spike in cases, so how do we handle this? And also how do we handle all the other services that are needed? Because it’s not as if people suddenly stopped having diabetic comas or heart attacks or all other things we’re taking care of. So we need to have somebody who has those skills and can run departments focused on that.”
“If you’re about to start rolling out a vaccine, you need somebody who’s going to be trusted already to be able to be honest about what the pros and cons of that are. We just want to make sure the campaigns that are happening are happening with clear and concise and digestible information. We recognize that we have just gone through four years of having public trust in government agencies and information coming from them be undermined.
Dr. Olivia Campa, assistant clinical professor at UC Davis
UC Davis Assistant Clinical Professor Dr. Olivia Campa
“In my opinion, the biggest issue that we have moving forward is we have this dysfunctional care delivery system in Sacramento County. Whoever takes this position, I would hope that they would continue working on ‘how do we deliver better care to our Medi-Cal patients?’. That’s actually a very difficult and complex problem to solve … There’s been a fair amount of work to rebuild the delivery of Latino care. A lot of our undocumented patients in the region are Latino or Spanish-speaking. Part of having a dysfunctional care delivery system is when people are non-English speaking patients, navigating the system is much more difficult. Figuring out how to access primary care, specialty care, facing very long wait times. There’s already a lot of distrust in the community, so handling this with appropriateness is hard to do.”
Jonathan Porteus, chief executive officer of WellSpace Health
WellSpace Health Chief Executive Jonathan Porteus
“Someone needs to be articulate about the language of privilege, the language of implicit bias. Someone needs to be able to talk about it in a way that’s candid but not necessarily threatening to the point where it shuts down people of privilege, like myself. We need to learn to have cultural humility, and that comes with leadership and comes with the right person to have that dialogue.”
“The pandemic needs a very strong public health response, and I think overall the county needs to look for someone who really has the main focus as public health. I don’t think the county needs to worry so much about care delivery, the county can let that happen with the people who know how to do it. What this community needs is a county that has a strong public health emphasis.”
Joil Xiong, chief operating officer of Sacramento Covered
Sacramento Covered Chief Operating Officer Joil Xiong
“The county board of supervisors took action on [racism] as a resolution. It’ll be important for county leadership to use this as a lens through which they evaluate priorities and approaches. Some action items a new health services director could take to better serve communities of color include open dialogue with community leaders, funding for community-based organizations that represent and work with and empower those communities, a community advisory body that gives voice to historically marginalized and under-represented groups.”
Britta Guerrero, chief executive officer of the Sacramento Native American Health Center
Sacramento Native American Health Center Chief Executive Britta Guerrero
“We do have many federally qualified health centers in the county and we’ve been assigned the majority of the Medi-Cal lives, so I’d love to see the county fill that space to care for [the] undocumented and the uninsured. The FQHC’s have been filling this space … really the functionality of the county should be to cover those members.”
“It seems like when folks enter the county system for behavioral health, they’re not successful in completing that treatment. And so having culturally appropriate behavioral health and residential substance abuse treatment services available … our success rates are much higher obviously because we take into account all of the cultural issues … I’m not sure if the Native community is actively receiving services with the county.”
Ryan Tiêu, executive director and mental health director of the Gender Health Center
Gender Health Center Mental Health and Executive Director Ryan Tiêu
“We believe the county should prioritize a director that has an advanced understanding of intersectionality and its implications in our health care system. Centering the communities at the intersections of oppression will address some of health care’s most deeply rooted downfalls, which will improve the landscape of health care for all communities. This includes a fluency with Black, queer and transgender health disparities.
“The county can better the LGBTQIA community by providing multi-level and multi-pronged health care interventions, for not just individual health needs, but also systemic access and health justice for our most marginalized community members. Our communities need culturally competent health care from the county, and interventions targeting the social conditions from which these problems arise, such as poverty, racism and transphobia.”