Rowe, ex-health commissioner, had history of management difficulties

Issues preceded Hiring for Health job

mmeehan1@herald-leader.comMarch 14, 2011 

  • A rocky road for health department, ex-commissioner

    June 2001: Dr. Melinda Rowe, Jefferson County director of health, refuses to leave her job after being dismissed by Judge-Executive Rebecca Jackson. Jackson criticized Rowe's management and said she was concerned about a critical audit of Healthy Start, a program to reduce infant mortality.

    November 2001: Rowe left Louisville to become East Health District health director in Savannah, Ga.

    November 2003: Rowe is hired as health commissioner by the Lexington-Fayette County Health Department.

    June 2004: Lexington's Primary Care Center faces an "implosion" as doctors leave, and a management consultant reports an "atmosphere of intimidation."

    November 2005: Dr. Rice Leach becomes executive director of Lexington's Primary Care Center.

    March 2010: Leach retires. He later cites conflicts with Rowe as the reason for his departure. An investigation into the operation of the pharmacy begins by the Office of Inspector General and the state Board of Pharmacy.

    August: Dr. William North is hired as head of the Primary Care Center.

    October: Kyle Black, chief operating officer of the Primary Care Center, is reassigned, and Surinder Sabharwal, chief pharmacist, is suspended with pay because of a pharmacy investigation.

    November: Sabharwal returns to work but is reassigned.

    December: Rowe gets an overall positive evaluation by the board.

    Feb. 14: Board of Health reviews Rowe's decision to suspend or dismiss North.

    Feb. 24: North is reinstated.

    March 1: After a series of emergency public meetings where staff is highly critical of Rowe, she resigns as health commissioner. She takes a three-day personal leave and asks to be hired in the new position of public health physician.

    March 8: Leach, now health commissioner, extends Rowe's personal leave to weigh a decision about her future.

  • If you go

    Lexington-Fayette County Board of Health meeting

    When: 5:30 p.m. March 14

    Where: Lexington-Fayette County Health Department, 650 Newtown Pike, Conference Room C, third floor

After seven years and earnings of more than $1 million in a job funded by taxpayers, Dr. Melinda Rowe's tenure as head of the Lexington-Fayette County Health Department was undone in part by an issue that plagued her even before she took the job — her inability to manage people.

Records obtained by the Herald-Leader under a state Open Records Act request show that before Rowe was hired in 2003, five of the 12 people who evaluated her ability to do the job — including Dr. Rice Leach, the current health commissioner — questioned her ability to manage effectively.

Although none of them questioned her overall qualifications to run the department that now has 360 employees and a $28 million budget from state, local and federal money, some expressed discomfort with aspects of her personality.

"Her aggressiveness makes me uneasy. I am not sure how the staff will react to her," wrote Marge Keller, who has served as chairwoman of the Primary Care Center board and as a member of the health department's board. Keller said she had heard Rowe was "hard to work with and has left many 'enemies' in her wake."

While some evaluations by the Board of Health, which oversees the health commissioner, praised Rowe's knowledge of public health and her work ethic, the key to successful management seemed to elude her.

When the board meets Monday, it is expected to discuss Rowe's future with the department, said spokesman Kevin Hall. She has been on personal leave since resigning as commissioner on March 1. She has asked to stay on in a newly created position as a public health physician.

But the board has specified that, should Rowe get that job, she would have no supervisory authority.

Rowe's evaluations from 2008, 2009 and 2010 cited the need to improve staff morale and for Rowe to show staff members that she, not chief operating officer Rodger Amon, was the leader of the department. (Amon, who has had a long working relationship with Rowe, resigned the same day she did.) They also noted that Rowe needed to "delegate more wisely" and "seek appropriate assistance" when things went awry.

It's unclear what the board thought about Rowe's management in her early years as health commissioner. Ted Martin, an attorney for the board, said Rowe's first written evaluation was in 2006.

Rowe was hired at an annual salary of $154,000 in November 2003. But there are no evaluations for 2004, 2005 or 2007, although documents obtained through the open records request show Rowe received pay raises during those years.

Her 2006 evaluation contained a single handwritten paragraph from Dr. John Riley, then-chairman of the board. In the note, Riley praised Rowe's overall efforts, but he also wrote that "the one area the board did address was with regard to communication with the staff." He went on to mention "timeliness & presentation of information" as an area of concern.

Although Rowe's 2008-2010 evaluations reflect that the board thought she was improving, a management consultant was hired in 2010 to address issues of management and the work environment at the department.

On the advice of the consultant, some 30 years into her career as a public health executive, invoices show Rowe ordered books on public health management from Amazon.com.

The reading list didn't seem to help.

In a public meeting last month, Dr. Deborah Stanley, medical director of the Primary Care Center, talked about "the inability of our current leaders to provide a work environment that employees perceive to be safe and free of fear and intimidation."

State investigations

The resignations of the department's two top officers followed a series of emergency meetings and blistering public criticism of health department management by employees. Leach, who quit last spring as executive director of primary care because of disagreements with Rowe, was brought back by the board to serve as health commissioner.

He will decide whether Rowe will leave the department or stay.

While health department officials deal with those internal issues, there also are external pressures. The department is being investigated by the state Office of the Inspector General, part of the Cabinet for Health and Family Services, and the Kentucky Board of Pharmacy.

Two Primary Care Center managers — Kyle Black, the chief operations officer, and Surinder Sabharwal, the chief pharmacy officer — have been re assigned because of the investigation.

In addition, simmering tensions regarding the relationship between the Board of Health and the Primary Care Center, which provides medical care for about 17,000 poor people a year, has caused delays in moving forward with an $11.7 million federal grant for a new building for primary care to treat its patients.

Red flags in the past

Rowe; Leach; Dr. John Roth, chairman of the Board of Health; and William North, executive director of primary care, declined to comment for this story through department spokesman Hall.

Previous board chairwoman Marcia Stanhope also declined to comment.

But here is what public records and news accounts show:

Rowe refused to leave her job as Jefferson County director of health after feuding with Judge-Executive Rebecca Jackson in 2001. Jackson criticized Rowe's management style and was concerned about a critical audit of Healthy Start, a program to help reduce infant mortality.

Rowe has said her termination in Louisville was based on issues of politics, not performance.

After an apparently uneventful tenure as health director of the East Health District in Savannah, Ga., she came to Lexington in 2003.

Some of Rowe's evaluators before she was hired in Lexington noted that she "seemed inflexible" and "had problems with communication."

In 2004, a health department consultant said the Primary Care Center was in danger of "an implosion" because of the "bureaucratic nature" of the organization and the "atmosphere of fear and intimidation."

According to the evaluations of Rowe by the board, which has the authority to hire and fire her, the members of the panel appeared aware of problems with leadership, management and morale at the department for at least three years.

But, it's unclear whether they understood the scope of Rowe's problems.

Rowe's evaluation of Dec. 31, 2010, showed she "meets performance standards" for leadership.

Yet by March, she had resigned.

Who's in charge?

Some at the health department appeared to question who actually was running the show — Rowe or Amon, who was hired in 2005 on Rowe's recommendation.

In Rowe's 2008 evaluation, in an apparent reference to the influence of Amon as chief operating officer, the board members said they "would like for Dr. Rowe to be known by staff as the key leader of the staff and as the internal voice of the health department."

In the same evaluation, Rowe was praised for "improving communication with staff' by implementing a staff rewards program but was urged to "continue to work on improving staff morale."

In 2009, the board again praised her efforts and said she was making headway on morale issues. She was directed to complete a survey of staff morale by December 2009.

But, according to documents, that survey wasn't completed until mid-2010. Andrew Wiener, a former University of Kentucky psychology professor, was brought on as a $6,000 a month management consultant.

Rowe's 2010 evaluation noted "there is still ongoing strain among other administrative staff" but indicated progress had been made.

The board also suggested she "needed to improve on the way to delegate wisely" and noted she had "improved on leadership with Mr. Amon. Need to establish more of a leadership role with Mr. North. Improve relationship with HD (health department) and PCC (Primary Care Center)."

What the board saw as improvement apparently didn't translate to the workplace.

"While there has been talk of being open and transparent," Stanley said in her public comments last month, "health department leadership has not been able to gain the trust of the employees."

Reach Mary Meehan at (859) 231-3261 or 1-800-950-6397, Ext. 3261.

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