Six of the state's 61 health departments are losing their directors; pandemic made some of them delay or advance their departure

By Melissa Patrick

Kentucky Health News

Nearly 10 percent of the state's health departments are losing their directors, with five retiring and one resigning. And the 61 district and county health departments are losing other staff due to fatigue and stress of the pandemic.

Some of the directors who are leaving say it's due in part to the pandemic; others say it made them stay an extra year. "Many of us did not want to leave during the height of the Covid response," said Dr. Kraig Humbaugh, commissioner of the Lexington-Fayette County Health Department.

Sara Jo Best, president of the Kentucky Health Departments Association, said the pandemic has caused exhaustion, stress and depression among many public-health employees and has likely contributed to retirements.

"The health-department employees were either loved or hated at various times throughout this pandemic," Best said. "So it wasn't uncommon for us to get threatening phone calls, for us to have terrible encounters with individuals. People thought we were doing too much or they thought we weren't doing enough. There were a lot of things that got politicized that should not have. So you know, not only did they work long hours, gave up weekends, gave up holidays, didn't see their families, but on top of that, sometimes they were subject to a lot of verbal abuse and sometimes physical threats."

Best said she didn't know the number of retirements. The state Department for Public Health declined to provide the number of employees or the names of the directors who are retiring without an open-records request. Best provided the names of directors who are leaving by Aug. 1, the most popular date for state workers; some are already gone, due to accumulated vacation and sick time.

Besides Humbaugh, the retiring directors are Lake Cumberland District Health Department Executive Director Shawn Crabtree; Northern Kentucky Health Department District Director of Health Dr. Lynne Saddler; Graves County Health Department Director Noel Coplen; and Ashland-Boyd County Health Department Public Health Director Maria Hardy.

Kayla Bebout, public health director at the Christian County Health Department, is resigning, effective July 16. 

Kayla Bebout

Bebout, who has been in public health for 14 years and director since 2017, said the pandemic was not the only reason she was leaving, but it played a role in her decision. Bebout said she is moving to a job outside public health and hopes to come back eventually. 

"I feel the personal need to step away mentally, spiritually, physically for little bit, and to get refreshed," she said. "I have intentions of hopefully coming back to public health, but at this moment, I've got to do what is best for me, personally and professionally and that is to step away for just a little bit." 

The state has 61 district and county health departments, with most counties as part of a district.

Coplen, of Graves County, has worked in the state system for 34 years, 28 with the health department, said he had decided to not leave during the height of the pandemic. "I just felt like I owed it to my community and my staff that was working so hard, all of our public-health partners," he said, adding that he is leaving now because "It was time for me to retire."   

Shawn Crabtree

Lake Cumberland's Crabtree, who has 30 years invested in the state retirement system, 20 as district health director, said likewise.

"Actually, Covid prompted me to stay," he said. "I was gonna retire last August. But, you know, my board and my community and my staff have always been good to me and they're important to me, and I saw this pandemic being . . . the thing that I've been training for, for the last 19, 20 years. And I really didn't want to walk out and leave the people that's been good to me. And, you know, it was an overwhelming experience. So to think about handing that off to someone who may or may not have had . . . any kind of background or expertise, I just, I didn't feel like it was the right thing to do."

Crabtree said he was leaving because it makes financial sense to do so. "There just comes a time when you're in the retirement system, that financially it doesn't make sense to continue to work at the job," he said. State employees 57 or older can retire with full benefits when their age and years of service equal 87.

Hardy, of Ashland, said in a text reply to a voice mail that she has planned for three years to retire on July 31 of this year.

Dr. Lynne Saddler

Northern Kentucky's Saddler, who has worked in public health for 30 years, 11 in Northern Kentucky, acknowledged that the pandemic has been hard on her and her staff. She said that in January, she realized that the "stars aligned" and it became evident that for a number of reasons it was time for her to retire -- one reason being it's time for the department to do its community health assessment and reset priorities.

"I felt like it really should be done under new leadership, the person who's going to carry the health department forward to its next chapter should be the one at the helm going through these planning processes," she said. "And so it was a good stopping spot for me and it was good for the agency." 

Humbaugh was senior deputy commissioner of the state health department before becoming commissioner of Lexington's department in 2016. He said he would be seeking other opportunities.

"I know that there are several people that are leaving, but some of us actually kind of stayed on . . . because this was so important," he said. "I told our board last winter that I [thought] we'd have more control over Covid this summer, so it would be a good time for me to transition away."

He stressed that while the state has made great progress against Covid-19, it's important to remember it is not over yet, and the mental health needs of public-health employees should continue to be addressed. 

Mental health, public health and the pandemic

Challenges of fatigue, stress, depression and post-traumatic stress disorder among public-health workers have been widely reported during the pandemic.

A recently released Centers for Disease Control and Prevention survey of more than 26,000 public-health workers found that 53% reported symptoms of at least one mental-health condition in the past two weeks, including PTSD (37%), depression (32%), anxiety (30%), or ideas of suicide (8.4%). Symptoms were more prevalent in those who were not able to take time off or worked more more than 40 hours a week. 

In response to many of these concerns, Best said the state health department has surveyed its employees and provided some mental-health training, and local departments have done internal assessments and offered supports. 

"We hired a group to come in and do sessions with our staff," said Best, who is the public health director at the Lincoln Trail District Health Department. 

Crabtree, of Lake Cumberland, reiterated some of what Best said about the stress of the pandemic, saying his staff never knew when they picked up the phone if it would be in support or in opposition of their work. "That's a grind," he said. 

He said one way his agency handled the stress is to give staff opportunities to take some time off if they were feeling burnt out or overwhelmed, even when it was not convenient to do so.

Dr. Kraig Humbaugh

Humbaugh said the Lexington department has "recharge moments," encouraging employees to take breaks and do any number of given activities, like yoga or working on a puzzle. In addition, he said employees have access to an employee-assistance program.

Saddler, from Northern Kentucky, said her agency also works on supporting employees' mental health, first and foremost by talking about it, and making sure everyone knows they have a comprehensive and  confidential employee-assistance program. 

"There are times in our lives, all of us, including me, when you need to have that person, that objective person to talk to and work through things and that there's no shame in it and that it's something to take advantage of because it is so beneficial," she said. 

Saddler added that it's important to know that "we are all forever changed personally and professionally by this pandemic," and that she tries to convey to her staff that "we need to be kinder and gentler to ourselves and we need to be kinder and gentler to each other moving forward."

State Health Commissioner Steven Stack told Jack Brammer of the Lexington Herald-Leader that he knew there always has been public criticism of government, but dissent from sound medical advice took “an emotional toll” on him as he and Gov. Andy Beshear tried to save lives.

“What kept me going?” Stack asked himself. “A lot of people out there who I think and hope saw someone who cared.”