Perspective on Ottawa County Board of Commissioners and Its Health Department
Two mini grants give context.
As a public battle takes place between the Board of Commissioners and the Ottawa County Health Department, it is instructive to look back at two small, but not insignificant votes. On June 6, 2023, Sandra Lake, the Community Health Manager for the Ottawa County Department of Public Health, presented two mini-grants to the Finance and Administration Committee of the Board of Commissioners. Typically, approving mini-grants are simple decisions, where a committee approves these low-dollar amount grants with little-to-no questions, deferring to the so-called “experts.” Mini-grant approvals then go from the Finance and Administration Committee to the full board, where they are rubber stamped with approval.
But today in Ottawa County, we have a board that scrutinizes programs thoroughly, and does their research before voting. Sometimes this causes controversy and frustration with county employees used to operating autonomously, spending money freely, and implementing programs with ideological underpinnings.
These two mini-grants, wrapped in inviting language, were programs that should concern local residents. The first was a $5,100 mini-grant from MDHHS for a contract with Brightstreet Group for Process Mapping for a Community Information Exchange (CIE) (p.221). This contract was to be a “localized effort to create and sustain the technology and relationships required to support Social Determinants of Health (SDOH) needs of both individual and community.” It was to “maximize a person-centered approach by ensuring social care information is collected only as needed and is stored safely.” This grant was not to establish the CIE, but to “better understand local needs and work toward establishing a localized CIE.” Ms. Lake described the grant as needed to collect data to understand what health needs are in the county. The program, a bi-directional exchange of clinical data with focus on social determinants of health and ensuring health equity, would share data between communities and then the State of Michigan. While it was stated that CIE currently is not feasible at the state level, the data collecting and infrastructure built through this mini-grant could potentially lead to a state-level implementation.
The terms “health equity” and “social determinants of health” are key phrases. Ms. Lake described health equity as “everyone will be treated with dignity and respect.” Yet these phrases are more concerning than that simplified definition. When you go to the Michigan Department of Health and Human Services (MDHSS) website to look up Community Information Exchange, you’ll find a knowledge base resource list and a CIE Task Force Glossary of Terms. In the glossary of terms are definitions for health equity and social determinants of health. They are defined as follows.
Health Equity: Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. Health equity also means reducing and ultimately eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups.
Social Determinants of Health: The conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. Social determinants of health refer to macro patterns pertaining to population health that are observable in aggregated data.
According to the CDC, achieving health equity requires efforts to “address historical and contemporary injustices, overcome economic, social and other obstacles to health care.”
What these definitions begin to touch on is a Critical Theory approach to health. Critical Theory is a “Marxist-inspired movement in social and political philosophy.”
Implementing a Marxist-inspired approach to public health is not in the best interests of the county. It is an attempt to infuse another government system with ideology that divides people by class, race, or other identifiers, and begins placing qualifiers before the word and application of “justice”. This only leads to a perversion of the ideal of “justice”.
The other concern with this grant was the sharing of data and personal information of county citizens. The grant would provide data to the state, who would use that data to help develop their statewide goals and agendas. This grant focused on social determinants of health and social care, which includes referrals to non-medical resources, such as food pantries, day cares, and other areas of potential need. The referrals and data are not protected under HIPAA laws, which means as healthcare providers discuss social determinants of health and possible needs of patients, the information is not required to be kept private. The data collection under this grant would have been shared at the state level.
The second mini-grant discussed on June 6, 2023, concerned the development of a health equity policy and plan for a Community Health Advisory Council (CHAC) (p.235), at a cost of $7,000. One of the stated goals of this grant was to “develop a Health Equity policy, framework, or toolkit that will help influence health equity programming across multiple sectors including private organization, community organizations and public agencies.” As Commissioner Moss pointed out in the vendor information, the founders of Intersector Partners were trained in Equity, Inclusion and Anti-Oppression through Building Bridges Colorado. A quick search of their website shows training offered in courses such as “groundwork for white folks,” “uprooted for white folks,” and “confluence care for multiracial and biracial.” Building Bridges states they address “issues such as power and privilege along lines of race, class, gender, religion, sexual orientation, culture, and other identities.” Once again, we see the critical theory/Marxist lens being applied. Partner that with the focus on “health equity” and citizens should be alarmed. So, the commissioners expressed concern with the county partnering with an organization that highlights participation in such ideological trainings and potentially bringing that viewpoint to the county’s health department.
While these were mini-grants with small financial ramifications, the true impact was in the ideology that was being introduced along with them. While the opposition has resorted to meme-level outrage any time the board mentions Marxism or equity, the point to understand is that these programs actually do include this ideology. The reason for the outrage is that the county currently has a board that actually researches these proposals prior to voting for them. The frustration from the left, that Marxist or socialist ideas are being turned away, is understandable because the left has embraced Marxism.
The frustration has boiled over into what appears to be insubordinate behavior by members of the Department of Health, and anger from the left. It is instructive to keep in mind that while the previous board had a “republican” majority, they either didn’t govern as such, or were asleep at the wheel. Voting down these two grants is an example of fiscal conservatism and, more importantly, demonstrates adherence to limited government principles. Along with that, it provides a rare glimpse into an application of the check and balance process embedded into American government. To those pushing the leftist agenda — the health department, its partners at the state level, and outside organizations — the rejection of these two mini-grants sent a much larger message.