Clinton County is facing one of its biggest controversies in years, and it’s over the unlikely issue of where to build a new Health Department facility.
Several members of the Board of Health and other residents are opposed to the idea of moving the public facility from the county seat of Carlyle to the Breese campus of St. Joseph’s Hospital, which is operated by a private Catholic organization that has offered to donate the land.
Opponents argue that such a plan would violate the separation of church and state, limit services to female patients, allow the hospital to further monopolize medical care in the county, use taxpayer money to help boost corporate profits and put the facility in an area that lacks diversity.
“The hospital is going to have caveats and restrictions with any sale (or donation) of land,” said Dr. Deanna DuComb, a Carlyle dermatologist who’s leading the charge against the proposed move. “And these caveats and restrictions relate to women’s reproductive rights and birth control.”
DuComb has been serving four years on the Board of Health, an advisory panel of citizens in medical fields. She wanted to continue, she said, but the Clinton County Board didn’t renew her appointment at its meeting Monday night.
On the other side of the debate is the Health Department administrator, several Board of Health members and other residents who favor moving the facility to Breese.
Administrator Cheryl Lee said statistics show the western half of the county is growing at a faster pace than the eastern half; it would be convenient for Health Department patients to be near specialists, imaging and other hospital services if needed; and a Breese location could attract people from Madison and St. Clair looking for affordable care.
“There’s a lot of misinformation and fear out there,” she said.
Lee worked in Springfield before taking the Clinton County position five years ago, which she said makes her less susceptible to local politics.
“I want to make sure that we do the right thing for the right reason, and that the decision is based on sound public-health practices,” Lee said. “We want (a location) where we can be the most successful, serve the most people and have the biggest impact.”
The controversy over the health facility has gotten so heated in recent months that Breese Mayor Charlie Hilmes asked the Clinton County Board to remove DuComb from the Board of Heath because, he said, she had offended Breese residents by implying they were racist. DuComb has rejected that characterization.
Current facility in old car dealership
The Health Department is funded by grants, fees and taxes. It shares a former Ford dealership building in Carlyle with the Regional Superintendent of Schools Office. County Board Chairman Bob Fix said officials have been talking about building a new health facility for 10 years and there is widespread agreement that it’s needed.
“We looked into renovations of the current building and found out it was going to be more costly than building a new one because of the (Americans with Disabilities Act) compliance and other regulations,” he said.
The Health Department now offers services related to immunizations, food and water quality, tuberculosis testing, West Nile Virus and other communicable diseases, lead poisoning, emergency preparedness and programs such as Smoke-Free Illinois and Women, Infants and Children.
A new facility would add a primary care medical clinic, expand low-cost lab work and offer gynecology, behavioral/mental health and eventually dental-health services, Lee said.
“We are growing,” she said. “We need a bigger space, and we’re also bringing in new services to serve our residents.”
Initially, the county estimated that a new facility would cost $1.5 million, but that could change when the project goes out for bid. Lee said the Health Department could put down $500,000 or $600,000 and borrow the rest, hopefully from the county.
Fix said the County Board would have to approve such a loan, but if the Health Department borrowed the money from a private lender, it wouldn’t need board approval. DuComb questions that conclusion. State’s Attorney John Hudspeth couldn’t be reached for comment this week.
Donated land available in both towns
County officials have received three offers of donated land in Carlyle for the health facility. Fix said each presents challenges, ranging from parking availability to possible underground contamination.
DuComb said she thought the county was focused on making one of those sites work or finding another Carlyle location when Lee invited St. Joseph’s Hospital CEO Chris Klay to speak at a Board of Health meeting in November. Klay offered to lease a nurse practitioner to operate the new facility and discussed the possible sale or donation of land on the hospital’s campus in Breese.
“It just came all of a sudden,” said Board of Health member Michelle Scott, a veterinarian at Carlyle Animal Hospital. “It was bizarre. Before that, there was no discussion on the building being somewhere other than Carlyle.”
Scott is opposed to moving the health facility to Breese. DuComb called it an attempted “power grab” by the hospital.
Klay said this week he reached out to the Health Department last fall after learning of its plan to open a primary care medical clinic, thinking both organizations could benefit by working together. He said it’s common for public health facilities to contract with private vendors for lab work and other services.
Klay said St. Joseph’s is now willing to donate the land, but even if that donation is accepted, the county wouldn’t be bound to collaborate with the hospital on clinical services, and the Health Department would own the lot and building.
“We are not pushing this as a hospital, and we will not push it,” he said. “The choice sits with the county.”
Lee said the St. Joseph’s site isn’t the only one being considered and that other properties have been offered for sale in Breese, as well as Carlyle and Aviston.
“There has been no commitment,” she said. “There has been no decision.”
Restrictions follow Catholic standards
St. Joseph’s is operated by Hospital Sisters Health System, a Springfield-based organization that also owns St. Elizabeth’s Hospital in O’Fallon, St. Joseph’s Hospital in Highland, Holy Family Hospital in Greenville and 11 other hospitals in Illinois and Wisconsin, as well as clinics and other facilities.
One of DuComb’s complaints is that the vast majority of doctors in Clinton County are affiliated with the HSHS physicians group and the others are renting office space from the hospital. She said this eliminates independence and competition, lowers quality of care and raises prices.
“Doctors aren’t the masters of their own fate anymore,” DuComb said. “They’re owned by the hospitals. They’re hired guns. That’s because of increasing corporatization, and that’s happening across the country. But when you’re in a rural area, you don’t have any choice.”
DuComb also objects to moving the public health facility to the St. Joseph’s campus on the grounds that it would violate the separation of church and state and limit reproductive services for women, including counseling related to tubal ligations and other forms of birth control, which the Catholic church has historically opposed.
The land transfer would involve deed restrictions, Klay said. That includes prohibitions on abortion, physician-assisted suicide, human cloning, embryonic stem-cell research and euthanasia.
“These are basic ethical standards that, as a Catholic organization, we can’t ignore,” Klay said this week.
The Health Department has never provided abortions or any of the other four services that would be prohibited. It has provided birth control when grant funding was available, Lee said.
When asked how St. Joseph’s deed restrictions could affect birth control, Klay said, “The prescribing of hormonal therapy will be handled in additional agreement documents, as appropriate, consistent with the ‘Ethical and Religious Directives for Catholic Health Care Services.”
Discussion turns to racial diversity
DuComb, 69, has operated an independent dermatology practice in Carlyle for nearly 40 years. She’s been president of the Clinton County Medical Society about 15 years.
In recent months, DuComb has become a lightning rod in the battle over the new Health Department facility. She has spoken at public meetings and paid to publish a letter in local newspapers. Her husband, veterinarian Frank Buckingham, has argued her case on social media.
At a Board of Health meeting in February, DuComb reiterated her main objections to moving the facility out of Carlyle and added a new one: Lack of racial diversity in Breese. She questioned if African Americans would feel comfortable being in the city “after sundown.”
“Breese is segregated,” DuComb said this week. “It’s always been segregated, and there’s a reason for that. There are good people who live in Breese, but old prejudices die hard.”
Breese had eight black residents (.2 percent) and 105 Hispanic residents (2.4 percent) out of 4,442 total in 2010, according to the U.S. census. Estimates in 2017 reduced those figures to zero and 62 (1.4 percent), respectively. Carlyle had 88 blacks (2.7 percent) and 43 Hispanics (1.3 percent) out of 3,281 total residents in 2010, according to the U.S. Census. Estimates in 2017 increased those figures to 238 (7.5 percent) and 145 (4.5 percent).
Mayor Hilmes said DuComb’s remarks were offensive not only to Breese residents, but anyone who lives in Clinton County.
“She was trying to paint us with a wide brush and imply that we are something we are not, and I took exception to that,” he said.
Hilmes said the city has made improvements since the days of his youth in the 1950s and ‘60s and it’s now more welcoming. He said he’s never known of anyone being denied housing or services because of race, religion or sexual preference since he was elected to City Council in 1987.
Hilmes said Breese is a great place to live with affordable housing, good schools and access to a major hospital.
“I believe that statements like (DuComb’s) do harm to an area,” he said. “I’m trying to get new business to come to town, and if they hear things like that, they’ll think twice.”
Mayor asks for board member’s removal
At the County Board meeting in March, Hilmes made a public statement and requested that DuComb be removed from the Board of Health.
At Monday’s meeting, DuComb’s name was left off an agenda list of four people recommended for appointment or reappointment to the Board of Health. Chairman Fix said later it was because of her “derogatory” comment in February.
“There were a lot of board members who didn’t want that,” said Fix, who also is Breese’s police chief. He said he and other residents were “hurt” by her implication that the city is racist.
Hilmes said this week he doesn’t care whether the health facility moves to Breese or not, but if it does, the city will offer its full support and cooperation. Fix called the proposal a “win-win.”
The Clinton County Board of Health is supposed to have nine voting members, according to Fix. Before Monday night, there were eight, but three of them (DuComb, Scott, the veterinarian; and St. Louis University retiree David Munz) were serving terms that had expired due to county oversight.
The other five are President Stephanie Pitt, a nutritionist; Dr. Chris Rivera, a Carlyle family physician; Dr. Robert Hyten, a Carlyle dentist; Terry Linton, a speech-language pathologist and special education administrator; and Rafael Him, the County Board’s representative.
At Monday’s meeting, County Board members were asked to reappoint Scott and Munz and appoint nursing administrator Christy Picard and Dr. Erin Fancher-Gagen, a Trenton family physician, to the Board of Health. DuComb, her husband, Scott and County Board member Deb Wesselmann all questioned why DuComb’s name was left out.
“I was shocked when I saw the appointments made and that Dr. DuComb was not on (the list),” said Wesselmann, who’s also a non-voting Board of Health member. “She was one of the people on the board who insisted on getting questions answered, and if she didn’t get questions answered, she went out and found them herself.”
Board of Health future uncertain
Wesselmann said DuComb may have upset people with her question about African-Americans being uncomfortable in Breese, but that Wesselmann saw a Confederate flag on Walnut Street, near the hospital, and she believes people in all of Clinton County may have “work to do.”
Wesselmann said Board of Health meetings aren’t run properly and told Fix that she wanted to be removed if DuComb wasn’t reappointed.
County Board member Dennis Middendorff asked where the four names for appointments came from and, after he didn’t get an answer from fellow board members, Lee spoke from the audience and said it’s not always easy to find people willing to volunteer. That led Middendorff to conclude that she determines who serves on the Board of Health.
“This is an extremely unusual process,” Middendorff said. “In effect, she’s picking her own bosses.”
County Board member Brad Knolhoff questioned why Munz was recommended for re-appointment when he spends winters in Florida and often misses Board of Health meetings.
The County Board voted 13 to 0 for Scott, 11 to 2 against Munz, 7 to 6 against Fancher-Gagen and 7 to 6 against Picard. Fix abstained because of his Breese position and relationship to the mayor. After the meeting, Scott said she hasn’t decided whether to remain on the Board of Health if DuComb is not included.
“If people who have been working hard and doing a good job are unceremoniously dumped off a board, I don’t think that’s proper,” Scott said.
The County Board vote leaves the Board of Health with only six voting members and complicates decision-making on the new Health Department facility. In February, the Board of Health voted 4-3 to move it to Breese, with Rivera abstaining because of his HSHS affiliation. But that vote was declared invalid because Munz hadn’t attended a minimum number of meetings and Pitt is only supposed to break ties, DuComb said.
On Monday night, Him said he wanted to defend Clinton County from recent criticism on diversity. He said he has won elections in New Baden and participated in community activities with no problems, despite the fact he has South American and Chinese roots and his dark-skinned wife is from Panama.
“I’ve never been affected by racism,” Him said.