The Anchorage Health Department has seen unusually high rates of staff vacancies since early 2022 — rising to a rate of 36.6% last month, the highest since 2018, according to data provided by the city. July saw the department with 53 unfilled staff positions out of 145 total.
The city’s public health authority isn’t alone. Many state and local public health agencies in the Lower 48 are struggling to fill vacancies.
But the Anchorage Health Department — which hasn’t had a permanent director for more than a year — also has faced turmoil and multiple leadership shakeups under Mayor Dave Bronson’s administration.
Former health department director Joe Gerace resigned last summer, just ahead of a report disclosing he’d fabricated or exaggerated his credentials and work history. A string of resignations and firings of health department officials involved in the city’s homelessness response preceded Gerace’s departure.
Kimberly Rash, who was initially hired as the department’s administrative division director, has been serving as a temporary acting director since Gerace left. Several other key leadership positions in the health department remain unfilled. It’s missing a public health division manager, a human services division manager and an epidemiologist, according to the department website.
The health department has played a pivotal role in city oversight of the most significant issues to hit Anchorage in recent years — the COVID-19 pandemic and homelessness.
“Yes, the mayor is concerned,” Bronson’s office said in response to questions about the staff vacancies from the Daily News.
Other city departments have also seen numerous vacancies, including the police department. Due to a nearly 50% vacancy rate in the controller division, the city in February entered into contracts with private firms for up to $2 million in professional accounting services to accomplish work usually done by city staff.
The mayor’s office said Bronson is confident that Human Resources Director Tyler Andrews and the HR team are “following his direction to develop and implement a plan to recruit and retain employees in Health and elsewhere.”
The city has also been actively recruiting a director for the health department and has interviewed several candidates, according to the mayor’s office.
“Given the broad scope of responsibilities of the AHD, we of course are seeking candidates of the highest caliber. In the meantime, Acting Director Kimberly Rash has continued to do an exemplary job leading the department, and she has the administration’s full support and confidence,” the mayor’s office said.
In March, the health department began including the vacancy rates in its regular reports to the Assembly’s Health Policy Committee.
“We continue to try to recruit, try to advertise, get our name out there, remain competitive in the market and do the best that we can,” Rash told members of the committee during her most recent report, on Aug. 2.
The city’s public health authority has wide breadth of duties: It oversees food and health permits and inspections, child care center licensing and inspections, runs Animal Care and Control, distributes WIC benefits, performs air quality monitoring, epidemiology and disease surveillance, and it provides health care including STI screenings, treatment of communicable diseases and other basic preventative care at its downtown clinic.
“The health department has an amazing amount of responsibility. And it comes with the responsibility of being a home-rule city. You have health powers, and if you want to exercise those health powers — be ready for it. It’s a lot,” said Assembly member Felix Rivera, who sits on the Health Policy Committee.
The health department also oversees and plans the city’s homelessness response, including acquiring federal grant funding for housing and homelessness efforts, and overseeing the city’s own alcohol tax grants to local providers, along with some boots-on-the-ground work.
Michelle Fehribach, spokeswoman for the department, said the staffing issues haven’t kept it from getting its usual grants.
“However, we haven’t been able to seek out or apply for new grant opportunities due to staffing limitations,” she said.
While the department has continued to provide normal clinical and outreach services, “it has used a combination of overtime and shifting staff as needed to cover job duties,” Fehribach said.
From 2018 through 2021, the department operated with many unfilled positions, according to city data. But vacancy rates each month generally stayed below 20% and above 10%, with a few outliers.
Higher vacancy rates have persisted for months now, climbing well over 20% in early 2022 and crossing above 30% that fall. The rate has stayed above 30% since, between 32% and 36% each month.
Many Assembly members point to a combination of factors — a history of instability, executive turnover and explosive allegations against the Bronson administration earlier this year — contributing to a decline in city workers. They say the impact has likely been worse for the Health Department, which saw a hostile and unprofessional work environment under Gerace and is grappling with a public health labor shortage.
“In some regards, we’re still reeling from Gerace’s tenure as health department director. And I think it’s going to take a long time for that department to heal and, internally, for morale to come back,” Rivera said.
The health department used to run “in the background” of the city, quietly working to improve public health and provide services to residents, Assembly member Anna Brawley said. It took a much more central role during the pandemic. Lately, it’s been “at the forefront because of bad leadership,” Brawley said.
Bronson campaigned for mayor in 2021 opposing pandemic-related restrictions and mask mandates. Bronson’s first pick for health department director resigned after facing intense questioning over qualifications and comments he’d made about the pandemic. Then Gerace took the reins in September 2021.
For the last two years “the story was kind of the toxicity, the drama, the active conflict,” Brawley said. (Before Brawley was elected to the Assembly earlier this year, she assisted the health department with several projects in her former role working at consulting firm Agnew Beck.)
“Now, it feels like in ‘23 we’ve moved into a new phase, but it doesn’t feel better. It’s like there’s less conflict, but it’s more like the skeleton crew who’s just trying to hold on,” Brawley said.
The department is contending with a highly competitive workforce market.
On a national level, the pandemic increased demand for public health workers. It also drove worker burnout and an exodus of staff from government health agencies. About half of all employees who were working in state and local government public health agencies in 2017 had left their jobs by 2021, a nationwide analysis found. And many with the skills to work in public health instead choose to work higher-paying jobs in the private sector.
“Overall, government entities tend to pay less competitively than private employers,” Fehribach said.
In stepping up to lead the department, Rash has done “an amazing job,” Rivera said, adding that the department is doing its best to fill positions and find a permanent director.
But “morale is at an all-time low” for city employees, as leadership instability trickles down, and as stress increases for remaining staff who take on more and more work, Rivera said.
“We need to do things to really liven things up, because it’s not a great time to work with the municipality right now. Doesn’t matter what department you’re in,” he said.
The mayor’s office said that improving morale and the workplace environment has been one of Rash’s top priorities as acting director.
“Additionally, Health has been working with an outside agency since August 2022 looking at resiliency and fleshing out more of the needs of staff and where executive management can make an impact. This work continues and we are currently working on changing the paradigm around wellbeing and understanding the challenges staff are facing,” the mayor’s office said.
Rivera said that finding a permanent director is the necessary step.
“Someone who will hopefully have ideas and a vision for how to move forward,” he said.