Betty's In Charge

Is Dallas County's most explosive bureaucrat ruining the health department?

Anderson's sentiments echo those of other area health professionals, who say the health needs of the county will remain in jeopardy until Culbreath replenishes the supply of doctors in the department.

"There's 6,000 doctors that deal with county health issues on a daily basis. Where do they go to get answers to the questions they have?" asks Dr. Roland Black, president of the Dallas County Medical Society. "Right now, if a doctor calls me and says we have an outbreak of meningitis, what do I do? We have no place to go."

If Culbreath is to succeed in her new job of managing the county's health needs, she clearly will need to rely on the advice of local doctors, whom she can call upon as needed to make up for her lack of medical expertise.

Culbreath has recently started a dialogue with Black and his colleagues, but her relationship with them so far has been thick with tension.

Perhaps Culbreath would do well to stop reacting so defensively--and explosively--anytime someone so much as hints that things need improving over at her county health department.

When asked recently to respond to concerns about the lack of doctors on her roster, Culbreath went on a verbal tirade about doctors--particularly her predecessors, Farris and Haley--who, she claims, were so administratively incompetent that the health department she inherited was a disorganized, dirty, do-nothing mess.

"I didn't start the controversy. What is it? That I'm black, that I'm not a doctor? I haven't told not one doctor what to do, neither has one doctor been cut," Culbreath told the Observer. "The last doctor wasn't doing too good. Give me a break about your fucking doctors, who don't manage a damn thing. Shit, girl, give me a break about the fucking doctors."

In time, Culbreath may manage to build bridges to the area's doctors. If she doesn't, though, chances are her bosses on the commissioners court either won't notice or won't care.

The five-member court is dominated by men who are not only moral conservatives, but fiscal fundamentalists who never saw a social program they didn't want to gut or a salary they didn't want to freeze (except, of course, their own, which they consistently, and generously, raise). Not surprisingly, they run a sprawling bureaucracy that has also been historically short on high-ranking minorities--something that John Wiley Price has made a career out of exposing in bureaucracies citywide.

In 1995, national health officials sharply criticized the court when several commissioners waged a moralistic battle that forced the department to cease distribution of condoms and needle sterilization kits for AIDS prevention. The commissioners had attacked health department doctors and their colleagues who loudly opposed the cuts, including Ron Anderson and members of the Dallas County Medical Society, and accused them of promoting immoral behavior.

In a last-ditch effort to save the needle program, a coalition of Dallas doctors--including the brother of epidemiologist Charles Haley--unsuccessfully tried to persuade state legislators to change state law in an attempt to recall commissioners Jim Jackson, Mike Cantrell, and Ken Mayfield.

Two years later, those commissioners haven't forgotten the gesture.
"Is this the same [Dallas County] Medical Society that in the last session of the legislature was going to go down and get a bill to have the commissioners recalled? Yes it is," says Jim Jackson, the ringleader of the court's conservative majority. "These guys are not my friends, and they're not going to like what I do."

Jackson, one of only two commissioners who returned the Observer's phone calls, says the merger of health and human services was designed to streamline bureaucracy and save money. Although Jackson dismisses fears that the court is cutting back on health services, he's unwilling to elaborate on why Culbreath was appointed and why she subsequently reorganized the departments.

"We should have a department that puts out a good value for the dollar spent," Jackson says. "I don't know what it is that she may or may not be planning for the next six months, but I will tell you that I have a lot of faith in her."

It's easy to see why. The commissioners court would blindly back Culbreath in this position for many reasons. Consider this: She's cheaper than a doctor. She has disdain for doctors. She's a taskmaster with no qualms about cutting people at the knees--especially if it plays to the commissioners' tight fiscal desires. And she's close to John Wiley Price, who was the only commissioner who fought like a tiger against his brethren in an attempt to save the needle program.

So what if the department becomes controversial again--or proves to be a shadow of its former self? The court appointed the perfect candidate to defend its politically scarred health department. After all, who's going to argue about needle distribution with a former social worker who has a drug-addicted son and is famous in the African-American community for helping people in need, oftentimes with money from her own pocket?

But Culbreath's clout extends even farther than that. Outside the county bureaucratic machine, Price has helped Culbreath build a formidable political career. She has held a host of positions on various city and county boards, all of which culminated in February with the appointment of Culbreath as chairwoman of the Dallas/Fort Worth International Airport Board--a powerful seat that is guaranteed to boost Culbreath's profile locally and nationally.

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