Mecklenburg’s county manager briefed top elected officials in January on the delay in cervical cancer test notifications affecting nearly 200 women. But the lapse wasn’t made public until this week – after inquiries from the Observer.
Dena Diorio told commissioners behind closed doors Jan. 10 that Pap smear notifications from public health clinics were not sent to a number of women – mostly poor and Hispanic, some undocumented – who needed follow-up care or counseling because of abnormal results.
Some commissioners said it was their understanding that the problem was to be kept secret.
“They were very specific that it was important not to talk to any members of the media,” said Commissioner Bill James.
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Diorio stressed that commissioners should not disclose information because it involved legal and personnel issues, James said.
“They wanted to control the information,” he said. “They were trying to avoid looking like they did something wrong.”
Fellow Republican Matthew Ridenhour, however, recalls no warnings at the meeting not to speak publicly about the problem. Because it was a closed session, he said, commissioners may have assumed they were to keep it confidential.
Republican commissioner Jim Puckett, who was also at the meeting, said the county should have alerted the media to help affected patients get information. “You don’t hide your mistakes,” he said.
Four left agency
Four people have left the health department because of the error, including the triage nurse authorities blame for the delays in notifications.
Problems in Pap smear notifications at the agency appear to have been occurring for about eight months. Early detection is considered key to preventing cervical cancer.
On Dec. 12, 2016, health clinic workers discovered that the notifications had not been made, said Diorio. She said she and Dr. Marcus Plescia, who has led the county health department for three years, were not informed about it until Jan. 4.
Our county manager likes to get information in front of the board as soon as possible. … We were as transparent as possible.
Dr. Marcus Plescia, Mecklenburg County health director
Most of the 185 women have been located by health workers and notified, but 20 women with results indicating they need follow-up have not been found.
Plescia said the agency is trying to contact an additional 100 patients – whom the nurse said she’d contacted – to ensure their test results have actually been communicated.
“So far, we have confirmed that many of the women received their results, but we have not yet reached them all,” Diorio told commissioners in an email Thursday.
Plescia said officials told the board Jan. 10 they needed to meet behind closed doors to discuss a personnel matter. Then, he said, Diorio provided commissioners with an overview of what happened.
The meeting took place “pretty soon after we discovered it, so there wasn’t a lot of information to share,” Plescia said. “Our county manager likes to get information in front of the board as soon as possible. … We were as transparent as possible.”
But the public didn’t learn of the lapse until Tuesday night, six weeks after commissioners were initially briefed. Diorio read a statement in an open meeting describing the problem.
Her statement came after The Charlotte Observer contacted the county on Monday seeking confirmation of the problem and follow-up information.
Puckett said he believed it was inappropriate for county leaders to discuss the issue behind closed doors in January.
“It was not a personnel issue, not a legal issue and not a land purchase,” Puckett said.
“They went behind closed doors because it was embarrassing. If the media hadn’t gotten wind of it, this would still be quiet.”
Commissioner Pat Cotham, a Democrat, said she and some other board members remain uncertain whether it was legally justifiable to discuss the issue in closed session.
Staff members typically meet privately to discuss individual employees, but administrators did not mention any employees by name, Cotham said.
Cotham said she does not recall any talk about related legal matters, which are also discussed during closed-door meetings.
“It was like, ‘Is that all there is?’” Cotham said. “I talked to a couple of commissioners and we were like, ‘What the hell is this?’”
They went behind closed doors because it was embarrassing. If the media hadn’t gotten wind of it, this would still be quiet.
Mecklenburg commissioner Jim Puckett
Jonathan Jones, director of the N.C. Open Government Coalition at Elon University, said if specific names weren’t shared, the personnel exception to the state’s open meetings law would not apply.
“This sounds like a serious policy matter that should have been discussed in the open,” he said, “and the law makes clear that general personnel policy issues cannot be discussed in closed session.”
James also said that after the meeting some commissioners wondered whether going into closed session was legal.
He said commissioners received no information about a specific employee. They were told that an unidentified nurse had not carried out her duties.
Diorio said Thursday that the closed meeting was proper because it involved personnel matters. “The item was a properly presented personnel matter and was provided to the board within the correct legal context,” she said.
It was also discussed with commissioners in a closed session on Feb. 7, she said.
Commissioner Vilma Leake, a Democrat, said Thursday she didn’t recall hearing in January that patients had not been notified of their test results.
“I recall nothing that said we had not gotten in touch with these women, because I would have immediately been on top of it,” Leake said. “I still say the information we got on Tuesday night, whatever we got in January, we did not get the same information.”
Ridenhour remembered the January meeting as providing explicit detail.
“We were fully briefed,” Ridenhour said. He recalls hearing the number of patients affected and the findings of an investigation that at the time was just beginning. Ridenhour said he believed the session was closed because the board discussed a health-related issue that had a personnel component.
Ridenhour said he believes Diorio and Plescia have done a good job investigating the problem.
“Something like this shouldn’t be rushed, trying to get to the bottom of it, and, in that rush, perhaps overlook something or not be thorough in the investigation,” he said.
Chair Ella Scarborough, a Democrat, said the investigation is proceeding properly.
“I believe the board and our staff believe that when we get all the information, we’re going to make better decisions. I trust staff to do what I know is right,” she said.