Doctors, public officials at odds over role of Tippecanoe County health officer

LAFAYETTE, Ind. ― Recently resigned Tippecanoe County Health Officer Dr. Greg Loomis' vision for the job is vastly different than the job description and the vision of the current county office holders.

This clash in vision and personalities ultimately led to Loomis submitting his second ― and final ― resignation to the county commissioners on July 17.

“When I see something that needs to be fixed, that’s kind of what I like to do,” Loomis said. “I don’t do well with boundaries.”

Boundaries are where Loomis clashed with Tippecanoe County public officials.

Loomis resigned at the end of April but later rescinded his letter, postponing his departure until the end of 2026. Then on July 15, Loomis received ― and accepted ― a job offer from an Indianapolis business, prompting his final resignation.

By his own account, Loomis' tenure as health officer since May 2022 is marred by behind-the-scene confrontations with county office holders. But Loomis also touts his team's achievements, such as a 24% decrease in opioid deaths and a 44% decrease in fetal infant mortality.

Loomis' leadership relocated the Recovery Cafe to 2300 Ferry St. and expanded it beyond its needle exchange program to include a free medical clinic, and a navigator to help participants get Medicaid. He's also added medical-assisted therapy programs, which are prescription plans to curve the addicts’ cravings so they can get clean.

Of the 20 participants in the community corrections medical-assisted therapy programs, none have relapsed, Loomis said.

“I saw what needed to be fixed," Loomis said. "I knew what needed done. I just needed to get the programs in place to do it.”

All of this is beyond the traditional scope of the county's health officer.

“Obviously, the health officer position has been part time for the entire time," Tippecanoe County commissioner Tom Murtaugh said, "and it’s been just an advisory position.

“Right now, there’s not even a job description for the health officer position because it’s an advisory role," Murtaugh said. "The health officer is to work closely with the board of health to design an initiative to promote public health and deal with the issues that any particular community is dealing with in regards to public health and to come up with programs and initiative to help with those.

“There is a full-time, very capable health administrator on staff," he said. "That job is to implement the plan put together by the board of health and the health officer.”

Overt signs of tensions

“We’ve had some situations where, quite frankly, there’s been some disrespect shown from him to some elected officials and to some department heads and employees,” Murtaugh said. “We’ve had to deal with those through (human resources).”

Loomis also revealed his frustration at some county officials.

“Who draws the line to tell a physician of 40 years you’re not allowed to do this even though it’s a public health urgent matter?" Loomis asked. "Is it an ex-sheriff? A dairy farmer? A guy who used to stock shelves at Pay Less and now is a banker?

“Is that who tells you to draw the line? Is it (county council members) Ben Murray? Kevin Underwood?" Loomis said. “I would think that when there’s a public health problem, it should be at the discretion of the public health officer to determine if something needs to be done and how to do it.”

Loomis' proposed plan

Loomis worked full-time hours, expanded health department programs, including ousting contract health-care provider Quality Correctional Care from the community corrections center in favor of contract health department nurse practitioners under his supervision.

This ended the practice of community correction employees dispensing medication to the work release participants, Loomis said, calling that practice illegal.

Loomis' proposed plan has the backing of the board of health, board President Dr. Julianne Stout said.

“The whole board is very much in consensus with saying at this point the health officer position really needs to be a full-time physician who is leading an interprofessional team," Stout said. "That’s what it’s going to take to continue to see these positive changes in all the metrics that we’ve seen.”

Loomis' plan for the department, which has grown to be the second-largest health department in the state, was to structure a small business that runs all of the county-operated health-related ventures ― the Gateway to Hope, the Recovery Cafe, the health department, the health services provided at community corrections -- while at the same time partnering with other health organizations in the county to get services for patients who are in need.

The plan would not burden taxpayers by using grant money and by billing Medicaid for treatment of local participants, Loomis said.

His plan was to use money from the state's Health First Initiative to fund new staff positions for nurse practitioners, as well as to increase his salary this year to $112,000 and $175,000 in 2025. Eventually, Loomis' vision was for the health officer to serve as a CEO of this small business, supervising the staff while the practitioners cared for the participants' health needs.

As for billing Medicaid for service, Loomis' calculations indicate the county could have received more than $258,000 in the first quarter of 2024, which would then go back to the taxpayers and could perpetually fund the health department programs. However, the county officials did not do approve what he needed to bill Medicaid, Loomis said.

The goal of Loomis' plan was to have the health officer's salary at $300,000 for 2027, which Loomis planned to be his first year without him. Ideally, that salary would entice a physician who is tired of corporate constraints in today's medical field to step up to the position, Loomis said.

Loomis works well beyond the hours of the advisory job that pays roughly $63,000 a year. No one disputes that, and Loomis tells anyone who will listen that it's not about the money. He doesn't need the money. The salary increases in his plan was to make the job viable for whomever succeeded him in 2027.

“This program was completely, totally, self sustainable ― even hiring a new health officer at $300,000," Loomis said of his plan. "Even if we were short the year that they hired a new health officer, I made it very clear that the $175,000 salary of mine can go to them to offset any cost the county had to pay. I’ll do it for free.”

Stout sent an email Thursday to the health board members indicating that Porter County has a full-time health officer who earns $150,000; and St. Joseph County pays $200,000 if the health officer is part time and $250,000 if the officer is full time.

Loomis' plan for a full-time health officer and nurse practitioners, as well as expanding the duties of the health department, failed, Murtaugh said, because Loomis didn't follow through on the approval process.

“There’s a plan that’s put together, but it’s not being implemented or followed,” Murtaugh said of Loomis' proposal.

“There’s a process to do that, meaning to upgrade a position or to make a new position, create a new position within county government," Murtaugh said.

“That process means that you run it through commissioners and the personnel committee. And obviously, counsel has to fund it," Murtaugh said. "Also, that has to go through a third party. We have a contract with a (human resource consulting) company named Wagner, Erwin and Sheely, which reviews any job description that is done to assign them a pay upgrade.

“Dr. Loomis was told this process," Murtaugh said. "It’s all outlined in a flow chart, but he never submitted it. It was never submitted to be a full-time position. Ever.

“He simply just didn’t go through the correct channels to get that done,” Murtaugh said. “I’m not saying it would have been approved.”

Health department services at community corrections

Loomis said he became concerned for the county's liability when he learned that community correction staff passed medications to the participants in the hours when QCC was not staffing the work release center.

He proposed taking over the medical side of community corrections as part of his proposed plan, which Loomis said he presented in August and no one would follow up with him to discuss it. But when QCC suddenly gave notice that they were dropping its services to the county's community correction in late January 2024, Loomis had to piecemeal a program and contract with nurses, he said.

Since his resignation, Loomis made it clear that the medication he prescribed for community corrections participants must be destroyed, and a new provider must prescribe the medication.

“Obviously, there’s been a lot of drama," Murtaugh said. "Somebody is telling participants at community corrections that they’re not going to be able to get their meds. And that’s unfortunate. Never once did they not get their meds, and we’re working on a solution and have a solution in place."

The dust-up Tuesday over participants receiving their medication was quickly resolved when Murtaugh, as the county commissioner president, signed an emergency contract with QCC, who resumed community corrections care on Wednesday morning. The commissioners will have to approve the QCC at its Aug. 5 meeting.

“It was not an ideal situation, but we got it done," Murtaugh said of the community correction participants being panicked into thinking they would not get their medication.

"It does feel a little like the participants at community corrections were used as pawns in this situation," Murtaugh said. "They obviously are some of the most vulnerable of our society, and I think that’s incredibly unfortunate.

“I just want so assure not only the community but those individuals that their needs will be met. They will have their prescriptions.”

Murtaugh said the taxpayers are paying roughly $295,000 for 2024 for QCC's services at community corrections.

Loomis pointed out that if the county had approved his plan, they could have generated that much revenue in one quarter by billing Medicaid.

Loomis leaves the county because he and the public officials could not resolve their difference and move forward.

“The first time in my life," Loomis said, "I’m fighting a fight that’s not winnable."

Moving forward

Stout said members of the health board, the county council and county commissioners will meet July 29 to discuss the path forward. The meeting will not have a quorum of any either board or the council, so it technically does not violate Indiana's open meeting laws.

Murtaugh said he's not opposed to discussing a full-time health officer, but for now, he believes they can have a health officer in an advisory role in just a few weeks.

Stout said the board is somewhat limited in its authority. It can, for example, support the idea of a full-time health officer and make a recommendation for Loomis' successor. But ultimately, the commissioners select the next health officer and whether it's a full-time, part-time or advisory position, and the council decides on the salary.

“As a board of health, our mission, always, is protecting the health of the individuals in the county and our whole region, particularly, serving underserved individuals making sure that safety net is there,” Stout said. “We feel really confident in our ability to make sound recommendations.

“If we have any chance to continue the good direction we’ve been going, it sure would be excellent.”

As for Loomis, he said he'll consult if asked, but he's not returning to the health officer's job.

“I truly wish the county well. I want them to be extremely successful," he said. "I worry about the people I’ve taken care of. They’re not going to have the care they deserve and need. That’s very worrisome to me. But this is an impasse."

Reach Ron Wilkins at rwilkins@jconline.com. Follow on Twitter: @RonWilkins2.

This article originally appeared on Lafayette Journal & Courier: Doctors, public officials at odds over role of Tippecanoe County health officer