With the number of cases of coronavirus escalating along with the number of deaths therefrom, San Bernardino County Public Health Director Trudy Raymundo will depart from her position prior to the end of the month.
CaSonya Thomas, the county’s assistant executive director of human services, to whom the public health department is answerable, in a memo dated May 4 to the sheriff, district attorney, county treasurer, assessor, county chief financial officer, the county’s deputy executive officers and all county department heads announced Raymundo’s departure.
“The purpose of this memo is to share with you that Trudy Raymundo has announced her intention to resign from her position as the county’s director of public health effective May 29,” Thomas wrote.
No explanation for Raymundo’s abrupt departure was given. There were hints that the county’s two top administrators and the members of the board of supervisors were apprised of the move toward Raymundo’s departure some time ago, as Thomas’s memo was not directed to them, but provided to them as an electronic carbon copy.
Much of the memo was laudatory toward Raymundo, who has been an employee with San Bernardino County since 1990 and moved into a position within the San Bernardino County Department of Public Health as a program coordinator in 1997. Over the next dozen years she served in the capacity of administrative analyst in the department and then promoted into the position of assistant director. In 2010, she was elevated to serve as interim director of the department. In 2012, the qualifier “interim” was dropped from her title and she became the public health department’s director.
There were hints in Thomas’s memo that Raymundo’s departure was forced upon her, which is supported by the context and timing of her exit.
Raymundo is neither a nurse nor a doctor, and she has no extensive training in the field of medicine or the biological sciences. Rather, she holds a bachelor’s degree in accounting and business management from California State University San Bernardino. Her elevation to the head of the public health department appears to have been a calculated one, freely entered into by one of the county’s previous chief executive officers as well as the board of supervisors in 2012, which as it was composed then involved two of the board’s five current members.
The calculation at that time was that Raymundo, as a numbers cruncher who had no training or especial interest in medical or public health issues, was someone who would not get abstracted into the minutiae of, or worry about, the latest trends in public health maintenance and medicine and addressing any single individual’s or groups of individuals’ medical needs but who would instead focus on the bottom line, concerning herself with economic management of the department and constraining her underlings to conforming to the budget the board of supervisors and the county CEO had laid out for her to remain within.
There were repeated indications over the years that Raymundo was essentially unschooled with regard to public health issues, per se. As the head of the department, Raymundo was called upon to present reports to the board of supervisors with regard to items that body needed to consider and vote upon relating to the public health department. Raymundo was credited with having authored those reports, most of which dealt with the topics in question on a relatively superficial level without going into great depth, and giving the board members only a basic orientation and voting recommendation. Occasional press inquiries made directly to Raymundo, however, laid bare that she had no command whatsoever of the contents of those reports or the technical considerations upon which they were based. Indeed, after a relative handful of such inquiries, the county made a practice of routing any further such inquiries away from her to either the county’s official spokesman or a woman specifically hired to serve as the public health department’s spokesperson.
Had circumstances remained as they were previously, the county’s strategy of employing an individual with no expertise in public health issues as the head of the department of public health might have proceeded without consequence. The advent of the coronavirus crisis, however, resulted in a series of inadequate responses by the department which ultimately appear to have had fatal consequences.
In the crucial month-and-a-half to two-month run-up to the pandemic manifesting locally in March, Raymundo, who is provided with a base annual salary and add-ons equal to $196,349.73 together with $103,046.36 in benefits for a total yearly compensation of $299,396.09, failed to act with alacrity and use her hard-nosed business acumen and the negotiating leverage she had as a department head with California’s fifth-largest county population-wise to purchase adequate reserves of equipment, devices, materials and medicine, particularly the reagent needed to perform virus testing, to meet the crisis head on.
Essentially, throughout the initial stages of the crisis, public health officials and the medical community in San Bernardino County were flying blind, as they were unable to test anything more than a minute percentage of the population.
In the last week of March, the health department offered what it said would be testing for the most vulnerable element of the county population, including those aged 65 or older with the signs of COVID-19, including fever, cough, lethargy, and difficulty breathing. When county residents evincing that symptomology applied for those testing opportunities, an untold number were turned away with no acknowledgment whatsoever that they had even applied. This was repeated over the course of the next couple of weeks when the county claimed it was again hosting testing clinics. Despite the health department at that point having the phone numbers or email addresses of a significant number of individuals who had potentially contracted the coronavirus, the department of public health made no follow-up with them to check on their welfare or COVID-19 status.
The testing debacle prompted San Bernardino County Board of Supervisors Chairman Curt Hagman to put out a guardedly apologetic statement on April 10 that, “We understand the high demand for COVID-19 testing in our county and we are making every effort to organize drive-through events throughout the county. We are working closely with state and federal partners and exploring all avenues to increase testing capacity, despite a nationwide challenge with shortage of supplies.”
One element of Thomas’s memo suggested that Raymundo was pushed out the door.
“Trudy has graciously agreed to participate in the transition of leadership for the remainder of her time with the county,” Thomas’s memo states. “Given her advance notice, the county is able to plan for a smooth transition.” The use of the term gracious implied that Raymundo was accepting something that was being imposed on her.
Thomas’s memo further indicates that Raymundo is yet intent on pursuing “future endeavors.” Yet nowhere in the memo does Thomas provide an explanation of why it is that Raymundo, if she indeed is anxious to remain active, is stepping away from an assignment that provides the opportunity for her to fill her time with the meaningful endeavor of serving as the head of the county’s health department during a monumental health crisis.
In her memo, however, Thomas pushed past that without mention, instead commending Raymundo for her past work.
“As you are well aware, Trudy and her team have a long list of accomplishments for which she and the entire county organization can be proud, most notably her department’s national accreditation by the Public Health Accreditation Board, the creation of the thriving Community Vital Signs project, and the team’s work in the county’s ongoing response to the COVID-19 pandemic,” the memo states. “Trudy has also built a skilled team of public health professionals and we appreciate her many years of dedication that will translate to great service for years to come. She and her leadership have demonstrated the determination, compassion, and resiliency for which our county has come to be known. Please join me in thanking Trudy for her service to the county and the people we serve, and in wishing her the best in her future endeavors.”
Some have suggested that the board of supervisors, which has co-existed with Raymundo as the head of the department of public health for a decade because of her ability and willingness to live within the budget provided to her department, is now scapegoating her because through the board’s tightfisted approach it had failed to appropriate an adequate amount of funding to her department in time for Raymundo to go out onto the open market and purchase, using the economies of scale that large bulk orders of the needed testing products would have created, the needed kits and quantities of reagent to meet the county’s testing needs.
Previously, David Wert, the county’s official spokesman, characterized Raymundo as “a competent, hard-working, and accomplished professional whose department under her leadership has earned national accreditation and won numerous state and national awards for innovation and public service; someone who is putting in long hours seven days a week to protect our community when she could easily walk away and retire comfortably.”
This week, Wert defended the county for having promoted Raymundo, whose educational and experiential background consists of training in accounting and business management, as the director of public health.
“To make things more clear, as is the case in many large counties including Los Angeles and Riverside, the public health department is led by a director, who is not a medical professional but rather an administrator, who supervises a health officer, who is a medical doctor,” Wert said. “The director in LA is Barbara Ferrer, who has no background in medicine, and she supervises the health officer, Dr. Muntu Davis, MD. The director in Riverside County is Kim Saruwatari, also not a medical professional, who supervises the health officer, Dr. Cameron Kaiser, MD. Trudy had been a public health administrator for 14 years before she was appointed director. Directors are appointed by higher-level administrators. Trudy is supervised by and reports to the author of the memo, CaSonya Thomas, and was appointed by her predecessor. The health officer, under state law, is appointed by the board of supervisors, but reports to the public health director.”
-Mark Gutglueck