Anchorage ballot measure on chief medical officer has roots in pandemic disputes between mayor and Assembly

Jan. 19—This spring, Anchorage voters will decide whether the city's top health official, selected by the mayor, needs confirmation from the Assembly in order to serve.

Last week, members voted 9 to 3 to add a ballot measure asking residents whether to amend the municipal charter to require that future Anchorage chief medical officers undergo a degree of public scrutiny that thus far has not been a part of the appointment process.

Supporters of the measure say it brings the important chief medical officer position in line with the public process for installing other department heads and top public safety officials.

"Public health is the third leg of the public safety stool," Vice Chair Meg Zaletel said during an Assembly meeting. "We confirm our fire chief, we confirm our Chief of Police. It makes sense that we would confirm our medical chief if we want to be consistent in our approach to public safety."

Opponents, including Mayor Dave Bronson, say it's an unnecessary and vindictive hindrance on executive authority. Especially his.

"It's a solution in search of a problem," Bronson said in an interview this week. "There are so many other things the Assembly should be focused on ... They need to stay out of the mayor's operations, they need to stay out of my business."

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The move is the latest salvo in a years-long skirmish between Bronson and the Assembly — the Assembly has repeatedly revised municipal rules to add more checks and balances over the mayor's administration, including political appointments and contracting protocols. And many of those battles, including the current disagreement over the chief medical officer, date back to the contentious period of lockdowns and emergency orders during the height of the COVID-19 pandemic.

More public process

The chief medical officer is not a city employee the public hears much about. But the job is important and influential, particularly when there is a health crisis like a pandemic.

In Anchorage, the position is the municipal government's top medical advisor on issues concerning public health — essentially the doctor providing guidance on a range of topics that are implemented by the Anchorage Health Department. The position guides the programs providing immunizations in the health department's public clinic, staff administering vaccines for seniors, as well as the city's reproductive health care services and testing for sexually transmitted diseases.

Managing the large bureaucracy and personnel within the health department falls on the director, who has to be confirmed by a vote of the Assembly.

The chief medical officer, on the other hand, is a role that until recently was vaguely outlined within municipal rules.

"Despite the importance of position, there currently exists no provision of Code which establishes or provides any real definition to the position," read a November ordinance sponsored by Assembly Member Daniel Volland.

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That measure clarified the official role and duties of the position, and added a requirement to the qualifications that the person must have completed an accredited residency.

According to Volland, who spearheaded the effort on the Assembly to let voters decide on amending the charter, the ballot measure is a continuation of the same push to bring the chief medical officer in line with other top city roles that require greater scrutiny and public input.

"Especially during a medical emergency, the role becomes very consequential. They have to advise the mayor when exercising special powers," he said.

Volland said that if the position has to be confirmed by the Assembly, it creates an opportunity for the public to weigh in: They can email representatives about their experience with the nominee, raise concerns and offer questions for the Assembly to bring up during a confirmation hearing.

Much of this was an issue back in 2021, before Volland was elected, and the current chief medical officer, Dr. Michael Savitt, was criticized in a public letter from members of the Alaska chapter of American Academy of Pediatrics for remarks he made about COVID-19 and public health measures.

"As your colleagues and peers, as well as concerned citizens of this city, we no longer feel that you demonstrate the ability to accurately and objectively advocate for the public welfare of the residents of this community," the five pediatricians wrote to Savitt.

At the time, the state was in its worst phase of the pandemic, with sky-high transmission rates and overwhelmed hospitals forced to ration care. Many doctors — and plenty of other residents — did not agree with public health decisions being made by the Bronson administration, which had come into office railing against lockdown measures, business closures, and mask requirements. Some — including some community councils — believed Savitt deserved some of the blame for the administration's policies.

"The current unconfirmed municipal Chief Medical Officer (CMO) has received an unprecedented rebuke by experienced professional leaders in the local medical community concerning misleading statements the CMO has made on the public record regarding the pandemic and public health best practices to address the pandemic, raising concerns about the CMO's objectivity and fitness for the role," wrote members of the South Addition Community Council in a 2021 resolution, first passed and circulated by the Rogers Park council, that called called for the position to require Assembly confirmation. Volland was a member of the South Addition Community Council at the time.

Volland said that while the ballot measure is an outgrowth of that resolution, he does not view it as a referendum on Savitt or his job performance. But he added that he was moved by doctors and health care providers attending a contentious Assembly meeting in September 2021 to testify about how overwhelmed the hospital system had become because of the COVID surge, and were jeered at by Bronson supporters in the chamber.

"To see how they were treated by members of the administration, including the mayor, who seemed to imply they were guilty of malpractice ... was very hard to watch," Volland said. "Part of my time that I want to use on the body is how can we restore trust in the medical community."

'A personal attack'

Bronson does not see things the same way.

"I happen to know Dr. Savitt very well, he's an outstanding physician," Bronson said. "It seems to be a personal attack on him."

The mayor penned an op-ed the same week the Assembly voted to add the chief medical officer confirmation requirement to the ballot, titled "Anchorage's chief medical officer deserves our thanks," which praised Savitt's character and public service.

Bronson said he was compelled to write the piece because of the negative things being said about Savitt in discussions around the ballot proposition.

"I felt this is an attack on someone who is an extremely good public servant," Bronson said. "I'm thrilled with the service he's given this city. And he's just under attack continuously. I don't understand it, and I don't like it ... someone had to stand up and tell the truth."

Bronson said Savitt had been inaccurately depicted as opposing masking and vaccinations during the pandemic, which was not the case. The mayor said Savitt has supported those measures but emphasized that they were choices best left up to individuals, an approach the two shared. Bronson said Savitt had even pushed him to get vaccinated against COVID.

"I didn't," Bronson said.

Though he is not in favor of the measure, he supports letting voters decide on its fate at the ballot.

"I'm almost never, if ever, against having the people vote on things. That's good government," Bronson said.

He said there are large problems the municipality is grappling with that the Assembly would be better to spend time and effort addressing: the housing shortage, homelessness and the natural gas supply in Cook Inlet.

"Why now? Why didn't they do this 20 years ago? Why didn't they do it 10 or five years ago?" Bronson asked. "It's because I'm in office. They're doing all these things, and they're usurping much of the authority of the mayor and taking it for themselves."

One person who doesn't totally disagree with that analysis is Assembly Chair Chris Constant, who favors amending the code to require the chief medical officer be approved by the body.

"Absolutely it's in light of the mayor's choice of individuals to fill that role," Constant wrote in a text message.

He pointed to the pediatricians' letter as evidence that Savitt's peers did not have confidence in his performance during the pandemic.

"There was no judge of qualifications, except the mayor. And there are many well founded concerns about the mayor and his judgement in relationships to public health policy," Constant said.

For more than a year, Constant and several other Assembly members have crafted measures increasing oversight of the city's executive branch and reining in mayoral powers, including lowering the dollar threshold for public contracts requiring Assembly approval, among other policy adjustments.

"What Dave Bronson has illuminated is that much of our government depends on trust and good faith. If the last 2.5 years have taught us anything it's that our code never contemplated the level of incompetence or the level of patronage a determined administration can achieve. The Assembly has acted appropriately to manage the incompetence of his administration," Constant wrote.

The measure will be one of several proposals going before voters this spring, along with several bond propositions. Ballots will be sent to voters March 12, and are due to be postmarked and sent, or returned by drop box or in-person, by April 2.

The last day to register to vote in the municipal election is March 3.