'A rush of fear': The human impact of Ottawa County's health department cuts

HOLLAND — Every few hours, Sierra Schuetz checked to see if Ottawa County's leaders had posted a new version of the 2024 budget — one that she hoped might save her job.

She worked for the county's health department, running a program that provided free food to about 22,000 low-income residents each year. In late September, Schuetz was steering a van full of bags of fresh produce bound for a nearby farm where about 75 migrant workers were waiting.

She was 31 years old, six months pregnant and increasingly worried about how she was going to provide for her own family. On Sept. 26 — just six days away — the county's board of commissioners was set to vote on the health department's budget. If it passed as proposed, Schuetz's bosses told her that her job would be eliminated.

"I get a rush of fear just thinking about it," she said.

Her van sped by cornfields, a Cambodian Buddhist temple and a few Trump flags fluttering in the early fall breeze. Eight of the 11 commissioners on the county board that would decide her fate were political newcomers who had channeled voter rage over pandemic-era restrictions into a successful insurgent campaign last fall.

The new commissioners, all Republicans, had been trying since January to fire the head of the health department and replace her with a safety manager from a local HVAC company who had risen to prominence as a critic of mask mandates. They had blocked the county government from accepting grants that mentioned the goals of the Centers for Disease Control and Prevention or World Health Organization. And they had passed a measure questioning the safety of vaccines.

Now they wanted to return the health department's budget to pre-pandemic levels, which they hoped would help return their county to a moment before the coronavirus disrupted their lives and their community.

Political history

At the time Ottawa Impact formed, COVID-19 had killed more than a million Americans and triggered one of the largest government interventions into everyday lives since World War II. Even though deaths caused by the virus had declined dramatically, the anger, mistrust and disinformation that grew out of the government's response were still radiating through the nation's politics at all levels.

In Ottawa County, a fast-growing, middle-class community of about 300,000 people on the Lake Michigan shore, battles over mask mandates and whether to get vaccinated had divided families and torn apart church congregations. They had eroded trust not only in medical experts and government institutions, but also among neighbors and friends. They had turned the county, which voted to reelect Donald Trump by 21 points, into a place where the Republican Party's future was taking shape.

That was especially evident when the majority of the county board was won by Ottawa Impact-backed candidates in November 2022. The grassroots organization was created in direct response to pandemic-era mandates.

In the aftermath, no local institution faced more pressure than the county's 100-person public health department. Before the pandemic, its workers had drawn little attention. Health department employees inspected restaurants and sewage systems. They tracked communicable disease outbreaks and immunized children.

Lately, though, the new county commissioners and their supporters had come to see the department's workers as foot soldiers in a much larger army of unelected experts and unquestioning bureaucrats whose power needed to be checked.

One of those workers was Schuetz. Her van pulled to a stop in a dusty parking lot where the migrant farmworkers were gathering after a day in the fields. The farmworkers, most of whom came from Mexico, wore hoodies to protect themselves from the sun and the chemicals. Schuetz handed each of them a bag of onions, tomatoes, corn and watermelon that she had purchased that morning from a local outdoor market.

"Thanks for the food," one of the workers said.

"Thank you for the work you're doing for our farmers," Schuetz replied.

Soon the food was gone and Schuetz was back in her van, struggling to understand why her job, which had nothing to do with the coronavirus, mask mandates or vaccines, was suddenly at risk.

"The problem isn't that there's not enough money," she said. Tax revenue was surging. "It's not that I am doing a bad job or that the work doesn't matter. It's this other reason that's so far away from who I am and what I do."

She worried she was destined to become a casualty in someone else's ideological war.

The background of Allison Midema

To understand why Schuetz feared she could lose her job, it helps to go back two years to a time when the coronavirus pandemic was still raging and Allison Miedema, now one of the Ottawa County commissioners, decided to quit hers and become a politician.

Miedema had spent more than 20 years teaching, first to at-risk children in public schools and then at a private Christian school near her home. The pandemic had put deep strains on her relationships with some of her closest family members, especially with her youngest brother, Joel VanderSchuur, a doctor in Portland, Oregon, whose days were consumed caring for patients who were dying of the virus.

In April 2021, more than a year after COVID cases first emerged in the United States, Miedema and her husband were suffering from fever and fatigue. VanderSchuur urged them to take a coronavirus test. He knew his sister and her husband were young, healthy and likely to recover quickly. But he was concerned for their mother, who was in her late 60s and had been driving Miedema's son to school every day. She had only received one dose of the vaccine, which was just being rolled out.

"This is literally my job, and I can't even count how many patients I have had die or stay on a ventilator due to COVID," VanderSchuur texted her that April. "I'm not meaning to upset. This just affects me deeply on a day-to-day basis."

Miedema wouldn't commit to taking a test. Her son, she said, had recovered from his fever, was symptom-free and unlikely to be contagious.

Over the next few days, their exchanges grew tense. She complained that her brother was treating her like an obstreperous patient rather than a loving sibling. And she was hurt by his suggestion that her actions were selfish and putting their parents are risk. "All I'm asking is that you wouldn't be so quick to judge," she wrote. "Things are often more gray than black and white. Especially this year."

To VanderSchuur, though, her obligations to her family and her community in the middle of a deadly pandemic were clear.

"I cannot understand why you won't get tested," he wrote to her. "I am completely out of my mind thinking about how you could be so cavalier when it is something that is so simple to do. I have always known you to be a caring person . ... You could literally save lives by getting tested and yet you choose not to! How is this Christian?!!!"

A few months later, in August 2021, Gov. Gretchen Whitmer chose not to reinstate a school mask mandate, leaving the decision to local officials. In Ottawa County, the health department required children in sixth grade and under to wear masks until they were eligible for the vaccine. Miedema declined multiple requests for comment for this story but has spoken on the subject in speeches.

Shortly before the school year began, she said, she lay awake in the middle of the night crying. As a teacher with a degree in early childhood development, Miedema believed masks hurt children and hindered their social and intellectual growth. As a citizen, she believed mandates violated the country's founding principles.

She prayed for guidance. God, she said, replied in a "non-audible voice."

"He was asking me to resign from the job I loved," she recalled.

On Aug. 24, 2021, about 1,000 people, including Miedema, angrily protested the mandate at a county board meeting that lasted nearly seven hours. Miedema shared the story of her resignation during the public comment portion of the meeting.

Also in the crowd that day was Joe Moss, who formed Ottawa Impact to recruit and raise money for first-time candidates willing to try unseating the incumbent county commissioners. Moss's path into politics began a year earlier in the fall of 2020, after state and county officials learned of a COVID outbreak at his daughter's school and ordered its leaders to comply with the governor's mask mandate. They refused, and the officials padlocked the school's doors for more than a week. Moss also declined to comment for this story.

Miedema was asked if she was interested in joining Ottawa Impact's slate of candidates. The months leading up to the offer had been trying for her. She and her youngest brother were barely speaking. She had quit her job. Miedema was vetted by Ottawa Impact and agreed to run.

Soon she had new friends, a new mission and a new calling, born of her frustrations during the pandemic. One evening in April 2022, she stood at the pulpit of the Lighthouse Baptist Church with the other Ottawa Impact candidates for a political rally. The pews were packed.

Miedema talked about her decision to leave teaching and her governing philosophy.

"I have a great desire to stand up to tyranny," she told the crowd. "To stand up against anything that goes against God's loving rules for his people."

Targeting the health department

Once elected, Miedema's stand began with a motion to remove Adeline Hambley, the head of the health department.

Hambley was chosen to replace her retiring boss in late 2022 by the outgoing board. On Jan. 3, shortly after Miedema was sworn into office, she introduced a resolution to replace Hambley with Nathaniel Kelly, a safety manager with a local HVAC company who built a following among Michigan conservatives for his criticism of mask mandates and questioning the safety of the coronavirus vaccine.

Miedema said little from the dais about her motion, which passed easily. A few days later, she explained her thinking to one of her constituents, who complained that Kelly was unqualified for the role.

"Over the past few years, I have seen science become political in nature — one where many well-known doctors and scientists have been silenced," Miedema wrote in an email. These "medical professionals" were ridiculed for their views and pressured to abandon "the oath they had taken on behalf of their patients and community," she continued.

Kelly wouldn't let the medical establishment cow him and would prioritize "citizen's rights and healthcare freedom," Miedema wrote. These were principles that she and the new county board members believed had been compromised during the pandemic. They were the values the new board members had vowed to protect.

Hambley sued the board in February, arguing the commissioners couldn't remove her as county health officer without cause. While she clung to her job, Schuetz and her colleagues inside the health department clung to the hope that the new board members would come to see merit in their work.

Instead, the relationship grew more fraught. At board meetings, the new commissioners criticized health department initiatives that aimed to curb the spread of sexually transmitted infections through education and free condoms. The programs, commissioners said, encouraged irresponsible sexual behavior.

They blocked the department from accepting state grants that sought to reduce health disparities rooted in racial and economic differences. Sylvia Rhodea, the board's vice chair, disparaged these "health equity" grants as "Marxist." Health department officials insisted they were integral to their work.

"Public health cannot get away from health equity," Sandra Lake, the department's community health manager, told Rhodea at a board meeting this summer. "It would be like telling a firefighter not to use water."

Schuetz understood why the department's actions had generated so much anger in the county. Health officials were responding to a once-in-a-century pandemic that killed nearly 1,000 local residents, according to state data. Their actions — mask mandates, contact tracing and vaccine promotion — had largely mirrored those of neighboring counties and were in line with state and federal recommendations.

But to county residents, who doubted the seriousness of the coronavirus and were suspicious of government, the response seemed unnecessary and even punitive.

"A force was used during COVID. There were new rules. There was social pressure," Schuetz said. "Now a new force has formed [in the county] to meet it."

Schuetz believed that if the new board members made an effort to meet her colleagues and learn about their work, they could break through the suspicion and mistrust.

She wanted to tell them about how she'd fallen in love with farming and fresh food. She and her boyfriend, Fred Flipse, were in high school in Ottawa County when they befriended a local organic farmer who invited them to help with his harvest. At 19, they dropped out of community college to work on organic farms across the United States and then travel the world.

She wanted to show commissioners the programs she had started during her two years with the health department. As the coordinator for Ottawa Food, Schuetz worked with 45 food pantries across the county. One program she launched this year rescued more than 1 million pounds of food from restaurants and grocery stores. Refrigerated trucks ferried the food, which was on the verge of spoiling, to churches and nonprofits.

Another, paid for with a $120,000 state grant, provided migrant farmworkers in the county with fresh produce, rice and dried beans. Schuetz purchased the food from local farmers.

She wished commissioners could see the meaning and joy she found in bringing healthy food to people who were hungry and struggling. "These aren't just jobs where you clock in and clock out," she said. "This is devotional work."

But the opportunity never came. With each passing week, the chances of repairing the damage and mistrust wrought by the pandemic and the country's increasingly poisonous politics seemed to grow more remote. "It feels like they don't want to learn or connect with us," Schuetz eventually concluded. "And that's devastating."

Mistrust and freedom

This summer, Miedema met up with her brother, who visited from Portland. They'd barely spoken since their blowup over COVID two years earlier.

The siblings grew up together in a tidy, rustic home surrounded by small family farms and nurseries. But their childhoods in Ottawa County were marked by stark differences. VanderSchuur, who is gay, struggled with his sexuality. "I felt like I was an awful person for having these feelings," he said.

At 16, he fled to California in his parents' car with plans to see the ocean and end his life. Eight days later, he got into a minor car accident. A police officer ran his plates and alerted his parents, who brought him home. After he came out as gay, his friends and some of his favorite teachers stopped talking to him.

"I felt truly vilified," he said. Eventually, he found a new circle of friends at the local public university, Grand Valley State. His parents, who initially struggled with his sexuality, embraced him. He attended medical school in Detroit, married and built a new life out West.

Miedema spent her entire life in Ottawa County. Like her brother, she attended Grand Valley State. Upon graduation, she began teaching preschool. In campaign speeches, she described herself as "a child of the one true king ... Jesus Christ," a wife who had married her "best friend" and a mother to her teenage son.

Miedema invited VanderSchuur to her house; they went for two long walks together in the woods with her son and kayaked next to each other during a family trip. VanderSchuur decided it was best to "try to thaw the relationship," steering clear of any conversations that touched on politics or the pandemic.

A few weeks after returning to Portland, VanderSchuur learned that his sister had blasted the health department for participating in a local Pride festival that included a drag queen reading a children's story. Miedema said the festival and story hour were "promoting sexual promiscuity" and normalizing deviance in ways that would further the spread of disease.

VanderSchuur saw the events as lifelines for people like him. "That would have been an amazing thing for me to have as a kid," he said. "I was so isolated."

This time, though, he resisted the urge to confront his sister. He didn't think Miedema was anti-gay. She and her husband had attended his wedding in Portland several years earlier. But he believed the pandemic had changed her, darkening her views of the country, making her more suspicious and less willing to listen and seek compromise.

That same mistrust of government, the courts and even their own employees animated the new board members' approach to leading the county.

Most county commissions focused on things like roads, parks and public safety. The new Ottawa board members had spent much of their first year in office passing resolutions that aimed to safeguard citizens' freedoms. In May, they voted to declare Ottawa a "constitutional county" and resist any federal or state efforts to constrain citizens' rights — especially their right to bear arms.

In August, they passed a resolution telling the health department to provide more information to parents about how to get vaccine exemptions and waivers for their children. During the debate, Miedema condemned government officials and employers who pressured people to get vaccinated during the pandemic.

"Government's role is not to threaten, bully, coerce or bribe," she said. "It's to defend the freedoms we have, to stand in the gap."

The resolutions were largely symbolic. Most of the board's power came from its ability to choose how to spend the county's budget. In late August, commissioners took aim at health department spending.

Initially, Hambley was given two days to cut the department's $18 million spending plan by more than 50 percent. She said the reduction would've made it impossible for the department to meet minimum state and federal service and spending levels that are required to receive outside grants. The department, she warned, would run out of money to pay its employees in a matter of weeks.

After Hambley was told to proceed anyway, she took to social media calling the board's actions "retaliatory," "fiscally and legally irresponsible" and a "threat to public health."

Moss, the board chair, accused Hambley of "inciting fear and panic" in an effort to undermine her bosses. A few days later, hundreds of people gathered on the lawn in front of the department, chanting, "We support you!" as the department's workers left at 5 p.m.

Schuetz and her co-workers, many of whom were in tears, waded into the crowd to thank them and headed home for the day.

By late September, the county's leaders had backed off their earlier, more severe cuts and were proposing a total health department budget of $14.4 million, down about 20 percent from the previous year's spending.

The new budget rejected about $2.2 million in federal COVID grants that helped pay for immunizations and could be used to help track the spread of hundreds of communicable diseases. It also cut about $400,000 from the department's health education division, which housed programs that aimed to curb youth suicide, substance abuse and the spread of sexually transmitted disease. The Ottawa Food program that Schuetz oversaw was part of that division.

County health officials pressed the board to explain the rationale behind the cuts. The clearest answer came in a news release in which Moss described how the pandemic had awakened the county's residents to the "tyranny of public health." The health department's misdeeds, he argued, extended beyond its COVID response.

In Moss's view, liberal forces throughout government, academia and the nonprofit world were using the department to foist their agendas on his conservative county. "Climate change, gender-affirming care, abortion, racial equity and social justice are increasingly identified as public health concerns," he wrote.

Cutting the department's budget was one way to fight the spread of these dangerous ideas in the place he called home and had promised to defend.

The full board was scheduled to vote on the proposed budget at its next meeting, scheduled for Sept. 26. Schuetz planned to attend. She wanted to say something during the public comment portion of the meeting, before the vote.

Schuetz knew her chances of saving her $55,000-a-year job were slim. But that wasn't her only goal. She hoped her words might help the commissioners to see her and her colleagues not just as line items on a budget or as their adversaries, but as people trying to address real needs and real pain in the place where they all lived.

The meeting

Schuetz finished work at the health department and rushed off to teach a yoga class that she'd picked up as a side gig to bring in a little extra money. Her helmet from another part-time job — working for the fire department — sat in her car's back seat.

She arrived at the county government complex around 7 p.m. The meeting that would decide her fate was already underway.

Inside, she signed up for public comment and the clerk handed her a slip to mark her place — No. 66 on the list. The county boardroom was already at capacity, so she found a seat in the overflow area, where a live stream of the meeting was playing on a screen at the front of the room.

County residents addressed the board in rushed, often angry, three-minute bursts.

Some speakers attacked the budget cuts and those who supported them: "Don't be complicit in this heartless and cruel plan!" said Marla Walters, a 67-year-old resident of Holland Township.

Some thanked the new board members for standing up to powerful forces seeking to undermine the country's democracy: "I pray for every single one of you every day," said Joel Buck, a project manager with a local safety equipment manufacturer. "The amount of hate and just evil that comes back at you is beyond processing, just the vulgarity. There's no discourse we can have in our country any longer. It's just one side pitted against the other."

Schuetz was having a hard time sitting still. She had planned to write her speech the night before but had been too anxious to focus. So, she found a quiet spot in the hall, near the bathroom, and started to outline her thoughts on her cellphone. The meeting was entering its third hour.

No. 55: "No single department has exerted more power and control over the county than the health department."

No. 56: "Only a fool would say that COVID is over."

No. 58: "I am sorry you believed the lies about COVID! It was a hoax!"

Schuetz looked up from her draft: "I'm feeling a little hopeless," she said.

The clerk called out No. 66, and Schuetz made her way to the lectern. Supporters of the new commissioners filled the seats on one side of the meeting room and those who opposed them were on the other.

"I'm Sierra Schuetz. I'm an Ottawa County employee," she said in a soft voice. "It's my absolute honor and privilege to serve as the coordinator of Ottawa Food."

The room fell quiet.

Schuetz talked about the impact the proposed budget cuts would have on her, her partner and their "little growing family." She talked about how "immensely stressful" the last few years had been for everyone. "Family relationships have been hurt. Friendships have been hurt, and programs have been affected," she said.

And she suggested that it didn't have to be this way. "Reconciliation and healing are available to each of you and to us as a community," she said. On the dais, Miedema listened and scribbled some notes.

The commissioners didn't begin discussing the proposed budget until 11 p.m. Much of the debate focused on Ottawa Food, which all the commissioners agreed was needed in a time of high inflation. "I think this entire board has the desire to have people well taken care of," Miedema said.

None of them wanted to take responsibility for passing a budget that didn't include funding for it.

Rhodea blamed the health department for its demise, saying she had been "absolutely blown away" by how difficult it had been to get information on the program's precise costs. Hambley and her backers on the board countered that the department had been "shut out" of the budget discussions and had never been asked for the information.

Schuetz shifted in her chair and ran her hand across her stomach, where she could feel the baby kicking.

"How are you feeling?" her boss texted her.

"I feel tired and just weary," she replied.

A motion by Doug Zylstra, the lone Democrat on the board, to add $200,000 to the budget to cover Schuetz's salary and other costs associated with sustaining Ottawa Food failed 7-4. Those who voted against the measure, including Miedema, maintained that the health department's leadership could find the money for the work in its $14.4 million budget.

Schuetz's bosses argued they were being asked to make an impossible choice. If they added money to Ottawa Food, they would have to take funds away from other essential programs that addressed youth suicide and substance abuse. Schuetz sympathized. "This is so senseless," she said after the final vote had been cast.

Her job was going away and, along with it, an entire infrastructure built up over the last decade to address food insecurity county-wide. The problem wasn't a lack of money, but rather a deficit of understanding and trust.

Schuetz left the government center a little after midnight. A light rain was falling as she climbed into her rusting 2007 Chevy. She wondered if she should have spoken louder and more forcefully at the board meeting, if her words had made any difference at all.

She slipped into bed next to her partner, who was back from a bartending shift. Schuetz was too worried and upset to sleep. So, she grabbed her fetal monitor, pressed it to her stomach and listened to the rapid beat of her unborn child's heart.

This article originally appeared on The Holland Sentinel: 'A rush of fear': The human impact of Ottawa County's health department cuts