After 11 terms as a Mecklenburg County commissioner, Republican Bill James, right, went down to defeat in Tuesday's election, along with all other Republican incumbents on the board. Democrat Pat Cotham, left, was the top vote getter. (Photo: Nell Redmond, The Charlotte Observer)

Acknowledging years-long failures in Mecklenburg County’s health department, county officials on Tuesday called for an overhaul of the agency.

County Manager Dena Diorio warned county commissioners that addressing substandard patient care, poor management, outdated technology and other problems listed in three reports would take at least 12 months. Other officials said the fixes would take longer and may cost taxpayers millions of dollars.

“Things will get worse before they get better,” Diorio said.

The comments follow the recently released reports from two consulting firms and the county’s Internal Audit office that detail issues at two publicly run health clinics. The issues included workers failing to put accurate information in patients’ files, patients enduring unacceptably long waits for appointments and other lapses in care.


The reports also recommended sweeping changes to management, saying top leaders and supervisors failed to hold employees accountable. One consultant suggested making senior leaders re-apply for their positions.

Mecklenburg leaders ordered reviews of the health department after acknowledging in February that the two health clinics did not notify at least 185 women about abnormal Pap smears.

The mistakes helped lead to the resignation of Health Director Marcus Plescia and four other employees.

“This is a wake-up call,” Commissioner Vilma Leake said. “It’s sad that something had to happen to make us aware of the needs of this department.”

Also, on Tuesday, three commissioners acknowledged they had received complaints about racism and cronyism in the agency.

They said there are worries that African-American workers would be shut out of promotions and senior leadership posts in the possible reorganization. Commissioner Pat Cotham said she has already seen evidence that African-Americans with advanced degrees and years of experience were denied promotions in favor of white workers with less education and seniority.

Leake said she had heard about similar concerns. Commissioner Trevor Fuller said there are complaints about cronyism in hiring.

“Is this going to be another example of where the job description is written for people you want in these jobs?” Fuller asked. “I wanna see whether or not we’re essentially rearranging the chairs.”

The comments represent an about-face for some commissioners and county administrators.

Plescia and others for months have defended the agency and assured the public that the Pap smear lapses did not reflect the quality of patient care or extensive problems with management.

In a May 9 memo to staff, Plescia said race relations among employees had improved during his three-year tenure.

“The executive leadership team is now comprised of two white males and four females, two of whom are African-American,” he wrote.

But on Tuesday, commissioners said it was time to acknowledge the agency’s failures and set a new course. Diorio said recommendations concerning what changes should be made and their approximate costs will be discussed in the Aug. 2 board meeting.

“We never want to be here again,” board Chair Ella Scarborough said. “We must always keep our eye on the ball.”

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