Building ‘legacy’ at health department
Taylor wants SCHD viewed as ‘place for everybody’
On a difficult day during the height of the Delta surge, Dr. Michelle Taylor, director of the Shelby County Health Department, walked into her office, frustrated. h Travis Green, her deputy director, asked her what was wrong, then suggested they talk about the priorities she had mentioned when interviewing for the position as director of the agency overseeing the public health of the largest county in Tennessee.
He told her to write the word “legacy” on her blank whiteboard, Taylor recalled months later, and told her, “Every time you get upset, I want you to look at that and realize that is what we’re here for. You want to leave this place better than you found it. That’s what you told me when you started.”
Today, after eight months on the job as director of the Shelby County Health Department, the word “legacy” is still written on Taylor’s whiteboard. Underneath it is a list of priorities for the department. To the left, she has a list of words written by people who visit her office, people ranging from her mother to staff to guests. “Meditation,” “spirit,” “perseverance,” “accountability,” “integrity,” they’ve written.
“I don’t want the health department to be an afterthought for people,” said Taylor, 46. “I want people to understand that this is a place for everybody, that your tax dollars in many different forms fund this place and this is a place where you can receive quality services no matter what service you’re going for. … To do the job, do it well and have people understand that we really love what we do here and
we’re passionate about improving health and protecting health, if I can do that and leave this place better than I found it, then I will have done my job and I will have advocated for the Shelby County Health Department and the people who work here in the right way.”
Job a homecoming after years away
For Taylor, entering this role and returning to Shelby County was a homecoming. She laughs, since news articles about her appointment as director usually lead with the fact that she graduated from White Station High School.
People ask her if she knew what she was getting into, joining the Shelby County Health Department. She “honestly did,” she says, since she last worked in the department in 2013.
Because of her upbringing in Memphis, “I do understand the history of this place. I understand the political landscape. … and I just understand and love the people. It made it easy to even say you know what, I think I want to go home and do some good work,” Taylor said.
Taylor arrived in Memphis during a difficult time for the county. The county had been stripped of its authority to distribute COVID-19 vaccines by the state, and its previous director of the department, Alisa Haushalter, had resigned.
She was the “right person for the season,” said Keith Norman, vice president of government affairs at Baptist Memorial Healthcare and pastor at First Baptist Church Broad Ave.
“She was able to come in at a point in time when the sensitivity of what was taking place around the county was a political issue and she depoliticized it very clearly and got straight to the work that was the most important part,” Norman said. “She was a calming voice and also a practical voice. She was able to present practical information and to galvanize a workplan that was needed when she came in.”
Dr. Manoj Jain, an infectious disease physician in Memphis, was another person who got to know Taylor through her work on the City of Memphis-shelby County Joint COVID Task Force.
There, he saw that she was “incredibly collaborative,” Jain said.
“She works very well in bringing people together, both political leaders, scientific leadership and obviously the staff and all that are necessary to do the work,” Jain said. “She’s very positive, very motivated. I think there’s a lot of energy that she brings to that position.”
She’s very engaged in testing and sequencing and watching for new COVID-19 variants, Jain said, and following the detailed scientific discussions around the virus, then breaking it down in ways the public can understand.
Taylor’s time both in Memphis and away prepared her to come into the health department during that difficult time in the COVID-19 pandemic, she said.
She holds a masters in epidemiology from the University of Tennessee Health Science Center in Memphis, a doctor of public health from Johns Hopkins University in Baltimore and a master in public administration from Harvard University in Cambridge.
Her experience as a pediatrician, a mother and a member of the Air National Guard, plays into the role of leading the health department, she said, although this is her first time leading an entire organization.
“As a leader you’re constantly learning,” Taylor said. “You’re constantly growing. I knew that in theory, but now I’m living that out. It’s such a privilege and an honor to be able to do this work, because I really have been able to bring all of my training to bear.”
Her role as Air National Guard Aerospace Medicine Division Chief was particularly “similar to the pace here,” Taylor said. “Fast. Something always coming at you.”
She began as a branch chief for credentialing and privileging, making sure that everybody who requires any credential or privilege in the air national guard nationwide had them. When COVID hit, she was in that role.
When the Air National Guard Aerospace Medicine Division Chief — who would later become the Air National Guard Surgeon General — found out she had a background in epidemiology and public health, he asked her for help.
When he moved up in the ranks, she did too, becoming the aerospace medicine division chief.
Renovations, data collection among priorities
Shelby County as a whole first met Taylor as health director through the regular COVID-19 task force briefings: a calm voice, going over statistics as the virus ebbed and flowed.
But the health department is far more than just combatting COVID-19, Taylor wants the public to know, something that is illustrated by the priorities listed on her whiteboard: Clinic renovations, Ehr/data sharing access bureaus, healthcare for homeless, accreditation (health equity) and behavioral health unit.
Green, the deputy director, said he knows the work at the health department is rewarding, but it also feels like you’re dealing “with a 100-year flood … every other hour.”
“Sometimes you just need a north start to guide you and keep things in perspective,” Green said. The words on that whiteboard, he suggested to Taylor, could provide those north stars. “We’re very much rallying behind the north stars that she’s given us. When people go in her office they see that on her wall and they walk out and they’re like I know what she’s focusing on, I know what she’s dedicated to. She’s been able to effectuate the change in the little time she’s been there as a leader and its very rewarding and beneficial to the people of Shelby County.”
The county has already budgeted funds to renovate its satellite clinics, which offer services ranging from immunizations to breastfeeding support across the county.
“I believe that every person in Shelby County deserves to walk into a space that looks like the quality of services that are being provided in that space,” Taylor said.
Another priority is achieving accreditation from the Public Health Accreditation Board (PHAB), something the health departments in Knox and Davidson counties currently have. Working toward that accreditation predates Taylor’s time at the health department, but was stalled due to COVID-19. Now, they hope to get back on track, showing “that we’re in compliance on every level of public health and that we’re proven to
make sure that what we say we’re doing, we’re doing.”
The department is also moving toward having electronic health records, a way to collect and share the immense trove of data, much of which has been collected for years on paper.
COVID-19 showed that data is a powerful way to work on health issues, Taylor said.
“Imagine if the same resources we brought to bear with COVID, we brought to bear with gun violence as a public health issue,” Taylor said. “Racism as a public health issue. The history of public health in Shelby County, where we were and where we’re going. We have some of those things in computers if somebody has done a project or decided to look at a particular issue, but if we look at that across the years, all of that scanned in, all of that information at our fingertips, oh wow.”
And last, there are the “pie in the sky” ideas that Taylor hopes will be implemented someday in the future, including adding more healthcare for people experiencing homelessness and creating a behavioral health unit. Some of that is already in action in smaller ways, with the health department providing hotel rooms to house individuals experiencing homelessness when quarantining or isolating during the COVID-19 pandemic. And, for the first time, the health department has been asked to participate in convening a work group as part of the Memphis Shelby Crime Commission to do an inventory of existing behavioral health services and find out where the gaps lie.
Creating a health department ‘for everybody’
Part of Taylor’s role in moving the health department forward also involves looking back.
“We can’t move forward as a community at all, as a health department at all, unless we know where we came from, unless we understand truly the lived experiences of the people that we’re serving,” she said.
She remembers visiting the old vital records room in the health department as a resident at Le Bonheur Children’s Hospital. There, they were shown card catalogues, with children listed on white cards and orange cards.
Up to a certain year, records for African American and other children of color were kept on orange cards, while white children were kept on white cards, Taylor said.
“That right there lets you know that institutional policies were infused in folks from a very early age from the time they were delivered, either over here at what used to be John Gaston, the colored hospital, or a Baptist or Methodist, wherever you were delivered if you were white in this county,” Taylor said. “It is a stark example of how those institutional policies remind you that funding was different, depending on where you were delivered, and of course we know that if resources and funding are different, then eventually health outcomes are going to be different. … Institutional polices, segregation, racism gets infused in every aspect of life. It’s what we call social determinants of health in public health.”
Taylor has held many roles over the years, but as director of the Shelby County Health Department she’s now in a position where she can make a direct impact on these issues that she has pondered for years.
For Taylor, both her parents grew up in South Memphis, attending segregated schools. Her grandparents “did not even come close to having” the choices she has today, and that’s not even considering her great grandparents.
“Because I have Fred Britton, Hattie Rae Britton, all of my grandparents, because I have that perspective, everything that we do here is to make sure that (underresourced) families are treated in the same way as a family who is resourced and is maybe just running in here for a birth certificate,” she said. “It means that we care about the services you are receiving and we’re not acting like poverty is a moral failing.”
She was “so proud” the day that the health department began offering COVID-19 vaccines to 5-11 year olds, her daughter being the first to receive a shot. That day, she saw a broad array of socioeconomic diversity coming in to receive vaccines for their children, she said.
“You got to see what a true public health department where everybody in the county understands this is for everybody, you got to see what that looks like. That’s what I want,” Taylor said. “Public health truly is for everybody and we get to create an environment where every service we push out to whoever it is in Shelby County, they feel like this is my public health department and I’m proud to come here and get the service.”
“I want people to understand that this is a place for everybody, that your tax dollars in many different forms fund this place and this is a place where you can receive quality services no matter what service you’re going for.”
Dr. Michelle Taylor