Detroit's new health director endures controversy while learning job

Christine Ferretti
The Detroit News

Correction: This story has been updated to clarify that Denise Fair said she wanted to be a neurosurgeon when she was younger, not a neurologist. 

Detroit — Denise Fair's early days as the new leader of the city's Health Department have been marked with the controversial hiring of a new animal control director and a vow to provide every resident "an opportunity to thrive."

Fair has fielded questions at community town halls, shadowed health workers visiting families with lead-poisoned homes and says she plans to trade in her high heels for an animal control uniform to clean out dog kennels. 

"I can only learn about what they are doing on a daily basis if I experience it with them," said Fair, 36, an Ypsilanti native who moved to the city 18 months ago. "I cannot lead behind a desk. I need to be out in the community, out in the department, and my team expects that."

Denise Fair, Detroit's new chief public health officer, oversees a team of about 230 employees managing more than 40 programs.

The University of Michigan graduate was appointed two months ago as Detroit's chief public health officer, the latest to take on the role that's been held by a dozen others in the last 15 years. Among her early goals, Fair said what she's trying to develop with her team of about 230 employees involved with 40 health-related programs, is trust.

"To me, this is not a job; it is a calling," Fair said in a Wednesday interview with The Detroit News. "I really feel led to the city of Detroit."

In her first months, Fair has partnered with the city's water department on an initiative that will bring social workers to households facing the threat of water shutoff and will head an effort to address harmful lead exposure in homes.

She also worked with the city's executive leadership team to hire the new head of Detroit's Animal Care and Control, a selection that's proved contentious.

Mark Kumpf is the fourth director for the troubled office in as many years, and his hiring was met with immediate backlash from some welfare groups over his record and firing from the Animal Resource Center in Montgomery County, Ohio.

Fair defended the decision to bring Kumpf on to lead the city's animal control, saying he was fully vetted and met all of the qualifications for the $100,000-per-year job. 

"He came prepared with full knowledge of Detroit. He'd already done his research," she said. "He has been faced with some protesters who haven't been as supportive, but he's definitely very, very strong, and I'm fully supportive of him."

Fair, who earned a master's degree in public health at the University of California, Berkeley, was appointed in August by Detroit Mayor Mike Duggan, replacing Joneigh Khaldun, who left in the spring to become the state's chief medical executive. Fair will earn $200,000 per year, according to the city. 

Prior to Khaldun, former gubernatorial candidate Abdul El-Sayed served in the post for about a year. 

Fair has held roles with Trinity Health and as a group practice director for Henry Ford Health System, overseeing primary care clinics in Livonia, Southfield and Novi.

Guy Williams, president and CEO of Detroiters Working for Environmental Justice, said the city's health department has long had representation on the board of the Urban Research Center, a partnership with University of Michigan researchers, community groups and health institutes focused on initiatives to improve health in Detroit neighborhoods. 

But the health department's frequent leadership changes have presented challenges. 

"What seems to be a casualty of the turnover is the ability for the leader to really have strong budget support for any kind of initiative that takes multiple years to produce the impact," he said. "Fundamentally, it slows down progress."

Current health worries for residents, Williams said, are centered on water-borne pathogens, the damage associated with flood waters in homes and water shutoffs.

"Public engagement is growing in acceptance of something that's worth doing well by the city after a long time," he said. "The health department seems bent on doing that better. I would encourage them to stick with it."

Fair said her early focus in Detroit is building on efforts to address preterm births and lead contamination and carrying out plans that were in the works for the department before she arrived. 

Among them, Fair will oversee the health department's relocation in December to the former Red Cross building at 100 Mack Ave. in Midtown. 

By July, the health office expects to run mobile clinics throughout the 139-square-mile city to offer supplemental nutrition program for women, infants and children as well as immunizations and vision and hearing screenings for children ages 3 to 18 who need them.

"My vision is for every Detroiter to have an opportunity to thrive," she said. "This is one way to do that."

As for animal control, Fair said it's "prime time" to look into fixes. It's an area, she said, where there's been "a lot of missed opportunities."

Detroit's animal control operation has long faced criticism over its lack of resources, shelter conditions and exorbitant fees. This month, the animal shelter amended its vaccination practices amid a review by two state regulatory agencies over allegations of improper certifications. 

"We identified a problem and we corrected it immediately," Fair said of the vaccination issues. "Whenever a new leader comes on board, including myself, we're looking at everything that may appear to be broken to figure out how we can fix it."

Other fixes on the horizon, she said, will target shelter conditions and curbing overcrowding. The office also plans to expand its shelter and call center hours.

Fair said the health department is in the midst of finalizing its future strategy and a community improvement plan based on priorities identified in an 18-month health assessment. The citywide survey included feedback from about 2,000 residents.

She's also in the process of hiring medical and nursing directors and a public policy head and soon will be touring the city's council districts to discuss the health and wellness of Detroit communities based upon findings from the 2018 assessment.

According to the report, access to fresh foods as well as quality schools and public transportation, job programs and childcare ranked high for quality-of-life needs in the city. 

Monica Lewis-Patrick, president and CEO of We the People of Detroit, said she's eager to meet with Fair and learn more about her vision for addressing affordable housing and water, accessible food, air quality and health disparities, all of which are economically challenging to residents.

"All of these things should land in her wheelhouse and she should be concerned about," said Lewis-Patrick, who heads the group of community activists and academics who conduct health studies and fight for clean and affordable water. "I would be excited to talk with anyone who wants to solve those big issues for the citizens of Detroit."

Earlier this month, Fair joined Duggan in announcing $9.7 million in grants for lead abatement in hundreds of low-income households in southwest Detroit. 

"Lead is a No. 1 priority," said Fair, noting about 90 percent of the city's housing stock was built before 1978, prior to a ban on lead paint. "We have children, people in these homes exposed to lead."

Last summer, the health department launched a lead prevention pilot targeting five city zip codes with the highest prevalence of elevated blood lead levels in Detroit children. 

In 2018, the office secured $1.4 million in new funding to support education, outreach and testing for pregnant women and young children most at risk to effects of lead exposure.

The state Department of Health and Human Services on Wednesday allocated $6.5 million to seven cities and organizations — including nearly $1.3 million for Detroit — for lead inspections and removal for eligible households.

Fair said her early inspiration for the medical field came after she met now U.S. Housing and Urban Development Secretary Dr. Ben Carson at age 10, and became intrigued with his story. 

She set out to become a neurosurgeon but later decided to switch gears. She turned to an academic adviser at the University of Michigan, Elzora Holland, for advice. 

"She told me 'you are a natural leader, you should think about public health,'" Fair recalled. "She definitely inspired me to really live out my dream."

Holland, who now runs a mentoring program with high school students in Atlanta, said Fair was always a "critical thinker and one to move the needle."

"It was easy to support her because she was a go-getter. She had a lot of ambition about her from a very young age, said Holland, who left the university in 2007. "Once she had that aha moment, I knew she could handle public health and she had the background, people skills and personality. She just went for it and she never turned around."

When the chance came earlier this year to lead Detroit's health department, Fair said she jumped at it. 

"I just had this moment where I realized I can definitely make a difference and positive effect for almost 700,000 residents, and that's powerful," she said.