Lee names McDonald as interim health commissioner

Gov. Bill Lee has named Morgan McDonald as the interim commissioner of the state Health Department. McDonald was previously the agency’s deputy commissioner for population health. She takes over from Lisa Piercey, who announced in April she planned to return to private practice.
Here is the release from the governor’s office:
NASHVILLE, Tenn. – Today, Tennessee Governor Bill Lee announced the appointment of Dr. Morgan McDonald, MD, FACP, FAAP, as interim commissioner for the Tennessee Department of Health (TDH), effective Friday, June 3.
“Dr. McDonald is a committed public servant, and I appreciate her continued leadership during this time of transition,” said Lee. “I am confident she will serve Tennesseans with integrity.”
McDonald is the Deputy Commissioner for Population Health at the TDH and formerly served as an Assistant Commissioner and the Deputy Medical Director for Family, Health and Wellness. McDonald earned her undergraduate and medical degrees from Vanderbilt University and completed her residency in internal medicine and pediatrics at the University of North Carolina at Chapel Hill.
McDonald will serve until a permanent commissioner is named.
Piercey leaving state Health Department

Health Commissioner Lisa Piercey is leaving Gov. Bill Lee’s administration at the end next month.
Here’s the release from the governor’s office:
NASHVILLE, Tenn. – Today, Tennessee Governor Bill Lee announced Department of Health Commissioner Dr. Lisa Piercey’s departure from state government to enter the private sector, effective May 31. Lee will name a successor in the coming weeks.
“Lisa led our state’s health response through one of the most challenging crises Tennessee has faced, and I commend her faithful service to Tennesseans,” said Gov. Lee. “She has played an
invaluable role in my cabinet, and I wish her much success as she enters the private sector.”
Dr. Piercey joined the Lee Administration in January 2019. As commissioner, she served as a member of the Governor’s Unified Command Group during the COVID-19 pandemic, spearheaded efforts to innovate public health operations across the state and bolstered the healthcare workforce pipeline.
Read the Health Department memo about why it fired Tennessee’s chief vaccination official

Tennessee made national headlines this week for firing the top vaccination official at the Department of Health . The state has has been mum about the reasons for Michelle Fiscus’ termination, but she has alleged being made a scapegoat for GOP lawmaker anger over a state policy urging teens to get vaccinated against COVID-19.
Now the state is releasing a memo written by Tim Jones, the chief medical officer at the Health Department, to Commissioner Lisa Piercey claiming Fiscus didn’t work well with others and didn’t seek permission and guidance about the content of a letter “regarding her own interpretation” of state law regarding the authority of minors to get vaccines without their parents’ permission. Fiscus says the letter was drafted by an agency lawyer and “blessed” by Gov. Bill Lee’s office.
UPDATE: The Fiscus camp denies misdeeds, pointing to her glowing performance review as recently as last year.
Here’s the full text of the letter:
To: Lisa Piercey, MD, MBA, FAAP, Commissioner
From: Tim Jones, MD
July 9, 2021
Re: Expiration of service of Michelle (Shelley) Fiscus, MD
Based on program management deficiencies and failure to follow appropriate processes and procedures, please accept this recommendation to expire the executive service of Dr. Michelle Fiscus, Director, Vaccine Preventable Diseases and Immunization Program (VPDIP), Tennessee Department of Health.
This recommendation is based on Dr. Fiscus’s failure to maintain good working relationships with members of her team, her lack of effective leadership, her lack of appropriate management, and unwillingness to consult with superiors and other internal stakeholders on VPDIP projects.
On multiple occasions during the 2020-2021 COVID response, Dr. Fiscus has failed to maintain satisfactory and harmonious relationships among her team. In February 2021, CEDEP leadership and TDH Human Resources received multiple complaints from program staff regarding her management style, treatment of employees, and poor program morale. Dr. Dunn met with five senior team members who expressed consistent complaints related to management of the program by Dr. Fiscus during the COVID response. He had several coaching sessions with Dr. Fiscus, with minimal improvement in the situation noted. Two of her most senior leaders have subsequently resigned.
On March 7, 2021, Dr. Dunn and I met with Dr. Fiscus and another departmental physician to mediate complaints against Dr. Fiscus of disrespectful treatment and ineffective management. The meeting terminated with a refusal of both parties to communicate constructively, and with a refusal by the other physician to work further on the VPDIP team. Dr. Fiscus was coached on professionalism and teamwork.
Dating back to December 2020, the vaccine planning team required intervention by CEDEP leadership to address inefficient use of team resources, including poor inter-program communication regarding vaccine distribution. Repeated failures by Dr. Fiscus to appropriately delegate to others resulted in repetitive, long, and inefficient meetings. These meetings took already busy colleagues away from other tasks.
Over the past three months Dr. Fiscus requested to give a new non-profit organization TDH funding to support VPDIP activities. This organization was founded and led by Dr. Fiscus, had no Executive Director or other employees, and had no other substantive source of funding. Providing funds to such an entity would be poor judgement and a substantial conflict of interest.
In June, 2021, Dr. Fiscus communicated directly with a state university regarding the department producing COVID-vaccine reports for the institution. She did not notify or consult with supervisors, and the situation only became evident when departmental legal counsel received formal documents directly from the university memorializing the arrangement. The requested reports were not produced by the department.
In May, 2021, Dr. Fiscus broadly shared a letter regarding her own interpretation of state and federal law with external partners with respect to vaccinations and other medical treatment of minors. The letter should have been reviewed by both leadership and departmental legal counsel. However, Dr. Fiscus did not share the letter nor otherwise include any of these parties in the drafting process prior to sending it out. This action resulted in confusion of both law and policy for private providers, parents, and legislators.
These examples clearly demonstrate that Dr. Fiscus’s performance in this role has led to strained relationships with internal and external stakeholders at multiple levels, and to an ineffective and non- cohesive workplace. Her leadership and management of her team does not foster the culture or environment expected at the Tennessee Department of Health.
Health commissioner warns of possible COVID-19 surge

State Health Commissioner Lisa Piercey is warning of the next potential spike in COVID-19 infections despite the downward trends of the last quarter.
The Nashville Post reports the state’s infection rate dropped 85% between January and the middle of this month, but that 8,500 new cases were reported over the last week, with the active case count jumping by 1,000 people. Hospitalization rates are also creeping up.
“I’m fairly certain it’s going to get worse. What I don’t know is how high the next surge might be,” Piercey told lawmakers. “We are already starting to see — we saw a plateau for three to six weeks — now we are starting to see it tick back up ever so slightly. What I don’t know is whether that will be a blip or if that will be a pretty substantive surge.”
Piercey said the statistics underscore the need to convince more Tennesseans to get vaccinated. Gov. Bill Lee has announced the state will drop all restrictions on COVID-19 vaccines by early April, meaning innoculations will be available to anyone who wants one.
“Some of the vaccine hesitancy we have encountered was expected. We anticipated some of it, but there has been, to be honest, some vaccine hesitancy that we did not anticipate, and we can’t readily identify reasons for that,” she said. “That’s why the market research piece is so important, in all 95 counties, particularly among rural conservative and rural white men, why they are hesitant and how to address it properly.”