‘I am and feel responsible for every person living in this county’: Alicia Thompson comes home to lead Spokane Regional Health District

Coming back home always was the goal for Spokane Regional Health District’s new administrative officer, Alicia Thompson.

She returned to Spokane after a long career as a public health administrator almost 50 years after arriving. At 15, her father moved to Spokane to serve as marketing director for Expo ’74. She graduated from Lewis and Clark High School and eventually, in the 1990s, as epidemiologist at the health district.

In Thompson’s telling she left the health district almost against her will as she looked for career opportunities elsewhere.

“When I left, I didn’t really want to leave. I loved working here,” she said. “But I wanted to go into leadership. And so I applied elsewhere and that started me on my leadership journey, to gain the experience and knowledge and abilities that I now have that prepared me to be my position.”

Leaving her position as chief operating officer of Chiricahua Community Health Centers late last year and coming back to Spokane has “felt like coming home.”

A new direction

In recent years, leadership at the Spokane Regional Health District was in turmoil as former Administrative Officer Amelia Clark dismissed former Health Officer Bob Lutz in 2020 at the height of the COVID pandemic without approval by the Board of Health. After facing multiple complaints she violated state law, Clark left her post in 2022 and agreed with state health officials not to ever serve in the position again.

Since Clark’s exit, the public health agency has been overseen by a team of interim administrative officers. As the first appointed administrative officer since Clark’s ouster, Thompson wants to bring “a sense of stability” back to the health district.

“It’s been a rough time for SRHD. I would say the last three years have really been rough for the amazing employees. I’m very conscientious of that fact and I want to provide a very stable, collaborative, calm and thoughtful leadership,” she said.

A priority for Thompson is to ensure her employees have the opportunities within the health district so they don’t have to move elsewhere to move up like she did. She also wants a set succession plan in place so there are “strong internal candidates” for her job when she leaves. To provide the stability the district needs, Thompson hopes to stay in her job for 10 or more years.

The Spokane Regional Health District, like other health districts, has a firm divide between the administrative officer, who oversees practical operations, and the health officer, who directs the public health mission. Thompson describes herself as a “maestro” who oversees an orchestra delivering public health.

Dr. Francisco Velázquez has served as health officer since 2021. Thompson said she “loves” Velázquez and has complete confidence in him.

“I plan to let Dr. Velázquez do his job. Because he is great at it,” she said.

Over the course of 2024 the health district will go through the process of developing a new strategic plan outlining the organization’s goals over the next three to five years. According to Thompson, the health district is in a “very strong place” financially, though she does want to make changes with her leadership.

“I’m a quality improvement person. I’m not a stagnant person. There’s always room for improvement. And so this is an amazing organization that is run extremely well. But there’s little opportunities that we could maybe do things a little bit different, that would make us even better,” she said.

‘Deliberative’ communication

A little more than two weeks from her first COVID diagnosis, Thompson wants the public to know the pandemic is still in Spokane.

“People are still dying. Yes. They are still dying. They are still being hospitalized,” she said.

But emerging from the crisis, Thompson hopes the health district can improve its communication to the public. Rather than relying on the authority of their expertise, the health district should communicate in a way that “community members can hear.”

“We frame messages in a way that are really compelling to us,” Thompson said of public health officials. “They’re not so compelling to our community members.”

Many public health officials assumed they would be believed by the public before the pandemic, Thompson said. Now many individuals are distrustful of public health officials – whether rightly or wrongly. In a future crisis Thompson hopes the district can tailor public health recommendations more closely to Spokane.

“If a recommendation doesn’t make sense for our community, then we need to figure out what would make sense for our community.”

Based upon her experience as a public health official during the pandemic, Thompson will be “deliberative” and “much less willing to take a recommendation and run with it.”

In 2020 Thompson oversaw public health in Cochise County, Arizona. When a small number of coronavirus vaccines became available, Thompson rigidly enforced age requirements ensuring the elderly received those vaccines first. She later learned those federal recommendations were based on the average life expectancy of a white man while Cochise County’s population is 38% Hispanic.

“We were hard and fast following that recommendation. And consequently, we had an extremely high death rate among Hispanic elders,” she said – noting Hispanic people have a significantly lower life expectancy than white men.

Thompson learned this during an equity and inclusion training for her department. She “just kept bawling” because she felt responsible for those deaths and “didn’t even think about it.”

“When you know that you made a decision that led to many, many elderly grandpas and grandmas in the Hispanic community dying because you said that they were not old enough,” she said with tears in her eyes. “Not realizing that they did likelihood of them getting to that age was so small. It’s just really hard to carry that weight of people who died because they did not have access to the vaccine you had.”

Thompson hopes to bring the same equity training to the Spokane district.

Asked what she wants the public to know about her, Thompson said she wants every person in the city to know that she cares.

“When I am in this role, I am and I feel responsible for every person living in this county and their health and their well-being. My heart goes out to our community members.”