New Southern Nevada Health District leader ready to put agency on the move

By Conor Shine

Saturday, Nov. 23, 2013 | 2 a.m.

Dr. Joseph Iser may not consider himself a relocation expert, but he’s fast becoming one.

Iser, who in September began his job as the new chief health officer for the Southern Nevada Health District, recently found a place to live after six weeks staying in a hotel near the Strip. Soon, his agenda will be to find a new, permanent home for the health district’s offices.

About two years ago, the health district relocated to its current headquarters on Valley View Boulevard after its old building at 625 Shadow Lane was condemned.

The decision to unilaterally close the health district’s main building in 2012, which scattered its services across several valley locations, was one of the key factors in a breakdown in relations between Iser’s predecessor, Lawrence Sands, and local elected officials. Those disagreements led Sands to resign in June 2012. His departure left the district in the hands of Dr. John Middaugh on an interim basis until Iser was hired two months ago.

Now, consolidating the health district’s services is back on the front burner.

“I would like to see us in the next six months at least have a plan in place for a transition to new buildings,” Iser said.

Despite stepping into an agency in flux, Iser has taken his new challenges in stride, armed with his quick smile and calm demeanor, a testament to his Midwestern roots.

Born and reared in the Kansas City, Kan., area, Iser spent much of his early years baling hay, milking cows and slopping pigs on his aunt and uncle’s farm.

He received his medical degree from the University of Kansas before joining the U.S. Public Health Service. That initial two-year commitment stretched into 24 years, during which Iser worked for a number of federal agencies, including the Department of Defense, Food and Drug Administration and Centers for Disease Control and Prevention.

He’s also served as the chief health officer in two California counties and was most recently the top public health official for Washoe County.

Shortly after he was hired in late September, he found himself immersed in the aftermath of a tuberculosis outbreak at Summerlin Hospital that left two dead and another 26 infected.

“The tuberculosis issue at Summerlin Hospital has taken up many, many, many hours,” said Iser, who was hired at an annual salary of $235,000. “We’ve been quite involved.”

Earlier this month, another tuberculosis diagnosis — this time at Coronodo High School — again put the health department on alert.

Iser's also been dealing with limited mobility in his left arm, which has been in a sling for several weeks due to a recent rotator cuff surgery.

In addition, Iser, 63, also has been working to fill two key executive positions on his staff, one for a chief administrative officer and another for an environmental health director who is responsible for overseeing restaurant inspections, among other duties.

Looking ahead, Iser soon will start work developing next year’s budget for an agency that has operated at a deficit in recent years. The district now is operating on a $65 million annual budget. The budget is $8 million more than the district’s annual revenues, forcing the agency to dip into its reserves to fully fund its operations. Negotiations with the district’s employee union are expected to start in January.

Iser said Clark County’s high population density and large number of visitors make it unique from a public health perspective.

“It brings in a lot of people from all over the country and world. What that means from a public health point of view is increased risk for infectious diseases like tuberculosis,” he said. “The other issue relates to the number of restaurants here. The risk of food-borne illness will be much greater in a city this size with the turnover of the staff you see here as opposed to a smaller town. We’ve got to make sure that people are trained in hand-washing and safe food handling.”

Once he’s filled out his staff and found a new building for the health district, Iser says he wants to work on improving the effectiveness and efficiency of his agency to balance its budget.

“I think we need to transition some of our people to different jobs. I think there are areas we need to be doing more in that we’re not right now,” he said.

One step toward that will be a community health assessment and subsequent community health improvement plan that Iser hopes to develop.

Iser said he also wants to focus on infectious disease, whether it’s cutting down the number of green pools that breed mosquitoes or improving the monitoring of tuberculosis outbreaks.

“We’re a bit passive in regards to tuberculosis,” he said. “We need to be nimble and responsive so we can go out once a person is identified and do case-finding beyond that person with their family members, classmates or work colleagues.”