Jim Harless contacted me recently regarding yet another unique story about Oak Ridge. He personally was involved in the Oak Ridge Health Department as it evolved and wondered if I would like to document that history in Historical Speaking. Of course that interested me.
Jim has been most helpful by sending me a lot of details of this unusual organization's history. He also introduced me to "Dog Tag" art, which he invented.
What made our Health Department unusual? Like many other aspects of our city, the Health Department first began during the 1940s as a part of the unique Oak Ridge experience. Each Manhattan Project site created a new city of workers and their families. Part of what the Army faced was how to provide for the health of these quickly forming cities.
Oak Ridge led the way as it was the first site selected by the Manhattan Project's General Groves on Sept. 19, 1942. Right away this once peaceful valley and ridge river bottom land and its group of communities changed drastically. People who were accustomed to city living and had never considered living in East Tennessee moved into what some called "Dog Patch." Yet, they expected health services just as any other community would.
By November 1942, construction was underway in Oak Ridge (Site X) and throughout the first months of 1943, the city, soon to be known as Oak Ridge, was being built right along with three government facilities. The Y-12 electromagnetic separation plant and X-10 graphite reactor, both of which started construction in February 1943, and K-25 which started construction in June 1943, also required health services. Happy Valley, the construction community for K-25, also required health services for the few years it existed.
As the houses were being built, the scope of this brand new city rose from an original planned number of 13,000 to 50,000 by the summer of 1944, and to an eventual swell of 75,000 by August 1945.
Also expanding were the Army's efforts to provide the whole range of health services as it strived to meet the growing health-related needs of the city and the workers. At the three facilities and in the city, all looked to the Army for necessary health-related care and services.
A 50-bed Army hospital was built and staffed in 1943 as one of the first major community health care service efforts. The first baby was born on Nov. 8, 1943. Red Cross ''Gray Ladies" served as the pioneering secret city's first volunteers at the new hospital. The hospital served the community and the federal facilities.
During the Manhattan Project, like everything else, health care and other health-related services were provided by the Army. Although some civilian jobs were created as needed, the Army took care of the population in every way possible.
The comfort and care of the population was a key strategy for attracting scientists to work on the critically important work of creating an atomic bomb. No expense was spared and nothing needed to assure the success of the project was withheld. General Groves literally had a "blank check" and he used that authority to assure the workers and their families were well taken care of -- health care and other health-related services being no exception.
After the war ended in 1945 and the Atomic Energy Commission was formed to take control of the nation's atomic energy program from the Army, several changes occurred as a part of the transition from Army to civilian control. However, health care and health-related services continued to be provided by the federal government until the city was incorporated in 1959.
The transition from a secret city in 1949 brought many changes, and would lead to radical changes in the Oak Ridge Health Department, especially related to how it was funded. The first phase of the three-phase history of public health services in Oak Ridge funded by the federal government ended with incorporation of the city in 1959.
Jim Harless, who worked for the city of Oak Ridge from 1973 to 1985, most of that time supervising environmental health for the Municipal Health Services Department, says, "While most unique, the Oak Ridge Health Department, has seen a great deal of change over time.
"Originally, the city of Oak Ridge had the only municipal-funded health department in Tennessee. It came about in a bit of an unusual way."
Oak Ridge may well be THE only city to ever be required to solely fund its health services.
Jim continues stating, "The city Health Department celebrates much the same date of origin as the incorporation (of the city) in 1959. The saga of the Oak Ridge city public health begins with the federal staff of the Public Administration Service (PAS), the federal contractor operating Oak Ridge like it was a city, worked to pull together an initial draft charter in part during 1957 and 1958."
This was in preparation for incorporation as the federally provided health services program was fast coming to an end with the plans to incorporate the city.
Jim notes, "Mr. R. D. Hutcheson, commissioner of health, state of Tennessee, and A. Shipley, regional health director met in Nashville on Jan. 29, 1958, with PAS staff D.B. Henry, and R.D. Stover. The meeting came forth to say the future needed public health services could be furnished by Anderson County Health Department, but 'there seemed to be general agreement among these officials, however, that the additional expenses to the county for providing health service to Oak Ridge should be borne solely by Oak Ridge.' "
This is what was most unusual and still seems strange to me. No other city in Tennessee was required to pay for health services and pay taxes as well.
This arrangement was and remains to this day to have been the single such arrangement ever made in Tennessee. I am not sure why Oak Ridgers agreed to it and continued to fund public health over the years. Maybe there was no choice at the time.
Jim further states, "Consideration apparently was not given to the fact that Oak Ridgers already were making a sizeable contribution through their tax payments to the operation of the Anderson County Health Department. The original charter PAS had called for a contract city-county health operation. This is reported in the charter plan in 1958.
"City planners of the early times had anticipated a city-county contract, shown in the initial charter, in which costs of health operations were shared," Jim continued. "When the state officials designated Oak Ridge to be the 'sole' payer, the city rapidly set up a committee on public health and welfare for short-term planning for Oak Ridge. The results of that final report are found in their document, dated May 1959," Jim said.
Jim also cites references for his conclusions, "Other year to year city operations of health, the funding of health, and the relationship of the city to the joint state/Anderson County health department were reported at length in the 60-page budget document, per David Ammons, (1982) by report and MEMO to M. Lyle Lacy III, February 20, 1981.
"Oak Ridge was, by 1958 and 1959, operating using a state-city working verbal agreement, even if the city did not feel it was a fair agreement, the effort began moving forward," Jim continued. "The city was moving to cooperate with a city Health Department. At least it would have some control over a city health operation. Over time, with the Oak Ridge city public health and its city residents paying costs for many years, but not without asking the state/county health office for help in funding or manpower for public health, multiple times over the years.
"But, finally, over two decades had passed and the city did, soon after that, convince Anderson County or the joint state operation to come into Oak Ridge to begin health service delivery to Oak Ridge citizens and residents by the 1983 time period. A former regional director from Knoxville, now retired, attended and told me the state officials tried to get Oak Ridge city to continue to participate or offer some funding to city-county health, but Oak Ridge declined, feeling it had paid and operated health services for 25 years and that was enough."
Jim Harless concludes, "Mr. Dave Ammons was perhaps the most active city staff person, as research and budget director, who acted upon and worked to deal with what he described as an inequity."
Ammons deserves considerable credit for ending the practice of forcing Oak Ridge to fund its health services and the transition to the last of the three government operations phases of Oak Ridge public health.
For nearly 25 years, from 1959 to 1983, the Oak Ridge Health Department, a function of the city and funded by the city, provided excellent public health services to include environmental monitoring, restaurant inspections, day care services inspection, school inspections, animal control and a multitude of other health related services. Those individuals who worked as nurses, supervisors and health workers are understandably proud of the many years of exceptional services.
The present arrangement began about 1983, and continues to the present date. There is reason to feel the county-state operation will be the final and long-lasting Oak Ridge service provider of public health services.
Art Miller, district director, Anderson County Health Department, provides insight into the history of that organization and relevant information about present day practices that include Oak Ridge. The Anderson County Health Department seems to have begun with three employees, a doctor and two nurses in the 1930s.
Beginning in the 1980s, when phase three of Oak Ridge health services came into being, the Anderson County Health Department provided services to Oak Ridge at locations in Oak Ridge until 2005 when both health departments combined in one new location at 710 N. Main St. in Clinton. Services increased and costs decreased.
Art says, "The staff now numbers 49 and primary care for the uninsured has been added. The dental clinic is state of the art and has tripled in number of patients seen. Since moving in 2005, a large conference room has been added along with office space for primary care. A third dental clinic room is to be added this summer. Anderson County Health Department sees over 20,000 patients a year but public health touches everyone every day."
The ACHD Web site is www.healthdept.org.
This article has attempted to provide a brief history of a most unusual arrangement whereby Oak Ridge was required to pay for public health services. In doing so, I have focused on the three phases of how health services has been provided to citizens.
Another of the many interesting and unique facts that should be captured as well is the association between the Oak Ridge Health Department and the Environmental Quality Advisory Board. Jim says that was one of the unique things he found when he arrived in Oak Ridge in 1973. EQAB was created Oct. 19, 1970, as a temporary board and made permanent March 12, 1973, according to records found by Jackie Bernard.
Over the years, the working relationships and partnering efforts have helped assure Oak Ridge environmental concerns are addressed. One just has to look at the record of the city of Oak Ridge dealing with the mercury contamination of East Fork Poplar Creek to see examples of such joint cooperative efforts.
There is also the relationship to Earth Day. Jim wanted to time this brief history of public health in Oak Ridge to publish just before Earth Day 2009 to bring additional attention to the importance of each of us doing all we can to protect our home planet for the long term.
Sen. Gaylord Nelson, Founder of Earth Day, said this about the first "Earth Day" in 1970, "Earth Day worked because of the spontaneous response at the grassroots level. We had neither the time nor resources to organize 20 million demonstrators and the thousands of schools and local communities that participated. That was the remarkable thing about Earth Day. It organized itself."
Of course, that initial Earth Day 39 years ago has grown into a massive celebration of our planet and is now helping to place a "green" emphasis on all we do. Enjoy Earth Day 2009, celebrate at A.K. Bissell Park on Saturday, April 25, 2009.
