Monroe County health board sets Oct. 22 hearing on possible removal of health officer

Monroe County’s board of health voted unanimously Monday (Oct. 12) to hold a hearing on whether there is cause to remove county health officer Sarah Ryterband. She is less than two years into a four-year term, scheduled to run through the end of 2028.

The 5–0 vote came at a special meeting of the board, which started at 4:30 p.m. Monday at the county health department’s building at the corner of 7th Street and College Avenue in downtown Bloomington.

The hearing on Ryterband’s removal has been scheduled for Oct. 22, right after the board’s regular meeting, which starts at 4:30 p.m. Ryterband attended Monday’s meeting, but did not speak.

No specific allegations against Ryterband were described during Monday’s meeting. Board president Lisa Hanner-Robinson stressed that the decision to hold a hearing did not mean the board had already decided to remove her.

The possibility of Ryterband’s removal comes against a backdrop of allegations made by former health administrator Lori Kelley, who was fired in September this year after roughly four years in the position. Kelley’s attorney, Mark Waterfill, has said she was sexually harassed at work and fired in retaliation for complaining about the treatment.

Waterfill said Kelley had filed a charge with the federal Equal Employment Opportunity Commission and intended to pursue litigation. The board did not say Monday whether Kelley’s allegations have any connection to its consideration of Ryterband’s removal.

Monday meeting’s announced purpose was for the board of health to decide whether to hold a hearing under state law, which establishes the grounds and procedures for removing a local health officer.

Under state law, a health officer can be removed for failure to perform statutory duties, failure to enforce state health department rules, or other “good cause.” The law also says that a health officer facing removal is entitled to at least five days notice, a hearing open to the public, and representation by an attorney.

“The board has made no decision, and none will be made until after the hearing in open session, once Dr. Ryterband has had full opportunity to respond,” Hanner-Robinson said.

Hanner-Robinson also raised a separate possibility, which was ending Ryterband’s employment under the terms of her contract, without establishing cause for removal.

Hanner-Robinson said the board was not waiving what she described as a contractual right to terminate Ryterband’s employment at will, without cause. She later added that even if the board pursued that option, it would allow Ryterband an opportunity to present her case publicly.

That raises a legal question about the relationship between the employment contract and the statutory office of county health officer.

Indiana law establishes a four-year term for a local health officer and specifically limits the circumstances under which the officer can be removed. The board chair’s description of an at-will contractual provision indicates a different potential standard for ending the employment relationship. Whether exercising such a provision would legally accomplish removal from the statutory office, notwithstanding the requirements of state law, was not discussed at Monday’s meeting.

Procedures for Oct. 22 hearing

After voting to hold the hearing, the board unanimously adopted a set of procedures intended to govern the proceeding and any similar hearings in the future.

Under the procedures to be used on Oct. 22, a designated board member will have up to 30 minutes to present evidence and arguments supporting removal, including testimony from witnesses. The burden of establishing cause for removal will rest with that presenter.

Ryterband will then have up to 30 minutes to present her response, including witnesses and other evidence. She may be represented by an attorney. If the board grants additional time to the board’s presenter, Ryterband will receive an equivalent extension.

Each side will also have an opportunity for a five-minute rebuttal or response. Witnesses will be asked to testify under oath, and board members may question those offering testimony. Time spent answering board members’ questions will not count against the allotted presentation time.

The resolution says written evidence will become part of the hearing record, with copies furnished to the board and the opposing party.

During discussion of the procedures, board member Stephen Pritchard raised a question about whether evidence had to be presented in writing or through direct witness testimony. County attorney David Schilling clarified that the rules would permit oral testimony and statements that were not submitted in writing. Such statements would become part of the recorded proceeding.

After the evidence and arguments are presented, the board will close the hearing, discuss the matter and decide whether cause for removal exists and what action to take.

Hanner-Robinson noted that under state law Ryterband needed to receive written notice at least five days before the hearing. Schilling agreed to arrange the notice.

Ryterband’s four-year appointment, contract

Ryterband took over as health officer at the beginning of 2025, after the resignation of Clark Brittain. The board of health selected her as Brittain’s successor at its Dec. 11, 2024 meeting. That appointment was subsequently approved by the county commissioners at their Dec. 18, 2024 meeting.

At the Dec. 18 commissioners meeting, county administrator Angie Purdie described the term of Ryterband’s appointment as running from Jan. 1, 2025, through Jan. 1, 2029.

At the Dec. 18, 2024, meeting, Molly Turner-King, an attorney for the county, presented the employment contract, saying it was similar to the agreement with the previous health officer. She described a four-year contract with eligibility for reappointment.

The commissioners approved the contract unanimously, after correcting the compensation amount in the original motion from $48,800 to $43,800.

Ryterband, who had served on the health board before accepting the health officer position, attended the meeting. She told commissioners that her fellow board members had asked her to take the position and that she had given the decision considerable thought. “When my fellow board members asked if I would step up into this new role, I thought about it long and hard,” Ryterband said. She described her decision in terms of serving the community in a larger role.

Under state law, a local board of health appoints the health officer to a four-year term, with the possibility of reappointment. The health officer is the executive officer of the local health department.

The health officer also has significant authority over department personnel. Under state law, the health officer may hire the staff needed to carry out the department’s responsibilities, subject to county executive approval. That includes the health administrator position formerly held by Lori Kelley.

The board of health is responsible for appointing the health officer. In turn, the health officer is responsible for overseeing the department’s operations and personnel.

The prospect of removing Ryterband comes against the backdrop of a four-year period of turmoil for the Monroe County Health Department, which has seen significant employee turnover, the collapse of a longtime family-planning clinic, repeated changes in leadership, and, more recently, a staffing crisis affecting basic public health services.

Four years of turmoil at the health department

The period began with a leadership transition in summer 2022, when longtime health administrator Penny Caudill retired and Lori Kelley took over the department. By December of that year, enough employees had begun leaving the department that it generated questions about staff morale and management.

At the time, health board member Stephen Pritchard acknowledged challenges associated with the leadership transition, but disputed the characterization of the departures as a large exodus. At least some employees left due to other life circumstances separate from conditions at their health department work.

The board itself experienced controversy in February 2023, when county commissioners removed Ashley Cranor, a 13-year member who had previously chaired the board. Cranor had indicated that she intended to resign because she was planning to move away, but had not yet submitted a resignation.

As justification, commissioners cited her absences from meetings during 2021, when the board was meeting frequently because of the COVID-19 pandemic. There was also a need to appoint a licensed physician to satisfy the board’s statutory membership requirements. Cranor is not a physician. Cranor questioned the circumstances of her removal.

The commissioners initial decision had not been made at a public meeting. After The B Square questioned whether that violated Indiana’s Open Door Law, commissioners took a public vote on Feb. 15, 2023, to remove Cranor.

There was turnover in the county health officer position, too. Thomas Sharp, who had held the position since 1976, resigned effective April 30, 2023. His successor, Clark Brittain, served for less than two years before resigning at the end of 2024, saying the job had become more demanding than he had anticipated.

The board selected one of its own members, physician Sarah Ryterband, as his replacement.

The most publicly visible controversy involving the department during that period was the closing of Futures Family Planning Clinic, which had been operated by the county government since 2006. Futures provided reproductive health care supported by federal Title X funding, administered locally through the Indiana Family Health Council (IFHC). The clinic had experienced extensive staff turnover and had been without a clinic manager during its final months.

On Aug. 21, 2024, the board of health voted to suspend county government operation of Futures for 30 days and terminate its last remaining employee while trying to preserve the possibility of reopening. Two days later, IFHC informed the county that it would terminate the Title X contract, effectively ending the county’s operation of the clinic after 18 years.

In its Aug. 27, 2024, announcement, IFHC attributed the decision to continuing staffing problems. The county did not subsequently reopen Futures. Instead, IFHC established its own Bloomington Family Planning Center, which began seeing patients Feb. 10, 2025.

The loss of Futures came against a backdrop of broader staffing losses. In August 2024, county personnel administrator at the time, Elizabeth Sensenstein, told The B Square that 21 full-time employees and seven part-time employees had left the health department since June 2022. The department’s full complement of staff was roughly 50 employees.

The closure did not end questions about the administration of Futures. Former employees questioned whether county leadership had responded adequately to staffing concerns, communicated with employees or worked effectively with the organization supplying its federal funding.

By the end of 2025, the health board was also experiencing turnover in its own membership. At its Dec. 18 meeting, three members concluded their service simultaneously: chair Dawne Aurora DiOrio, Lee McKinley and George Hegeman.

Hegeman had served for 36 years and had reached the end of his term. The terms of DiOrio and McKinley were not scheduled to expire until later years. Their departures left three vacancies on the seven-member board.

Meanwhile, the department was confronting another challenge in its effort to provide services. IU Health announced in 2025 that it would end a contractual arrangement under which its nurses had provided public health services for Monroe County for more than 60 years. That work included vaccinations, communicable-disease testing, case investigations and contact tracing.

The arrangement ended Dec. 31, 2025, leaving the county responsible for finding another way to provide those services.

By August 2026, the department had no public health nurses on staff. At an Aug. 20 health board meeting, Kelley reported that 60 of 108 disease investigations in the department’s work queue had not yet been started. Employees in other positions were covering some of the nursing duties.

At the same Aug. 20 meeting, former public health nurse Christina Kempf alleged that staffing shortages, inadequate training and difficulties with department leadership had contributed to her resignation.

The latest major leadership upheaval came last month, when Kelley was fired after roughly four years as health administrator. County officials initially acknowledged only that there had been a change in administration, without publicly explaining the circumstances.

Kelley’s attorney, Mark Waterfill, said she contended that she had been sexually harassed at work and fired in retaliation for complaining about the treatment. Waterfill said Kelley had filed a charge with the federal Equal Employment Opportunity Commission and intended to pursue litigation.

Who serves on the board of health?

Because it has two vacancies, the board that will consider Ryterband’s removal has five members, rather than the seven prescribed by state law.

As of Monday, its members were chair Lisa Hanner-Robinson, vice chair Michael Teague, Stephen Pritchard, Kay Leach and Kevin Moore. Six of the seven authorized board appointments are controlled by county commissioners, with the seventh made by the county council.

A change in state law that took effect July 1, 2026, broadened the authority of county commissioners to remove certain appointed board members without establishing cause. Under the revised state law, a health board member appointed by county commissioners serves at their pleasure as long as the three-member board of commissioners retains the same membership it had when the appointment was made. The statute also retains separate grounds for removal based on attendance or failure to perform statutory duties.

Of the five current health board members, one was appointed by the county council rather than the commissioners. That one is the current chair, Lisa Hanner-Robinson. Leach was most recently appointed by the commissioners in March 2023, before the current lineup of commissioners took office.

The other three members (Teague, Pritchard and Moore) were appointed by the current three commissioners, Julie Thomas, Lee Jones and Jody Madeira. Under the new law, those three board members are subject to removal at the pleasure of the three county commissioners, while the trio that appointed them is unchanged. It’s due to change at the end of the year, when Lee Jones leaves office and is succeeded by Democrat Trent Deckard, who is the only candidate on the Nov. 3 ballot.

Last Friday (Oct. 9) county commissioners held an executive session, closed to the public, on the topic of pending litigation. The apparent pending litigation was the planned lawsuit by the former county health director, Lori Kelley, who alleges her termination was unlawful.

The executive session was followed by the resumption of the meeting of the county commissioners from the day before, which they had recessed for a day, until after their Friday executive session. But when Julie Thomas and Jody Madeira came out of recess on Friday, they immediately recessed the meeting again until next Friday (Oct. 16).

For Ryterband, it’s not the county commissioners who will directly decide the question of her continued service as health officer. It’s the board of health that will make the call.

The first question is what evidence the board will hear on Oct. 22. After the evidence is heard, the question will fall to the five current members of the board of health: Is there sufficient cause for ending Ryterband’s service as Monroe County health officer, before the conclusion of the four-year term approved in December 2024?

Appointment of Ryterband as Health Officer: Dec. 18, 2024