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Transcripts

July 29, 2003

Host: Michael Grant
Topics:
· TB exposure of children and adults at three different child care facilities;
· Effectiveness of city council districts.
In-Studio Guests:
Dr. Jonathon Weisbuch, Director of Public Health for Maricopa County;
Keno Hawker, Mesa Mayor;
Wayne Ecton, Scottsdale city council.

>> Cary: Tonight on "Horizon," dozens of children and adults in Phoenix will be tested for tuberculosis tomorrow, after someone who worked at three different child care facilities tested positive for the lung disease. We'll tell you what you need to know about the TB exposure of up to 325 people. Plus, these men are just some of the people behind an effort in Scottsdale to change their city council from one elected at large to one with council districts. We'll take a closer look at the effectiveness of city council districts.

>>> Good evening, I'm Cary Pfeffer in for Michael Grant.

>>> First a look at headlines. Arizona schools and voters may strike it rich with a couple of new ballot proposals. One initiative would mandate that lawmakers fund Arizona schools at the national average for kindergarten through high school. The other would randomly select an Arizona voter to win one million dollars for voting in a primary or general election. The two ballot initiatives will be introduced tomorrow by Tucson doctor Mark Osterloh. Osterloh, you might remember, played some key roles in the passage of other initiatives, including Clean Elections in 1998 and healthy Arizona in '96 and 2000.

>>> The Maricopa County public Health Department will begin testing children and adults tomorrow for exposure to tuberculosis. The testing comes after a day care worker was diagnosed with the infectious disease. Those thought to be exposed are children and co-workers at a private Phoenix day care center and at two child care facilities at John C. Lincoln Medical Center. Joining me with more information on the tuberculosis and its exposure is Dr. Jonathon Weisbuch, director of public health for Maricopa County. Dr. Weisbuch, first of all, when people here tuberculosis exposure, they will automatically be concerned. First, please put perspective on this.

>> Dr. Wiesbuch: Thank you, Cary. Tuberculosis today is not the kind of disease that people have to get panicked about as they did 100 years ago. 100 years ago, 1% of the population would get sick every year, now it's a very, very rare disease in Maricopa County, and frankly, that's one of the problems, because when people come in with a cough or with a fever and that cough doesn't go away, the doctors who are treating them don't necessarily think of tuberculosis.

>> Cary: They don't look in that direction necessarily.

>> Wiesbuch: That's right. So you get a situation where this individual was coughing, is being treated for a pneumonia, and with the concern that the individual has exposed all of these children in these three centers, but the individual is now in isolation, being treated. There is no further chance of exposure to this group. Now it's our job in public health to do the cleanup work and identify if anybody has been infected, treat those individuals, find out if anybody has an active case of disease and make sure they get the appropriate treatment.

>> Cary: It's a matter of tracking down everybody that this person was around and testing those people and just making sure?

>> Weisbuch: Absolutely. There are three important points. The physician has to make the diagnosis early enough and then tell us. And even if they only suspect a dying know circumstances they should tell us, because then we can move our troops into the place and then begin to test every individual. Once we've tested the individuals and identified those who are potentially at risk to getting an active case, or have an active case, then the third part of the program moves in, and that is making sure that those individuals take their medication on a regular basis for up to nine months. That last part is really the hardest part, but it has been that part of the active approach to tuberculosis that has really caused the decline in the incidence of this disease, because if you can treat it for a long period of time, then people don't get sick and pass the disease to others.

>> Cary: Treat it and be disciplined about it along the way.

>> Wiesbuch: Exactly.

>> Cary: One of the difficult parts of tuberculosis is you can be exposed and have it remain dormant within you and have it come out and be a potentially infectious -

>> Wiesbuch: That's exactly right. This is why we're so concerned about this large population of children, because children are at risk when an individual is coughing in their environment, and we want to make sure that every one of those children is either not infected at all, we'll know that from the skin test, or if they are infected, we want to make sure that we give them prophylactic treatment during that infected treatment when they are not an active case so that they never become an active case. That's the critical part with regard to the management of children.

>> Cary: What do you know about the person who ended up starting this process? Because, again, we don't end up hearing about these kinds of cases all that often. How does somebody like that get exposed and then in turn -- and this is an unusual situation. This is one person who ended up working in three different situations, so the amount of exposure ended up being a great deal more than the average case, I would assume.

>> Wiesbuch: Right, that's true. I mean, it's not for us to give information about the individual.

>> Cary: Right, exactly, but it seems an unusual set of circumstances that ended up leading to all of this.

>> Wiesbuch: We find this often in tuberculosis. One individual, sometimes a child, who will be in one or two day care centers or the individual could be an aggressive parent who is coming in and she's coughing and sees kids. Sometimes the situation is such where there is a staff person that gets infected for one reason or has a latent case which breaks down for whatever reason and they begin to cough. As I said a moment ago, the physician who is treating them doesn't think tuberculosis because they never see tuberculosis today, or very rarely, and then you have this two or three or four weeks or months in cases where persons are -- we've seen this in hospitals and other situations. It's not unusual, but it's always a major public health event, and we have to go after it.

>> Cary: Something that you neat to wrestle with.

>> Wiesbuch: That's right.

>> Cary: And in this sort of circumstance, if there is to be good news measured in all of this, it does raise the awareness, and for you, it helps you get the message out to primary care physicians that don't forget about this.

>> Wiesbuch: That's exactly right. There is an old saying in medicine, that when you are making a diagnosis, think that most of the time when you hear hoof beats it's a horse, but every now and again it's a zebra. This is a zebra. The docs are watching. You've got to think zebras. The other point is, tuberculosis still must be fought everyday in this county and around the country. While it's rare, it is still a potential hazard. We had a major epidemic in the '80s. We cannot cut back on the funds that tuberculosis requires in order to carry out the work we do. It is very expensive. It costs about $10,000 for each individual whom we test after this whole thing will be done, for every individual. This is going to be a very expensive effort in order to do the job.

>> Cary: Why does it end up being that much?

>> Wiesbuch: It's so expensive because we have to put people in the field and do the skin test, then we have to follow those people up, then - >> Cary: Over a 9-monday period of time?

>> Wiesbuch: And treat them. So every patient has to be seen by our staff at least two or three times a week to make sure they are taking their medication on a regular basis. If we find five or six or eight kids, which is a possibility who are latent cases, not sick but have been infected, we'll have be contacting them. That's where the expense comes in. It's a huge man power intensive situation, but, our public Health Department in this community is, I think, doing the right thing. We've got great people doing the job, and I just have to sit back and watch them work, because I don't do anything. They do all of the work.

>> Cary: They do the hands-on?

>> Wiesbuch: They do the hard work.

>> Cary: Dr. Jonathon Weisbuch, thank you very much.

>> Wiesbuch: It's been a pleasure.

>> Cary: Good information, too. Should city council members be elected at large or represent a district. A couple of citizens groups in Scottsdale want their city to switch from an at large form of representation to one in which each councilmember is elected from a district. In a moment, I'll talk to one of the city council members and the mayor of Mesa whose city recently switched to council districts. But first, Paul Atkinson profiles the effort in Scottsdale and looks at 20 years of district representation in Phoenix.

>> Well, look at this one this morning. A smart council candidate would back change to a district system.

>> Reporter: South Scottsdale residents George Knowlton and Bill Crawford want to see their city go from a system where councilmembers are elected at large to where they are elected from districts.

>> Bill Crawford: This is the City of Scottsdale, 35 miles long. Unfortunately, this is where most of the council representatives live and the mayor. So, to say that they are not accountable and they are out of touch with what's going on in the south, I think is probably fairly true. If you were to take a rope, 35 miles long and stretch it from the city to north Scottsdale and go like this in an ark, you would end up out in Buckeye. How would you like to have a city council that lives in Buckeye telling you what's going on in south Scottsdale?

>> George Knowlton: What you are going to see with districts, you'll see accountability. You'll see the common man be able to run. You are going to be able to see people that are in the heart of the city be able to represent that portion of the city. Right now, we don't have that. Downtown is going downhill. The McDowell corridor is going downhill, and there is no excuse for that.

>>Barbara Klien: I believe it might decrease costs for campaigning in that that would be encouraging to ordinary citizens, however, the few sources that I know of actually show an opposite result that that doesn't happen. >> Reporter: Barbara Klein served on a Scottsdale citizen's taskforce that combined council districts and is against the idea.

>> Barbara: Fewer voters will actually elect a representative, because in a single member district, up to 49% of the voters will be solely represented by someone that they didn't elect.

>> Reporter: Klein suggests having Scottsdale council members elected in districts will be more costly to the city, citing not only the cost of developing districts and redistricting, but also, the larger cost of what she predicts would be poor representation and divisiveness. Then, there's the concern of voter inequity.

>> Barbara: If you are voting in a district where there is a big turnout, everybody goes out and votes because it's really important to them, your vote is worth less than somebody voting in a district that has low voter turnout.

>> Reporter: If approved by voters, Scottsdale would be the 6th municipality in the valley to go to districts. Surprise, Glendale, Peoria, Phoenix and Mesa elect council members by districts. Phoenix has had its system in place for 20 years.

>>Mike Bilecki: You've got a system where you've got council people are accountable. They are accountable to a constituency and you had a system where that wasn't always the case.

>> Reporter: Mike Bilecki helped recruit Terry Goddard and others to back a district system as part of the effort by the Phoenix firefighter union to end an elected government unable to keep with the fast growth of Phoenix.

>>Mike: At the same time, the old structures of power and influence at city hall were well cemented into the charter form of government, into a general system of elections where the whole council is elected at once. It made elections very expensive. It made core sets of voters in north central, central and east Phoenix a predominant voter base.

>> Reporter: Bilecki says the Phoenix district system makes for better service, focuses more attention on neighborhood concerns, while still allowing council members to focus on the big picture.

>> MikeYou take a look at the way Phoenix has addressed the big ticket items, transportation, water, police and fire, and you see a system in which, yeah, the council people ought to advocate what their districts need. You can take some comfort that somebody is looking out for your neighborhood and whether you ought to get another fire station or not. But in total, the success in Phoenix in producing sound policy decisions would tend to support that this system, with -- even with the competition between districts, has netted out sound police.

>> Reporter: Critics point to the lack of elected minority councilmembers in Phoenix, particularly Hispanics and fear districts in Scottsdale would do the same.

>> Barbara: I would like Scottsdale to wait and spend money on an alternative election system that would offer full representation to everybody, and better representation to minorities and minority voices, but the idea of going to single member districts, I think, is risk without benefit and cost without value.

>> Reporter: Knowlton and Crawford think going to a council system in Scottsdale is a risk that needs to be taken and have no doubt voters will agree.

>> Cary: Joining me now is Mesa mayor Keno Hawker. His city fully implemented the district form of representation last year. Also here is Scottsdale city council Wayne Ecton. Mayor Hawker, you've lived in both worlds. Talk about what your experience was because it actually was sort of a transition process that you saw. You started 13 years ago with at large members being elected to the Mesa city council and now you are in a district system. What do you think?

>> Mayor Hawker: I can see advantages and disadvantages of both. My preference is actually for a hybrid which I tried to push with four districts and the mayor and two councilmembers at large, it gives you an interesting 4-3 dynamic. Probably the rallying cry for the district system, we have some minorities that are not being represented, and by carving up the city and also by having the Justice Department then enter into whether your districts will pass muster and get their approval was a pretty daunting task that has some drawbacks to it, some that we didn't see and are now realizing. As an example, when the census took place and Reed to redistrict the areas because of the population change, we had some district councilmembers that represent very little of the very district they were elected from, which was kind of an unintended consequence of going to districts, but I kind of like the hybrid, the 4-3 combination better than a do a peer district system.

>> Cary: And Wayne Ecton, you are looking at a situation where you have people in your city who are saying the biggest chunk of the City of Scottsdale doesn't necessarily have people living in it active on the city council.

>> Wayne Ecton: That's correct. And of course, that's also where the biggest chunk of people live, and they have a very good opportunity to run for city council and be elected. They had people in the past on city council. They had people in the last election that ran for city council. They weren't elected. So it's really an issue there of voter apathy, getting the people out to vote and vote for your people. So, there is two sides to the story. Certainly there is people that feel like they are not being represented, and I don't know that I agree with that, because I live as far north as you can live in Scottsdale, and I spend most of my time on southern downtown Scottsdale issues. But there is a perception, and that perception, we need to deal with it and to decide exactly what we might do and how we might go about it.

>> Cary: We just heard in Paul's taped report, the study that had been done on behalf of the city, looking at it. And the bottom line recommendation there is that the council -- that the district system not necessarily be adopted. Cost factors also end up playing a part here, it seems like.

>> Wayne: Yes, there is no question, the mayor and I were chatting a little bit before we came on the air. There will be a huge cost to go to the district system, but there are also continuing costs. They will probably require more staff for the council people. It will require more staff work which may generate a need for more people on the payroll in the city. I think every city is different. It's hard to determine in advance what that might be, but it will be a cost venture. The people may feel better about it. They may do good in that respect.

>> Cary: Right, because you have to address voter apathy and address other issues. I misspoke there, the report actually found in favor of districts. And I apologize for that.

>> Wayne: That's right.

>> Cary: Mayor hawker, talk about the cost factor as far as what Mesa has experienced because you've lived through this, not only the cost for the city, but also costs for people who are thinking about running. If you are running just in your -- sort of in your neighborhood, it seems like it's a more likely scenario for somebody who is just thinking hey, I'd like to be on the council and I feel like I want to hear my voice -- my opinions heard in that forum.

>>Mayor Hawker: Right, in Mesa's case with 400,000 people, divided into six districts, it makes it a lot more manageable, 60,000, 70,000 people versus 400,000, just putting up campaign signs city wide is a daunting task. Also, the signature gathering requirements are less for the district than they would be for at large council race. So from a cost to enter as a candidate standpoint, it is less. From a municipal standpoint, because the districts have more constituent requested peers than we did in the past, there is more of a staffing requirement to make sure you respond timely, that you respond specifically to that individual and that -- in that instance, and also a lot more neighborhood meetings and gatherings require the attention of the council members from the district system, where I don't think that there was a person that you called to say, you should be here because this is your neighborhood.

>> Cary: Right.

>> Hawker: When you were at large, you could duck that if you wanted to and not go to one. If it's in your district, you show up. So there is quite a -- I would say even more of a time demand, not a less, for district system.

>> Cary: And unfortunately, for some people, and so many of the folks who live in the valley lived in other place, the district system in some east coast cities ended up getting a bad rap because people would say it's a completely parochial thing, we make sure you take care of your own and it creates problems. And some people may have that sort of in the back of their mind.

>> Hawker: We really haven't had that in Mesa. The councilmembers that ran the first priority was the city at large. The City of Mesa councilmembers and it's not just I'm a district councilmember and that's all I represent. So we were very fortunate up to date that that has not been an issue for us. I hope it continues. The other thing is there hasn't been vote trading. It hasn't been what's in my district, what's in yours, because we're spending a disproportionate amount of money in the downtown corridor with the art center and projects because everyone realizes that's a key to keeping that thing sound and strong, because of your core center deteriorates, the rest of your town can. So it hasn't been a problem.

>> Cary: Council member Ecton, that's the same situation for the City of Scottsdale. While most everybody lives up north, the focus of attention, just by the nature of the center of the city sort of concerns ends up being outside of where some of these people live?

>>Wayne: That's exactly right. And in talking with some of the Phoenix council people, asking, you know, the same kind of question that you asked the mayor, they haven't had as much vote trait trading as you might expect, but they've had some. But it tends to work a little bit differently, each district comes forward with their desires and everybody else supports it, because when they come forward with theirs, they expect the same kind of support.

>> Cary: Right.

>>Wayne: The bigger problems in Phoenix have been the downtown area, because there is a district person there, and that person may tend to think that what he wants and what he's hearing is the right thing, when the downtown really owns -- is owned by the whole city.

>> Cary: Right.

>> Wayne: So that becomes a little bit awkward. So there are many facets to making the change. It's a big change. To me it seems like it'll be a big change in government, whatever we decide to do.

>> Cary: Right.

>> Wayne: And a lot of people will have to go in a different direction and think in a different direction, and spend more time on different kinds of items. And you know, I have a little bit of concern that you'll spend more time on the small items and not as much on the major items, but that may not be true. You know, it depends on the dedication of the individuals. I know that a lot of the cities that originally went to districts, they were very happy in the beginning, but as time went on,

>> Cary: It can change.

>> Wayne: It can change the other way. You have situations where you don't have candidates running, a person runs unopposed or they are out beating the bushes to find a candidate to even run at all, and time changes things where initially they might have a great desire to run and be involved, but when they find out the amount of work that's involved and the amount of time that's involved, they change their mind.

>> Cary: And some of the headaches and telephone calls and other things.

>> Wayne: It will be cheaper initially to run in a district because of the mailing costs, if nothing else, but what I read and hear is that well, the cost of running throughout the nation is going up, regardless.

>> Cary: In general.

>> Wayne: In general, so that's certainly a factor and we'll over the long haul have an impact.

>>Mayor Hawker: If I could comment on one aspect of that. If you do have a conflict with a district person kind of on their own, I found that the role of a mayor becomes more important. I was a little surprised at this, because you think everyone would jump in, but if the mayor takes on the position of a district person, it frees up all of the other district people to really examine the issue. So whether you intended it or not, it does have a little bit more dynamic with people looking to the mayor for advice on some issues that aren't clear cut.

>> Cary: Right. The role of the mayor sort of changes and is enhanced in some ways.

>> Mayor Hawker: Right, where in the full district system, all seven people in Mesa's case are looking at all the issues, but in this case, people focus on their districts unless it's an issue that the mayor raises the issue or it's a real citywide issue.

>> Cary: Talk about the minority concerns and has there been more of an addressing of that now that you are in a district situation? Have some of those concerns been addressed to you, do you think? Or is that still in process?

>> Mayor Hawker: Well, the district that was carved out to meet the Justice Department's criteria, did have a contested race with two real viable candidates. One was probably a little bit more connected with the Hispanic community than the other, but I think they are both representing Mesa and Mesa's interests. So it -- I think that maybe over time, we'll find out more. With just one district, it hasn't been that apparent in Mesa yet. Not quite like it is in Phoenix.

>> Cary: Right, exactly. And it seems like the fact that there is Justice Department oversight any time you move into the district system has to be a factor in the back of any municipality's mind because that's another step and it's a major step.

>> Wayne: We don't know exactly what they are going to do and what they are going to say. There have been people that are projecting that well, they'll draw a line here and here and here, well, the line may be like this. It depends on the ethnic groups in the population and where the bulk of the people live. So there cavern can be real surprises that comes out of that, not that that's good or bad, but there can be some surprises.

>> Cary: What's your sense? What's your sense of -- we're getting down to the end here, but I want to give you a chance to say how you feel it's going to turn out in Scottsdale.

>> Wayne: Well, you know, I have a very strong feeling, and a partial commitment, I guess, to putting something on the ballot for the people. I think the real question is what is it exactly we put on the ballot. We do have the committee recommendation. It's a good recommendation. They spent a lot of time on it. What they didn't spend time on is well, what's wrong with the current system, and what are the other alternatives that we ought to maybe give serious consideration. So we've asked for a little more information and study and then we'll have to make a decision. I think we'll end up putting something on the ballot. I know they are out gathering signatures to put the straight six on the ballot. So it's quite possible that we decide something other than that, and there might be two issues on the ballot.

>> Cary: Right.

>> Wayne: But I don't know where it's going to come down. I think the people deserve representation and what they want and how they want to approach it.

>> Cary: Wayne Ecton, thank you very much. Mesa mayor hawker, thank you for your perspective. Appreciate your being in.

>>> "Horizon" is back Thursday night. Here's what's in store.

>> Reporter: Are you a quest residential customer who was billed for services you didn't order or billed more than once for the same product or service? If so, you might be due a refund or credit. The consumer fraud lawsuit against quest is settled. Find out what Arizona consumers can expect. Attorney general Terry Goddard joins us Thursday on "Horizon."

>> Cary: And on Friday, print reporters join Michael Grant for a look at the week's top stories on the Journalists' Roundtable. That's Friday at 7:00. Thanks very much for watching. We appreciate your tuning in. See you next time.

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