STATE OF NEVADA [RIAN SANDOVAL AMY ROUKIE, MBA, Governor “drintater,DPBH RICHARD WHITLEY, MS JOHN Mt DIMURO.DO, MBA Director, DIS (Ch Media Oe DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC AND BEHAVIORAL HEALTH 4150 Technology Way, Suite 300 Carson City, Nevada 89706 ‘Telephone: (775) 684-4200 - Fax: (775) 687-7570 October 30, 2017 Richard Whitley, Director Department of Health and Human Services 4126 Technology Way Carson City, NV 89706 Director Whitley: regret to inform you of my resignation as Nevada Chief Medical Officer effective immediately. I feel that my ability to represent the Division of Public and Behavioral Health and carry out the statutory obligations of this, office has been irreparably compromised. The demeaning communication, censure and bullying behavior exhibited by the newly appointed Division Administrator Amy Roukie has created a hostile work place which is no longer conducive to a positive and productive work environment. Despite several attermpts over the past few weeks requesting assistance in mediating my concerns regarding Mrs. Roukie's behavior, I have received no support. We met several weeks ago to discuss my escalating concerns regarding the multiple issues related to Mrs. Roukie, including those voiced to me by several other department unclassified employees. At your suggestion, I obtained and reviewed the relevant NRS related to the Chief Medical Officer position provided to me from Deputy Attorney General Linda Anderson. Despite the required cross-departmental and cross-divisional collaboration from my office, the organizational flow chart disseminated last week created by Administrator Roukie appears to contradict statute and has the Chief Medical Officer directly reporting to Mrs. Roukie, the DPBH Administrator and not you, the HHS Director. This newly revised organizational flow chart also further {isolates me from collaboration amongst our other medical and dental providers by removing all direct reports to my office. Upon discussing this organizational issue with many of my physician State Health Officer colleagues, this arrangement is atypical and ultimately creates obstacles towards fulfilment of my statutory obligations. While I have thoroughly enjoyed my work at the Department and am proud of our many accomplishments during my tenure including the creation and implementation of AB474, streamlining of the cancer registry NAC, and addressing several issues within the Nevada Department of Corrections and DHCEP, I feel I have exhausted all options to rectify this issue. Given the lack of support, resignation is my only course of action. Respectfully, John M. DiMuro, DO, MBA ‘Nevada Chief Medical Officer