Michelle Taylor, Mayor Brandon Scott’s pick to lead the city’s health department, was advanced by a City Council committee Thursday, putting her one vote away from overseeing one of Baltimore’s largest and most complex agencies.

Taylor, who was chosen by Scott in May and began work on an acting basis in August, came to Baltimore by way of Shelby County, Tennessee, where she oversaw a health department in the Memphis area.

If approved by the full council — which meets again next week — Taylor will serve as the top doctor responsible for a sprawling number of services and policies in a city challenged by public health issues including sexually transmitted diseases and drug overdoses. The potential for federal funding cuts by the Trump administration also looms over Baltimore. Of the city’s various agencies, the health department is among the most reliant on federal grants.

Such challenges were on the minds of council members as they peppered Taylor with questions for more than an hour Thursday night prior to the 3-1 vote to advance her nomination. Thery were particularly focused on opioid overdoses, which in Baltimore have outpaced any other major American city, Baltimore Banner reporting has found. The rate has since begun to drop, but still remains substantial.

Taylor pledged to lower the city’s annual overdose death rate by 40% by 2040, a goal that Councilman Isaac “Yitzy” Schleifer, the meeting’s chairman, said did not feel ambitious enough. Schleifer cited the city’s progress in reducing the number of homicides, which topped 300 for almost a decade. The homicide count is now on track to end the year at fewer than 150.

Taylor argued that 40% in 15 years is a “very ambitious goal,” given the numerous social factors at play for people suffering from addiction.

“Reducing crime and reducing deaths are two different ballgames,” she said.

Schleifer replied, “I’m just going to have to respectfully disagree ... especially when we’ve had such great results from [the Baltimore Police Department].”

Litigation pursued by the city in response to the opioid crisis has made Baltimore the recipient of $579.8 million in legal judgments and settlements against pharmaceutical manufacturers and distributors. The city will spend $36.7 million of that money this year on a number of initiatives, including 25 new positions in the Health Department.

Pressed by Councilman Ryan Dorsey, Taylor pledged to pursue the creation of overdose prevention centers, also known as supervised injection sites. Legislation opening the door for such sites has been repeatedly introduced at the state level, but has faced pushback.

“Yes, I support overdose prevention centers,” Taylor said. “The mayor supports overdose prevention centers. We’re going to do everything we can as a health department to bring OPCs to Baltimore.”

If confirmed, Taylor would take the reins of the department after an extended period without permanent leadership. Scott dismissed the city’s previous health commissioner, Dr. Ihuoma Emenuga, in July 2024 amid an investigation into her secondary employment at a health clinic. Emenuga, who was just seven months into the job, was cleared of wrongdoing by state prosecutors and spoke out in an interview.

The health department was then led by interim commissioner Mary Beth Haller. Long-running problems, such as proper staffing and building maintenance, have festered under temporary leadership.

Baltimore has also faced questions about its response to behavioral health crises, involving multiple city agencies, including police and the health department. This summer several city residents died at the hands of city police who were responding to behavioral health-related calls.

Taylor told council members that she plans to create a new division of behavioral health within the department.

Council President Zeke Cohen urged her to go further and assess the city’s relationship with Behavioral Health System Baltimore, a city contractor that oversees other groups providing behavioral health services.

“I think it’s extremely important we set high expectations, that we demand accountability, that we hold our behavioral health authority to produce actionable data,” Cohen said.

Taylor said she believed that there was room to improve the city’s relationship with the group and that she wanted to explore ways in which the city can legally assist with behavioral health services.

Councilman Paris Gray asked Taylor about her plan to cover any budget shortfalls that may arise as a result of federal funding cuts. Almost 50% of the department’s funding comes from federal sources.

Taylor said she wants to strengthen the city’s collaboration with other health organizations in hopes of referring patients elsewhere should it become necessary due to budget cuts.

Schleifer, who cast the sole vote against advancing Taylor’s nomination, cited her failure to follow through with an agreement to hold a series of public listening sessions ahead of her confirmation hearing. Taylor said she’d made a mistake in agreeing to the sessions, adding that she didn’t know the city’s standard process for nominees at the time. She apologized.

“The right thing would be to move forward with what you committed to,” Schleifer said.