The fallout from the Jeff Cogen scandal continues at Multnomah County headquarters.

Last week, WW reported that Lillian Shirley, who heads the county health department, leaving to oversee public health for the state. That left the county's largest department leaderless just as state and local officials are rushing to implement the Affordable Healthcare Act.

The solution, announced on Friday, is that the county's chief operating officer, Joanne Fuller, will step down from her post take over Shirley's job. That means the county will operate with an interim chairwoman, Marissa Madrigal, and no chief operating officer until after next year's election.

County spokesman David Austin says the shift is a temporary solution. "The chief operating officer position is not going away. The duties are being temporarily re-distributed among county officials," Austin says. "We are in an unusual spot and we need to make sure people are in place during healthcare transformation."

Madrigal took over last month when Cogen resigned after admitted an affair with health department employee Sonia Manhas.

She announced the change in an email:

Dear Health Department colleagues, As you know, your director Lillian Shirley has accepted a position with the State Public Health Division. Lillian has demonstrated true excellence in promoting public health, and I wish her the best as she takes on this new role. We have asked Joanne Fuller to serve as interim Health Department Director while we make a longer-term plan for the department. This decision comes after consultation with the Board of Commissioners and leadership in the department. In order to support the vital work underway in the Health Department, KaRin Johnson will continue to serve in her critical role as Deputy Health Department Director and each Department Leadership Team member will continue to lead their areas of responsibility to ensure service and work continues. We have full confidence in the leadership team but recognize that historic Medicaid expansion and the building of a new Health Department headquarters have placed unprecedented demands on their individual workloads and that of their staff. We will continue to support them fully during this challenging time and will make every effort to communicate with you as our long-term plan develops. I realize this has been a time of great change for all of us. Thank you for the excellence and focus you bring to work each day. Marissa