‘Frustrating as hell’ - Democrats’ plan to shake up Washington public health can wait
Shaking up local public health departments while COVID-19 still ravages our state, and before we’ve had time to absorb all the lessons it’s teaching, doesn’t make sense.
That’s what we said in December, when Republicans on the Pierce County Council orchestrated a coup attempt against the Tacoma-Pierce County Health Department (TPCHD) and nearly succeeded.
And it’s what we’re saying now, as Democrats who control the Legislature push to expand local health boards and force a regional restructuring of the public health system, which is now decentralized across Washington’s 39 counties.
We stand at a moment of great hope; vaccine eligibility for every adult in our state is less than two weeks away, and vanquishing a virus that’s killed nearly 5,300 Washingtonians shines like a lighthouse on the horizon.
Pressure on local public health departments has never been greater, as they juggle vaccination events, virus testing, contact tracing and their usual workload of non-COVID responsibilities.
They shouldn’t have to try and keep up with complicated, quickly evolving legislative proposals to revamp how public health is managed in our state. A year from now, it will be a worthwhile conversation. Today it distracts from what should be a singular focus to defeat this virus.
“Every minute our people spend testifying about this, thinking about this, is a minute taken away from their mission,” Derek Young, chair of the Pierce County Council and the TPCHD Board of Health, told us Thursday. The Gig Harbor Democrat added that “it’s frustrating as hell” to defend against this legislation, promoted by members of his own party no less, while COVID-19 remains a clear-and-present threat.
“Let us get out of this now,” Young said, “and we’ll talk about governance later.”
House Bill 1152, which passed the House and awaits action in the Senate, has been amended so many times, it’s hard to keep straight. It would create a confusing bureaucracy of advisory boards, a steering committee and a new layer of regional public health officers between local health districts and the state Department of Health.
There would be four regional public health centers, two on each side of the state, at a projected cost of $2.6 million. The idea is to provide shared services to smaller health districts that can’t afford them on their own. But some critics fear an erosion of local control.
The bill also would mandate an equal number of elected and non-elected members on local health boards, intended to reduce the influence of politics in public health policy. TPCHD is currently one of only eight health boards in Washington with a guaranteed seat for a non-elected member — one local physician alongside seven politicians.
Bringing diverse voices to the table is a good idea, but HB1152’s prescriptive formula doesn’t fit every county.
There’s one piece of the bill we like very much: Any government that wants to terminate its partnership in a local health department must give 12-months notice. This would prevent hasty divorces like what Republicans on the Pierce County Council almost pulled off last year; in the end, their attempt to dissolve TPCHD’s 48-year pact with Tacoma failed in a split council vote.
Is it too much to expect Democrats in Olympia to practice what they preach? Why not wait a year before forcing a major overhaul of Washington’s public health system?
Fortunately, a key Democratic leader is wary of moving too fast. “I’m not really excited about having my health department regionalized in the middle of a pandemic,” Sen. Christine Rolfes of Bainbridge Island, chair of the Senate Ways & Means Committee, said at a committee hearing Wednesday.
Rolfes asked whether Spokane County would want to try out some of the proposed changes as a pilot project. It’s an intriguing idea, since the bill is sponsored by Rep. Marcus Riccelli, D-Spokane, and public health leaders in the Spokane area have been its most ardent backers.
They want to de-politicize a health board that voted in November to fire Spokane County’s health officer, who made unpopular decisions to keep the conservative county largely locked down this past year.
TPCHD’s health director, Dr. Anthony Chen, has also taken political heat for exercising caution during the pandemic, such as when he advised schools not to reopen last fall.
Public health policy is fundamentally controversial and always has been in the South Sound, even before COVID-19 arrived. How can it not be, when it revolves around issues like public smoking bans, needle exchange programs and childhood immunizations?
“We agree that insulating public health from politics is needed,” Young told the Senate health committee last week while testifying on HB1152, “but I’m not sure how this bill addresses that, or even if it’s possible.”
What’s really needed from legislators this year is a stable revenue source to pay for chronically underfunded foundational public health services. They also should commit to fully assess the lessons of this pandemic when it finally ends.
But to embark on a public health reorganization plan right now would be premature, distracting and disruptive. That’s as true for Washington today as it was for Pierce County in December.
This story was originally published April 3, 2021 at 6:00 AM.