Regional Health Districts Bill Garners More Support in Legislature

A bill to create four regional health districts across Washington and provide significant funding for basic public health services is advancing state law. And after several revisions, what opponents criticized as a blow to local control is now gaining more support.

“What originally felt like a handshake for the health authorities, who have fought so hard this year to keep Washingtoners healthy, now feels like a bill to live with, but with some improvements,” said Kate Dean, Jefferson County commissioner who also chairs the county health department.

While HB 1152 still aims to isolate public health from local politics, the proposal no longer aims to dissolve local health authorities that are usually dominated by elected officials. Instead, local health authorities would have to align elected officials with health professionals and other stakeholders, and four regional offices would help coordinate joint services. The aim is to eliminate inequalities across the state.

At a public hearing last week, Pierce County Councilor Derek Young, who also chairs the Tacoma-Pierce County Board of Health, cited “significant improvements” in the new bill.

Meanwhile, Senate Majority Leader Andy Billig, D-Spokane, told reporters last week he was confident the bill would get to the Senate, where, if passed, would go to the governor’s desk, to be included in the law.

Senator Marko Liias, Chairman of the Majority Authority, D-Lynwood, also supported the proposal, saying it would help depoliticize public health. He pointed to the layoff of two public health officials in his district’s Snohomish County in 2019.

“It’s been over a year. I still have no idea why our chief health officers were fired, ”he said. “They entered into some kind of confidential agreement and gave no transparency to the public. I think this type of decision-making just doesn’t make sense on major public health issues. “

Legislators have also drawn attention to public health officials who left work during the pandemic. During the public testimony on HB 1152, Minister of Health Dr. Umair Shah – a proponent of the law requested by the governor – told lawmakers that the pandemic put public health officials at the center of political controversy.

“Sometimes we had these health officials who were unable to do their job or who were asked not to continue their work,” he said. “I am very concerned about public health workers, not just in Washington state but across the country. There are many people who are tired. ”

Public health officials across the country have left the field during the pandemic. When Lewis County tried to replace its retired health officer last year, officials cited high demand – rather than high supply – in their search. Ultimately, Dr. Alan Melnick and Steven Krager took over Lewis County along with several others in southwest Washington.

Shah added that public health officials “have been defamed for making decisions that are in the best interests of protecting Washingtoners.”

Challenges

Despite some stakeholders joining the bill, many opponents still have their heels in their heels. Senator Ann Rivers, Clark County’s R-La Center, told lawmakers during a public testimony that she “braised” over this bill.

“This bill gives the impression that it is all local health departments, but without examining what errors at the state level may have contributed to local health departments having greater trouble,” she said.

Shah shot back, citing the state’s favorable metrics compared to the rest of the country. According to analyzes by the New York Times and Statista, Washington is one of the few states with the lowest COVID-19 cases per capita.

Rivers also argued that the bill would add another layer of bureaucracy whose funding would not result in ground-level efforts and reduce local scrutiny.

When funding is linked, rivers “could be forced to do something that may not fit their local culture”.

Rep. Marcus Riccelli, a Spokane Democrat who sponsored the bill, agreed that there would be “accountability” with an increase in funding. He also pointed out the bill’s nullity and nullity clause, which ensures that the ReThe structuring would only come into effect if the state approves the funding for assistance.

As Riccelli sees it, the new regional centers would serve to decentralize public health, since in the current system state officials – rather than a specific region – have to intervene when the districts have problems. The plan provides for public health to be “supported by the state, coordinated regionally and implemented locally”.

While the legislature is working to bring the bill to the Senate, the question of whether it is up to date remains open. While proponents say the pandemic should be the catalyst for change and that the restructuring and funding spurt is long overdue, others are still cautious about undergoing a major restructuring before the pandemic is over.

HB 1152 quickly moved from public hearing to executive session last week and is next in the Senate.