Lawmakers consider limiting authority of local health officials

Wading into a public debate that has grown heated on social media, the House Local Government Committee held a hearing Thursday afternoon for House Bill 121, which would limit the authority of public health officers and health boards, and give elected bodies more power in setting public health policies and orders. The measure is part of a broader effort by Republican lawmakers, telegraphed after the November elections, in response to local health department directives and former Gov. Steve Bullock’s response to the COVID-19 crisis.

Opponents testified that the measure would insert politics into science-based decision making and potentially slow public health responses during an emergency.

Supporters of the measure said the bill would ensure that overzealous health officers and health boards could be kept in check by voters via elected officials. For example, they said, health orders implemented by some county health boards and health officers that were stricter than statewide mandates were made without citizen input and have harmed small businesses.

“Our elected officials bear the responsibility of taking all factors into account when setting policy. Now, I will grant that at times, elected officials make judgments that are not universally accepted, or that they might even make mistakes. It’s part of living in a free society,” said Rep. David Bedey, R-Hamilton, the proposal’s sponsor. “Under House Bill 121, there are no restrictions on the ability of our public health officials to provide elected officials sound advice, which I cannot help but think would most often be persuasive.”

Under the bill’s provisions, health officers and health boards could still issue health orders during public health emergencies, but elected officials, like county commissioners, could amend or rescind those orders. In non-emergency situations, the bill would remove the power of local health boards to issue orders and require them to instead propose actions, which the elected governing body overseeing them could approve or deny.

Bedey has also sponsored another measure he said is in response to the COVID-19 pandemic. That measure, House Bill 122, would limit how long emergency and disaster declarations issued by the governor can remain in effect without legislative approval, as well as streamline the convening of a special session of the Legislature so lawmakers can vote to overturn a governor’s emergency orders. Another bill, House Bill 145, sponsored by Rep. Paul Fielder, R-Thompson Falls, would strip local health boards of the power to enforce health mandates and issue orders, instead limiting them to making recommendations to elected officials.

While Bedey said he understands concerns from opponents that public health decisions could become politicized, he said that in an extended health crisis like the current one, local public health orders more strict than statewide directives need to be weighed against economic and business impacts.

“Real-world situations and crises often have many more than one, or even two, dimensions that need to be considered,” he said.

Opponents, on the other hand, said the measure would unintentionally lead to politics leaking into decisions about public health, which they said should be made based strictly on science.

“House Bill 121 throws public health squarely into the political arena,” said Jane Webber, a Cascade County commissioner and member of the county’s Board of Health, in testimony on Thursday. “Do not place the decisions of our health and your family’s health in the hands of politicians. I am a politician, and I openly acknowledge there are some in politics who are easily swayed … possibly by a phone call, sometimes by a campaign contributor.”

Opponents also said that requiring approval from elected governing bodies, especially when two health entities are involved, as in the case of joint city-county health boards, would add another layer of bureaucracy to decisions that often need to be made quickly. Additionally, they argued, public health officials already have accountability to voters since health board members are appointed by elected officials.

Speaking on behalf of the Association of Montana Public Health Officials, Gallatin City-County Health Officer Matt Kelley said that people in the public health field do the work because they “are almost always motivated by the spirit of public service.” Kelley said the suggestion that public health officers make decisions because they’re “power drunk,” as one bill supporter said Thursday, is wrong.

“Every board of health member and every health officer in the state is pretty worn down right now,” he said. “It is somewhat painful and discouraging to hear of those efforts somewhat demonized by people who are calling us power-thirsty.”

The House Local Government Committee took no action on the bill following Thursday’s testimony.