A bill in the state Legislature to create regional public health districts has been altered to exclude its most controversial provision: dissolving local health jurisdictions.
The move comes after lawmakers fielded concerns from a Washington State Association of Counties (WSAC) workgroup, which includes Lewis County Public Health Director J.P. Anderson.
On Tuesday, Anderson said the original idea of ending local boards of health was “shocking,” and the most concerning part of the bill, which he and Lewis County commissioners have opposed since Gov. Jay Inslee announced the proposal last month. But still, Anderson said the bill’s proposed regional districts threaten to supersede decision-making by local officials.
Recognizing that the bill — repeatedly called a “work in progress” by lawmakers — will undergo many more iterations, and that conversations between lawmakers and stakeholders have so far been productive, Anderson said he doesn’t foresee a version of the bill he would support.
“At this time, I don’t see what the benefit to Lewis County would be. I don’t see what the benefit to these services we’re trying to deliver to the people of Lewis County would be,” he said.
The substitute bill, which passed from committee on a 10-4 vote (with one excused), would create nine districts to “diversify and stabilize” funding for public health, with the aim of enabling state and local entities to share resources and functions. Local boards of health — oftentimes composed of mostly elected officials — would also be altered to include tribal representatives, health practitioners and consumers. The idea is to depoliticize public health.
Committee Chair Rep. Eileen Cody, D-Seattle, said the hope is to protect local control, increase funding and ensure accountability.
“We’ve improved this, but not perfected this,” said Rep. Marcus Riccelli, D-Spokane, who sponsored the governor-requested bill. “I’ll meet with folks anywhere, anytime throughout the state to have this discussion.”
Anderson said so far those conversations have been productive. Despite opposing the bill, he said “good faith” discussions will be important.
“I think there’s a hopefulness now, around the bill, but I do think that there’s still a lot to be discussed and understood,” he said.
Anderson also critiqued a key idea behind the bill: that politics can be removed from public health. Others, including Republican lawmakers, have echoed the concern, arguing that the shift would simply put public health decisions in the hands of state officials, or Gov. Jay Inslee, instead of local officials.
“Some issues do become inherently political, so the idea that you can remove it by consolidating that under one elected official, I think just didn’t seem realistic,” Anderson said.
Rep. Skyler Rude, R-Walla Walla, who voted against the bill, said something similar during an executive session last week.
“Restructuring over disagreements at a local level doesn’t take the politics out of decision-making, especially if we’re shifting to our state executive branch, which I feel strongly is not immune to politicizing health decisions,” Rude said. “So I just think it’s important to respect local control and local decision-making and those structures that exist, even if we disagree with those decisions.”
Proponents, however, cite the bill’s requirements that the voices of elected officials be balanced by medical professionals and other community members.
Ranking member Rep. Joe Schmick, R-Colfax, said he’s worried smaller counties in his district would be overshadowed in a regionalized system.
“I have a hard time in thinking that setting up another level of bureaucracy is going to be expeditious in getting that money to the counties,” he said.
Several lawmakers voted to move the bill out of committee despite their concerns, many citing confidence that more discussions will lead to better iterations of the bill.
District 24’s Rep. Steve Tharinger, for example, cited his own fear that regional districts could end up hampering local efforts.
“But I do understand — and the virus has highlighted — how poorly our public health system is organized in the state,” he said. “And there’s more work that needs to be done.”
One Republican — Rep. Paul Harris, R-Vancouver — crossed party lines to vote the bill out of committee.