WENATCHEE — The state Department of Health and local health districts across the state have been strained by the COVID-19 pandemic.
House Bill 1152 would reorganize public health to solve issues brought up during this health crisis.
The bill would:
- Form four regional health district centers that would operate between the state Department of Health and local health districts.
- Change the composition of boards of health to include non-elected members like health care providers, representatives of community organizations and people who have faced significant health inequities.
HB 1152 passed the House on March 8. Read the bill here: wwrld.us/bill
Chelan-Douglas Health District board member Ruth Esparza, who is also a member of the Wenatchee City Council, and Wenatchee attorney Tony Gonzalez met with The Wenatchee World to discuss the merits of House Bill 1152. Gonzalez said his stance on House Bill 1152 is his own and does not represent the position of his employer, Columbia Legal Services.
This is an edited version of the conversation.
Wenatchee World: What does House Bill 1152 aim to do? How would it change public health change in the state?
Tony Gonzalez: House Bill 1152 redesigns the system we’re currently in. Instead of just relying on local health districts to manage public health, it adds additional layers of supervision to make sure that all of public health services are coordinated with each other and at least talking with each other in a formalized way. The additional thing that it does is that it adds community voices and health experts to the decision-making process, so it’s not just recommendations, but it’s authority to make specific decisions.
WW: What are the general responsibilities of the Chelan-Douglas Health District Board of Health?
Ruth Esparza: The primary purpose of the board of health to ensure the health and safety of both Chelan and Douglas counties. The Board of Health also oversees the job of the executive director of the board of health.
WW: How do you think House Bill 1152 would change your work as a member of the board of health?
Esparza: Right now what we have is four county commissioners, two mayors, two city councilmembers from Wenatchee and Leavenworth.
With this new bill, I see this as diluting those accountable voices by bringing to the decision-making table individuals that would not be accountable to anybody, to the community. And not only that, basically, I see this as unnecessary. If it’s not broke, why fix it?
The argument is that local health boards around the state politicized the whole pandemic, and we need to change that. I would disagree with that because we didn’t politicize it. If anything, I think this bill is politicizing it by taking local control away from local, elected officials and bringing it to the state level where they’re the ones overseeing the health and safety of local communities. I disagree with this bill. I understand that they want to create efficiency, but I don’t think it’s going to create efficiency.
Going back to your question, how would our jobs change?
You’re diluting the local control by bringing other counties into the mix. Chelan and Douglas counties would have to play with the other counties. And that’s good in all, and I think we’d play well with the other counties. However, when emergencies hit, sometimes resources become limited. And now it means that we have to figure out who’s going to get what resources. I think dilution of resources may potentially happen with this board.
WW: To repeat something Ruth Esparza said, if it’s not broken why fix it? Why do you think the local boards of health should change?
Gonzalez: There’s so many ways to try and answer that but I’m going to try to keep it to three major ones. It’s no secret that the pandemic has shown us that this system is broken. Not only in the sense of what is known publicly but also by looking through the public records available.
The second part to that is all of last year we saw our Latinx community suffering the most here locally. And it took a really long time before the health district responded to that. During the pandemic, the situation was made worse with some of the conversations that were happening trying to pass blame onto quinceñeras and suddenly it seemed like every single day there was a quinceñera. Or informal conversations about tracking carne asada sales. Again, trying to shift the blame onto the Latinx community locally. Those words matter and especially when you’re making these decisions.
The last point on that is, as a county, we had advantages. Our numbers were low. Everything on the west side started to happen, and we saw what was happening, and we did not take advantage of that.
What’s troubling from the public records is that we saw our medical experts pleading to let them do the work. Instead, we saw politics take over, and it ultimately ended in a lawsuit against the governor to try and get rid of the restrictions that were put in place for the benefit of everyone across the state. Trying to take advantage of the fact that we had low rates, and we only had to wait about a month before we saw our infection rates go through the roof. And we saw, again through the public records, our hospitals begin to reach to the Department of Health because they understood that our health district did not have the resources to deal with the emergency that was coming and that was ongoing.
This bill would level much of that, to the extent that it can. People are going to continue to have their personal beliefs and personal values, but it makes sure that the people who have the least amount of authority or power are at least at the table. It makes sure that the people in charge and educated on public health matters have decision-making authority.
We only need to look at our public records and the emails that were going around inside of the health district to understand. We needed our medical experts there. We needed more of them, and we needed them to have authority to push back on the politicization of all of this.
The most troubling thing to me is we went through all of this last year, and I have not heard a public conversation on this bill. This is an important bill that impacts our two counties and our entire state. And I haven’t heard our elected officials take a stance on it yet. I haven’t heard that publicly made. We should be pushing them to see what their stance is and why they may have whatever beliefs they may have.
WW: Currently, the members of the board of health are all elected officials. Under House Bill 1152, how would this change?
Gonzalez: Under House Bill 1152, our board would change in some ways. Currently, we have eight members. Under House Bill 1152, if our elected officials remained the same, that number would grow to sixteen because we need to have an equal number of three different categories. And those categories are: consumers of public health, a broad other category that could include community organizations or nonprofits, and the third category is some kind of medical expert.
From those three categories, again, if we maintain the eight elected members, we would need two members from each different category, so that adds six. The remaining two individuals could come from either category. That would change how our board of health is run. The activities for the health district would largely remain the same. They would continue to worry about construction, sewers, the very local and municipal problems that we have. They can continue to focus on that.
The important part is when we do have outbreaks of any kind now you have community voices, now you have expertise on the board of health that can voice their opinions and weigh in on the decision-making. If you look at the structure that we have right now, we have one person who has any kind of medical training. That’s it. And that one person has to educate on any of the opinions that exists. That person used to be the chair. They’re no longer the chair anymore.
Who’s the chair? The chair right now is Dan Sutton who not only has a business interest but also was a part of the lawsuit. I don’t understand how people don’t have a problem with that, but that’s not for me to say. That’s something for me to point out. We had two other people on the board of health who have business interests and who were also a part of the lawsuit. Why we need medical experts and community representation on our board of health is exactly for those reasons. We have three people on the board of health who have identifiable business interests. Three people who were also on the lawsuit, right? And in the lawsuit, we had some serious things that happened.
For example, our health officer apparently submitted a declaration he didn’t know was going to be submitted. We also had the Sheriff involved to go and find our then health administrator to get a declaration. We see it through the public records that he felt this was wrong that the health district should not be involved in a public lawsuit. And at the time, our chair of the board of the health was the medically trained person. And when the lawsuit failed, shortly thereafter, the chair changed.
These are very concerning things that happened that no one talked about. There was a little in-depth coverage, but if it wasn’t for these public records, this side of the story wouldn’t be coming out. So, we need to make sure that medical experts are on there so that you don’t have a health officer being forced to submit a declaration in court. And you don’t have a situation where you have members on the board of health who might have interest in making sure a lawsuit continues because we know what ended up happening. All we have to do is look at the data that was posted by The Wenatchee World. We saw the cases explode.
As for accountability, I think this House Bill 1152 is trying to make sure that accountability comes up. As for the individuals themselves, they get elected by the board. So, in a sense, you’re having elected officials elect who ends up being on the board. That causes me concern but we got to do it somehow.
WW: Are there any things you’d like to respond to?
Esparza: Let’s start with the lawsuit against the governor. That’s what I’m trying to say is that this bill is telling local communities that they cannot sue the governor otherwise we’re going take your local voices, your local power away from you. That’s what I’m saying that this bill is the one that politicizes the whole issue, especially with this pandemic.
Basically, this is a punishment for having been involved in the lawsuit. I will say, I was in the lawsuit myself. I was one of those board members that joined the lawsuit against the governor. The reason why we decided to sue the governor is because the pandemic was going on early on. Wenatchee, East Wenatchee, Douglas, Chelan County, we were not seeing an emergency at that time. What we wanted, and the whole purpose of the lawsuit was so that the local health department can take control — release a little bit if we had to and tighten a little bit if we had to if the pandemic got worse.
But we wanted to make those decisions based on what was happening in our region because at that time what was happening is that Seattle was seeing a huge explosion of cases and our communities were not seeing that. In fact, we hadn’t seen any explosion yet.
The lawsuit happened about five months before we saw any explosion of this pandemic. So to say that the lawsuit and the board members who were involved in the lawsuit were basically reckless for joining in a lawsuit when we had duties for the health and safety of our community I think is a little disingenuous.
The problem here if you look at what the governor eventually did is exactly what we wanted to do with the lawsuit. Recently, at the turn of the year, the governor actually created districts to where, depending on how things were going with pandemic numbers in that district, that district could move up to Phase 2 or Phase 3. And if it happened to be that the numbers shot up, then we would pull it back to Phase 2 or Phase 1, which is exactly what the local health department wanted to do.
Now, were there disagreements within the local health department? Of course there were. We all agree to that. There is nothing wrong with having disagreements when you’re making decisions.
And so, I guess my argument is this: if that kind of disagreement was happening on a local level with elected officials who all kind of understand what their communities need to do to move forward, imagine the disagreements that could happen if you get community members and medical experts. We already have a medical expert on the health board. He is our public health officer. He does advise the board, but ultimately it’s the board that has to be accountable to this community.
Now, were we interested in making sure here locally that our economies survived? Yes, because we believe that a healthy economy creates healthy communities. We were very much aware and very much prioritizing the health of the community, but we were not going to stand by and let the governor completely bankrupt our economy in this area. And I’m sorry, if that creates a problem, then it’s a problem I’m willing to step into.
As to not having the Latino voices heard, that’s inaccurate too. Early on, we formed several committees to bring Latino voices to those committees so that then the chair of that committee who was Veronica Farias, who is our public relations officer of the board of the health, then she would bring the information back to us. It is no different than what city governments do here and everywhere else. We form committees where the community at large could have their voice heard, and those committees bring those recommendations to the table for decision-making for policy-making. That’s what we already have.
I’ll give you this analogy. It’s kind of like wanting to have the planning commission and the historic preservation board and parks code enforcement boards, and wanting all of them to come to city council, sit at council table, and they make the decisions also along with the elected officials. Except, this bill is even worse. This bill dilutes the elected official vote because it is very specific that the elected officials, in other words, accountable voices, are not the majority on this board, which is ludicrous to me.
Again, I don’t like this bill.
Could we change things? Sure, we can change things, but I don’t like it because if you dilute the elected positions basically it’s taxation without representation which is so un-American.