Pam Kohlmeier, MD: Was shrinking SRHD Board of Health illegal?

By Pam Kohlmeier, M.D., J.D., FACEP

Since 1997, the Spokane Regional Health District Board of Health (BOH) has been entrusted by the community to protect our public’s health. On Nov.15, however, through Resolution No. 21-0791, our three Spokane County Commissioners violated this trust when they improperly gutted our current BOH by removing all leaders from Spokane and Spokane Valley city councils. The commissioners’ resolution appears to violate current BOH bylaws and various state laws. There are three strikes against the validity of the Board of County Commissioners’ adoption of Resolution No. 21-0791, which should be further explored.

Strike one: Violation of the BOH bylaws. The primary purpose of the BOH, as stated in its bylaws, includes inviting “active participation of all professions, persons and organizations interested in public health,” and serving “to unite the municipalities and the county in a cooperative effort.” It is hard to understand how the removal of all Spokane City Council members helps achieve this purpose. Moreover, the commissioners’ retention of the mayor of Millwood, while retaining no representation from the two largest cities in the county, is a political move, at best.

The BOH bylaws state that the BOH shall consist of 12 members: three Spokane County commissioners, three elected officials from the city of Spokane, two elected officials from the city of Spokane Valley, one elected official from an incorporated town in the county, and three at-large citizens appointed by the commissioners. Any amendment to the bylaws needs to follow a prescribed process outlined within the bylaws, which did not happen. Therefore, the bylaws were violated, but who are the enforcers and what are the consequences?

Strike two: The potential for statutory violations including the Open Public Meetings Act (OPMA). Drastic changes made to the BOH membership requirements that have been in place for years should not happen without significant discussion. It is not plausible that the commissioners independently concluded to cut out all Spokane City Council and Spokane Valley City Council members, retain the Millwood mayor, and add medical/public health experts as the result of only minimal discussion during their official meeting Nov. 15. Yet, if two commissioners discussed this outside an official meeting, the OPMA was violated. A public records request will add clarity on what (actually) transpired.

Additionally, the commissioners’ resolution oversteps their statutory authority to “create” a health district and prescribe its board of health membership in one resolution. That was already legally done effective Jan. 1, 1997, by Resolution 96-0825, which created a health district (SRHD) with an 11-member BOH. While statutory authority exists to create a health district with a BOH, it does not authorize the gutting of a current BOH while retaining that health district. Does the commissioners’ resolution create a statutory violation?

Further, while there is statutory authority for commissioners to “expand” the size and composition of the BOH, here the commissioners have diminished the size of the BOH by removing all major city leadership. Might this be another statutory violation?

Strike three: The commissioners’ alteration to our BOH membership fails to await Washington State Board of Health (WSBOH) rules. Official rules regarding the proper implementation of E2SHB 1152, which requires the addition of medical and/or public health experts on local boards of health, is still pending. The rulemaking process began with a document filed in June (WSR 21-13-024) which states the WSBOH is required “to establish rules for the appointment process of these nonelected members of local boards of health in a manner that is fair and unbiased, and ensure to the extent possible a balanced representation of elected and nonelected persons with diversity of expertise and experience.” WSBOH rules may require more equitable ways to appoint qualified individuals to local health boards than word of mouth by commissioners. The county commissioners should see what the WSBOH says first before reacting prematurely.

Unfortunately, the portions of E2SHB 1152 that address local board of health composition were inspired by missteps by our BOH related to the illegal firing of our local health officer during a public health emergency. Now, Spokane County Commissioners have shifted their focus to selectively gutting our BOH – as the public health emergency continues – by selectively removing city leadership from our BOH.

To prevent demonstrating, once again, a need for state intervention on matters of local BOH leadership, Spokane County Commissioners should rescind Resolution No. 21-0791.

Dr. Pam Kohlmeier is licensed as a physician and an attorney, teaches Health Law and Professionalism in Public Health at a local university, and serves as a member of PHACTS (Public Health Action Coalition Team of Spokane).