COVID-19 decisions could shift to county mayors from public health boards

Spurred by fears that appointed public health boards hold too much power in the COVID-19 pandemic, a state legislator is trying to change Tennessee law to put crucial decisions in the hands of county mayors in six large counties.

State Rep. Jason Zachary, a Knoxville Republican, has filed House Bill 0007 in advance of the 112th General Assembly, legislation giving the county mayor authority to enact health policies and relegating public health boards and other health officials to the role of advisory bodies. The bill applies to Shelby, Davidson, Knox, Hamilton, Sullivan and Madison counties, all of which have health departments that operate independently from the Tennessee Department of Health.

Zachary’s main point of contention is that authority delegated to health boards by state law during the state of emergency creates “an imbalance of government,” enabling them to function as legislative and executive bodies simultaneously.

“The health board always assumed they were an advisory board, and then all of this health pandemic started, and it revealed this section of TCA 68 that gives them this vast power that no one can do anything about,” Zachary said.

The legislation “rebalances government” and puts those health boards back in their proper role, he added.

Health boards are appointed by the elected county mayor and approved by elected members of the county commission, or the Metro Nashville City Council in Davidson County. 

But Zachary still says the unelected boards shouldn’t have powers such as the authority to close down businesses for weeks at a time if they don’t require masks to be worn by workers or customers.

Under the law, health boards in those six counties can set business rules, mask requirements and social distancing regulations during the state of emergency. Gov. Bill Lee has chosen a hands-off approach on those six independent groups while issuing executive orders for the other 89 counties, including giving mayors authority to make mask mandates. 

Republican mayors in several counties, such as Williamson and Sumner, opted for mask mandates, drawing criticism from conservative groups.

House Speaker Cameron Sexton of Crossville is backing the legislation after previously calling for the six independent health departments to fall under the same rules as the other 89.

“Our elected officials are held accountable by voters through the election process; we also elect our leaders to make tough decisions, not to have those decisions made by unelected bureaucrats,” Sexton said in a statement. “The independent health boards are unrestricted with their autonomy and control, and their unchecked actions are further damaging businesses in areas like Davidson, Knox, and Shelby Counties. I appreciate Chairman Zachary for his hard work and for his desire to continue standing with our business and community leaders. Together, we will ensure a strong economic recovery across all three grand divisions of our state.”

The Knox County Health Department health director is appointed by the mayor, and the medical professionals who serve on the board are nominated by their professional organizations and appointed by the Knox County Commission.

In response to questions about the legislation, the Knox County Health Department issued a statement saying it will follow the measures the Legislature passes.

Yet, it stated, “As a general practice, we believe that public health should always remain apolitical and recommendations should be based on medical and public health expertise from professionals in their field. In times of public health crises, this expertise is even more critical to have at the table.”

In Metro Nashville, Health Department officials and Mayor John Cooper have butted heads with nightclub owners on Lower Broadway, a major source of revenue for Nashville but a place where health officials believe COVID-19 cases proliferated as city officials tried control the virus but allow businesses to start operating.

Cooper did not say he opposed the legislation but didn’t endorse it, either, pointing toward the need to depend on people in health and medical fields.

“Now more than ever, we need to value science. Boards of health need brilliant scientific and medical minds, and any mayor or governor will need that expertise,” Cooper said in a statement.

In Metro Nashville, Health Department officials and Mayor John Cooper have butted heads with nightclub owners on Lower Broadway, a major source of revenue for Nashville but a place where health officials believe COVID-19 cases proliferated as city officials tried to control the virus but allow businesses to start operating.

Dr. Alex Jahangir, director of the Metro Nashville Health Department, said he would “leave the politics” to politicians and speculated that the bill would not affect Nashville as much as other counties because of its metropolitan form of government.

“With Mayor Cooper, we currently have someone that listens to subject matter experts and studies and understands the science and best practices before making a decision,” Jahangir said in a statement. “My hope and belief is that the people of Nashville will always elect leaders to the office that follow a similar process when addressing situations.”

Jahangir pointed out the Metro Nashville health board is made up of six members with “extensive” professional experience in public health and health care, which was done intentionally to “ensure this level of competency.”

Most Democrats, though, believe the legislation is ill-advised.

State Rep. Bo Mitchell, a Davidson County Democrat, called the bill “dangerous” and an effort to further politicize the virus, which he notes does not differentiate between party affiliations.

“We’ve had over 4,000 people who’ve died in Tennessee,” Mitchell said. “We’ve going to take the authority away from the professionals, the people who know the most about the subject matter, and we’re going to give it over to politicians, the leaders of this state who have failed at every turn in this pandemic, and now we’re going to give them even more authority to do nothing?”

State Rep. Gloria Johnson, a Knoxville Democrat, also criticized the measure, saying it is “ridiculous, dangerous and anti-science.”

Johnson argued the bill is being driven by vocal Knox County groups who oppose the wearing of masks, which are designed to prevent the spread of COVID-19.

She pointed out Knox County Mayor Glenn Jacobs, a former pro wrestler, helped make a video posted on Facebook by the group “Freedom Forward,” with fiery Armageddon-type scenes that attacked the Knox County Health Board and its volunteer members.

In the video, Jacobs says the foundation of America “is once again under attack – from some ominous enemy abroad and sinister forces within.” He goes on to say unelected bureaucrats are creating policies “with no accountability and no recourse.”

The video was shown at a Knoxville event where several officials participated. Zachary acknowledged he spoke at the event but said he had nothing to do with the video’s production, even though Jacobs reportedly said he co-wrote it. Zachary declined to comment about its contents.

Knox County health board members felt threatened by the video, according to TV reports. Jacobs, who could not be reached for comment, reportedly said the video wasn’t meant to be shown on social media but apologized to board members for the tone of the video. He declined to apologize, however, for its sentiment.

Johnson said the video went too far in depicting the health board members as some group with ulterior motives.

“These are doctors and public health people who are trying to assist during the pandemic, and the vast majority of folks in Knox County support the health board,” Johnson said. “But there are a vocal few who are just acting as if (board members) are working outside their authority, and clearly it’s in statute.”

Shelby County Mayor Lee Harris, who has been working closely with the county health director since the pandemic struck in March, has raised concerns about the lack of cohesion on statewide policies to attack the virus. 

A former Democratic state senator, Harris said he isn’t worried about Zachary’s bill because it isn’t a problem in Shelby County. He notes the legislation is hardly registering there because it won’t prevent the spread of the virus.

“Local leaders are in the fight of our lives and they’re talking about number 99 on the list of the top 100 things to do,” Harris said. “It’s very frustrating. We are in the fall surge, our kids aren’t in school, and businesses that are open are seeing their life’s work go up in flames.”

State leaders should focus, instead, he said, on the main issue: stopping the spread of COVID-19. Harris urged the Legislature to pass a mask mandate, organize a safe school reopening plan, stop pushing contact sports and find a way to staff hospital overflow facilities in Nashville and Memphis.