West Virginia legislators are engaged in a contentious debate over a bill that would give county commissioners more control over decisions made by county health departments.
As explained by our Brad McElhinny, Senate Bill 12 “would require county commissioners and other health-appointing agencies, like city governments, to approve or disapprove rules passed by local health boards. It would require a public comment period for new or amended rules.”
The primary issue here appears to be smoking regulations. Currently, county boards of health can and do make unilateral decisions about where smoking is not allowed.
Bill supporters, like Senator Charlie Trump (R-Morgan), argue local health departments have too much authority to make sweeping public health decisions with no oversight.
“It’s a good government bill,” Trump said on the Senate floor Tuesday. “Government belongs to the people. We are their servants. We are their instruments.”
However, bill opponent Senator Mike Romano (D-Harrison), who is a former Harrison County Commissioner, said the legislation politicizes health decisions.
“We are simply taking public health out of the hands of the experts and giving it to people like me, county commissioners,” Romano said. “We’re going to put public health decisions in the hands of people whose primary concern in many cases is their political future.”
We are told that county commissioners do not like the bill. They probably do not want to deal with potentially controversial proposals by their health departments on issues like smoking and needle exchanges.
However, these are public policy, as well as health, decisions.
For example, lawmakers make policy decisions all the time that impact the health and safety of constituents, including legislation on tobacco and vaping products. In doing so they rely on expert opinions, as well as input from the public.
That is what should happen here. Health departments do their jobs by recommending rules they believe enhance and protect the safety of citizens. As this bill is written, then through a process of community input and a review from the county’s elected officials, a decision is made.
There is nothing unholy about that. In fact, that is the way anti-smoking laws have been adopted in most states. According to the American Lung Association, 28 states and the District of Columbia have passed comprehensive smoke-free laws.
In neighboring Ohio, voters approved a smoking ban inside public places. In Maryland, the legislature passed a law limiting exposure to tobacco smoke.
West Virginia county health departments and local health boards that have put in place anti-smoking rules have made wise decisions. Smoking is dangerous, second-hand smoke is a health threat, and West Virginia has one of the highest smoking rates in the country.
However, these kinds of actions gain greater acceptance if they include public input and legislative approval—in this case, an elected county commission or a health-appointing agency such as a city government.
Anti-smoking laws are good for the health of citizens, and adopting them through a democratic process is good for the health of government.