Pre-approval for certain public health measures advanced

Lawmakers gave first-round approval Jan. 26 to a measure that would put constraints around community-wide directed health measures.

LB203, introduced last session by Omaha Sen. Kathleen Kauth, would require approval by a majority of elected officials on the board of health for an area impacted by a community-wide directed health measure before it could take effect.

The bill defines a community-wide directed health measure as a public health action or intervention by a local public health department involving the total population of the department’s jurisdiction when there are “no known epidemiological links.”

Under the proposal, a public health director would need to receive written approval from a majority of the publicly elected representatives who are appointed to the city-county health department prior to a measure being issued.

Kauth said the proposal arose from actions by local public health officials during the coronavirus pandemic, which she said involved “unelected bureaucrats” making decisions that “removed civil liberties.”

The ability to restrict citizens’ liberty should be limited to elected officials, Kauth said, because those officials can be held accountable at the ballot box.

LB203 would change the role of county health officials in regard to the community-wide directed health measure process “from one of authority to one of advisement,” she said.

A Health and Human Services Committee amendment further would require an approved measure to expire seven days after issuance unless renewed by a vote of the local health board. Continuing approval would be required every seven days thereafter.

An amendment to the committee amendment offered by Omaha Sen. John Fredrickson would allow emergency meetings to be called to vote on such measures and for virtual conferencing to be used to carry out the bill’s provisions.

Fredrickson, who described himself as “conflicted” about LB203, said his intention was to improve the bill. Many boards that govern public health officials meet only sporadically, he said, making the original timeline of voting at the next regularly scheduled meeting “unrealistic” in an emergency situation.

Sen. Tom Brandt of Plymouth expressed concerns about the underlying proposal, saying public health officials have the experience and expertise to respond to “fast-moving” emergency situations, while elected officials likely do not.

He noted that measles recently was detected in Lincoln’s wastewater, an early warning of a potential outbreak. Adding another layer of bureaucracy to address that sort of public health situation doesn’t seem like the best way to solve the problem, he said.

Lincoln Sen. George Dungan echoed those concerns. While LB203 may appear on the surface to be a small change to laws governing local health officials, he said, it’s part of a larger pattern of undermining public trust.

“I have concerns that … we are undermining both the process that has been established already to make sure that we’re protecting the citizens of Nebraska, and also undermining the long-standing confidence that we should have in public health officials, in doctors and in science,” Dungan said.

Also opposing the bill was Sen. Dan Quick of Grand Island. He said his local public health director did “an amazing job” during the Covid pandemic and used her expertise to pull together the entire community when the virus “spread through Grand Island like a wildfire.”

The local hospital did not have enough ventilators to treat everyone, he said, and patients had to be flown elsewhere.

“We live really close to the hospital [and] it was like a war zone,” Quick said. “I mean we had helicopters flying people … out of our St. Francis hospital to Omaha or Lincoln, wherever they had available ventilators.”

Handling that kind of crisis should not be left to county boards or city councils who lack medical expertise, he said.

Following the 34-3 adoption of the committee amendment, senators voted 43-0 to adopt the Fredrickson amendment. LB203 was then advanced to select file 28-13.