Lawmakers are weighing whether to limit the powers of local health directors over public health measures

LINCOLN — COVID-19 has placed an enormous strain on hospitals and the healthcare industry, causing thousands of cases and deaths in Nebraska’s nearly three years of pandemic.

Public health leaders, as well as state and local governments, have taken measures to combat the spread of the coronavirus that have helped “rescue” local hospitals, according to one registered nurse in Lincoln.

“When DXM [directed health measures] were announced, all bedside doctors, including myself, would breathe a sigh of relief,” nurse Julia Keown told the Health and Human Services Committee on Wednesday. “We actually cheered because we knew it would work, and it did.”

Keown explained that these measures have resulted in fewer patients dying from COVID-19 and fewer healthcare professionals having to tell families via Zoom that their loved ones have died.

One legislative proposal aims to change who can take these actions, removing authority from public health leaders and changing their role to an advisory one.

Legislative Bill 421, proposed by state senator Kathleen Caut of Omaha, would require county or city councils to vote on targeted health measures along with the approval of state officials.

“This retains the importance of the education and experience of health directors, but redirects responsibility for restricting freedoms,” Kaut said. “It should also help redirect public anger from the director of public health to the elected officials who own it.”

Keown was one of five medical professionals who testified against the bill on Wednesday. Two individuals testified in support of the bill.

“Defend our rights”

Caut said her bill is a direct response to actions taken during the pandemic, which she said have curtailed personal freedoms. She said this includes mask-wearing requirements and restrictions on public gatherings.

“It is very important, especially in an emergency, to protect our rights,” said Kaut. “Elections have consequences, and the responsibility for decisions concerning the freedoms of citizens should rest with these elected officials.”

The bill reflects the backlash in Lincoln and Omaha to the health measures, which led to an unsuccessful recall campaign against the mayor and city councilors in Lincoln and lawsuits against the health director in Omaha for issuing a mask mandate without city council approval.

Then-Attorney General Doug Peterson dropped the lawsuit after the Omaha City Council approved an ordinance allowing the council to veto public health measures.

Dr. James Lawler, professor of infectious diseases at the University of Nebraska Medical Center, said the bill would make Nebraska less safe because it could delay health decisions.

In all his experience, Lawler said, critical and effective public health measures depend on speed, technical expertise and professional courage.

“LB 421 will blow it all up in Nebraska,” Lawler said, adding that speed is the most important principle.

Daily Operations

The health departments of Douglas and Lancaster counties issue about 120 work restrictions and isolation or quarantine orders each year, Lawler said, except for COVID-19.

This includes actions against diseases or pathogens such as hepatitis, salmonella, norovirus or tuberculosis, which must be approved by elected officials.

“Most of the time, these orders are done quietly. The emergency is contained and we never hear about it,” Lawler said. “But I, for one, am very glad that these unsung heroes work tirelessly behind the scenes every day.”

This means that any targeted health action will require county or city approval, as well as state approval.

Dr. Jim Nora, an infectious disease doctor from Lincoln, testified against the bill and said health professionals also want to stand up for freedoms and values. He said health policy should never be arbitrary or discriminatory.

John Cannon, executive director of the Association of Nebraska County Officials, also testified against.

He said it could be difficult to assemble a quorum of city or county council members, in addition to having to comply with the open assembly law.

“Arbitrary, wide coverage”

Omaha’s David Splonskowski testified in support of Kout’s bill because he said his family was affected in the spring of 2020, largely due to restrictions placed on church gatherings.

This placed an “undue burden” on his worship, he said, but those concerns remained “silent” when he contacted his county’s health director.

“It doesn’t necessarily prevent bad decisions being made,” Splonskowski said of the bill. “But at least it allows residents to petition their local elected officials to limit certain health directives.”

Stacey Skold of Malcolm, Ph.D. in the humanities, said that over the past three years, unelected officials have issued “arbitrary wide-ranging” mandates that have undermined democracy.

Passing Kauta’s bill would close a loophole in medical guidelines, Sköld said, arguing that the bill needed more language to ban injections as part of health measures.

Ultimately, Sköld said the Legislature should also draft a medical bill of rights.

“Very scary time”

State Senator Lynn Walz of Fremont, a member of the committee, expressed concern about how the bill would affect her community during severe flooding in 2019.

Fremont has become an island, Walz said, and if the health director’s actions regarding the quality of contaminated water required additional approval, she wondered how it would work.

“It was a very, very scary time for members of our community,” Walz said.

State Senator Brian Hardin of Gering, vice chairman of the committee, said Caut’s bill would act as a system of checks and balances for health directors. Throughout the hearing, he resisted the testimony of his opponents. State Senator Ben Hansen of Blair, chairman of the committee, said the bill seemed reasonable because of the unprecedented actions taken in response to COVID-19.

Dr. Echo Koehler, speaking out against the Nebraska Nurses Association, said the bill would add “red tape” and undermine public health.

State Senator Machaela Cavanaugh of Omaha, another member of the committee, has repeatedly thanked medical professionals for taking the time to testify and has openly stated that she will not vote on the bill.

“You can thank me for not passing this bill,” said Kavanaugh Keown, a registered nurse.

The committee did not take immediate action on the law.

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