Shifting responsibility: Fishers impacted by law removing authority from local health departments

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Health departments throughout Indiana are adjusting to the passage of Senate Bill 5, which requires local elected officials to approve measures more stringent than state-issued executive orders during a declared emergency.

In essence, the bill requires local elected officials to make the final decision on matters of health care policy under their jurisdiction rather than allowing health department officials to establish policy on their own. Proponents of SB5, which passed when the General Assembly overrode a veto by Gov. Eric Holcomb, view the change as bringing accountability to the decision-making process, while those in opposition see it as a roadblock that can slow reaction time during an emergency.

The impacts are felt more directly in Fishers, which established its own health department 10 months earlier. Fishers is one of only a handful of municipalities in Indiana with its own health department.

Now, instead of utilizing city councilprovided authority to make and enforce decisions, the Fishers Health Dept. will need to provide the council with recommendations and let the councilors make the final call.

“We of course always work closely with the mayor and with our elected officials here in the city, so hopefully it will be less of a hurdle here than in other places, but it is still a hurdle that we haven’t had before,” said Monica Heltz, Fishers Health Dept. public health director. “I don’t, frankly, think that all of our elected officials want to have that responsibility in making the decisions regarding the health and welfare of the community, but that is part of the role in being an elected official. We just hope that it doesn’t result in any serious consequences with the additional (steps).”

Ensuring that elected officials can be held accountable for decision making was a key point of emphasis for the Republican majority in the General Assembly.

“The legislative body just wanted to make sure that, at the end of the day, an elected office holder, somebody voted on by the people, was making the final decision,” said Indiana House Speaker Todd Huston, a Republican state representative whose district includes Fishers. “I don’t think it limits flexibility. We didn’t change any of the actions that a health department or a health official could recommend. We are just saying that before those actions come into effect, they need to be approved by somebody who is actually elected by the voters.”

The veto override passed 36-10 in the Senate, with four abstentions. It then passed in the House, 59-30, with 11 abstentions. The measure was largely partisan with Republicans voting almost unanimously to override Holcomb’s veto. Only three Republicans voted against the override, all in the House.

From the majority perspective, public health emergencies like COVID-19 are complex, and elected officials are the ones who should be ultimately responsible for making critical decisions on how to address it.

“There are a whole lot of factors that need to be considered, not just health, but economic and educational,” Huston said. “All the components need to be factored in by the people who are making the final decision and, quite truthfully, will have to stand one day potentially for reelection, and then the people can voice support or opposition to the types of decisions that were made.”

District 30 State Sen. Fady Qaddoura, a Democrat, voted against the bill. Qaddoura said local health officials largely have the better training, and expertise should be empowered to guide health care policy.

“This bill assumes that there is no collaboration between health care experts at the local levels and their elected officials and their communities, which is absolutely false,” he said. “During this pandemic, we’ve seen, on a day-to-day basis, even on an hour-to-hour basis, a high-level of coordination between the Indiana department of public health with health officials and professionals with elected officials. So, the bill is trying to falsely convey that the way we managed the pandemic was only following health care experts with no coordination with municipalities or cities and so on.”

Another aspect of SB5 troubling to Qaddoura is that when a policy is established, local businesses and citizens have several opportunities to appeal it before being compelled to obey. For example, if a county were to enforce a mask mandate when the state is not, a local business could ignore the mandate. Then if challenged by a local health official, it could choose to ignore the mandate while appealing to local elected officials while waiting for the case to be heard at a circuit or superior court.

“In a way, we are giving people every opportunity not to follow guidelines while this appeal process is still pending,” Qaddoura said.

Fishers Mayor Scott Fadness said the city will adapt to the new law.

“When we talk about these types of legislations, they are often founded and motivated by the most extreme situations,” Fadness said. “One situation would be that we need to protect the residents from a group of public health officials who have gone rogue and are putting undue restrictions on their residents. On the flip side, I think the idea that public health officials are going to have elected officials clamp down on them and never let them do their job is also a rare occasion.

If you are already in good communication with your public officials, it can seem like another bureaucratic step that you have to take. We’ll deal with it.”

Senate Bill 5 path to veto, override

  • Jan. 7, 2021: Senate Bill 5 was authored by Senators Chris Garten, Ron Alting and Mark Messmer.
  • Feb. 8, 2021: Bill passes the Senate on third reading, 40-8.
  • Feb. 9, 2021: Bill is referred to the House.
  • April 6, 2021: Bill passes the House 65-28.
  • April 21, 2021: Bill’s final draft is formally adopted by the House (65-29) and Senate (37-12).
  • April 28: It is signed by the President Pro Tempore of the Senate (Rod Bray) and the Speaker of the House (Todd Huston).
  • May 4, 2021: Bill is vetoed by Gov. Eric Holcomb.
  • May 10, 2021: Veto is overridden by both bodies and becomes law.

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