Indiana lawmakers advance public health overhaul despite concerns over local control
INDIANAPOLIS (WISH) — The author of a bill to overhaul Indiana’s public health system on Wednesday said the measure does not change local officials’ control over services.
The Senate Health Committee approved the bill after a nearly 4½-hour hearing in which several witnesses railed against what they believed was an expansion of the state’s public health authority. At issue is a set of services county health departments must provide in exchange for expanded state funding. To qualify, health departments would have to agree to provide, at minimum, a uniform set of core public health services. Those services range from immunizations and disease control to sanitary building inspections and pest control. Counties that choose not to receive the additional funding could continue to provide their existing level of service with existing levels of state funding.
The provision was meant to address one of the key findings of the Governor’s Public Health Commission: Indiana’s public health departments vary widely when it comes to services offered.
For example, State Health Commissioner Dr. Kris Box said, only 39 of Indiana’s 92 counties offer tobacco cessation programs.
The core service requirement was enough for some at the hearing to accuse lawmakers of forcing local officials to accept state public health mandates. Brad Rogers, president of the Elkhart County commissioners, said he would rather see the funding provided as individual grants, with local officials allowed to pick and choose which additional public health services to fund.
“Let’s keep the county elected officials accountable and not shift that onus to unelected health officials at the state level,” he said.
Bill author Sen. Ed Charbonneau, a Valparaiso Republican, said Rogers’ characterization is based on fear and anger over the state’s COVID-19 response. Charbonneau said nothing in the bill strips any authority from county officials over how programs are implemented.
“If a county doesn’t want to be part of this, they don’t have to be,” he said. “They have to take affirmative action to be involved. If they don’t do that, the day after we pass the bill, it’s going to be the same local health department services as the day before.”
The Senate Health Committee approved the measure unanimously but at least three members said they want to see language clarifying what state officials can and cannot do if counties decide to opt into the additional funding. The measure now must go through the Senate Appropriations Committee because the legislation would create mandates that involve the use of state money.