Commission Votes to Dissolve Board of Health
Even as Knox County COVID cases mount, the body that has guided the pandemic response may lose its authority.
by jesse fox mayshark • december 22, 2020
"High burden" cities ranked for COVID-19 activity. (source: White house covid-19 task force).
In a meeting that extended past midnight on the darkest night of the year, on a day that Knoxville was designated as having the worst COVID-19 outbreak for a city its size, Knox County Commission voted to dissolve the county Board of Health.
The ordinance will be up for a second vote at Commission's January meeting.
Commissioner Kyle Ward proposed the ordinance change, which passed on first reading by a 6-4-1 vote. It will require a second reading at Commission’s Jan. 25 meeting.
The vote reflected mounting protests over the past several months by people alarmed by the power of the Board of Health and opposed to its mask mandate and other restrictions. It also inevitably reflected political divides — in the community and on Commission itself, which is sorting out its own power dynamics, as the close vote attested.
“No matter which side of the fence you fall on, it’s political,” said Commissioner Terry Hill, who voted against the ordinance although she has expressed reservations about the Board of Health’s actions.
The ordinance would dissolve the board and then reconstitute it as an advisory body. But even if it passes, the immediate impact could be minimal. Power over public health decisions would devolve to Dr. Martha Buchanan, the county’s health officer and director of the Health Department.
Buchanan sits on the Board of Health and has supported all of its pandemic orders — a point she raised to commissioners Monday night in urging them not to dissolve the board.
“I voted in favor of everything the Board of Health has done,” she said.
She noted that when she was directing the response in the early months of the pandemic, before the Law Department decided that power should rest with the Board of Health, she enacted the first wave of restrictions herself.
“I actually was the first to put in place a safer-at-home order,” Buchanan said. “And closed businesses, honestly, even before Governor (Bill) Lee did. It's not like things are going to change if the decisions are in my court.”
One of the peculiarities of the vote was that the commissioners supporting the ordinance voiced unequivocal support for Buchanan, while voting for the thing she said she didn’t want.
“I will support you 100 percent,” promised Commissioner Carson Dailey. “I may not agree with your decisions, but I'm telling you tonight I will support you, I will support your decisions.”
Buchanan recited some of Knox County’s recent statistics to commissioners: 8,782 new cases of COVID-19 since Dec. 1, and 70 deaths in the same period — an average of 3.3 deaths per day.
“I would say that deciding who has the authority to make decisions right now is like confronting a wildfire and arguing over who needs to hold the hose,” Buchanan said. “It’s not appropriate.”
The volunteer Board of Health is made up largely of local medical professionals nominated by their professional associations, along with Buchanan, Knox County Mayor Glenn Jacobs, a citizen representative and a representative from the school system. It was thrust into decision-making in June when the county Law Department opined that it had to approve any public health orders.
But even if the ordinance change were largely symbolic in the near term, it would be a victory for local anti-mandate activists and for a statewide movement led by a new group called Tennessee Stands. The movement is entwined with conservative politics. Its leader, Franklin resident Gary Humble, was a featured speaker in Knoxville recently at a post-election rally for President Donald Trump.
Humble also spoke to County Commission at its October meeting, where he was treated as a celebrity by the anti-Board of Health protesters in the crowd. He urged commissioners to dissolve the board.
Monday’s vote also signaled power shifts on Commission, albeit somewhat tenuous ones. The six commissioners who voted in favor of the ordinance were Ward, Dailey, Justin Biggs, Commission Vice Chair John Schoonmaker, Charles Busler and Richie Beeler.
Ward, who just joined Commission in September, has been an active rookie. He and Biggs have led efforts to rein in the Board of Health. Busler, Dailey and Schoonmaker also comprise an occasional alliance, with Beeler as a frequent adjunct. They are close to County Law Director David Buuck.
Ward and Biggs tend to be allies of Jacobs, while the Busler-Schoonmaker-Dailey axis has had some clashes with him. But four of the group — Ward, Biggs, Schoonmaker and Dailey — logged into Monday’s virtual meeting from the Main Assembly Room in the City County Building, where Commission typically meets. They were joined by Buuck.
Ward and Schoonmaker had objected to Commission Chair Larsen Jay making this month’s meetings virtual without consulting with the rest of Commission. Jay said the county’s soaring COVID-19 numbers made it the only safe thing to do.
The quartet of commissioners elected to go to their regular meeting space and join the Zoom link from there. Biggs had said he wanted to be there in case any members of the public showed up not knowing the meeting had been moved online.
Joining Hill in opposing the ordinance were Jay and Commission’s two Democrats, Dasha Lundy and Courtney Durrett. Jay, Lundy and Durrett have been the most consistent votes in support of the Board of Health over the past four months.
Commissioner Randy Smith abstained from the vote after failing in motions to delay either the first or second reading.
Jacobs is Buchanan’s boss, although he can’t supersede her health orders. He seemed tepid toward Ward’s proposal Monday night. He has often publicly disagreed with Buchanan and the Board of Health on pandemic restrictions, but he told commissioners he worried about the stress of placing all decision-making back on her.
“One thing I am concerned about … is putting a lot more pressure on her and what that would do to her personally,” Jacobs said. “That’s an issue for me.”
Ward did not speak much about his own ordinance, having laid out his concerns about the Board of Health in previous meetings. In essence, he said, he didn’t think an unelected board should have the power to impose mandatory orders.
“I support the five core actions,” Ward said, referring to the health behavior guidelines. “I support people wearing masks in public. I have strong confidence in Dr. Buchanan and her team. For me, it’s very simple. I’m a constitutional conservative, I think this is the right thing to do.”
Jay, arguing forcefully against the measure, reiterated the recent toll of COVID-19 in the county.
“While we were having this meeting, the White House today named Knoxville the number one city in the country for the spread of COVID,” he said, referring to a weekly report released yesterday by the White House COVID-19 Task Force. “Tennessee is the worst place in the world for the spread of COVID. And here we are discussing how to sideline professionals with expertise and knowledge on basic health and how to save our community.”
A Divided Forum
Before Commissioners began their debate, they heard from nearly 30 speakers during a virtual public forum. Holding the meeting electronically appeared to shift the balance of who signed up to speak.
In recent months during in-person meetings, Commission has attracted large crowds of mask-refusing anti-mandate activists. They have been allowed into the balcony of the Main Assembly Room despite the county’s mask mandate. They have typically dominated public forum.
But with Monday’s meeting online, the roster of speakers offered a broader range of views. Those supporting the Board of Health outnumbered those supporting Ward’s ordinance.
Many in the anti-mandate group logged in from a shared computer at the Press Room venue on North Broadway, where they had organized a prayer meeting. (Organizers said that as a religious service it was exempt from the county’s restriction on gathering size.)
“This is a middle ground that will unite the two sides,” said Andrew Flores, speaking in favor of the ordinance. “It is not taking away mandates — mandates will be there. It is shifting the power from the Board of Health to the health officer.”
Knoxville resident Gray Comer, on the other hand, asked commissioners to support the board. He cited reports that public health officials across the U.S. are resigning and retiring because of public anger and abuse over pandemic restrictions.
“This is a result of a sustained campaign against science, facts and common sense by a vocal minority that successfully use bullying tactics to browbeat various local and state governments into submission,” Comer said. “And this is precisely what the ordinance change proposed by Commissioner Ward would do.”
As the meeting wound toward a vote, Smith lamented the challenge of finding a common way forward in the county’s COVID response.
“What can we do that unites the people of Knox County in the best way,” he asked, “so that we can all work together and move forward through this epidemic?”
Hill said the same question troubled her. But she said that she did not think Ward’s ordinance was the answer.
“If we turn around and make a decision like this right now, in the midst of this crisis, when there's so much division that we already know about, it is not going to make any division or conflict go away,” Hill said. “In fact, I would suggest to you that it probably would only make it even worse.”