Commission Dissolves Board of Health

Martha Buchanan

Commission Dissolves Board of Health

Mask mandate, other regulations up in the air as public health authority shifts back to the county health director.

by jesse fox mayshark • March 30, 2021


Dr. martha buchanan speaks to the media after monday night's county commission meeting.

Knox County Commission voted 8-3 Monday night to abolish the county’s Board of Health, a largely volunteer board made up of local health professionals that has been guiding the county’s response to the COVID-19 pandemic.

An 8-3 vote shows how partisan and politicized public health has become.
The board will be reconstituted as a strictly advisory body. Under Gov. Bill Lee’s pandemic executive orders, power to set public health regulations will now shift to Dr. Martha Buchanan, director of the county Health Department. It was unclear after Monday’s meeting exactly how that transition will take place.

“I need to meet with the law director to understand what the ordinance means, meet with the (county) mayor to understand where we are in that, and look at how to move forward,” said Buchanan, who serves on the Board of Health herself and has supported all of its COVID-19 regulations.

The ordinance revision adopted by Commission does not take effect for 15 days under the county charter. Buchanan said she believes that means the board’s orders — including the countywide mask mandate in public indoor places and a 1 a.m. curfew on restaurants and bars — will remain in effect for that period.

“That would be my assumption, but I’m no legal scholar,” she said, adding that she will talk to Law Director David Buuck for clarification.

After that, Buchanan would have to issue her own orders to extend or enact any restrictions.

Public protests against those regulations began late last summer, and gradually won over members of Commission as anti-mask activists packed the balcony of the Main Assembly Room month after month and railed against the “unelected bureaucrats” on the health board.

Some of those protesters were back Monday night, running through complaints during public forum that they acknowledged were by now familiar.

“I realize we're here at the point now to do what needs to be done,” said Kevin Hill, one of the organizers of the group. “I want to remind you, this can’t happen again.”

Warning of ‘Embers’

Commissioners passed the ordinance on first reading in December, even as Knoxville was being designated as one of the nation’s leading COVID-19 hotspots. But commissioners delayed the second reading in January, initially until April, before voting last week to bring it back this week instead.

The first reading passed by only 6-4-1, but last night commissioners Terry Hill and Randy Smith — who initially voted against it and abstained, respectively — both switched to yes votes.

In a text message after the meeting, Hill said that a “combination of vaccines, lower cases and drop in hospitalizations leads me to feel the timing was favorable. I did not feel comfortable at all 60 days ago given the data at that time.”

Knox County’s active cases and hospitalizations have dropped significantly from December and January, and the death toll has slowed its pace. Case rates appear to have reached a plateau, however, with the county registering between 50 and 100 new cases eight of the last 10 days.

Across the country, many places that had seen sharp decreases are now seeing numbers rise again. Dr. Rochelle Walensky, the new director of the federal Centers for Disease Control and Prevention, said during a news conference Monday that the recent numbers give her a sense of “impending doom.”

That was among the reasons that Commission Chair Larsen Jay gave Monday night for his opposition to the ordinance change, which was proposed by Commissioner Kyle Ward.

“While it’s encouraging to see vaccinations are up and cases down, I don't believe the forest fire has yet been fully extinguished,” Jay told his colleagues before the vote. “There are still hot embers, and as a former Boy Scout, I know you never leave a hot fire unattended and simply walk away.”

But Jay was the only Republican on Commission to vote no, joining its two Democrats, commissioners Dasha Lundy and Courtney Durrett. Besides Ward, Hill and Smith, the Republican commissioners voting in favor were Vice Chair John Schoonmaker, Charles Busler, Richie Beeler, Carson Dailey and Justin Biggs.

The degree to which public health has become a partisan issue during the pandemic was reinforced by a fundraising email sent out immediately after the meeting by the Knox County Democratic Party, with the subject line, “The GOP just DISSOLVED the Health Board.”

Board Reactions

As for the Board of Health itself, the new ordinance reinstitutes it as an advisory body, apparently keeping its membership intact. But it is unclear whether that means members will begin new terms or continue their old ones, or even how many of them will want to stay.

Dr. Patrick O’Brien, a colonel and chief medical review officer in the U.S. Air Force National Guard, sent commissioners an email Monday saying he would not continue to serve on an advisory board.

“I do not feel I can adequately serve in this newly established advisory role,” he wrote. “It was an honor and privilege to serve on the Knox County Board of Health with my fellow board members, but I feel as though given the direction that has been set by the Knox County Commission, it is time for me to step aside and focus my time and energy elsewhere.”

On the other hand, Dr. Maria Hurt, a clinical assistant professor in the University of Tennessee’s College of Nursing, said in a text message after the meeting that she would be willing to continue on the board.

“I hope the Board of Health can continue to serve our community in some fashion — we shall see,” Hurt said. “However, I believe we rose to the occasion under incredible circumstances, and that legacy is good enough for me.”

She noted that the board had not set out to manage the pandemic and was thrust into that position last June by the county Law Department, which determined that the board should be in charge rather than Buchanan. Commission’s vote last night effectively returned the county to where it was from March to June of 2020, with Buchanan leading the response.

Ani Roma, the citizen representative named to the board last fall, also said she would be willing to continue: “I will serve in any way I can.” Other board members could not be reached last night. The board’s next scheduled meeting is April 21, which would be after it will legally cease to exist in its current form.

Jay saluted the board members during his statement Monday night, saying, “These are community volunteers who have dedicated a lot of their time and have been treated fairly poorly during the last year.”

But in a sign of Commission’s general exhaustion with the whole topic, which has occupied the body for most of the past seven months, no other commissioners made statements either supporting or opposing the ordinance.

One effect of the vote will be to make proposed legislation by state Rep. Jason Zachary essentially meaningless for Knox County. Zachary, R-Farragut, is pushing a bill that would make boards of health across the state advisory-only. Its prospects for passage are uncertain, but since Knox County will no longer have a Board of Health as defined by state law, the bill would have no impact here anyway.