The Utah Legislature voted Thursday to ease the public health credentials required for the state’s Health Department head, clearing the path for the governor to institute a new leader whose background did not fit the previous requirements.
State law doesn’t require a medical degree for the position but mandated that a nonphysician must have a master’s degree of public health or public administration or have at least seven years of professional experience in public health, with at least five of those in a senior level administrative position, according to the law.
SB6006, sponsored by Sen. Allen Christensen, will ease those statutory requirements so the executive director would only need to work for five years in public health and spend three of those in a leadership position — making Richard Saunders, who took over the Utah Department of Health earlier this month on an interim basis, eligible for the post.
Asked for the justification of changing those requirements, Christensen replied: “Plain and simple, that’s to accommodate Mr. Saunders.”
Several House and Senate lawmakers raised concern during floor debate about diminishing the standards for the post for a specific candidate.
Rep. Suzanne Harrison, a physician by profession, argued that the legislation sends the wrong message and could erode the public’s trust in state leaders during the health crisis.
“I have real concerns about changing and lowering the bar for the department of health leadership in the midst of the most unprecedented pandemic of our lifetimes,” the Draper Democrat said. “We need someone with the training and experience to be able to understand and truly advocate for the health of the public.”
She joined 14 Democrats and one Republican in opposing the measure in the House.
Sen. Luz Escamilla, who was one of four Democrats who voted against the bill in the Senate, said the Legislature has had “a history with this department of changing the bills or changing the statute every time we want to accommodate someone.”
“I actually happen to think that’s probably not the best way of moving with public policy,” she said.
Other lawmakers argued, though, that the Health Department director needs more management and administrative skills than medical expertise in order to successfully run a department that controls one of the state’s largest budgets.
“We need a strong leader in there to lead up that huge department with a lot of employees,” said Christensen, R-North Ogden. “Physicians are great physicians. They’re not necessarily great managers.”
Of the six states that surround Utah, he said only Arizona has a physician currently in charge of its health department.
The original version of the legislation would have given Saunders the ability to choose a nonphysician as deputy director of the department. But an amendment approved on the Senate floor maintains that a director who is a nonphysician must have at least one deputy director who is a physician with experience in public health and who is licensed to practice medicine in the state.
That was enough to appease the Utah Medical Association, which had previously spoken against the bill.
“They were concerned that we were losing the medical point of view at the Health Department and when people ask questions is a person who is not a physician going to be able to answer them?” Christensen noted during floor debate. “That’s why we put the deputy director there as a physician and that made them happy with that change and they said with that they can support [it].”
The bill would allow a nonphysician executive director to select a second deputy without a medical degree, so long as the person had graduate-level schooling in public health and at least five years of experience in the field.
Sen. Evan Vickers, R-Cedar City, said he thought the amended bill struck the right balance to ensure the department has both medical and administrative expertise.
“From time to time I think there really does need to be [in] an organization like the Department of Health someone that can really be a manager and step in and reevaluate programs, reevaluate physicians, reevaluate structure and I think this is an opportune time to do that,” he said. “At the same token, I feel strongly that there needs to be medical professionals, especially a physician, near the top.”
Dr. Joseph Miner, a physician who spent more than three decades leading the Utah County Health Department, has headed up the state’s Health Department since 2015. Early on in the pandemic, though, Miner was reassigned to work at home because of health issues that make him more susceptible to COVID-19.
With Miner telecommuting, Gov. Gary Herbert in late March installed the former leader of the Utah National Guard, Adjutant General Jefferson Burton, to lead the Health Department’s day-to-day response to the coronavirus. Burton, who’s also running for a seat in the Utah House, directed the agency’s coronavirus response for several months.
Saunders had been working as Burton’s chief deputy during the pandemic and took over as interim executive director of the health department on Aug. 1, he told a legislative subcommittee Monday. Miner is serving as the agency’s chief medical adviser.