In the News

Semi-independent Tacoma-Pierce Health Department is part of long American tradition

December 10, 2020
Michael Mirra | Op-ed in Tacoma News Tribune

The proposal by Pierce County Council members Pam Roach and Doug Richardson to change the Tacoma-Pierce County Health Department into a county executive department poses interesting questions of governance and accountability.

As The News Tribune reports, they seek to give the “people . . . more control and influence” of TPCHD through their elected council members.

This is an important civic value. Yet, as a description of how American governments function, or should function, it is incomplete.

There is another tradition and practice, also deeply embedded in American governance and responsible for some of this nation’s most notable public achievements. It is the role of semi-independent public authorities, including health departments.

Public authorities date from the early 20th century. Governments at that time were undertaking large or complex functions understood to need some insulation from the oscillations and pressures of politics. This was thought necessary for several reasons.

The first reason arose from projects that would take a long time and need protection from electoral cycles to allow for their long-range planning and financing.

Two other reasons have a particular pertinence to the Health Department. A measure of independence was thought necessary for activities that cross political jurisdictions and need cross-jurisdiction coordination without domination by any one jurisdiction. TPCHD, for example, serves Pierce County and all of its cities and towns.

Also, an independence was thought valuable for functions that require technical expertise that should not be subject to politics, such as engineering, science or public health.

Early prominent examples of public authorities include the Port of London Authority, created in 1909; the Port Authority of New York and New Jersey; the Tennessee Valley Authority; and the Bonneville Power Administration.

Public housing authorities, like Tacoma Housing Authority, which I help lead, also come from this tradition In part that’s because our job includes the technical expertise and long-range work of real estate development, financing and property management — duties that would be risky without a measure of stability that comes from an independent status.

The Health Department comes from this same tradition. It requires a highly specialized expertise offered across political jurisdictions. Its effectiveness requires a high degree of public confidence in that expertise. Such confidence is more likely if the expertise has some independence from political consideration.

There is nothing quite like a pandemic to show why this is important. The damage that happens without this independence or confidence was on full display when President Trump muzzled the expertise of the National Institute of Allergy and Infectious Diseases, led by Dr. Anthony Fauci.

In contrast, Pierce County has been fortunate to have the expert, steady and independent judgment of its Health Department and its fine director, Dr. Anthony Chen.

Tacoma Housing Authority has benefited directly. Three examples stand out for us. First, TPCHD led us to become one of the first large Pierce County portfolios of residential property to go completely tobacco free.

Second, TPCHD helped us fashion a responsible response to meth contamination and helped the state update its regulations defining contamination levels.

Finally, and most pertinent today, the Health Department is helping us manage through the pandemic in ways to keep our staff, tenants and clients safe.

Public authorities still need, and do have, an adequate measure of accountability to the public, in various ways. First, they remain decidedly public agencies. This means they are subject to the Open Public Meetings Act, the Public Disclosure Act and other public safeguards.

Perhaps more important for the concerns raised by Roach and Richardson is that elected officials either serve on or appoint their governing boards, and provide funding.

In that way, their governance is a mix. It reasonably balances an independence with public accountability.

This balance has served the public well. It is not clear why disrupting this balance, and doing it in a rush, must happen in the depths of a worldwide and worsening respiratory contagion.

This op-ed originally appeared in the Tacoma News Tribune.