Madison County residents packed Monday’s commissioners meeting to voice strong opposition to a proposed power shift at the county’s Board of Health.
In May, commissioners voted to begin the legal process to dissolve Madison’s health board and have elected leaders assume direct control (rather than make appointments). A state law that went in effect in 2012 permits commissioners to eliminate boards of public health, which act largely in an advisory role. If finalized, the move would eliminate Madison County’s 11-member Board of Health — currently composed of local medical professionals, including a doctor, nurses, a pharmacist, a veterinarian and one commissioner.
According to the UNC School of Government, local boards of health serve as the governing and policy-making bodies for public health services in their jurisdictions. These boards typically include health professionals and representatives of the general public, and are designed to provide oversight that is independent of day-to-day political decision-making. While North Carolina law allows counties to transfer those powers to the board of commissioners, such moves require formal action and the creation of an advisory committee that mirrors the original board’s membership.
As of now, fewer than 40 of North Carolina’s 100 counties have made the switch.
What’s at stake
Physician and former board member Dr. Shannon Dowler was among those urging commissioners to reconsider.
“Moving the Board of Health to the commissioners actually increases liability… and it creates a tremendous conflict of interest,” she said during public comment. “This move creates tremendous vulnerabilities. Separating community health from local politics is critical.”
Residents offered praise for the current health department’s leadership and track record — including improvements in birth outcomes and communicable disease prevention. One veterinarian noted the department’s success in protecting residents from rabies exposure, while another speaker warned that the change could lead to the loss of trained staff.
“I do not see the need to restructure the governance of the health department,” one resident said. “Will we lose more positions that are vital to its operation?”
Other speakers called the proposal a partisan power grab, comparing it to recent moves by commissioners in nearby counties to assert control over public libraries.
Dr. Jenny Barnhardt, a longtime Marshall resident, urged commissioners to keep politics out of public health.
“The main thing I want to underscore is to ask you all not to make our health department a partisan endeavor,” Barnhardt said. “I'm asking you to keep the Board of Health intact with its current duties.”
Still, a few residents expressed confidence in the commissioners. Cindy Davidson of Big Laurel said she trusted their judgment.
“You all already are overseeing the county and you've done a good job,” Davidson said. “So you have my total support.”
A public hearing and final vote are expected at the board’s next meeting in July.
