State public health rules make it difficult for a coordinated response to KC

In March 2020, as COVID-19 started to overwhelm the country, Kansas City subway health officials have acted step by step.

CORE 4 – the name of the pandemic partnership between Kansas City and Jackson County in Missouri, and Johnson and Wyandotte counties in Kansas – came together early to shut down businesses and ultimately issue a broad stay-at-home order. .

The coordination came at a time when Kansas and Missouri state officials had yet to act. Local authorities said they wanted to send a clear message and avoid confusion between states and counties. The quick action probably saved lives.

“We don’t live on an island here in Kansas City,” Mayor Quinton Lucas said in June 2020.

But such concerted action will be more difficult to implement in future emergencies.

State lawmakers, concerned about government overreach and under pressure from business groups, have stripped local public health officials of much of their near-one-sided power. Changes to emergency management laws in Kansas and Missouri have established a new set of rules for the next health crisis.

Local health officials in both states, approval from elected city and county councils will now be required for business closures longer than 30 days and other measures intended to disrupt the spread of the disease.

Sanmi Areola, the director of public health for Johnson County, lamented how public health had become involved in politics. Coordination at the start of the pandemic, he said, was “absolutely critical” for effective messaging and public compliance with masking and distancing as well as the closure of schools and businesses.

Now he has no authority over schools and will need approval for business closures, limit collection and mask warrants. Preventing future public health crises, Areola said, will be a challenge under the new laws.

“It will definitely be more difficult to move forward. In public health, if we wait for what we think is happening, it is too late. “, did he declare. “And that’s why it’s hard for people who aren’t trained to see that our job is to prevent bad things from happening.”

Lisa Tremmel Freeman, CEO of the National Association of City and County Health Officials, said “every minute counts” in a public health emergency. The general public, Freeman says, often doesn’t realize how quickly public health officials act before a potential emergency reaches the COVID-19 ladder.

“They come up all the time and you just don’t hear about them and the reason is that public health is doing its job,” Freeman said. “If Ebola were to reappear and the dangers of it could not be dealt with quickly by public health officials, consider the terrible consequences for the country. ”

Lucas said it more bluntly. “If there was an Ebola outbreak in Kansas City tomorrow and it spreads quickly, do you want to wait 3 weeks’ notice and public comment, or are you going to take action? Although Ebola is not as easily transmitted as COVID-19, it is much more deadly, with death rates of up to 90%.

In Missouri, Kansas and other states, decisions have been made that will slow down the whole process, Freeman said. Those decisions, she said, did not take into account another type of pandemic or public health emergency.

Local health officials in Kansas cannot take any action without the convening of a local governing body. In addition, any order approved by a local body may be contested by affected residents or businesses. Parts of the Kansas law surrounding court challenges may soon be overturned by a Johnson County judge.

While Missouri officials can take action faster, their decisions can be overturned at any time by a municipal or departmental council with a simple majority vote, and must be extended by the council every 30 days. The law specifically mentions capacity and attendance limits, but applies to any health ordinance that “directly or indirectly closes, partially closes or imposes restrictions on the opening or access to” businesses, schools or churches.

In Kansas City and Jackson County, public health orders on businesses last year included capacity restrictions and rules requiring entry of masks.

Parson signed the bill last week in Jefferson City, flanked by representatives of the restaurant industry.

He said that while he supported local control, “there had been overbreadth at the local level” last year. He relied on limitations on private gatherings and the ability of residents to attend church among them.

“There are freedoms that outweigh the consequences,” he said.

For health authorities in multiple counties, the law requires approval from the city or county council of each health service jurisdiction, essentially eliminating the coordinating ability of a group like CORE 4 to act uniformly in the metro. of Kansas City.

“The moment one of them decides we maybe don’t want to do this anymore, we can have that reverse domino effect where it then puts pressure on your elected officials” in a neighboring county, “said Dr Rex Archer, director of the Kansas City Department of Health.

“If we do this in one jurisdiction, people can just go to another jurisdiction to work or participate in these businesses. This problem of playing each jurisdiction against each other is really going to bother us. “

CORE 4 coordination was clearest at the start of the pandemic. In joint statements and press conferences, health professionals described almost identical stay-at-home orders and business closures.

As the metro began to reopen, jurisdictions began to diverge. KCMO and Wyandotte County were the first to implement mask orders, but were followed weeks later by Johnson and Jackson counties.

In the fall, as cases of COVID-19 began to increase, each locality took a slightly different approach to imposing new restrictions. Likewise, the lifting of the restrictions in the spring has been phased in. Johnson County was the first to withdraw its mask mandate by a county commission vote but it was quickly followed by other jurisdictions.

Throughout this, Areola said, local health officials have always met and coordinated the messages and overall goals.

Rep. Fred Patton, a Republican from Topeka who helped draft the Kansas emergency management bill, acknowledged there would be obstacles to working with the new rules, but said it would still be possible .

“It’s a challenge when you try to get the governing bodies to work together because one sees a situation one way and the other sees it a different way,” he said. “But often, whether it’s a pandemic or economic development, they put those differences aside and do what’s best for the region.”

Despite the initial coordination, Bill Teel, executive director of the Greater Kansas City Restaurant Association, said the rules were not applied uniformly in all jurisdictions.

For example, Johnson County accepted plexiglass as a replacement for indoor social distancing, unlike Kansas City. And as the restrictions were lifted and then reimposed in the summer and fall, each county offered slightly different time and capacity restrictions.

Teel said he wanted business owners to have a stronger voice during the early days of the pandemic and believed the new rules in Kansas and Missouri would ensure that.

“As restaurateurs, we were very aware of the risks and what was needed to operate safely,” said Teel. “I don’t know if they didn’t trust us or if they just wanted to be more restrictive, but I felt like they were more restrictive than they needed to be.”