Last week, the House Civil Judiciary Committee approved Rep. Chris Kannady’s House Bill 2504, which would restructure the Tulsa and Oklahoma county health boards, giving the state more power in how they work.

The bill reorganizes the health boards, giving the state health commissioner (and his boss, the governor) a seat at the table.

The state commissioner also gets what amounts to a veto over who the local board can hire as its executive director and the power to ask for the firing of any executive director he doesn’t like.

The bill also prevents the local health board from asking county commissioners to pass any health rules that are any stronger than the low-bar rules set by the state.

That’s not a huge issue because cities pass most of the important health rules, including the controversial COVID-19 pandemic’s mask ordinances, but it’s still a shot across the local board’s bow, and reduction of its authority.

Last week, a Tulsa World editorial outlined concerns about how the bill would weaken the autonomy of our local health board and suspicions that the bill is political payback for Tulsa Health Department Executive Director Bruce Dart’s strong voice during the pandemic, especially his comments about the public health concerns raised by President Donald Trump’s Tulsa rally this summer.

But there’s another issue that also speaks against HB 2504, and it should concern every Tulsa County taxpayer.

The proposal changes a long-standing inplicit deal with the people of Tulsa County and makes them pay for less than they bargained for.

Decades ago, the Legislature set up a three-headed public health system in Oklahoma. Tulsa and Oklahoma counties administer their own programs. The state health department takes care of the rest of the state.

In exchange for that local autonomy, the property taxpayers in the state’s two largest counties essentially pay for their own departments.

The Tulsa City-County Health Department has an annual budget of about $32 million.

About half of that is paid for with a small slice of your county property taxes, currently 2.58 mils. The health department’s millage has hasn’t risen in decades.

Most of the rest of the local health department’s budget comes from grants and federal funding, much of which flows through the state but doesn’t involve a penny of state taxes.

The local health department gets a small sliver of state appropriations, about $3.9 million, which is earmarked to fund the Children First program that sends specially trained registered nurses to work with first-time mothers.

The bottom line is this: The state doesn’t pay for the vast majority of the operating costs for Tulsa County’s health department. It pays for none of it, except for one program.

In fiscal year 2021, the state Health Department had a $811.6 million budget ($71.4 million of it from legislative appropriations).

About 34% of that money was dedicated to community health services, largely through the 68 organized county health departments.

Other than that Children First funding, Tulsa and Oklahoma counties did not receive any state funds. That money went a lot further in rural Oklahoma because it didn’t go to the two biggest population centers, which are paying their own freight.

(By the way, taxpayers in Tulsa and Oklahoma counties still pay the same state taxes as everyone else. If you do the math, you’ll find that most of the appropriations going to rural health programs are coming from urban taxpayers who see none of its services.)

For a long time that’s been the deal, and it’s worked well.

Tulsa has a good health department that attacks local issues and makes long-term plans to improve local health outcomes. Our children get vaccinations, and our restaurants are clean. Often, the local health department has led the way for programs that are well ahead of the state’s efforts.

Our local public health programs certainly wouldn’t be any better and probably would be a lot worse if it were being run by the state. Remember, the state health department was essentially bankrupt a few years ago because no one knew where its money went.

Now the Legislature wants to change that bargain.

Tulsa County taxpayers will still get to pay for the local health department, but the control will be shifting toward Oklahoma City.

There’s no doubt, the Legislature has the authority to do that, but every Tulsa County taxpayer should scream if it does so.

Word of the week: Imprimatur: The official seal of approval, often used derisively (by editorialists) in reference to arrogant bosses or bureaucracies. A friend and consistent email correspondent suggested this one about the same time I ran into it in Robert Caro’s absurdly long biography of Robert Moses, “The Power Broker.”

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