The Need and the Cure
By the 1980s, the Washington State Department of Social and Health Services was suffering from a structure that made little practical sense. When local health departments were moved into DSHS, Senator Lorraine Wojahn of Tacoma opposed the idea, believing that the provision of public-health services suffered. From the beginning of her legislative career in 1969, first in the House and later in the Senate, she worked for legislation to improve health services, particularly for children, women, and seniors. In her words:
It had been expected that when people were released from mental institutions or prison, the one-agency structure of DSHS would help guide them through follow-up social programs. Instead, the separate departments acted independently and became competitors for diminishing funds. Wojahn recalled:|"[W]hen we removed the local health departments, DSHS didn't do much of anything to support it, except I think there were some local contractors partially funded by the state, so we removed their authority. And it shouldn't have been merged with DSHS, I didn't think. I thought it was a huge mistake. Then they lost their mental health programs; it all went down the tube when we put them together" (Oral History, 454).
"I felt that DSHS was treating every problem as a social problem. A medical problem is not a social problem and social science is not a true science, but health care is. And we needed to have them separated; we should never have joined them" (Oral History, 452).
The complexity of shifting some DSHS duties to a new department also involved the state agency then known as the Department of Motor Vehicles. The proposed bill included a provision that changed the Department of Motor Vehicles to the Department of Licensing. The licensing of all medical professionals was shifted to the new Department of Health. To add to the complications, federal Medicaid money needed to remain with DSHS because it supported children's programs.
Building Support
Because Republicans held a majority of one in the 1989 Senate, Wojahn chaired no committees that year, but she held seats on the important Rules and Ways and Means committees. She worked on both Senate and House members to drum up support for the creation of a Department of Health having broad powers. In support, she pointed out things such as that regulating sewer systems was not just an environmental issue, but also a public health issue.
In the House, Representative Peter T. Brooks (1917-2012) of Walla Walla led the way in passing the first 1989 Department of Health legislation. The version first presented to Gardner closely mirrored this House bill, and he vetoed it. A special session of the legislature, called primarily to address tax reform, gave lawmakers the opportunity to make changes to the Department of Health bill. A second special legislative session was called by the governor and a bill more closely mirroring the Senate version, and in large part responsive to the governor's concerns, made it to his desk. This one he approved, but not in its entirety. In exercising a partial veto, Gardner expressed disappointment that the legislature had not allocated sufficient money to support all facets of the new department, and he eliminated provisions of the law for which there was no funding.
The Department of Health
Functions transferred to the new Department of Health from the Department of Social and Health Services, the State Health Coordinating Council, and other agencies included personal-health and prevention programs such as immunizations; treatment of tuberculosis, sexually transmitted diseases, kidney disease, and AIDS; diabetes control; primary health care; cardiovascular-risk reduction; and newborn metabolic screening. Also included were environmental-health-protection services, the establishment of a public-health laboratory and public-health support services, and parent and child health services.
The bill called for the appointment of a secretary of health, as well as advisory committees needed to implement the workings of the new department. A 10-member board was established that included the secretary or secretary's designee and nine members appointed by the governor. Four of these were to have experience in health and sanitation -- an elected city official who was a member of a local health board, a local health officer, and two members representing the consumers of health care. The board's chairperson was to be selected by the governor from among the nine appointees.
Creation of the Department of Health stands as one of Senator Wojahn's signature accomplishments during her 32-year legislative career. She was present at Governor Gardner's signing of the bill on May 31, 1989, joined by staff members, including intern Kathy Lynn, Myra DeLaunay (1926-2002), Evie White, and Dr. Robert Atwood, for an official photo with the governor.