Iowa Department of Public Health Director Mariannette Miller-Meeks on Friday reversed plans to eliminate the top administrator’s position at the Division of Tobacco Use Prevention and Control. Her comments came several hours after Democratic State Senator Jack Hatch predicted “legal action” to challenge the way IDPH downsized its smoking prevention programs.

Early last week, news broke that Bonnie Mapes was out after a decade as administrator of the IDPH Division of Tobacco Use Prevention and Control. Democratic State Senator Herman Quirmbach accused Miller-Meeks of firing Mapes, but Mapes said she took early retirement when her position was eliminated. The 2012 Iowa budget sharply reduced state funding for anti-smoking programs. A major advertising campaign aimed at preventing young people from starting to smoke will be scrapped. Miller-Meeks said work on smoking cessation and prevention may be integrated into other branches of the IDPH, such as the Division of Behavioral Health and the Bureau of Chronic Disease Prevention & Management.

At a meeting of the Tobacco Use Prevention and Control Commission on August 5, Quirmbach and Hatch charged that Miller-Meeks violated state code when she eliminated Mapes’ position.

“There’s a law and everybody has to obey the law,” Quirmbach, a non-voting member of the state’s Tobacco Use Prevention and Control Commission said Friday. “This is not something that one has any discretion over. The law is clear.”

Hatch, co-chairman of the Legislature’s Health and Human Services Appropriations Subcommittee, threatened legal action Friday against Miller-Meeks in her capacity as public health director if the situation isn’t remedied.

“She’s in violation. If she doesn’t change shortly, then I’m sure there will be legal action,” Hatch said. “The only legal action you have left … is sue her in district court. Any citizen can do it, the commission can do it, a legislator can do it. It will not go unnoticed.”

IowaPolitics.com quoted a written statement from Miller-Meeks:

“The department received counsel from the attorney general’s office as we explored the options available to meet the Legislature’s and commission’s priorities of funding the Quitline and community partnerships,” Miller-Meeks said in the statement. “The department’s actions are within those statutory requirements.”

Here is the relevant portion of the Iowa Code. Section 142A.5 states that the IDPH director must “Establish and maintain the division of tobacco prevention and control” and “Employ a separate division administrator […] in a full-time equivalent position whose sole responsibility shall be the administration and oversight of the division.” Miller-Meeks had named Dr. Patricia Quinlisk as interim director of the Division of Tobacco Use Prevention and Control following Mapes’ departure. Quinlisk is already Iowa’s state epidemiologist and the medical director for the IDPH.

Speaking for the Attorney General’s Office, Geoff Greenwood told the Des Moines Register on August 5,

“We feel the statute is very clear. We did not advise that an Iowa Department of Public Health employee with significant other duties could serve as the tobacco division administrator,” said the spokesman, Geoff Greenwood.

In a phone interview Friday evening, Miller-Meeks said she had misinterpreted the statute. She said she would find another interim administrator, whose sole duties would be to run the tobacco division. She said the person’s pay would probably be significantly less than Mapes’, because the new administrator would oversee fewer employees.

Miller-Meeks confirmed last week that she may ask the Iowa legislature to pass a bill dissolving the separate IDPH division for anti-tobacco efforts. She argued that many other states already combine smoking cessation and prevention with other aspects of public health policy. It’s clear that Hatch and Quirmbach will fight any such legislation during the 2012 session.

I don’t think the bureaucratic structure within the IDPH is as important as the amount of money allocated to Quitline and other anti-smoking programs. Smoking contributes to most major public health problems. If the IDPH can continue work on reducing the smoking rate without having a separate division to coordinate those efforts, I am open to that change. Iowa has the second-lowest percentage of adults who smoke in the U.S., but there’s always room for improvement.

Iowa House Republicans sought to eliminate state anti-smoking funding during the 2011 session. If the GOP gains control of the Iowa Senate in the 2012 elections, I would expect a strong push the following year for eliminating not just the Division of Tobacco Use Prevention and Control, but all the IDPH programs that currently focus on smoking.