Mississippi’s troubling position near or on the bottom of most good health measures nationwide requires a sharply focused and outcome-proven state public health department.

More than reasonable doubt exists that the Department of Health, its governing board and top administrator are getting the job done.

Sen. Alan Nunnelee, R-Tupelo, chairman of the Public Health Committee, introduced a bill that would reconstitute the state Board of Health with seven members and, in effect, hand the state health officer, Dr. Brian Amy, his walking papers.

Nunnelee — who held public hearings in late 2006 about the department’s performance, with subpoenaed witnesses offering sworn testimony — is using the mandated expiration (called “sunset”) of the department’s existence as the opportunity for major restructuring.

Nunnelee said a fresh start is needed to rid the board of alleged conflicts of interest so that it can operate as a smaller, more manageable, seven-member body. Two members would be selected from each of the three Mississippi Supreme Court districts, with a “consumer” member appointed at-large. At least one member from each of the three districts would be a physician. The governor would appoint four members, and the lieutenant governor would name three members.

The state health officer — who is the department’s chief executive — would be appointed by the governor, with Senate confirmation.

Nunnelee makes a strong case for starting over with a new board structure. Hearings held last summer and fall revealed widespread dissension within the 2,100-employee agency. Director Amy’s performance has been called into question by some board members and several legislative leaders.

Nunnelee said an officer of the Legislature’s chief investigative arm, the PEER Committee, calls the department a “beautiful facade as thin as an egg shell.”

Nunnelee probably will find significant support for many of his reforms, but winning approval, especially in the House, of a governor-appointed chief health officer will be a tough sell.

Effective reform probably is achievable without that provision, if it becomes a stumbling block. If the board is purged of financial and regulatory conflicts of interest, a new board could be trusted to select a competent health officer.

The sun won’t set on the agency until June 30, and plenty of time remains before legislative deadlines push a final action. The facts have been laid on the table by both the PEER Committee (in its 2005 report) and legislative hearings.

The 2007 session should not end without adoption of reforms eliminating conflicts of interest, nepotism and toleration of any standard that’s less than measurable quality and progress.