The Gallatin City-County Board of Health has approved a local mask mandate that largely aligns with an existing statewide order, despite hearing Friday from dozens of residents who disagree with requiring face coverings.

Gov. Steve Bullock issued an order last week requiring most people to wear masks in most public settings but allowed local governments to enact their own more restrictive rules.

The local health board passed a rule on Friday that diverged in several ways from the statewide rule.

The local rule says that those who don’t comply can be charged with a misdemeanor. The statewide rule doesn’t include specific penalties for not wearing a mask but instead says that those who don’t comply can be asked to leave a business or can be charged with trespassing or other crimes.

Even though people could be charged with a misdemeanor in Gallatin County for noncompliance, the health department has said it will focus on education rather than enforcement.

Bozeman Police Chief Steve Crawford has said, if necessary, the police will issue citations to those who don’t wear masks, while Gallatin County Sheriff Brian Gootkin has said sheriff’s deputies will not.

The local rule, unlike the state rule, also requires masks in schools for students above the fifth grade. The Bozeman School District and Montana State University have already said they will require masks.

The local rule focuses on requiring masks in public indoor settings. It also says they must be worn at construction sites when social distancing isn’t possible. Construction sites have been connected to several coronavirus cases in the county, including a cluster in Big Sky.

Children younger than 5 and those with certain medical conditions are exempt from the rule.

Health officer Matt Kelley asked people not to confront others for not wearing masks and instead leave the area or quietly alert an employee. People can also contact the health department call center at 406-548-0123 but shouldn’t dial 911, which is reserved for emergencies.

The board approved the local rule on a 7-2 vote.

Those who supported it cited research indicating face coverings can limit transmission of COVID-19. They acknowledged that the public health consensus has changed over the last several months as knowledge about the virus has grown and more personal protective equipment has become available.

They also said masks are simple and inexpensive and less disruptive than other regulations like stay-at-home orders.

Several board members said their role is to protect public health, even if it restricts personal liberties.

Board member Joe Skinner, who is also a Gallatin County commissioner, voted against the local rule because, he said, the health board and law enforcement don’t have the resources to enforce it and because there isn’t conclusive scientific evidence on the benefit of wearing masks.

Board member Justin Kamerman also voted against the rule, calling it “too divisive.” He said he wouldn’t comply.

Dozens of residents spoke out at the meeting against the local rule.

They accused board members of cherry-picking evidence to support a mask mandate and criticized them for not presenting any scientific evidence that indicates masks might be ineffective or might harm people by limiting their breathing.

Others questioned the seriousness of COVID-19 as compared to other illnesses like the flu and called into question the accuracy of the data the health department provides about the virus.

Some said a mask mandate violated their constitutional rights. One even threatened to sue board members who voted for a mask mandate.

Several said they have medical or mental health conditions that exempt them from the mask requirement but said they have been harassed and no longer feel comfortable going out in public.

Only a few people spoke in favor of masks, citing scientific evidence that widespread mask usage can limit the spread of COVID-19 and saying the concerns about masks are overblown.

Thousands submitted written comments over the last few weeks in advance of Friday’s meeting, including hundreds speaking both for and against the rule.

Health officer Kelley said a mask mandate is important given the increasing number of cases, hospitalizations and deaths nationally and locally.

Gallatin County reported 45 new cases on Friday, the biggest increase since the pandemic began. There are now 103 active cases in the county with four hospitalizations. One person has died.

Gallatin County now sees about 20 new cases each day, which is difficult for the health department’s contact tracers to manage, Kelley said, especially because the new cases each have a high number of close contacts associated with them.

The health department’s contact tracing team is moving into a single facility and plans to use new software to increase efficiency, he said. The health department may also hire additional contact tracing staff.

Kelley said the increase in new cases worries him because the tourism season is well underway, local schools are preparing to reopen and MSU students will soon be returning, all of which could further increase cases.

The testing of symptomatic individuals and their close contacts is still “working relatively well,” Kelley said. The health department typically receives test results in one to three days and is able to follow up with those who test positive the following day.

However, surveillance testing of asymptomatic people is taking too long. Quest Diagnostics, the private lab that the state has contracted with for surveillance testing, is overcapacity. To replace Quest, MSU and a North Carolina facility will begin processing these tests next week.

On Friday, the health board also extended the county’s rule that requires symptomatic people awaiting test results and those who have been identified by the health department as a close contact of someone who has tested positive to self-quarantine. The rule also says those who have tested positive must remain isolated until they are no longer contagious.

The rule is now in place until Oct. 22.

The board passed the rule 8-1, with Kamerman voting against it.

Those who provided public comment raised concerns that the rule gave the health department too much power and could be abused.

Kelley said the health department has not yet needed to use the rule and does everything it can to get people to comply voluntarily.

The Gallatin City-County Board of Health initially met last Tuesday to decide whether to require masks but moved the meeting because some attendees refused to listen from another room, a violation of state restrictions on large gatherings.

The following day, Bullock issued a statewide mask mandate.

The board then reviewed Bullock’s rule and drafted a new local rule before holding Friday’s meeting.