Local health officials from Nevada’s two largest counties have written a letter of complaint to Gov. Steve Sisolak alleging they’ve been shut out of decision-making for coronavirus restrictions.

In a scathing joint letter, officials from the Southern Nevada Health District and Washoe County Health District said that not including them in the state’s COVID-19 directives has led to a chaotic local response. They say they’ve been forced to change plans based on the governor’s decisions with little or no notice.

“Since we are not consulted and engaged, we receive little or no advance notice of what these policy changes may be, and we are forced to react after decisions have been made and announcements are occurring,” the letter said.

The letter also said Sisolak, a Democrat, seemed to be consulting with outside groups rather than local health officials about his directives.

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The letter was signed by SNHD Chief Health Officer Fermin Leguen, Washoe County Health Officer Kevin Dick, Southern Nevada District Board of Health Chairman Scott Black and Washoe County District Board of Health Chairman John Novak.

Sisolak spokeswoman Meghin Delaney said the governor’s office is disappointed that the claims raised in the letter were not brought up during regular communication with state and local officials.

Still, Sisolak’s chief of staff Michelle White plans to host a meeting to discuss the issues raised in the letter, Delaney said.

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White also pushed back on claims of exclusion, according to the Las Vegas Review-Journal, writing in a response letter that the governor’s office has “regularly been in touch with and held robust conversation with elected officials in both Clark County and Washoe County — who purport to represent their communities as a whole.”

In the letter, health officials point to Sisolak’s Sept. 29 announcement that he would increase the state’s gathering limit from 50 to 250 for most indoor and outdoor events. Health officials said they weren’t aware of the details of the announcement until 6 p.m. the night before, when Sisolak’s senior adviser, Scott Gilles, informed them.

But even then the briefing from Gilles was “more consideration than local health officials have received from you in the past.”

Vice President Mike Pence, meanwhile, wrote a letter to Sisolak last week saying his restrictions on churches "openly discriminate against people of faith," and urged the Democratic governor to "reconsider."

He said that Sisolak's “subjective decision to disproportionately apply mitigation efforts in ways that appear to openly discriminate against people of faith.”

“While I am pleased you are interested in protecting entertainment and tourism jobs, your decision to prioritize blackjack and slot machines over places of worship is offensive to millions of Americans,” Pence wrote. “I hope you will reconsider, and extend the same courtesy to churches, synagogues, and mosques that you have offered to casinos across the State.”

Nevada has placed a 50-person cap on all places of worship, no matter the capacity of the building, as a part of the state's coronavirus restrictions.

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But casinos, along with other businesses such as restaurants and movie theaters, may permit up to 50 percent capacity, allowing casinos to grant access to hundreds of patrons at a time.

Fox News' Brooke Singman contributed to this report.