LINCOLN, Neb. (AP) — Nebraska lawmakers have declined to re-confirm the state’s chief medical officer, citing his past conflicts with members of the Legislature.

Senators voted 22-15 on Tuesday for Dr. Joseph Acierno, three votes short of the minimum support required. Acierno was appointed by then-Gov. Dave Heineman in 2013 and re-appointed by Gov. Pete Ricketts in December.

Some lawmakers who worked with Acierno say he hasn’t cooperated with them in the past, and accused him of displaying a sarcastic and demeaning attitude.

Sen. Sue Crawford of Bellevue says Acierno was defensive when confronted with problems in the department. Sen. Sara Howard of Omaha says Acierno has been an obstacle to reforms that lawmakers deemed necessary within the department.

Acierno was not immediately available for comment.