The Once and Future Department of Public Health Part Four – Pagosa Daily Post News, Events and Video about Pagosa Springs Colorado

Read part one

Public health has been a “growth industry” for some time, although it got a huge boost from COVID.

When the SJBPH District was created in 1947, the population of Archuleta County consisted of about 3,000 rural residents; The population of La Plata County is about 15,000. One of the first works undertaken was the vaccination of children. The whooping cough vaccine was recently approved. The polio vaccine had not yet appeared; the measles vaccine was still a decade away.

Another public health need in 1947 was the inspection of dairy farms, dairies, and restaurants.

Originally, three other counties—Montezuma, Dolores, and San Juan—were part of the San Juan Basin Health Unit (the organization’s original name). At some point, these other three counties formed their own independent public health department. It is not clear to me exactly when these changes occurred.

We can imagine that the health department staff consisted of two full-time employees in 1947. But the public health landscape was about to change. Federally funded public health programs that emerged in the 1960s and 1970s—such as the Comprehensive Health Planning Act of 1967—created a national system of health planning agencies and allowed the development of community health centers across the country. .

By 2013, SJBPH was spending $4.6 million annually, most of which was funded by federal and state contracts. Archuleta County contributed only about $133,000 to the SJBPH budget this year. Our population in 2013 is about 12,000 — about four times the population in 1947. La Plata’s population has tripled to about 52,000.

Our county’s population is now about 13,500, and La Plata’s is about 56,000. Next year, SJBPH expects to spend about $7.9 million; Archuleta County will contribute about $284,000 to this effort.

The SJBPH staff now consists of more than 75 employees, according to the district’s website. I believe less than half a dozen of these employees work full-time in Archuleta County, although a report last March by Executive Director Liane Jollon indicated that Archuleta County receives a per capita share of SJBPH services roughly equivalent to of what is provided in La Plata County.

As mentioned in part two of this editorial series, most counties in Colorado — 47 of 64 — operate a local, independent, county-funded and county-operated public health department.

Only 17 counties participate in shared multi-county public health districts. Archuleta County has been one of those 17 counties for the past 75 years…sharing funding and management of the San Juan Basin Public Health District with neighboring La Plata County.

Last week, we learned that La Plata County has set aside $750,000 in its 2023 budget to plan for its own independent public health department. County Manager Chuck Stevens described that amount as a “one-time expense” and therefore an appropriate use of reserve funds. He also mentioned that La Plata County is working with consultants to plan for their department.

I could not find any funding in Archuleta County’s 2023 budget for planning or staffing an independent public health department, although the BOCC has agreed to dissolve the SJBPH shared district on December 31, 2023.

You can download the termination agreement here.

The joint resolution to dissolve the district is one of two important documents approved by both BOCCs on November 15. The other document is an Intergovernmental Agreement (IGA) that specifies how SJBPH assets will be distributed between the two counties. For example, “Real property located in La Plata County, building, fixtures and equipment” would accumulate in La Plata County, while “Real property located in Archuleta County, building, fixtures and equipment” would be owned by Archuleta County.

La Plata County will acquire six vehicles. Archuleta County will acquire two. Ownership of the computers and “technology assets” located in each county will be transferred to the home county. The records will be jointly owned, except that patient records will continue to belong to each individual patient, at least in theory.

You can download the IGA here.

During a recent conversation with an acquaintance who follows the development of SJBPH much more closely than I do, it was suggested that this breakup may be the best thing to happen to the public health landscape in Archuleta County… given the relatively limited influence our Archuleta County leadership has been able to exert over San Juan Basin public health programs and policies. For the past several decades, most of the government guidance for SJBPH has come from the La Plata Commissioners.

The two districts are indeed different in some important ways, beyond just their political leanings. The median age in La Plata County is 41; the median age in Archuleta County is 50. The median household income in La Plata County is about $69,000; here in Archuleta County, it’s about $56,000.

These two differences may suggest a slightly different focus for each county’s health policies.

Other differences are suggested by the priorities laid out in each county’s proposed 2023 budget.

Given the difficulty our businesses and governments face in finding qualified workers willing to stay in the community for more than a few months—the moment they realize they really won’t find an affordable home to live in—I would think , Archuleta BOCC will now advertise for Health District Director…

…Someone to oversee the challenging transition and ensure that the new health department is ready to begin operations on January 1, 2024.

There is no such position among Archuleta County’s current vacancies, nor is there any mention of such a position in the county’s proposed budget.

Bill Hudson

Bill Hudson began sharing his views in the Pagosa Daily Post in 2004 and I can’t seem to kick the habit. He argues that in Pagosa Springs, opinions are like pickup trucks: everyone has one.

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