Once and Future Public Health Department, Part Four – Pagosa Daily Post News Events and Videos for 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 formed in 1947, the population of Archuleta County consisted of approximately 3,000 rural residents; La Plata County had a population of approximately 15,000. One of the first tasks 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 requirement in 1947 was the inspection of dairy farms, milk processing plants, and restaurants.

Initially, three other counties – Montezuma, Dolores and San Juan – were part of the San Juan Basin Health Unit (the original name of the organization). At some point, each of these three other counties formed their own independent public health departments. I’m not clear when exactly those changes happened.

We can imagine that in 1947 the health unit staff consisted of a few full-time employees. But the public health landscape was about to change. Federally funded public health programs during the 1960s and 1970s – such as the 1967 Comprehensive Health Plan Act – established a nationwide system of health planning agencies and allowed the development of community health centers across the country.

As of 2013, SJBPH was spending $4.6 million annually, most of it funded by federal and state contracts. That year, Archuleta County contributed only $133,000 to the SJBPH budget. In 2013 we had a population of about 12,000 inhabitants – almost four times the population of 1947. La Plata’s population more than tripled, to approximately 52,000.

Our county population is now approximately 13,500, and La Plata has a population of approximately 56,000. SJBPH is expected to spend about $7.9 million next year; Archuleta County will contribute approximately $284,000 to that effort.

According to the district website, SJBPH’s staff now includes more than 75 employees. I believe less than half a dozen of those employees work full-time in Archuleta County, although a report from Executive Director Lianne Jolan last March indicated that Archuleta County receives its per capita share of SJBPH services. Which is roughly equivalent to the services provided in LA. Plata County.

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

Only 17 counties participate in shared, multi-county public health districts. Archuleta County is one of 17 counties that, for the past 75 years, have shared funding and governance of the San Juan Basin Public Health District with neighboring La Plata County.

We learned last week that La Plata County has allocated $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 thus, as a proper use of reserve funds. He also noted that La Plata County is working with consultants to plan for their department.

I have not been able to locate any funding in the 2023 Archuleta County budget for planning or staffing an independent public health department, even though the BOCC has agreed to dissolve the shared SJBPH district on December 31, 2023.

You can download the dissolution agreement here.

The joint resolution to dissolve the district is one of the two important documents approved by both BOCCs on 15 November. The other document is an Inter-Governmental Agreement (IGA) that specifies how the assets of the SJBPH will be distributed between the two countries. For example, “real property, buildings, furnishings, and fixtures located in La Plata County” would accrue to La Plata County, while “real property located in Archuleta County, buildings, equipment, and fixtures” would accrue to Archuleta County. Will pass ,

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

You can download the IGA here.

During a recent conversation, with an acquaintance who has been following SJBPH developments much more closely than I have, it was suggested that this decommissioning might be the best thing that could happen to public health in Archuleta County. The scenario may be for … the relatively limited consideration our Archuleta County leadership has been able to influence on the programs and policies of the San Juan Basin Public Health. Over the past few decades, most government guidance for the SJBPH has reportedly come from the La Plata commissioners.

The two counties are actually different in some important ways, beyond just their political leanings. The median age in La Plata County is 41 years; The median age in the Archuleta count is 50 years. The median household income in La Plata County is approximately $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 displayed in each county’s proposed 2023 budget.

Considering the difficulties our businesses and governments face in finding qualified workers willing to stay in the community for more than a few months – at which point they realize they can’t really find an affordable home to live in Been – I would have thought the Archuleta BOCC would already be advertising for a Health District Director…

…someone to oversee a challenging transition, and to ensure that the new Department of Health is ready to begin on January 1, 2024.

There is no such position listed in Archuleta County’s current job opportunities, nor is such a position mentioned in the county’s draft budget.

bill hudson

Bill Hudson started sharing his opinion in Pagosa Daily Post in 2004 and can’t seem to break the habit. He claims that in Pagosa Springs, opinions are like pickup trucks: Everyone has one.

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