As we head into another weird holiday season, the problem (and promise?) of ‘public health’ continues to impose itself on our plans and conversations. Some commentators suggest that the weirdness is destined to remain with us, over the long haul.
That ‘this’ is the new ‘normal’.
We might assume, then, that at some point it will no longer feel weird.
The December 21 Archuleta Board of County Commissioners’ meeting kicked off with a lengthy presentation by the committee’s vice chair, Leslie Davis, one of the seven volunteers who served on the Health Investigation Committee formed in August 2021, with the intention of providing the Commissioners with recommendations about continuing the County’s participation in the San Juan Basin Public Health district — or, possibly, forming a separate and independent public health agency to serve Archuleta County.
Every Colorado county is required to operate a public health service, or participate in a joint public health district. The research provided to the BOCC on Tuesday included data about six different public health agencies, and ran to 148 pages.
The Committee’s conclusions, however, were more simply stated.
In conclusion, we learned much about the different health structures and services among those that we contacted and those that provided information. There are many more questions to be asked and research to be done. We learned that each community has their own population makeup (ethnicity, age), income, poverty, geography, and other data profile with potential implication for services and programming. We also learned that each public health agency (district or county) has their own challenges and opportunities and has to work within their budgets and resources. All of the public health agencies (district or county) are continuously assessing and reassessing to meet the needs of the people in their service area. BOCC may consider exploring additional questions with both SJBPH and the community to stay open to learning about the public health landscape and gaps that can be addressed in a responsive manner. Toward this end, BOCC may consider formal public outreach or polling as a next step to see what the public needs are and who the public health clients are and will be in the future.
One of the differences that became apparent in the Committee’s research was different ‘per capita’ expenditures among the six different agencies included in the report.
It appears that San Juan Basin Public Health was the only agency included in the study that serves more than one county. So… not exactly an ‘apples to apples’ comparison?
You can download the Committee’s ‘comparison chart’ here.
Here are the budget and ‘per capita’ comparisons from the report:
Alamosa County: Budget, $1.2 million; expenditures per capita, $73.92
Montezuma County: Budget, $2.4 million; expenditures per capita, $91.40
Delta County: Budget, $1.3 million; expenditures per capita, $40.11
Gilpin County: Budget, $0.4 million; expenditures per capita, $73.44
Grand County: Budget, $2.4 million; expenditures per capita, $91.40
San Juan Basin Public Health: Budget, $8.6 million; expenditures per capita, $124.87
This doesn’t tell the full story, however, because when you look at the amount contributed to the SJBPH district by the Archuleta County taxpayers, the contribution amounts to only $20.60 per capita — half the amount budgeted, per capita, for the lowest funded county in the Committee’s research: Delta County.
Suggesting that maybe Archuleta County taxpayers are getting an incredible bargain, through our membership in SJBPH?
Ms. Davis did not, however, use the term, ‘incredible bargain’ during her presentation on Tuesday. Instead, she reiterated the Committee’s conclusion that more research is needed before the BOCC will be able to make a prudent decision about whether to remain with SJBPH or start an independent agency.
The argument for more research was also made by the committee’s secretary, Marybeth Snyder, speaking at the Tuesday meeting.
“I think what we came up with is: there are more questions. I kind of envision a whole new committee to do the next step, because what we dug up, dug up more questions.
“Like, we’re not far enough along to have an opinion.”
I’ve attended only a couple of the committee’s public meetings, so I’m also not far enough along to have an opinion, other than to agree in general with Ms. Snyder’s comment — that a four-month effort, by a small group of volunteers, who apparently did not research any other ‘joint’ public health districts in Colorado, was an excellent start… but not enough to generate a properly prudent decision by our BOCC.
Could this be the beginning of a new ‘normal’? That our political leadership is going to start assembling volunteer committees to analyze the ‘cost-to-benefit’ ratios of all our County agencies?
Might be a step in the right direction…
Bill Hudson began sharing his opinions in the Pagosa Daily Post in 2004 and can’t seem to break the habit. He claims that, in Pagosa Springs, opinions are like pickup trucks: everybody has one.