One item on yesterday’s Tuesday March 15 meeting agenda, for the Archuleta Board of County Commissioners to consider, read as follows:
NEW BUSINESS
A. Consideration To Remain Or Separate From The District Public Health Agency
Following numerous discussions and presentations, the Board of County Commissioners will consider whether San Juan Basin Public Health should or should not remain as the District Public Health Agency for Archuleta County.
Presentor: Derek Woodman, County Manager
For at least the past year, the commissioners have been seriously questioning whether Archuleta County taxpayers have been getting their money’s worth out of the relationship with San Juan Basin Public Health, the public health service jointly funded by, and serving, La Plata County and Archuleta County.
The joint district was formed about 70 years ago. Each Colorado county is required to fund a public health service, which in some cases consists of a district serving more than one county, as is the case with SJBPH. But the questions posed by the Archuleta BOCC went beyond just finances, and included political disagreements.
The commissioners’ dissatisfaction with SJBPH has seemed based on several factors, including fees related to septic system approvals, perceived lack of communication, concerns that La Plata County was getting more than its ‘fair share’ of services, and the composition of, and limited voting rights on, the governing Board of Health.
Everything came to a head, so to speak, when SJBPH began enforcing mask mandates and isolation rules during the COVID pandemic, starting two years ago. The three Archuleta County commissioners and SJBPH found themselves, generally, on opposite sides of the political fence regarding COVID measures. So, last August, the BOCC convened a ‘Health District Investigative Committee’ to put some financial numbers to the question: ‘Should Archuleta County sever its relationship with SJBPH and form our own public health service, and what, exactly, might be the result?’
The BOCC heard a final report from the investigative committee on March 15. Except the report didn’t sound like a final report.
The research, as summarized by committee member Leslie Davis, 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…
…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 amounted 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 to the commissioners at yesterday’s BOCC meeting.
“As you all know, I was on the Health Investigation Committee, which prematurely ended its study last December.
“I get the feeling that San Juan Basin Public Health is pressuring our commissioners to make a decision about our public health, and I don’t understand why they’re in such a hurry. We determined, quite clearly, that we have to give them at least a year’s notice. That sort of answers today’s question. We’re not quitting today, because we’ve got to give them a year’s notice.
“But the sooner we get working on that, the sooner we can make a decision.
“At the last work session — I think it was two weeks ago — it was suggested that perhaps a new citizens committee be formed? Some talk was that it would be a smaller group, with more specific tasks. So maybe to have a better outcome than the larger group was able to do?
“I would like to promote that. I think that’s a good idea, to have a group pick up where the other one left off…”
Ms. Snyder then offered her services, to help with such a new committee.
Four other public citizens also testified, expressing the general idea that SJBPH was, politically, out of step with the needs and wants of Archuleta County citizens, and urging the BOCC to make a definite decision to immediately give SJBPH the required ‘one year’s notice to quit’.
I’m not sure whether any of these health service critics had attended the BOCC work session held earlier yesterday morning?
When SJBPH Executive Director Liane Jollon presented the BOCC with some of the facts and figures the commissioners had been looking for, for the past year?