Difficulties in communication have been exacerbated by social distancing, changes in the frequency of Board meetings, the challenges of onboarding of new Board members in a public health emergency, inability to meet in person, and escalated divides between social and political views that have occurred over the last several years.
— from the June 7 letter from the San Juan Basin Public Health (SJBPH) Board of Health
If you want to read the three-page letter from the SJBPH Board of Health, sent to the county commissioners in La Plata and Archuleta counties on June 7, you can download it here.
The core message from the Board of Health can be found in this paragraph:
The Board of Health has no decision-making power with regard to the structure of the Health District, and it remains the responsibility of the two BOCCs to determine whether or not the Health District should or should not remain intact. Therefore, we offer only a recommendation. It is the recommendation of the Board of Health that the current District be dissolved, and each county pursue their individual visions for Public Health services. There are long-standing differences in the way that these two counties view the regulatory role of public health and the services that should be delivered. The perceived and expressed desire for more direct management of public health services to suit each County’s needs can best be met by separation into two districts. A separation will entail its own challenges and will impact both counties. Development of a public health infrastructure to deliver the minimum core public health services will take some time to develop, perhaps longer than the one-year transition period. SJBPH staff and the Board of Health are committed to assisting both counties in a seamless transition.
As mentioned in Part One of this editorial series, the Archuleta Board of County Commissioners have not discussed this letter in a public meeting, nor did the BOCC share the letter with the taxpayers. The letter was obtained by a private citizens group through a CORA (Colorado Open Records Act) request.
The SJBPH district was formed about 70 years ago to provide certain types of services to the two neighboring counties, no doubt with an eye to avoiding the duplication of services, increasing efficiency, and better use of taxpayer funding. La Plata County contributes about four times as much funding as Archuleta County to SJBPH operations, based on population.
For Archuleta County, the annual financial contribution has amounted to about $20 per capita. About $80 per year, for each family of four. This expenditure has been providing public health services for 14,000 Archuleta County residents… in theory, at least.
(That might strike some taxpayers as a bargain, compared to, for example, the annual cost of operating the Archuleta County jail: more than $150 per capita. More than $600 per year, for each family of four. This expenditure provides incarceration for about 25 people, on average.)
For at least the past two years, however, the Archuleta commissioners have been asking, publicly, whether Archuleta County taxpayers have been getting their money’s worth out of our relationship with SJBPH.
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 in March 2020. The three Archuleta County commissioners and the SJBPH staff found themselves, generally, on opposite sides of the political fence regarding COVID measures.
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 in March. 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. The report ran to 148 pages, but offered one simple conclusion: more research was needed.
As the June 7 Board of Health letter indicates, the very idea that Archuleta County was considering a divorce caused a level of discomfort among three groups. SJBPH staff. The Board of Health. And the La Plata County Commissioners.
The letter’s ‘FROM’ section looks like this:
From: Karin Daniels, Chair, San Juan Basin Board of Public Health
Shere Byrd, Co-Chair, San Juan Basin Board of Public Health
Ms. Daniels resigned from the Board of Health shortly after sending out this letter. She was one of the three Board of Health directors representing Archuleta County. (The other two are Commissioner Alvin Schaaf and Dr. Jon Bruss.)
One of the La Plata County representatives serving on the Board of Health is La Plata County commissioner Marsha Porter-Norton, who argued her perspective during a Board of Health meeting last April.
“The (public health) district is many years old, but there does come a time when I think we have to, in a transparent and an honest way, say how is this marriage is working. Because it is a marriage made by the two boards of county commissioners. You all do fabulous work. But at the end of the day, both of the county commissions have to decide if we’re going to stay in this district. It’s frankly very challenging for La Plata County right now…
“We have to ask ourselves as leaders: How long are we going to let that continue? Every marriage is imperfect, but are we going to stay married and say, ‘We’re going to work on it, we believe in being in this together and we believe in the principles of public health and basic things that public health puts forth, such as vaccines, such as masks?’ These things have thrown a giant wedge in our ability to sometimes have a unified front.”
The simple political fact is that, during the COVID crisis, many citizens — in both counties — rejected the “basic things that public health puts forth” such as vaccines, such as masks, such as enforced business lock-downs.
Commissioner Marsha Porter-Norton may believe in certain “principles of public health”. Not everyone agrees with her.