At the end of yesterday’s (April 11) joint meeting between the Archuleta Board of County Commissioners — Ronnie Maez, Veronica Medina and Warren Brown — and the County Health Department Transitional Advisory Committee — Kathy Campbell, Ashley Wilson, John Ranson, Andrea Phillips, Sally Kennedy, Dr. Rhonda Webb and Mary Helminski — a member of the committee asked me if I was any less confused about the new County Public Health Department planning process.
It took me a moment to process the question, until I finally remembered how I had titled this editorial series.
I wonder if everyone involved isn’t a little bit confused, but maybe slightly less so following yesterday’s meeting.
Or maybe we’re just less confused about which parts of the process are most confusing.
Before we dig deeper into that particular meeting, I’d like to touch briefly on a separate presentation that took place just an hour prior in the same meeting room, when County Planning Director Pam Flowers outlined her vision for staffing the new Water Quality Division.
Water quality monitoring — and most expensively, the regulation of septic system installations — is legally the responsibility of a county public health department, as noted in Colorado Code of Regulations 6 CCR 1014-9. But the work can be assigned by the Board of Health to another agency… and some county governments assign this work to their building and planning Departments.
The Archuleta BOCC appears to want the OWTS (On-site Wastewater Treatment System) approvals and inspections to be handled by their Development Services Department, and has invited Development Director Pamela Flowers to hire the people needed to approve and inspect septic systems.
Legally, this decision appears to rest with a quasi-independent Archuleta County Board of Health. But the BOCC has not yet appointed a Board of Health, for whatever reason. So the BOCC has been moving ahead as if they were authorized to make this decision.
It’s confusing.
Ms. Flowers explained to the three commissioners yesterday that about 36% of all the septic systems approved by the two-county San Juan Basin Public Health (SJBPH) district last year were permitted in Archuleta County. Based on that percentage, and the 2022 SJBPH budget, and various other details Ms. Flowers has researched, she suggested that the new Water Quality Division would require the addition of four new County employees, along with new office equipment and new vehicles. (The new employees are indicated in yellow, below.)
Ms. Flowers predicted that the fees collected from property owners will cover the cost of the new staff, starting in 2024 when Archuleta County takes over this task from SJBPH next January.
But in order to get the new division ready to take over, the County will need to have employees and equipment and processes in place. In order to facilitate the necessary preparatory work, she foresees a need for about $162,000 that was not included in her department budget for this year.
The BOCC seemed comfortable with this proposal.
As Ms. Flowers was finishing her presentation (which you can download here) the members of the County Health Department Transitional Advisory Committee were arriving for their 10am meeting, and presently, the work session table was populated for a discussion about the confusing process of standing up a new county health department.
The two boards discussed, for example, the resolution that had appeared on the BOCC’s April 4 agenda, but had been tabled to allow the commissioners to explain to their volunteer committee why the resolution had specified “two commissioners” serving on the Board of Health, rather than the “one commissioner” recommended by the Advisory Committee.
Commissioner Warren Brown explained that he’d not been comfortable with only one County commissioner on the Board of Health, because he felt — even though all three commissioners are Republicans and presumably share certain values — the Board of Health would benefit from varied opinions coming from the elected officials.
The Advisory Committee appeared comfortable with that explanation.
The discussion also revealed that everyone is in agreement, that the future Director of the Public Health Department must — legally — be chosen by the Board of Health, rather than by the BOCC or the County Manager.
Also, the Board of Health bylaws must be approved by the Board of Health itself.
So we got some clarity on those points.
Also, everyone seemed comfortable with the idea that the Archuleta County Public Health Department will not attempt, during its first year of operation (2024) to offer the full range of health services currently hosted by SJBPH, but will offer all of the services required by Colorado law.
Just what ‘required services’ might be, is still not clear to me.
6 CCR 1014-9 provides a laundry list of services that must be provided by a county public health district, but the descriptions are sometimes rather vague, and leave a great deal of room for interpretation.
For example:
C. Inform and educate about public health issues and functions
1. Provide health education and health promotion policies, programs, processes, and interventions to support prevention and wellness
2. Provide information on public health issues and public health functions through multiple methods to a variety of audiences
D. Engage with the community to identify and address health problems
1. Engage with the public health system and the community in identifying and addressing health problems through collaborative processes
2. Promote the community’s understanding of and support for policies and strategies that will improve the public’s health
We know, for example, that Archuleta County is responsible for maintaining 320 miles of County roads. We might assume that means, “Maintain the roads in navigable condition”. But we don’t all agree with what “navigable condition” actually means.
Some might even claim that Archuleta County is failing to properly maintain our roads. (I’m not claiming that, but some might.)
In much the same way, a requirement — that our new Public Health Department must “engage with the public health system and the community in identifying and addressing health problems through a collaborative process” — could mean almost anything.
Or almost nothing.
If the County Public Health Department turns out to be anything like the County Road and Bridge Department, some taxpayers might end up disappointed.
But… how about those On-site Wastewater Treatment Systems?