PHOTO: Meeting of the Transitional Advisory Committee, April, 2023.
Last week, Archuleta County came a step closer to forming its new Public Health Department, with the publication of some recommendations from the Public Health Department Transitional Advisory Committee.
As noted in the memo addressed to the “Archuleta County Board of Health” the advisory committee was formed last February, specifically to research the programs that our new Public Health Department might be willing and able to offer in Archuleta County, following the dissolution of San Juan Basin Public Health (SJBPH). Another key aspect of their research has been aimed at developing an estimated budget for the 2024 budget year.
All Colorado counties are required, under state law, to provide a selection of public health services. For the past 70 years, those services have been provided by SJBPH district, jointly funded by Archuleta and La Plata Counties, and overseen by an appointed Board of Health. But last year — following a series of disagreements about the handling of COVID issues and septic system approvals — the La Plata County commissioners voted to dissolve SJBPH and stand up their own public health department starting on January 1, 2024.
Archuleta County had to decide whether to form a joint district with different nearby county, or form its own independent department. The BOCC picked the latter option, and will take possession of the existing SJBPH offices on South 8th Street at the end of the year. Reportedly, the building is in generally good shape.
It was understood from the start that it would likely to cost the Archuleta County taxpayers more to operate an independent agency, than we had been paying to support the joint SJBPH district in cooperation with La Plata County. Based on the budget developed by the Transitional Advisory Committee, that does appear to be the situation.
As mentioned above, the “Recommended Programs” have been submitted to “Archuleta County Board of Health”, along with an organizational chart and an estimated budget for 2024, (A rough estimate, sounds like.)
Here’s the organizational chart that is being suggested to the BOCC. You can click the chart for a larger image:
One obvious thing missing from this organizational chart is a Water Quality department. Early in the discussions about the independent Archuleta County public health department, the BOCC and County Manager Derek Woodman decided that ‘water quality’ should be handled by the County Planning Department instead of by the Public Health Department, since much of the work involves septic system approvals and inspections, and as such is closely related to home construction approvals and inspections.
Legally, however, that decision will need to be endorsed (or alternatively, rejected) by the County Board of Health, once it gets appointed.
Here are some of the ACPHD (Archuleta County Public Health Department) programs recommended to be handled by the personnel in the organizational chart shown above, summarized from the Transitional Advisory Committee memo:
Communicable Disease Prevention, Investigation and Control Programs
By law, certain diseases (known as ‘Reportable Diseases’) must be reported to public health agencies by health care providers and laboratories. ACPHD will need to work diligently to identify how, or from whom — as well as where and when — a person contracted a ‘reportable’ illness, in order to prevent the possible spread. Educating the community, and in some instances, businesses, on how to prevent the spread of communicable diseases will be a priority for the Department.
ACPHD is expected to house as many employees as possible in the South 8th Street building. The building has a laboratory for basic testing, but it’s anticipated that the majority of lab work will be sent to the regional lab in Durango.
A. Lab Testing: A contract with the La Plata County Public Health Department for needed testing will be established.
B. Child/Adult Immunizations: Core immunizations are provided by the Vaccines for Children program at the state level. This includes COVID vaccines for children. Adult vaccines are provided through the Section 317 program with the exception of travel vaccines. Provision of travel vaccines is a service that is cost-prohibitive to provide at ACPHD and is not recommended at this time.
C. Sexually Transmitted Illnesses: For certain tests, specimens have typically been collected or testing done at the South 8th Street clinic and this practice is recommended to be continued in 2024. These tests include blood or urine specimens for sexually transmitted infections.
D. Cancer Prevention and Early Detection: This program will be provided if the salary of a part time Family Nurse Practitioner can be supported by available general funds until an application to the Women’s Wellness Connection through CDPHE is funded, and an individual has been recruited to fill this position. In the interim, an agreement with Axis Healthcare will be explored.
E. Other Communicable Diseases:
1. On occasion, zoonotic (animal-borne disease) specimens have also been processed by personnel at the 8th Street clinic and then sent to the appropriate state laboratory for testing.
2. Depending on need and cost, a tuberculosis screening program may also be considered.
Maternal, Child, Adolescent and Family Health
These programs are designed to implement needed local strategies that increase health and wellbeing, work to decrease negative impacts on health, and strive for health equity across the life course of residents.
Funding through CDPHE is anticipated to cover most of the cost of these programs, including:
A. Woman, Infants and Children (WIC) program: This special supplemental nutrition program provides food, health care referral and nutrition education for low income pregnant, breastfeeding, and non-breastfeeding women and to infants and children up to age five who are found to be a nutritional risk. This program is not statutorily required but is highly recommended to continue through the ACPHD in 2024.
B. Nurse Family Partnership (in collaboration with La Plata County): This program offers support to first time moms from early pregnancy to the child’s second birthday. The purpose of the program is to improve pregnancy outcomes, improve the health of children and improve economic self-sufficiency of the family.
C. SafeCare: This supportive program for families with children under five provides in-home support to families to address home safety, child health as well as to enhance the parent-child relationship.