EDITORIAL: Planning for Archuleta County’s New Public Health Department, Part Three

Read Part One

The Archuleta Board of County Commissioners are currently hearing appeals from property owners who are unsatisfied with their valuation, as set by the County Assessor. So it’s not immediately clear if they’ve had time to seriously consider, and debate, the Public Health Department recommendations that were provided to them late last month by the five-member Public Health Transitional Advisory Committee.

It’s possible the BOCC will simply rubber stamp the recommendations without digging too deeply into the proposed programs and budget.

Here’s today’s agenda item:

BOARD OF HEALTH
A. Consideration And Approval Of Recommended Programs For 2024

At their work session on July 25, 2023, the Board of County Commissioners were provided with a memo from the Transitional Advisory Committee providing the committee’s recommendations for the programs to be offered when the County Public Health Department opens in January 2024. This agenda item is to approve the recommendations and to direct staff to begin creating the programs and hiring the required staff so that everything is in place on January 1, 2024.

Presentor: Ashley Wilson
Presentor’s Title: Public Health Director

In Parts One and Two of this editorial series, we shared a quick overview of the memo, touching on the actual programs recommended by the Transitional Advisory Committee.  Most of the programs that might be approved today are essentially the same programs that have been offered by San Juan Basin Public Health in recent years.

But not all of the SJBPH programs.  And perhaps with slightly different prioritization.

Between March 2020 and perhaps the end of 2021, SJBPH redirected its energy into attempts to mitigate the spread of COVID-19.  The effort was helped by a massive influx of federal and state money.  During that period, SJBPH conducted 4,413 ‘contact tracing’ investigations and administered about 109,000 doses of COVID vaccine — all while attempting to keep most of its normal programs running.

The change of focus was not popular with everyone in La Plata and Archuleta counties.  Especially unpopular were the business closures, school closures, masking requirements, and vaccination programs.  By the end of 2021, about 37% of the SJBPH area population remained unvaccinated.

The politics of COVID combined with other political differences to bring about a decision, by the La Plata County commissioners to dissolve SJBPH and create an independent La Plata-only health department.

Thus, the need for Archuleta County to also create an independent public health department, basically from scratch.  The memo that will be discussed this afternoon suggests a slightly limited selection of programs, but many of the most important ones.

Despite the smaller selection, the sample budget presented to the BOCC suggests a considerably larger cost to local taxpayers than what Archuleta County has historically been contributing the SJBPH.

But we knew that was going to be the case.

Here’s the sample budget in the July 25 memo. (The final budget will be adopted in December, following the required public hearing.)

As we see here, the largest cost, for the 2024 fiscal year, is projected to be ‘Salaries & Benefits’, at $868,572, plus contract labor at $167,613.  Total expenses are estimated at just under $1.4 million

The largest contributor will be Archuleta County ($548,908) followed by total Federal contracts ($314,110) and State contracts ($259,952).

As far as I can tell, however, this projected budget (above) does not include the costs for staffing and operating the Water Quality Division — which will operated by the County Planning Department.  The primary job of the Water Quality Divison is the inspections and approval of septic systems.  But it’s my understanding that, legally, ‘water quality’ falls under the purview of the County Board of Health, as a component of the overall Public Health Department.

I will be curious to see how this arrangement will play out, administratively.

For comparison purposes, we will note that Archuleta County has been contributing about $280,000 per year to help fund the shared SJBPH district.  That contribution has been a tiny portion of SJBPH’s $7 million budget,  La Plata County has been contributing about $1.1 million.

Only about 20% of the services provided by SJBPH are delivered in Archuleta County… the rest are delivered in La Plata County…

…and it’s interesting to note that 20% of $7 million is $1.4 million, almost exactly the projected budget for the new Archuleta County Public Health Department (ACPHD).  (Not including Water Quality?)

That further suggests that it will cost ACPHD about the same amount that SJBPH was allocating to services in  Archuleta County, but we might be getting fewer programs, and county taxpayers will be paying about twice as much as we were paying for SJBPH.

Not exactly a screaming deal.

But money hasn’t been the only challenge facing Archuleta County government lately.  We have also heard regular comments, from County officials and staff, about the difficulty in finding employees who can afford to live in Pagosa Springs, where we have the highest cost of living (according to a recent Region 9 Economic Development District report) but not the highest salaries.