One of the items briefly discussed by the Archuleta County Board of Health at their first ‘unofficial meeting’ on December 12, was a proposed 2024 budget.
The very first budget for the new Archuleta County Public Health Department. A budget that appears likely to change in the coming months.
As mentioned yesterday in Part One, some of the concerns among the Archuleta County taxpayers — when we learned that the Archuleta Board of County Commissioners were exploring the idea of dissolving San Juan Basin Public Health (SJBPH), the public health district we’d shared with La Plata County for 75 years — were financial concerns. SJBPH was funded largely by state and federal grants, to generate a budget of around $8 million annually, and Archuleta County was contributing only about $280,000 per year.
In exchange for that relatively small contribution, we seemed to be receiving, here in Pagosa Springs, all the public health services required by Colorado law plus a significant number of additional public health services not required by state law.
Here’s a graph showing the SJBPH funding in 2023:
Archuleta County taxpayers were funding about 5% of the SJBPH budget for 2023.
I imagine that — until the COVID crisis arrived — most taxpayers in Archuleta County or La Plata County had very little contact with SJBPH, and in fact may not even have known that this agency existed, unless they fell into one of the following groups:
- Parents seeking vaccinations for their children
- Pregnant or breastfeeding mothers, or women with young children
- Restaurant and food service companies needing health inspections
- People installing septic systems
- Persons who had been bitten by an animal
- Persons with addictions
- Persons with sexually transmitted diseases
- Persons seeking birth control
The rest of Archuleta County, outside of these groups, became rather acutely aware of SJBPH when COVID arrived, and SJBPH took charge of distributing masks, testing kits, and vaccinations. And also, publicizing those services.
Now that SJBPH has ceased offering these services — and certain other services that I didn’t yet mention — as of December 15, we will be relying on the staff of the Archuleta County Public Health Department and the Archuleta County Water Quality Department (two different departments) to meet the requirements of Colorado law.
And perhaps, other services not required by law… such as the federal WIC (Women, Infants and Children) Program that provides supplemental nutritional support for young families.
Colorado’s Public Health Act (SB08-194) took effect in 2008, calling for major reforms to the state’s governmental public health system, made up of the Colorado Department of Health and Environment (CDPHE), and 53 local public health agencies (LPHAs). The Act’s purpose was to ensure that Core Public Health Services were available with a consistent standard of quality, to every person in Colorado regardless of where they live. Over the decade since this Act was passed, Colorado public health agencies have done their best to meet the new “CPHS Framework” which defines “seven foundational capabilities” and “five foundational services”. You can download the instructional manual here.
Foundational Capabilities
1. Assessment and Planning
2. Communications
3. Policy Development and Support
4. Partnerships
5. Organizational Competencies
6. Emergency Preparedness and Support
7. Health Equity and Social Determinants of Health
Foundational Services
1. Communicable Disease Prevention, Investigation and Control
2. Environmental Public Health
3. Maternal, Child, Adolescent and Family Health
4. Chronic Disease, Injury Prevention and Behavioral Health Promotion
5. Access to and Linkage with Health Care
I’m one of the Archuleta County taxpayers who is typically curious about the cost of local government, and also the efficiency of local government. So I took a few minutes to look over the ACPHD budget. That budget was discussed briefly at the first ‘unofficial’ meeting of our new Board of Health on December 12, and was approved by the Archuleta Board of County Commissioners yesterday, December 19.
From what I could tell, the ACPHD budget takes up 17 pages of the larger Archuleta County 2024 budget. You can download those pages here.
As a news editor, and as a past or current member of various local government boards, I’ve been looking at government budgets for the past 20 years, without any special financial training or background to speak of. Nevertheless, I’ve occasionally been able to point out mistakes in the budgets of our local governments — such as an $975,000 error in the budget adopted by the Pagosa Springs Town Council earlier this month.
That error has been fixed.
However, the adopted budget for ACPHD threw me for a loop. I understand that this is a new department, but I could not make heads nor tails of the budget.
In one part of the budget it appeared that ACPHD would be spending $57,000 more than they had in revenue.
In another part of the budget, it appeared that ACPHD would be spending $684,000 more than they had in revenue.
In another part of the budget, it appeared that ACPHD would have a surplus of $500,000.
Suffice it to say, I was confused.
I was able to meet with the new director of ACPHD, Ashley Wilson, who has a Masters in Public Health, and she was herself a bit confused by the 2024 budget. She’s also had a lot of other things on her hands getting a brand new department ready to serve the community in January.
I had sent an email to the County Finance Director, Chad Eaton, and County Manager Derek Woodman, hoping to get some clarifications on the budget, but they have been busy with last minute budget changes requested by the BOCC and have not yet responded.
One thing seems halfway clear to me, however. The Archuleta County taxpayers will be paying much more than 5% of the cost, for our new public health department. What that actual amount turns out to be, I currently have no idea.