As mentioned in Part One, several people testified at the Tuesday, March 15, Archuleta Board of County Commissioners meeting, urging the commissioners to declare their intention to leave the San Juan Basin Public Health District, and find a way to serve Archuleta County citizens in some other manner.
Everyone seemed to understand that the Archuleta County government is required to give ‘one year’s notice’ to SJBPH, if the intention is to separate from the health district, and everyone also seemed to understand that the BOCC has absolutely no plan, whatsoever, for what we would do instead.
But that didn’t stop the members of the public from urging a separation, considering that the subject of a potential divorce was on the BOCC’s Tuesday agenda.
One of the chief complaints from the public? An alleged unwillingness, on the part of SJBPH, to communicate openly and transparently about alternative approaches to handling the COVID pandemic.
A few hours earlier, that same day, in that same room, SJBPH Executive Director Liane Jollon had met with the three commissioners for about 45 minutes, and had communicated (openly?) about many things. Alternative approaches to the COVID pandemic was not one of the subjects discussed, but quite a bit of information was shared about how thoroughly and effectively SJBPH has served Archuleta County taxpayers, compared to the taxpayers in La Plata County. Those are the two counties served by SJBPH.
Ms. Jollon admitted that the communications between SJBPH and Archuleta County have not been ideal during the pandemic. SJBPH was particularly eager to follow CDC meeting guidelines, and thus — as Ms. Jollon noted — Tuesday’s meeting was the first face-to-face meeting between the BOCC and SJBPH staff since March of 2020.
Ms. Jollon broke down, for the commissioners, the per capita percentage of services — various types of services — delivered by SJBPH in Archuleta County, compared to La Plata County, in the five “foundational services” all Colorado health districts are required to provide.
Communicable Disease.
Environmental Public Health.
Maternal, Infant, Adolescent & Family Health.
Chronic Disease, Injury Prevention and Behavioral Health.
Access to Health Care.
For the past two years, pretty much everything operated in the shadow of “Communicable Disease”. That is, COVID.
But if we look at the most recent “non-COVID” year — the most recent “normal” year — La Plata County accounted for about 80% of the District population, and contributed about 75% of joint “County Allocation” — about $522,000 — while Archuleta County, with the other 20% of the District population, contributed about 25% — about $184,000.
These combined County allocations accounted for about 10% of the total SJBPH budget. About 16% came from “fees for service”, and about 56% came from state and federal grants.
We then heard about the percentages of service provided.
According to Ms. Jollon’s Tuesday presentation, 30% of ‘Communicable Disease’ investigations done by SJBPH were performed in Archuleta County.
She noted that Archuleta County is particularly plagued by potentially infectious animal bites. “Interestingly enough, between 50% to 70% of the animals bites investigated are in Archuleta County,” she told the commissioners.
She said that 25% of business outreach during the COVID pandemic took place in Pagosa, and 20% of ‘outbreak’ investigations took place here.
About 20% of restaurant inspections took place in Archuleta County. Only about 10% of the childcare inspections take place in Pagosa, possibly due to a relative shortage of childcare facilities here.
In the area of septic system inspections, she told the commissioners, “a full 33% of the permits, and a full 33% of inspections, are in Archuleta County.” Similar percentages were shared for a range of family care programs, and for STI and cancer screenings.
SJBPH is working on a waiver program to discount their fees in support of workforce housing projects, Ms. Jollon told the commissioners.
She explained that the “Chronic Disease, Injury Prevention and Behavioral Health” components have been handled collaboratively with Archuleta County Human Services and other partners. This work includes drug abuse prevention, suicide prevention, and mental health treatment.
“We believe that we have more work to do, to build the necessary collaboration, and work ‘cross communities’. Especially post-pandemic. There’s a lot of evidence that we have had an increased need in mental health, due to the crisis of two years — being in a pandemic. And we expect to see more resources, and more ability to work in this space in the coming years…”
At the end of the presentation about the “five foundational services”, Ms. Jollon shifted gears slightly, and asked the BOCC to allocate money for opioid abuse, from federal ARPA funding.
“Southwest Colorado, and rural Colorado, is seeing an increase in suicide, and we’re seeing an increase in Opioid & Substance Use Disorder…”
By which, I believe she means, opioid addiction and abuse.
“These were both trends that were progressing, here in southwest Colorado prior to the pandemic. And then, with the added challenges of the pandemic, there is concern that we need to invest more in behavioral health prevention and services. So, there’s a lot of moving parts in behavioral health currently…”
The application to the BOCC was reportedly for $133,000 from Archuleta County’s ARPA grant. Unfortunately, (if I’m not mistaken) the BOCC has already allocated all of the $2.7 million in ARPA funding assigned to Archuleta County, mainly to broadband expansion and workforce housing.
Commissioner Warren Brown thanked Ms. Jollon for making the trip to Pagosa Springs, for an in-person meeting, and for sharing all the information she’d brought along.
Ms. Jollon assured the BOCC she would make an effort to visit Pagosa on a regular basis. Perhaps monthly?
Five hours later, the three commissioners were looking at this agenda item:
NEW BUSINESS
A. Consideration To Remain Or Separate From The District Public Health Agency
For various stated reasons, the three commissioners voted to take no action, make no decision about whether to leave or stay..
SJBPH has reported only 12 new COVID cases in Pagosa since February 19. Perhaps, now that COVID cases have practically vanished from Archuleta County, along with masks and quarantine recommendations, the urge to separate from San Juan Basin Public Health is also fading away. Or perhaps the BOCC felt differently about the urgency to separate, after getting a clarification about the types and levels of service that SJBPH provides to Archuleta County taxpayers.
According to the Tuesday discussion, the BOCC wants to gather more information, before making a decision.
At any rate, we know we will remain participants in the health district for at least the next 12 months.