County commissioners for Archuleta and La Plata counties voted on a joint resolution Tuesday to proceed with the “planned and orderly dissolution of the San Juan Basin Public Health District.”
“This has been a bit of a journey,” County Manager Chuck Stevens said in the meeting.
The public health department, which was formed in 1948, will be dissolved effective Dec. 31, 2023, and La Plata County will establish a new public health department by that date. The department currently services residents of both Archuleta and La Plata counties.
“That is a relationship that we have enjoyed and has worked for decades,” Stevens said. “However, in 2020 and 2021, there were some philosophical differences that began to arise largely in response to the COVID pandemic and public health’s role in that response.”
Archuleta County first initiated the dissolution in April, 2021 when it formed an investigative committee to explore leaving the partnership. Last April, a year after the first moves toward the separation were made, the Board of Health that oversees the department voted to recommend that the counties proceed with the dissolution.
A due diligence period followed, which gave La Plata County time to investigate what it would take to stand up a new public health department.
Commissioner Marsha Porter-Norton, who represents the county on the Board of Health, said the dissolution will allow for each county to better address the individual needs of its residents in a more tailored manner.
“I ran for office to create healthier communities, and I believe a dissolution of the district will result in healthier communities for the constituents it serves,” Porter-Norton said from the dais.
By state law, the dissolution must take at least a full year to complete. Colorado maintains several basic mandates for public health departments to ensure the adequate delivery of services to the public, including a requirement that the department conduct some sort community outreach to develop a public health improvement plan every five years. That will be underway shortly, and Porter-Norton said the county has asked SJBPH to break down the data by community so that it can use the information when it comes time to stand up a new department.
The county estimates it will have to spend $750,000 to get a new department up and running in the next year, but expects the department to be self-sustaining once it is operational.
Either county could have unilaterally withdrawn from the department, but doing so would have started the yearlong timer to dissolve the department. However, commissioners emphasized that both counties have an interest in maintaining the high level of care that residents receive from the department, and so the counties decided to move forward together on the issue.
“We want to make sure that the transition is smooth and the public health programs aren’t compromised for either county as we make this transition,” Commissioner Clyde Church said in the meeting. “That’s very important to all of us. We’ve talked about this extensively.”
The Board of County Commissioners also approved an intergovernmental agreement to facilitate the transition. The agreement addresses the county’s plans to distribute the various assets and obligations of SJBPH, including cash, real estate, grants, contractual obligations and patient records.
In accordance with the Equal Pay for Equal Work Act passed by the Colorado Legislature in 2021, the new county board of health will have to initiate hiring personnel for the new department from scratch; it will not be able to simply transfer over current employees of SJBPH.
However, the department’s Executive Director Liane Jollon said she will seek to retain her role within the new department. Jollon also emphasized the high level of support that the county has offered the department and said the staff is prepared for the challenges of the next year.
“There will be extra burden on the staff to continue that collaboration and set up both counties to be successful and ensure ... the continuation of programs and services,” she said after the BoCC’s vote. “We have not had just a normal day since (March 2020), so taking on that additional work and burden will feel very familiar to a staff that has really had their foot on the gas to work for healthy communities for quite some.”
Jollon said people can expect to receive the same level of care to which they are accustomed throughout 2023.
While La Plata County plans to establish a new department to serve its residents, Archuleta County remains unsure of the its next step.
“We will probably ... form some type of transition committee to look into what we need to stand up by the end of next year,” said Todd Weaver, Archuleta’s county attorney.
Weaver said the county had not yet decided whether it will establish its own department or try to join one of its other neighboring districts, such as the Silver Thread Public Health District.
The La Plata BoCC commissioned a report from the Denver-based Otowi Group that will contain in-depth analysis of the county’s public health needs going forward. Porter-Norton said she expects to receive that report soon and that it will be shared with Archuleta County when it arrives.
“We’re not tearing something down,” Porter-Norton said. “We’re taking something that is excellent and making it better.”
She said she is optimistic about the move, although the decision comes with a hue of sadness.
“I believe a dissolution presents an opportunity to put in place a structure that is more collaborative, more locally focused and more nimble, because if the pandemic has taught us anything, it is that unexpected events can have consequences right here in our communities,” Porter-Norton said. “... I take no joy in this vote; this is not a time for gloating, and it is not a time for hard feelings between the two counties.”
A previous version of this story misstated the frequency with which public health departments must develop public health improvement plans. Departments must do so every five years.