Public Health

Public health in Saguache County is the responsibility of the Saguache County Board of Health. Currently one County Commissioner ‘liases’ with the Director of Public Heath to provide administrative oversight, and the three County Commissioners together comprise the ‘Board of Health’.  This Board structure is not sufficient to develop healthy policy or programs, and as a result, Saguache County has some of the poorest health outcomes in the state.

When the Colorado Public Health Act of 2008 was passed, it was recommended that a 5 member Board of Health with broad community representation was best, but allowed rural counties a waiver.  The waiver was taken.

Our Board of Health currently has no medical or public health expertise on it, nor does it include any community members with relevant knowledge. Zero.  This condition exists because it is the path of least resistance. It assumes an absence of other suitable board members. There is not however, an absence of other suitable board members.  There is an abundance of suitable board members.

This organizational structure is one that should be used only as last resort, and we should be actively working to change the composition of the board.

The ‘Board of Health’  (three commissioners with no medical or health care experience) has considerable power to improve health care outcomes in the County, but with no expertise it operates only to adjudicate emergencies.   As the community grows, we must work to change the composition of the Board of Health, and transform it from a panel with no expertise to a panel with broad expertise.

The Board of Health could include one Commissioner and recruit other suitable members.  According to the Colorado Public Health Act of 2008, the Board Of Health should include members with staggered terms, and no business or government entities should be a majority of members.

The Colorado Public Health Act of 2008 provides guidelines for building a capable board of health, on which the local public health director can serve as a secretary. Members can come from a wide range of areas:

  • Veterinary Health (livestock and domestic)
  •  Seniors/Senior advocates
  • Veterans/Veterans advocates
  • Addiction/Behavioral Health/Mental Health
  • Environmental Health
  • Health promotion/education
  • Medicine
  • Nursing
  • Social work
  • Education
  • Community advocacy
  • Local media
  • Local business

Members of the board of health cannot be paid.   Administration oversight includes:

  • Select the Public Health Director
  • Hold Quarterly BOH meetings
  • Provide, maintain, and equip suitable offices and facilities for core Public Health services (defined here) https://www.colorado.gov/pacific/sites/default/files/OPP_LBOH_Pocket_Guide_Revised_2015.pdf
  • Follow the rules of the Colorado Board of Health
  • Hold hearings, administer oaths, and take testimonies related to the administrative duties as a Board of Health
  • Act in an advisory capacity to the Public Health Director
  • Approve the 5 year local Public Health Plan (regional/county coordination)
  • Determine necessary services and set local priorities consistent with state public health laws according to local needs and resources.

Restructuring the Board of Health in a way that leverages local subject matter experts and broad community representation would allow us to address issues the current Commissioners can and do not.  

-Despite Colorado law, the County still has no breastfeeding or pumping location for employees or clients.

-The Opiod Epidemic (my thoughts here) has been treated exclusively as a law enforcement issue, despite swaths of evidence that health-based approaches result in far more positive outcomes than law enforcement approaches, and can relieve the burden on local LEOs, reducing jail occupancy.

- Local chatter suggests that the Commissioners are considering relocate the Public Health Department to a second floor location without handicapped access for seniors and disabled persons.

If elected County Commissioner, I will take steps to restructure the Board of Health in a way that best meets community needs.