In Southwest Colorado, a New Public Health Dept Rises From Post-COVID Split

The La Plata County Public Health Department is in a period of transition. 

Until recently, the county partnered with Archuleta County to its east to operate the dual county San Juan Basin Public Health. However, SJBPH dissolved on Dec. 31, 2023, allowing each county to handle public health on its own. 

“The fact that the two largest and oldest regional health departments dissolved since COVID is somewhat unusual, I would say,” said Tracy Anselmo, director of La Plata County Public Health, referring to the dissolution of SJBPH and Tri-County Health Department. “It really is about the autonomy of decision making within the counties that those departments represent.” 

The dissolution is a result of pandemic-era politics. Like the rest of the nation, Southwest Colorado experienced masking protests and vaccine skepticism that put the health agency under pressure. 

“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,” La Plata County Manager Chuck Stevens said in 2022. 

Anselmo, formally trained as a registered dental hygienist, was hired as the interim director in Aug. 2023. After an initial search—which she did not apply for in order to uphold the integrity of the process—for a permanent director for the department failed to yield any finalists, Anselmo was hired as the sole finalist of the second search that concluded last month. 

After beginning her career in dentistry, Anselmo jumped into the world of public health in 2002 working for the Colorado Department of Public Health in their oral health unit. Before joining La Plata County, she most recently worked for the Delta Dental of Colorado Foundation as policy manager. 

The newly minted public health department is in the later stages of finishing its latest Public Health Improvement Plan (PHIP), which Colorado law is requires to be updated every five years. The plan will be finalized in the fall and center around three priorities: access to care, behavioral health, and climate and health. The plan then looks at identifying current strategies in the community, what needs to be amplified, and what the public health role in those activities are, Anselmo said. 

“We’re always looking at what are the gaps that public health may be or should be responsible for filling, given the ecosystem of health care, public health, in the community,” Anselmo said. 

In addition to services such as immunizations and suicide prevention, the department also manages septic tanks and conducts restaurant inspections, to name but a couple other responsibilities. The department does not offer primary care or behavioral health care, but a key responsibility is to make sure those services are available and known about in the county. 

While many of Anselmo’s priorities will be informed by the PHIP, she does have a couple of personal goals for the department. First, she’d like to make sure they are effectively leveraging partnerships in the community. 

“We are not the only ones working in certain spaces and understanding that ecosystem of a specific thing, say substance misuse, there are a lot of different organizations, agencies, parties out there working in that space,” she said. “We need to fit where we are most effective. So making sure that we identify who those partners are out there so that we can try to create a whole system that works well for the residents of La Plata County.” 

Second, she’d like to make sure the culture at the health department is healthy and there is room for her staff to grow, especially after three years of COVID-hampered morale. 

Heading into the post COVID era, Anselmo’s takeaways from the pandemic include the need to plan before things happen and build relationships before you need them. 

“I think that what we really want to take away from COVID, is we always need to be thinking about the next thing that’s going to be happening and creating better systems of response for those kinds of things,” she said. 

She points out that while the pandemic highlighted things such as masking and vaccinations, health departments were still working on issues like substance misuse or conducting restaurant inspections. They were simply doing these things on top of the more-than-full-time job that was fighting a pandemic. 

Nestled in an unassuming corner of Bodo Park, an industrial section of town just south of downtown Durango, Anselmo fears that people may not realize that the county has a public health department after the dissolution of SJBPH. 

Though, she says that the department being quiet is not a bad thing. 

“I just have to say, if we’re doing our jobs, we are often doing it quietly and people are not even aware that things are going on. That doesn’t mean if something happens, we aren’t doing our job. It just means that maybe they had overwhelmed us or there was something else that happened, like a pandemic.”