The Archuleta County Board of Health (BoH) heard an update on public health contracts for the state fiscal year 2025 from Archuleta County Public Health Department (ACPHD) Director Ashley Wilson at its July 18 meeting.
Wilson opened the update by explaining that the contracts for the ACPHD for its first six months (from January to June 2024) were taken over from San Juan Basin Public Health (SJBPH) and that the awards were often 20 percent of SJBPH’s previous awards for a similar amount of time (reflecting differences in population between Archuleta County and the total SJBPH service area).
She added that contracts with the Colorado Department of Public Health and Environment (CDPHE) are invoiced and that there is a possibility that the full amount has not been invoiced, which Wilson stated happened in multiple programs.
She indicated that the full amount not being spent was partially due to difficulties in invoicing data in real time to the CDPHE due to how the county system works — something she noted she and county accountant Stephen Slade worked to create a “stopgap” solution for.
Wilson stated that staff involved in providing services will also help with tracking purchases and hours to ensure that the contract funds are spent down as efficiently as possible.
She indicated that, over the ACPHD’s first six months, it did not spend $23,490.11.
The SafeCare program accounted for about half of these unspent funds, Wilson stated, adding that that was due to issues filling the position and that there was “really no way to spend that down.”
Wilson then reviewed a range of programs and the unspent amounts of funding for them, highlighting that some of the unspent funds were not billed due to staff having to learn what items could be billed for a specific program or the state not liking agencies to bill for large items in the final months of a contract.
She concluded that the department has created a variety of processes going into the next contract cycle to prevent contracts not being fully spent down, adding that she does “not like to leave money on the table.”
BoH member Stacey Foss asked if Wilson anticipates reductions in SafeCare funding next year given that not all the money was spent this year.
Wilson explained that she does not because the program is very “understanding” of staff turnover.
She added that one of the issues with SafeCare is that it requires training that only occurs periodically and the program will not pay for a staff member who is not trained yet.
She stated that she currently has a bilingual staff member working about 25 hours a week for the position and that she hopes to expand it to a full-time position if the program expands.
Wilson then discussed the contracts for the 2025 fiscal year, stating that the department received funds from the majority of the funding sources it received funding from in the 2024 fiscal year.
She explained that the ACPHD will not be receiving funds from the Colorado HIV/AIDS Prevention Grant Program (CHAPP) for HIV and sexually transmitted infection testing due to not being selected in a competitive funding process and would not be receiving funds originating from the American Rescue Plan Act (ARPA) due to the funds having been expended.
The CHAPP funding for January through June 2024 was $13,626.06, while the ARPA funds were $31,971, according to the contract funding chart Wilson presented to the BoH.
Wilson explained that the department is slated to receive $50,000 from the State Tobacco Education and Prevention Partnership (STEPP) and that this amount could potentially double due to the program receiving more funds.
She added that these funds could help support staff in the clinic, health insurance literacy and SafeCare program, which will incorporate tobacco cessation messaging into its work.
Wilson commented that the increase in STEPP funding was highly unexpected.
BoH member and Archuleta County Commissioner Veronica Medina commented that, although it is “hard to see” funds “left on the table,” she felt from community feedback and other observations that the ACPHD’s first six months of operations were “very successful” and that the funds had been used well.
She added that this success was attributable to Wilson’s leadership, staff work and the community’s willingness to embrace the ACPHD.
Medina commented that she is looking forward to what grants the ACPHD can obtain next year and what services it can provide to the community.
Wilson explained that the ACPHD will continue to receive Epidemiology and Laboratory Capacity (ELC) funding for COVID-19 prevention and testing work, adding that the department received an award for the next fiscal year that was slightly more than double the award received for its first six months.
She stated that the department expected to receive double its six-month funding awards for most of its full-year funding awards.
Wilson indicated that the Woman’s Wellness Connection cancer screening and detection funding remained relatively stable, but that the department also has an additional budget from the state that pays for mammograms and other services while the contract funds pay for administering the program.
She added that these funds for paying for treatments are currently limited, but could increase if the service is used more than expected by the CDPHE, which she indicated is likely.
Wilson stated that Local Planning and Support funding from the CDPHE “went up dramatically,” increasing from $33,011 in the first six months to $140,613 for the 2025 fiscal year.
She commented that the usage of these funds is highly flexible and they can be used to help cover staff positions not fully covered by other funding or help with supporting other programs.
She stated that the funding for immunizations was $20,081 for the first six months and the department received $27,712 for the 2025 fiscal year.
However, Wilson stated that she also applied for $23,856 in more competitive additional funding to help support the program, although she noted that she has not heard a decision on this application yet.
She added that this funding does not pay for immunizations directly, but pays for staff being available to provide them.
Wilson pointed out that environmental health funding increased, rising from $5,000 for the first six months to $22,000 for the 2025 fiscal year.
She stated that emergency preparedness funding went from $32,327 for the first six months to $44,992 for the 2025 fiscal year, although she noted the potential that additional money not spent by the program statewide in the 2024 fiscal year could roll over to the 2025 fiscal year and a portion of it could be awarded to the ACPHD, increasing the funding amount.
Wilson indicated that SafeCare funding went from $30,327 in the first six months to $56,752 in the 2025 fiscal year.
She noted that this was less than the initial award, but pointed out that the initial award included equipment and startup costs that are not awarded again.
The Connect for Health Colorado funding award went up from $19,062.68 for the first six months to $50,000 for the 2025 fiscal year, Wilson stated, adding that the ACPHD would also have its own contract with Connect for Health next year instead of having to subcontract with the La Plata County Department of Public Health.
Wilson explained that funding for the Special Supplemental Nutrition Program for Women, Infants and Children — commonly known as WIC — operates on the federal fiscal year, meaning the year will end in September.
She stated that the ACPHD received $52,490 in the first nine months of the program and will receive $58,823 in the 2025 fiscal year, which she noted is less than the initial award, although she commented it is “close” and the gap could be covered by other funds.
Wilson also noted several grants associated with air quality, breastfeeding support and other work that she explained are deliverable-based grants with only some having the potential for another award.
She added that she has a list of other grants that could be applied for if they match the strategic plans for the department.
Wilson concluded the update by expressing hope that it would prepare the board for the budgeting process in August and pointing out the amount of work involved in invoicing for these contracts and grants.
She added that she believes the department has made progress in increasing the efficiency of its invoicing processes.
josh@pagosasun.com
