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San Juan Public Health replaces SEUHD in SJC - Medially Speaking, Volume Two, Number Nine, 3/19/15

On March 2, public health in San Juan County took on a new name, a new look and a new direction, when San Juan Public Health became the official health department for the county.

For decades the Southeastern Utah District Health Department was the arbiter of public health in San Juan County. With administrative offices in Price, the health department served Carbon, Emery, Grand and San Juan Counties, which left San Juan County vying for it's share of funds, resources and services with the other three counties. Late last year the San Juan County Commission began exploring the possibility of establishing it's own health department, separate from the other three counties, with it's own funding and administrative resources and services. Eventually, the commissioners decided San Juan County residents would be better served by creating a new county health department. They voted to create San Juan Public Health.

The County Commission is the legal governing entity for the new health department. Commissioners appointed a Board of Directors with the goal of having a representative from each of the communities in county. In December, the Board hired Worthy Glover, Jr., to be the Director of San Juan Public Health. Glover served for eighteen years as manager of the Department of Workforce Services, in Blanding and Moab. The Board also retained the services of Donna Singer to be a contract consultant for the new health department. Singer is the former CEO of both Utah Navajo Health System, Inc. and Blue Mountain Hospital. Dr. Val Jones, Medical Director for UNHS, was hired as a contract physician, responsible for clinical operations.

"We were shooting for a July 1 implementation because the State goes on a fiscal year from July 1 to June 30," Glover explained in an interview on the morning the new health department went into operation. "But in February, the board for the Southeastern Utah Health Department decided to move the date to March. They said it was to get the state to move ahead and not drag its feet in recognizing us. Maybe they thought, 'If we do this, you'll sink or swim, and if you don't swim you can come back to us.'

"It's definitely a challenge," Glover continued. "I think everybody, even at the state level, has been trying to figure it out. For myself, there's legislative requirements, certain positions, certain things you have to have in place that I've been trying to figure out and account for so the state would feel comfortable recognizing us as a health department."

Glover said one of the things he did when hired was visit with several health departments up north that are similar in size to San Juan County's. Wasatch is most similar, and one of the smaller health departments. Until now there have been twelve health departments in the state. Now there are thirteen. The last time this happened was in 1979, when Wasatch and Summit Counties split, Glover explained.

He said he's excited about the challenge. The new health department has come a long way in a short time, ery of that service.

"My big initial vision is to try to find a way to expand to the entire county," Glover explained. "Now, anyone on WIC has to come to Blanding to get that service. We have some ideas about setting up partnerships with clinics and other locations, where the health department could have a regular schedule in various communities. And people would know we are in Montezuma Creek on Tuesdays, for instance, or whatever it is. Then they could come to us at those locations.

"If you qualify for WIC your finances aren't that strong anyway," he continued. "So it's a choice between using funds to get gas to come to Blanding or holding on to those funds. Up to now it's been in Blanding and a little bit in Monticello. The goal now is to make San Juan Public Health services as convenient for the citizens of the county as possible. Specifically with WIC, we want to expand quickly. We will, in some form, expand that service to all the communities."

Singer introduced Glover to the people of Montezuma Creek, during a recent gathering to dedicate the new UNHS EMS ambulance garage. She said SJPH will serve all the residents of San Juan County.

"And that means that the border of SJC is Arizona. That means those services belong here as well as in Blanding and Monticello," Singer said. "And we're hoping our focus is to convince everybody that we can all work together and accomplish much more. But in doing that there has to be quality of service south of Blanding. The game's not over.

"If we can get everybody together and recognizing that this county goes from the Arizona border to Moab, that we can all work together, we can do so much more for everyone," Singer continued. "There are issues in this community that need to be addressed. Access to water, air quality, these are all things that can come under the department of health with the state and county all working together. There are things we can do to make it better. And if we all work together we can do it."

Funding for the new SJPH will not be simple, according to Glover. The case for adequate funding will have to be made with the State of Utah and the other twelve health departments. The State budget will now be stretched between 13 health departments instead of 12, and health departments that include three-county or four-county consortiums, like SEUHD, and those that partner with other agencies, get a larger chunk of the budgetary pie, Glover said. But, SJPH can make a case for a consortium that includes the Navajo Nation, IHS and UNHS among other partners, Glover added.

Glover said SJPH can also conduct community health assessments to determine and address community health needs and concerns throughout San Juan County, and not just Blanding and Monticello.

SJPH will also play a role in seeing that residents, who want, can receive immunizations. He said the department does not want to infringe on the private sector clinics that give immunizations now, but it can coordinate immunization efforts and provide immunizations where they are not available. SJPH can also administer the Vaccines for Children program, for families with no insurance, and no way to pay for immunizations. Again, if private sector clinics provide this service, SJPH can help facilitate it.

"We don't want to take anything away from the private sector's ability to operate and pay staff members," Glover said.

Fee schedules are another item of concern for Glover, who insists SJPH will be mindful of the population from which fees are collected. He said SJPH will make sure fees are appropriate and not gouge the people it serves.

"One nice thing about our fees," Glover added. "We get to keep them in house. With SEUHD all the fees went to Price. They are not included in the state's funding formula. We just get to keep them and use them to fund our programs."

Glover said SJPH will aggressively pursue grant opportunities SEUHD did not pursue. He also noted that SJPH is in a position to put more effort into becoming locally sustainable. To find ways not to be a drag on the community but to provide services to the community.

"Our primary goal is to play a positive role in all the communities of San Juan County. We want to serve as many citizens in the county as we can," he said. "By having our own health department, we have one less layer of bureaucracy to go through to get these services to the citizens of the county. While there will always be layers of bureaucracy, there should be less. And the administrative overhead shouldn't be as significant. We should be able to take what funding we get, and use it more efficiently. And not have it get lost in administrative costs. We can decide what works best for San Juan County, according to State guidelines, but have a little more flexibility."

Glover and his staff brought San Juan Public Health to life on Monday, March 2, without a hitch. The staff includes Brittney Carlson-RN, Katie Knight-RN, Senna Yoakam- Office Specialist/Vital Records and Rick Meyer-Environmental Health Specialist. Glover said he has a great staff, and the new health department will save money with less bureaucracy and administrative waste. He said you need to have some bureaucracy, but it shouldn't take away from your ability to serve the people of the county.

"Part of my greater vision is to be a facilitator to get all the different healthcare entities in the county to communicate, collaborate and to connect," Glover added. "I think we're poised now, more than ever, to make something like that happen. With fairly new leadership at all these entities, all poised to say 'How can we do this better and collaborate, and ensure the citizens of the community are getting the appropriate level of care, and getting the services they deserve?' I see that and I think it's an exciting time. The timing for this new public health office is right. It's the right time."

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