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The good news, according to Chaffee County Public Health (CCPH) Executive Director Andrea Carlstrom, is that “It is still a really good day to be in public health, despite last week’s incident. We have awesome programming going on – we won’t let this cripple us. We’ll be thoughtful about how to do our service delivery in the future so everyone feels safe.”

Carlstrom was in the midst of her monthly update to the Chaffee Board of County Commissioners, acting in their role as the Chaffee Board of Health. While her update typically covers health programming, she referenced the incident that occurred at the Chaffee County Community Health Clinic in Salida last week, where a client physically assaulted one of the public health staffers.

Chaffee County Director of Public Health Andrea Carlstrom AVV file photo.

“It’s strange to think through all the threats that have been made in the last few years [during the COVID-19 pandemic],” she added. “Those were just threats. To have something physically happen to a staff member, it’s sobering. We are going to take this and learn from it.”

The incident, which occurred at the community clinic, resulted in an immediate lockdown of public health, with the staffer (which Carlstrom declined to identify due to privacy) taken to the emergency room.

She admitted that “this has rattled my team”, adding that her department is not ready to consider what the model will be like going forward in Salida. “My team wishes to take this slow, and not be traumatized by what is next.”

She added, “There has been an uproar of people begging for law enforcement to be involved, for charges to be pressed, that may or may not happen. I’m respecting the privacy of my staff right now, and the relationship with the [host site] church…. we are going to take it week by week.”

Carlstrom added that among the many messages of support from the community that have flowed in, many of them expressed concerns that the community clinic work might be halted. Carlstrom said that won’t happen, they are finding other ways immediately to distribute things like flu shots, and public health nurses are holding special walk-in immunization clinics, some will be popups, instead of at the church. She added that the Buena Vista location of the community clinic is in operation, and they will find ways to provide important preventative health services.

Asked about filing charges, Carlstrom said that neither her department nor the staffer has done so yet. She had been informed by Salida Police Chief Russ Johnson that “unless you press charges there is not even a case created.”

She said that she has learned that there have been earlier incidents with the individual that attacked her staffer, but that no one has pressed charges. “Then this behavior is just perpetuated — then it is somewhat tolerated in our community. I’d love to be part of the solution to figure out how we can navigate through uncertainties, that are preventing people from accessing care in other communities.”

“My experience is that the DA [District Attorney] can choose to pursue a case without the victim actually filing charges. It’s not uncommon,” said Commissioner Greg Felt.

He went on to add, “It is my understanding that it was spontaneous – not planned. We have some folks really activated in our community right now, but their activities are perpetuated … we need to think through history – and recent history, and yet it takes a crisis before we respond. I’d like us to take an upstream approach so we could prevent the crisis in the first place.”

“My team is what I’m focusing on, to make sure they feel supported. This will not be the end of this conversation,” responded Carlstrom.

Asked about the role of homelessness in the community Carlstrom was bluntly honest.

“We continue to field complaints about the homeless in our county… some communities are declaring homelessness emergency declarations in their counties. I don’t know if there is funding attached to that kind of declaration, but this trend is happening in other places.”

“I have a whole list of questions to the homeless outreach committee – what is the end goal? What are we trying to achieve?” she continued. “What safety concerns do we have and how are we addressing them? I’m pushing back on this committee, if we are going to do it, we have one shot to do it and do it right.”

Public Health Programs Proceeding

The good news from public health is the number of successful programs in process. Carlstrom said that public health has been extremely busy, and is juggling their inventory of vaccines for flu, COVID and RSV. Our flu season hasn’t hit its peak, and COVID-19 doesn’t have a season.

She noted that the county is in a very favorable position relative to low hospitalizations and deaths. She reported one active case of TB being treated outside the county, and public health saw one new West Nile case in October, which is unusual. The county just participated in a regional preparedness and response meeting last week, and that regional group is seeking funding for mosquito control next year.

Healthy Start has a new name

Carlstrom called out the state’s — and the county’s — growing maternal support programs, noting that the program formerly known as “Healthy Start” is now called “Nourish”. “It is busy, caseloads are up – and we have lots of families receiving services … we work alongside caregivers from birth to two-years-old to ensure [good] early childhood health outcomes.”

The state is seeing increased state’s enrollment in the WIC nutrition programs (Women, Infants, and Children). With the state announcing that it will be accepting new host entities next year, Carlstrom raised the idea that these programs in the county properly belong under public health.

“Here in our region our local Council of Governance oversees WIC – I have questions if that is the best fit for our WIC program in the county…. we want to take a stab at becoming the WIC overseer of the WIC program. The Council of Governance takes over when there are no other entities in the county to do it. But this is a new day and a new era, we have the capacity, the expertise, and the passion to take this on,” said Carlstrom. She added that the conversation will spill over to CCI – “it is surprisingly a very contentious thing right now … but it is one of public health’s greatest funding sources and we’ve been missing out.”

She reminded the BoCC that there has been frequent turnover in the entities running WIC programs. “We’ve been the constant. We can not just qualify them for WIC, we can set them up with Healthy Start, or the new Nourish program – now it’s sort of an orphan – it’s in there with housing and aging programs.”

Carlstrom went on to recap public health programs including the youth anti-tobacco and vaping programs which she said need to begin earlier. “By the time they get to middle school it’s too late.”

Then she moved on to the successful Aging Well programing, noting that the program had its greatest turnout for volunteers yet (155 volunteers) this past October, but she noted that it Aging Well still needs snow shoveling help.

Behavioral Health a Growing County Need

She pointed out to the BoCC that the county has what she called “Significant behavioral health needs,” adding that the behavioral health landscape is posing more of a dangerous threat.

“Despite us wanting to help them, they are a danger to us … Chaffee County is not immune from this wave of behavioral health needs presenting themselves, including mental health needs, drugs, and weapons.”

New “We are Chaffee Program”

Carlstrom noted that for 2024, CCPH is working with the Chaffee Housing Authority to create a new arm of  “We Are Chaffee” with the current working title “We Are Chaffee’s Future”, intended to focus on and lift up the county’s youth.