To: Board of Health
Through: Jennifer Ludwig, Director, Public Health
Prepared By:
prepared
Sara Miller, Otowi Group
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presenter
Presenter: Sara Miller, Otowi Group, and Dr. Chris Urbina
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Subject:
title
d. *Roles & Responsibilities of Contracted Medical Officer
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Purpose and Request:
recommended action
The purpose of this presentation is to provide the Board of Health additional information regarding the roles and responsibilities of contracted medical officials within local public health departments.
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Background and Discussion: Since the mid-1900s, Arapahoe, Douglas, and Adams counties have partnered with the Tri-County Health Department (TCHD) for public health services. In 2021, Douglas County, followed by Adams County, announced their intention to leave the TCHD partnership. With those departures, it became necessary for Arapahoe County to examine how best to serve the public health needs of residents and businesses.
Over the past six months, Arapahoe County has implemented a methodical and educated process to create a strong and stable local public health department and has worked to ensure that the newly created Arapahoe County Public Health Department (ACPHD) can effectively deliver services starting January 1, 2023 when Tri-County Health ceases to exist. In evaluating governance and organizational structures, the County considered how to establish department leadership, based on statutory requirement as well as regional and national best practices. Consistent with state statute, the public health director serves as the administrative and executive head of the county public health agency. The director must meet the minimum qualifications established by the state board of health and may be a physician, physician assistant, public health nurse or other qualified health professional. If the public health director is not a physician, the county or district board shall employ or contract with at least one medical officer to advise the public health director on medical decisions.
Across the country, and within Colorado, many public health agencies employ public health administrators to lead their departments and contract medical services, which is the approach adopted by Arapahoe County. Contracted medical officers must be currently licensed to practice medicine in Colorado without conditions, restrictions, or letters of admonition from any Medical Board and be a graduate of an accredited medical school (MD or DO).
Based on established business need, it is estimated the contracted medical officer would spend up to 40 hours monthly (approx. 10 hours per week) and would be responsible for the following under the administrative direction of the public health director:
• Support the planning, organizing, directing, and coordinating public health programs for the County.
• Advising the Arapahoe County Public Health (ACPH) Director and Arapahoe County Board of Health on public health decisions.
• Working with clinical staff to build trust and create a successful environment for public health services administered to community members.
• Interpreting and applying state and local public health laws, rules, regulations and orders, as defined in state statutes and regulations and in cooperation with the board of health and county attorneys.
• Consulting with agency staff about the enforcement of public health laws and rules.
• Providing authorization for vaccine and other public health drug purchases.
• Providing technical consultation to public officials, staff, and community organizations and agencies on public health and preventative medicine issues.
• Acting as the medical liaison to private sector medical care systems with respect to local public health issues.
• Counseling to the ACPH on the development of sound public health activities.
• Serving as medical provider of record for medical billing purposes.
• Other tasks may be included as needs are identified.
The County issued the attached Request for Proposal to secure a medical officer (firm or individual) to perform these services, of which a technical evaluation of respondents is underway.
To help inform future decision-making regarding the contracted medical officer, Dr. Chris Urbina will present information on the role and responsibilities of the position, providing operational perspective for Board of Health consideration. Dr. Urbina is a well-respected medical and public health professional, who served as Denver’s Director of Public Health and the Executive Director of Colorado Public Health & Environment under Governor Hickenlooper. Dr. Urbina currently serves as the contracted medical officer for Pueblo and El Paso counties.
Fiscal Impact: N/A
Alternatives: N/A
Staff Recommendation: N/A
Motion: N/A - Informational Item Only