Improving Indoor Air Quality—Community Spotlight

San Juan Basin Public Health

At the start of the IAQ project, San Juan Basin Public Health (SJBPH) was the statutory local public and environmental health agency for Archuleta and La Plata counties in Colorado and provided public health services, including environmental health services, to smaller surrounding counties. SJBPH’s mission was to advance health equity and help its approximately 70,000 residents to achieve their fullest health potential.

As of January 1, 2024, San Juan Basin Public Health has dissolved, with the two counties creating their individual health departments. Due to this change, the final period of the IAQ mini-grant was focused on transferring the accomplishments of the project to the successor counties.

What are some unique and innovative programs or services offered by your organization? Or: Tell us about a current project that excites you. Or: What has been a win/top accomplishment that makes you proud?
During the IAQ mini-grant project, the SJBPH team successfully competed for funding from several new funders for new IAQ projects. At the start of the project, SJBPH had around $14,000 for IAQ work; at the end of the project, approximately $110,000 was available to transfer annually to La Plata County Public Health for these services, and another $50,000 was available to both La Plata and the Archuleta County Public Health Department in one-time funding for related services.

This funding included support from the Colorado Department of Public Health and Environment (CDPHE) for residential and the de Beaumont Foundation for commercial IAQ programming. SJBPH used this funding for partnership development, research on local indoor air quality concerns, and intervention design.

How has your organization’s work made a difference for healthy housing in your community?
On commercial buildings, SJBPH partnered with Colorado State University and CDPHE to perform a comprehensive IAQ assessment at a local long-term care facility and stock supplies at the facility to improve IAQ inside the building and to prepare for smoke and dust storm emergencies that are becoming more common in our region. For residential buildings, SJBPH completed a draft program design, including “final draft” inspection checklists, resident questionnaires, supply lists, training and outreach plans, and evaluation mechanisms. CDPHE funds for 2024 and beyond were obtained by one of the successor county departments, so these work products can go through legal and communications department review at this county and then serve as their basis for a multiyear residential indoor air quality program.

What do you think is the most pressing challenge facing your organization and/or the community you serve?
There are three subpopulations in our community that may be disproportionately affected by indoor air contaminants and may find it difficult to access health information and resources, including information related to housing and health issues. First, residents of older housing stock, particularly older rental housing, who frequently report mold, moisture, and pest problems to their local health agency; second, residents of rural areas and older homes in urban areas that heat their homes with wood and coal stoves; and third, residents who live in rural areas, have low incomes, speak a language other than English as their first language, and have inconsistent broadband internet service. One of the two successor counties has obtained long-term funding for residential indoor air quality and will be focusing their program through intensive cross-referrals with local nonprofits and other partners that serve these groups, as well as other county public health programs with eligibility restrictions that align well with these needs.

Is there an opportunity on the horizon that you believe will have a positive impact on your work?
During the 2022 Indoor Air Quality mini-grant with NCHH, SJBPH improved its relationship with the Colorado Department of Public Health and Environment’s Environmental Justice Unit, which adds resources and integrates well with local health departments and CDPHE’s Office of Health Equity. These strengthened relationships build capacity to advance equity and justice by contributing a resource for SJBPH and the successor entities to engage communities and include them in decision-making.

What do you value most about your partnership with NCHH and others in the healthy housing space?
During this partnership, NCHH has advanced SJBPH knowledge of program design. Through NCHH, the project team came to better understand how to design a program that connects assessments results to interventions, whether that be physical, financial, or technical (or some combination of all three), and that avoids creating unmet demands. To assist with program design, NCHH provided invaluable tools to categorize the IAQ problems within the community. Without this conceptual framework, the idea of addressing IAQ in a comprehensive manner at a level of quality the community has come to expect would have been extremely daunting. The resources from indoor air quality project have made the problem not only feasible for the successor counties but has truly set them up for success.

How did being a part of an NCHH mini-grantee cohort and TA experience support and advance your work?
By the end of the 2022 Indoor Air Quality Mini-grant, SJBPH secured funding and designed programming to find IAQ contaminants that can be implemented by the successor legal entities. These activities add to the community’s capacity and should be the foundation for improvements on other metrics in the future. If SJBPH staff had not had the capacity to pursue these funding opportunities and present them to the successor counties, it is possible that the new county health departments that came into being in January 2024 would not have had the same ability to plan and offer IAQ services.

What is the most important lesson or piece of advice you would share with others doing this kind of work?
Given how much the project had to pivot toward focusing on transferring resources to the success or county agencies, several conclusions from the project may not be broadly applicable; however, two lessons certainly apply to any agency taking on IAQ program development.

The first lesson is the importance of dedicated staff to work on meaningful, long-lasting partnerships. SJBPH began the project with a policy and partnerships officer with strong relationships with the business community and time in funding awards for the agency emergency manager and environmental health director. These were key participants, but all had other demands on their time, including deliverables and key results for which they had primary responsibility even before the agency began to lose staff in response to the pending dissolution, and these key staff took on additional responsibilities. The original program development plan included a senior environmental health specialist to serve as project manager for several related IAQ projects; however, due to pending dissolution, there were not satisfactory applicants for this position. A complicated project like this requires staff that can spend a majority of their time and energy on making elements successful, especially long-term elements.

The second lesson is the incredible technical complexity of indoor air quality projects in commercial buildings such as the long-term care facility noted above. There is no standardized out-of-the-box assessment tool for these spaces given their wide variety in indoor composition, ventilation systems, and patterns of use. The Colorado State University program, with which SJBPH collaborated, uses a variety of techniques to create a truly comprehensive picture of a space, which takes multiple site visits of a half day to full day each, followed by extensive offsite analysis. Even after this was complete at SJBPH’s demonstration site, one of the team’s recommendations was a tune-up of the building’s HVAC system. The HVAC contractor was a general machinist and fabricator with no assessment experience, and the facility chose not to pursue bringing on a new contractor. Local public health agencies attempting to facilitate or offer service in this space will need substantial technical experience and tools. One of the CSU team’s goals was to identify which techniques out of their toolbox was most useful and could serve as a pared-down assessment protocol; once that research was complete, local public health agencies and businesses may find it easier to take on commercial indoor air programs.

Overall, there is a substantial need for workforce development and training in indoor environmental assessment.
Because SJBPH no longer exists as a legal entity, its website has been archived. To learn more about the indoor environments program launching soon at La Plata County Public Health Department, contact the team at eh@lpcgov.org.

 

Latest page update: July 9, 2024.