In more than eight years on the county's health board, having served as president three times and vice president once, Terry Thatcher had no trouble making her voice heard.
Yet at the group's most recent meeting, held for the first time at Pikes Peak Regional Development Center, Thatcher was briefly silenced.
It was actually just a technical problem. Amy Lathen, one of four new board members, had to help Thatcher use the room's microphones. "Make sure the red light is on," said Lathen, who regularly meets in the same room as a member of the El Paso County Board of Commissioners.
Only gradually did the symbolism become clear: The lead role shaping county health policy has passed from community members like Thatcher into the laps of politicians like Lathen.
Some who have fought for public health in the county find that scary.
"I think politicians have no business on boards of health," says John Potterat, who spent nearly 30 years working in the El Paso County health department. "I view it as packing the court."
The "court" is the group responsible for determining whether, say, the health department should put more energy into ensuring local restaurants are sanitary or seeing that local prostitutes are tested for sexually transmitted diseases. For years, the board consisted of five community members appointed by the county commission.
That changed April 14 when commissioners, following a state law that required them to redesignate a health board, took the opportunity to add four new slots and filled them with Lathen, fellow Commissioner Sallie Clark and city councilors Jerry Heimlicher of Colorado Springs and Marc Snyder of Manitou Springs.
The new group met for the first time Monday, quickly deciding to keep Dr. John Burrington, the board's only physician, as president, and to meet monthly at the Regional Development Center.
Potterat's skepticism has roots in personal experience: He helped build a local program for tracking and controlling the spread of STDs that was once considered a model for other communities (see "Unprotected," cover story, Dec. 11, 2008). He retired in 2001 amid pressure from commissioners and the Taxpayer's Bill of Rights to scale back public-health programs; health department funding from the county was then a robust $5.1 million a year.
This year, the funding is $2.8 million, prompting the board to kill the STD surveillance program and to discontinue pool inspections and other programs. In Potterat's view, the changes have not all been guided by science, but instead are influenced by local political views and priorities.
Now, politicians will actively share in setting department policies.
Clark doesn't view that as a bad thing. With commissioners already appointing members, she points out, the board has always been political, but its new members can help increase visibility and strengthen connections with other governmental entities.
"We will have more personal responsibility," says Clark, who adds that she wants more people to understand what the health department does and the strains it faces.
Local voters ultimately control the department's purse strings, and they said "no" last fall to a proposed sales tax measure that would have boosted its funding.
Randall Bjork, a physician and immediate past president of the El Paso County Medical Society, fears true visibility for the department won't come until an outbreak of salmonella or another infectious disease.
"It'll take something that will scare the bejeebers out of people," Bjork says.