Jill Blake has many responsibilities in leading the Public Health Department of Nevada County. Her team of 36 people has a budget of $10 million for the 2020-21 fiscal year. They work from the basic idea that the health of individual residents shapes the health of the whole community. So, they work with new mothers, children, adults and the elderly across the county to help them be as healthy as they can, no matter where they live or what their income or amount of schooling. Among other tasks, their mission embraces preventing and tracking 80 contagious diseases, from chicken pox to rabies to West Nile virus, and protecting the health of the whole community when disaster strikes.
The team’s motto is: “Safe, healthy and thriving communities.”
“These are entirely committed individuals: committed to this work, to this community,” said Blake, who grew up in Nevada County and has family here.
Jill Blake, M.P.A.
Nevada County Public Health director
– Master of Public Administration, University of Southern California
– Bachelor’s degree in English literature, University of California, Los Angeles
– UC Davis Public Policy Program certification
– California County Senior Executive credential
– Certified Public Health Accreditation Board site visitor
Blake’s daily fare includes juggling the needs and demands of staff and contractors, overseeing health programs and hashing out policies, eyeing budgets and writing reports, preparing for certification audits and attending meetings.
“There are layers of people who share those responsibilities, but ultimately, I’m the one responsible,” Blake said.
For the past 16 months, one of Blake’s most important responsibilities is not in the official job description or list of the department’s programs: Blake has kept her team together amid the pressure, chaos, uncertainty, fear, anger, despair, expectation, hope and occasional moments of joy they have felt amid the novel coronavirus pandemic.
Unlike many local public health departments across the United States, not one of Blake’s employees has quit, she said.
“A big part of my role is maintaining everything that we’ve needed to keep (the team) in place and to care for them, to support them, to provide for them, to get the additional bodies they need to get the work done — sometimes, to protect them,” Blake said.
“I am a servant to them.”
Blake has been with the county Public Health Department since 2012. She was named interim director in 2014 and assigned the job permanently in 2015. All told, she has been in the public health field for about 16 years, and worked with nonprofits related to public health for about 10 years before that.
Usually, the Public Health Department’s employees quietly tend to the health of county residents who often are elderly, isolated, vulnerable or poor. In her 2019 annual report, Blake described her team as “small but mighty.”
They are charged under state law to “take measures as may be necessary to preserve and protect the public health.” They run programs that help parents keep their children healthy with physical exams; screenings for dental and vision problems, lead exposure and tuberculosis; and therapy for physical disabilities such as cerebral palsy. They educate teens about the risks of using tobacco, alcohol and drugs. They help people with HIV/AIDS and hepatitis C. They also create and manage records of county births and deaths; and run the Women, Infants and Children food program locally.
In addition, Blake’s team helps people stay well with health clinics, education about healthy living and preventing suicide, home visits, vaccination clinics, and links to medical services.
Their responsibilities extend to “preventing the spread of any contagious, infectious, or communicable disease,” according to the California Health and Safety Code. Diseases they track and report to the state include diphtheria, measles, mumps and whooping cough; food-borne and sanitation-related illnesses such as botulism, E. coli infections and cholera; fevers such as dengue, typhoid and malaria; and sexually transmitted diseases.
“We were doing excellent work very quietly,” Blake said
The COVID-19 pandemic suddenly pushed the public health team onto the front lines. On top of their regular responsibilities, Blake’s staff began to monitor COVID-19 cases and trace the contacts of sick people to contain the contagion. They offered support and arranged help for people in isolation or quarantine. They answered calls from worried and frightened residents. As the pandemic’s demands overwhelmed her team, Blake pulled in resources and people from outside the department. As understanding of the virus evolved and public health guidelines shifted, she and others attended statewide meetings called for 7 in the morning and 10 at night.
Supportive conversations pulled team members through their 14-hour days and 7-day work-weeks, Blake said.
“If I see someone who’s getting pushed too much, I think, how do I reel that back and care for them, provide for them, with the objective of keeping the team whole?” Blake said.
Jarring spotlight and false understanding
Public challenges have added to the team’s load. Anger from some residents over lockdowns and mask-wearing — fueled by misinformation about COVID-19 and the effectiveness of public health measures — has been directed at the department. Protests have continued regularly at county Board of Supervisors meetings.
“To be thrust into that spotlight was pretty jarring to most people who have worked for decades in public health and have never had that experience,” Blake observed. “When we started getting this negative pushback and this rejection of science and this rejection of well-developed and well-demonstrated techniques like contact tracing… when people started to doubt and question and challenge, we had such a feeling of surprise…
“We realized that we had been naive about some elements of our community and the way that some bought into conspiracy theories and false narratives,” Blake said.
“We then had the sometimes painful experience of seeing some of those people get quite sick with COVID or lose a loved one to COVID,” Blake added. “We never want someone to have to experience debilitating illness or loss in order to better understand the impact of a disease or to dispel wrong information they received.”
In May 2020, people protesting health mandates filmed Blake in an impromptu and hostile interview outside her office. The recording made it around social media.
That post seeded a surprising source of support for Blake’s department and their mission: Friends of Nevada County Public Health. It’s a private Facebook group that now has more than 160 members. They have sent flowers, chocolates, home-baked treats, home-made cards and hand-written notes expressing thanks and encouragement to employees with the Public Health Department.
“It was so moving to this team, just a lovely surprise,” Blake recalled of the sometimes weekly, sometimes daily communications from the largely anonymous Friends. “It was like superfuel. That demonstration of support, when that other faction has been so vocal and so loud and pounding on the table… it just has meant the world. We live in a generous community.”
Balm: ‘You are heroes’
Support also came from several leaders in Nevada County government, notably District 1 Supervisor Heidi Hall, who was chairwoman of the Board of Supervisors during 2020. She would send emails to the department encouraging them amid the turmoil, even as others on the board minimized COVID-19’s devastation and opposed measures proven to slow the disease’s spread and save lives.
One of Hall’s emails, in particular, made Blake choke up with emotion as she read it:
“Please take my thanks and extend it to everyone in the department. You are the heroes of our time, and as such, also a target,” Hall wrote in April 2020. “Please know that I and many others appreciate you… Your work matters and makes a difference.”
“It was superfuel, and it was also balm” for her team members, Blake recalled. “It was such a comfort to hear how well they were understood, and the challenges they faced, by the chair of our Board of Supervisors.” Hall’s words, Blake added, “left a mark on us, and it’s a beautiful mark.”
Being witnesses to hardship and in the eye of the storm has brought the team closer together, as they pulled on each other’s strengths and confronted their own weaknesses, Blake said.
“I want to celebrate the commitment, the values, the resilience — all the things that make this an extraordinary team,” Blake said. “It’s been such an honor to work with them.
“We’re not martyrs and we’re not saints,” she added. “There’s been such compassion, such understanding on everyone’s part in a moment when others are suffering.
“I can’t imagine going through this with anybody else.”