Show: On The Town Station: KNCO File: 9:14.mp3 Air date: 2026-09-14 Source: OpenAI whisper-1 · shrunk from 26.1 MB to 5.2 MB --- transcript --- It is 1137 and 73 degrees, and it's time for our monthly visit with Dr. Tyler Hill, Chief Medical Officer with Sierra Nevada Memorial Hospital, Dignity Health. Hey, welcome back, doctor. Hey, good afternoon, or it's actually good morning. We're not the afternoon yet. Good morning. No, but it's been a beautiful few days. We had that big heat wave, what was it, last Wednesday and Thursday? Was that last week? It was hot, yeah, last week. Got really warm, and I don't know if you heard that I was talking with Rick Fisher, who was on vacation, the stock market guy, yeah. He was on vacation, and a hurricane hit. Oh, no. Yeah, so that'll alter your vacation plans a little bit. Yeah, may keep you there for longer than you were planning. Yeah, so we have such fine weather here. Even when it gets hot, we don't usually get hurricanes here. That is true. That's a good thing. Do you know, I grew up in Louisiana, this is hurricane season right now down there, so I'm quite used to all the hurricanes. Went through Hurricane Andrew in 1992, lost a shed, so lots of memories of losing power and changing plans as a result of hurricanes. Did you watch Twister? Did you see that movie, Twister? Yes, I've seen the movie. Did it hit home for you? Not so much. That's more in the Midwest, Oklahoma and Missouri, and some of those with the tornadoes. Yeah, but that was sad when the girl's father got pulled away into the- Tragic. Tragic. Yeah, we don't want that to happen to us. No, so it's beautiful weather here, beautiful, beautiful environment. And with that, I'd like to go ahead and get into the show and introduce our first guest of the day, yes, is Toby Gavon. He is our newly appointed County Public Health Director. Welcome to the show. Yeah, Tyler, thank you so much for having me. I really appreciate it. So we're going to get into your new role and some things as you've been with public health for a while. You've been a big part of the local health infrastructure for the last couple of years, and you were involved in the Health and Wellness Division before. And now that you've stepped into the director's seat, how has your perspective on our county's health shifted? Yeah, I'm fortunate to be with the department for going on eight years now. In the last four, as you mentioned, as the program manager for the Health and Wellness Division and really fortunate to lead a team of folks that were working on a variety of pressing issues for the community, whether it was overdose prevention or health education in our schools, school-based prevention efforts services. That was wonderful, but now in my new role as the Public Health Director, it's really been a great opportunity to learn more about other folks. I'm really fortunate because I know a lot of the folks within the department having worked there for such a long time, but getting more familiar with other programs across the department has been incredible. So our communicable disease team, immunizations, our public health nursing team, all of the services we have for families, whether it's home visiting or our WIC program. So that's been really great. Emergency preparedness. I mean, the thing about public health is we really do it all. And so I think the key for me coming into the position is really being fortunate to be a part of this team and continuing to work collaboratively like we do with the hospital and others. That's really a key part of how we do our work. So you were talking a little bit about the scope of this new role. And then when you look at the rural geography that we're in, what are the primary day-to-day responsibilities that concern you the most now? What's keeping you up at night? Yeah, well, I think we're really fortunate at public health to have such an incredible team that's mission-driven, that's working on these issues every single day for the community. The one that's kind of cuts across everything is really around access to care. And that can be access to medical care. It can be oral health care, substance use treatment. There's just a lot of issues that we're working on as a community to address any access barriers that are there. So some examples of this within our work at public health is we have a mobile health clinic. So we have our mobile health van that will go to schools, that will go to community locations to provide services because we really wanna address some of the challenges that people experience in just getting to that appointment. So bringing that appointment to people is key. And then we also coordinate a coalition of organizations and providers that are working on access to care called our Mobile Health Coalition. The hospital is a part of that. Providers locally are part of it, community-based organizations. And really, we're all trying to make sure that we're coordinating and collaborating when it comes to expanding access to care, whether that's through mobile health or whether that's through other initiatives. And it's really a great opportunity. We also have plenty of other pressing public health issues that we're focused on. Obviously, vaccine-preventable diseases, it's flu season. So we have a number of flu clinics that are coming up and we'll be hosting those all across the county. But really, we in Nevada County have a low vaccination rate. And so we're always concerned about things like measles. We've seen outbreaks happening across the United States and even here in neighboring counties. And so wanting to make sure that we're providing access to those services for folks across the county. And you were talking about access to care. And a big part of our kind of collaboration is primary care, having access to primary care physicians. And you were able to attend our residency recruiting event that we had this weekend, which is a big part of kind of what we're doing. Public health, all those things that you talked about, getting out with the mobile clinic, the Mobile Health Coalition, vaccinations, et cetera, et cetera. And then even participating in the hospital effort to bring more primary care into the area. So just for our listeners, I know we've talked about it before, the hospital each year hosts a recruiting event where we bring senior residents, their last year of training in family medicine, internal medicine, most of the kind of primary care specialties. And we host them for the weekend, put them up at the National, have some events for them to get out and explore the town, do a tour with a local realtor, a community tour, have a social event, presentations. They get to meet some of the primary care physicians and practices in the area to really kind of roll out the red carpet and show them how amazing it is to be here and all the things that we're doing. And public health is a big part of that. So I appreciate you being able to come there and network with those that are interested in joining Nevada County to provide healthcare. So that was a great opportunity. Yeah, it was really a great event. And I think as somebody who moved here about eight years ago, the quality of life that we have, the collaborative spirit within the healthcare field, like those are things I think that are hopefully helpful in your recruitment efforts because having great providers here, having primary care providers that are keeping people healthy, those preventative services that we love in public health, that's really critical. So it was a pleasure to be a part of that and just really a fantastic event and a wonderful opportunity for those residents and those physicians to join a great healthcare institution. I think that's always impressive and attractive to other healthcare professionals when they come in and see Western Nevada County, just how close we all are. Everyone knows everyone, either family, friends. We network both inside and outside of our workplaces. So I think it's always pretty cool to see and kind of show off to those prospective individuals. So let's shift back to your roots because you and I used to work together quite a bit on some initiatives prior to you taking this director role. But before this, you were a powerhouse in substance abuse advocacy, some things like the nitrous oxide. You were really vocal in some of those efforts. I've talked about nitrous oxide on the show, some other substance abuse issues like Kratom or Kratom, however you want to say it. And the nitrous oxide was being sold recreational in some of the smoke shops. And so for some of our listeners who might not be aware, why were some of these such an urgent issue and why does your advocacy make so much of a difference? Yeah, well, I think this is a really good example of collaboration again. I remember that you and Dr. Cates from the hospital reached out with some concerns about nitrous oxide use. And so our response when that happens is really to do some research and to check in with folks. And learning that there was just such little education that was out there about the impact of nitrous oxide, both the short-term and the long-term impact. And I think most importantly, just the ease of access, I think, particularly for youth. I mean, when you see some of the nitrous oxide canisters, it's really the tobacco and kind of vaping playbook, if you will, in terms of advertising toward youth. And so we, as public health, one of our main focuses is on education, right? And so as we did some research and we saw that there was very limited health education out there about the impact of nitrous oxide, and we really learned from you, sharing some of the impact that it has had on some of the clients that you were serving and the long-term impact from vitamin B12 deficiency and the neurological issues that can happen. And so being able to put together health education content related to that, and also being in the process of updating our tobacco retail licenses at Nevada City and Grass Valley, we were able through your advocacy and working together to incorporate a ban on nitrous oxide use at those tobacco retailers, to really address some of the access issues that we were seeing in the community. And so I think that's a really good example where we started off in Grass Valley, working collaboratively there, and then to Nevada City. And even just recently, there's legislation at the state level that's kind of mirroring using the tobacco retail license as a mechanism for preventing the sales of nitrous oxide for recreational purposes. And so for us, making sure people are educated, that they're aware of what the impact is of these products, because with nitrous oxide, there really wasn't anything that was out there at all. We had to develop our own fact sheet by putting together things from other places. And then we also developed an educational presentation for the schools so that they could share the impact on you. So I think that's a really good example of just how working collaboratively on some policy solutions can have an impact locally. Yeah, there was a lot of building into getting up to passing the local ordinances. And I would say that was as tough as it was to really dig in and see the challenges that were occurring and how easy of access it was for our youth and some of the long-term harm we were seeing coming into our emergency department and the hospitals and hearing more and more just devastating stories. It was also very exciting to see how much momentum we were gaining and working together for the community and really educating our youth and parents and schools. It was really wonderful. And then to see that kind of momentum carry up to the state level, that was a really cool moment. So really a shining star achievement for our county and just the advocacy. And again, the other part of just us working so close and knowing each other so well, forming that bond, we were able to get a lot done. So, looking outside of nitrous oxide, the landscape of substance abuse is a moving target. What else is on your radar from the public health aspect? Yeah, well, I think from a public health perspective, really, we're focused on health education and prevention. And so one of the things that's critical for us is being aware of the trends that are happening and how they impact the community and then bringing people together to assess what the issue is and what some of the best practices are that we can implement locally. I think a really good example of that has been the opioid overdose. Dramatic increase we've seen since the introduction of fentanyl into the drug supply. And that's something that we've worked on for a number of years using a variety of different interventions, whether that's education and training that we've been providing to community-based organizations, other agencies, schools, also making sure that naloxone is readily available for everybody. So, really just taking a look at what do we know works? What is science telling us works to combat these issues and then implementing those? And I think the collaborative work is so critical. We really work across sectors, whether it's with the hospital or community-based organizations, youth-serving organizations, to really build a culture here, a community-based prevention where people are looking out for each other and people are de-stigmatizing what it looks like to get help. We've got so many critical allies that we work with within the community and none of this would be possible without all of the work that they do. So, that's definitely one thing. We were pretty early in doing health education around Kratom and 7-OH, which is the kind of synthetic version of Kratom. It's much more potent. So, we developed some fact sheets that have been used across the state. We developed those, I think, about two years ago as we were hearing from people in the community because there wasn't health information that was available there. So, I think that's one issue. And then we're also really fortunate to have a lot of healthcare providers who care a lot about the community and about their clients and the folks that we work with every day. And so, they've been helping to get medication-assisted treatment available for substance use treatment and for Kratom and others. And so, really, it's a collaborative effort. It takes all of us working together to support a community approach to prevention that I think is really kind of the bedrock of what makes us effective. And we've actually seen opioid-related overdoses decrease by over 50% since the peak in 2023. So, just in a couple of years, we've seen a dramatic increase. And I really, you know, that's as a result of all of the work that everybody's doing. Yeah, it's been a phenomenal effort over the last few years. So, we're gonna take a break, and we'll be back and continue talking about public health. ♪♪ Life doesn't stop when you need surgery. But the right care can help you get back to it sooner. 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And, you know, what I want to dive into, we only have a couple of minutes left, but I really want to know, now that you're the man in charge, as we look forward three to five years, what is your North Star? What do you want the health of this county to look like? Yeah, well, I think, you know, I mentioned it before, but access to care is so crucial. Folks in the community face so many barriers to accessing care that trying to make that care easier to get is something that's really important. And so I know that we have our mobile health van and we're hosting mobile clinics on a regular basis, both at schools and out in the community. So I would love to see that be thriving just as an approach to providing care. I think meeting people where they are and making care easier is really important. And I know that's something that's important to all of our healthcare providers as well. And they're working on similar efforts and already doing so many things to make access to care easier. And so for me, that's really important just as kind of like an overall priority. I think though, you know, just, I know your question was kind of like, I now have the ability to craft this, but I think a lot of it has to do with like the approach that we take. I think we're so, collaboration is such a strong part of how we do our work in Nevada County across the board. And so that's really the thing that I wanna focus on is how do we bring people together? How is public health a convener? Similar to our mobile clinics, right? Where we're providing oral healthcare, we're providing immunizations, we're providing STI testing, but we're also bringing other partners to the table to do naloxone distribution, to bring food bags there so that we're providing access to foods from our local food banks for folks. And so really as a convener, public health coming together and helping to support our healthcare providers, our healthcare infrastructure, I think that's a really critical role that we can play and one that I'm really excited for us to play in the next three to five years. Now, rural hospitals, we have unique challenges. You know, the rural environment from a lot of the things you were talking about, recruitment funding, geography, travel, access. How do you see being able to partner, say the hospital here at Sierra Nevada to bridge some of those gaps? Yeah, well, you mentioned that recruiting visit and I think that's a start, right? Is sharing the story of what, of Nevada County and that collaboration. The number of community partners that were there to share their experience and to share the positives of living and working here and raising a family here in Nevada County was really great. I think that collaboration is also really critical. Supporting efforts around funding, around healthcare infrastructure that we can at public health is really important. And then you have the residency program and looking at different opportunities to partner there to provide care for folks, but also to provide a meaningful experience for residents being able to connect directly with those patients. I know there's been conversations around what that type of partnership looks like. So those are some things that are really exciting for me. All right, and as we wrap up, what is one thing you want every listener to know about their own role in our county's public health? Yeah, well, I think public health is community health. And I think we all have a role to play in that. So many of the initiatives that we've taken on have been community driven, where we've heard a concern, whether it was from the hospital or whether it was from a resident that really made us aware of that. And so I just like to highlight that people can come together to prevent, we've come together to prevent overdoses, our mobile health clinics, all of those examples are things where we've come together as a community to support. Toby, thank you so much. We'll see y'all back next month. Thank you. --- end of transcript ---