7 the importance of buckling up. Simultaneously another chronic condition was demanding the attention of the MCHD: mental illness. As the trend to deinstitutionalize psychiatric patients in the 1950s and ‘60s accelerated nationwide, Monterey County worked to support this in-need population who now had nowhere to go, said Melton. The solution came from an enduring partnership between MCHD and Interim, Inc., a community nonprofit focused on supporting people with chronic, severe mental illness. Interim has now built and operates permanent, affordable, supportive housing units for more than 150 people throughout Monterey County. As recently as 40 years ago, the MCHD oversaw the organization of the county’s first coordinated ambulance service. Before these efforts, not only did ambulance service not cover the entire county, there was no standard of medical training for those responding to emergencies, said Melton. Dr. Melton remembers the impact of this public health initiative clearly. “The first week we had a paramedic ambulance in Big Sur an 8-year-old child was stung by a wasp,” Melton said. “The ambulance was there, had an EpiPen and could respond to the scene of the kid who was allergic to the sting and treat him. It was the first example of the difference (EMS service) makes in a place 45 minutes from a hospital.” The closure of Fort Ord and Silas B. Hayes Army Hospital in 1994 brought new challenges to MCHD, Melton said. The Health Department responded by quickly mobilizing primary care clinics in Seaside and Marina. These humble beginnings included a former dental office lent to MCHD for Marina’s clinic. Seaside’s new location provided care from a rented trailer in a parking lot, remembered Melton. “Now there’s a county-wide clinic system. Now there are obstetricians, internists, and others,” Melton said. “Building the clinic system was a big step for the health department.” As the 20th century drew to a close, the MCHD responded to the HIV epidemic and helped residents grapple with their increasing concerns about environmental health and climate change. These layered concerns for residents prompted a new focus on innovative collaboration for the health department, Melton said. “Before 1990 local health departments were not viewed as engaged in community activities,” he said. “But since the 1990s, health departments all 1937 National Cancer Institute begins 1940s County of Monterey Health Department evolves to include other public health concerns, like vermin control, air pollution, and water quality 1940