Bernalillo County names first chief medical officer, Dr. Rebecca Fastle

Bernalillo County named Dr. Rebecca K. Fastle as its first chief medical officer, a new post meant to give the county a single medical leader across systems that have long been stretched between detention health, behavioral health and public health coordination.

Fastle started in the role on June 1. The county announced the appointment in a June 4 news release, saying the move is intended to improve coordination and public health services. Fastle brings more than two decades of clinical experience, along with executive hospital leadership, public-sector system transformation and correctional health care work.

Her background fits the county’s most sensitive pressure points. Fastle earned her medical degree from the University of New Mexico School of Medicine, is board-certified in pediatrics and pediatric emergency medicine, and most recently served as associate chief medical officer for special projects at University of New Mexico Hospital. She also worked as a physician leader within the Metropolitan Detention Center Health Authority, giving her firsthand experience inside the jail health system Bernalillo County is still trying to stabilize.

The county’s own job description makes clear why the position was created now. The chief medical officer is a key member of the BernCo executive team, reports directly to the county manager, and is charged with providing medical leadership across relevant divisions, departments and offices. The goal is not only better care, but high-quality health and behavioral health services delivered within a sustainable budget.

That mandate matters at the Metropolitan Detention Center, where UNM Hospital took over inmate medical care in August 2023 after a series of inmate deaths. Fastle will provide leadership and consultation for the Bernalillo County jail and the Youth Services Center, two places where medical decisions, mental health needs and custody operations intersect every day.

For Bernalillo County, the new role is a governance change as much as a staffing change. Residents should expect faster coordination between medical staff and county administrators, clearer accountability for jail and youth detention health, and a stronger push to keep care, safety and spending aligned. The county will be judged by whether the new structure reduces breakdowns before they become crises.