On Tuesday, the tri-county health department begins the true reveal, after 73 years of providing vital health services in a stretch of the metro area from Brighton to Larkspur – which is now home to 1.5 million people.
Douglas County will form a board that day to oversee a new public health department of its own. Few people in a politically conservative county know what this will look like and if it can be done at a reasonable cost.
Hastened by a global pandemic that has sparked raw emotion and politics stemming from controversial health orders and restrictions, the move has generated headlines and pushback. Meanwhile, Adams and Arapaho Counties are left to figure out where they go from here. Do they live together, or is it each their own?
Aurora, which spans all three counties, must also chart a precarious path about how and where its nearly 400,000 residents will continue to receive public health services.
“It’s the most expensive example of taking your ball and going home that I’ve ever seen,” Parker resident Matt Bateman told the commissioners at a public meeting last week. “After a brawl about masks – masks – we’re going to get our ball and go home?”
Douglas County’s decision was made last week unanimously by three of its commissioners, and in response to the tri-county health department’s extension of the mask mandate to all students and staff in schools through Aug. In doing so, the tri-county revoked the ability of its member countries to opt out of health orders.
Douglas County cried out that the repeal was a “violation” of the November agreement. Two days later, it formally began its withdrawal from an agency that administers 60 health programs — from infectious disease screening to vaccinations to restaurant inspections — and has a $66 million budget.
Tri-County Deputy Director Jennifer Ludwig called the Douglas County decision “unfortunate.”
“It’s really hard to see this changing, especially in the midst of a pandemic,” she said, “especially when the decision to do so revolves around politics.
“There’s more to a tri-county than just responding to a pandemic and issuing orders.”
“Okay… to move on”
The rapid-moving events on the east side of the metro area look similar to what has been playing out in Southern California in recent months, where half a dozen Los Angeles County cities — including Torrance, Beverly Hills, Whittier and Glendale — have taken the lead. Braking detected. To make the county’s public health department its own.
Cities’ central complaint revolves around what they see as overly restrictive COVID-19 measures. According to a story in Hermosa Beach’s Daily Breeze newspaper, West Covina is the only city that has really taken advantage of it so far.
Douglas County Commissioner Abe Layden said the split from Tri-County had been a long time coming. What began as a rural outpost at the edge of Denver’s southern suburbs half a century ago, with fewer than 5,000 residents, the county is now home to more than 350,000 people. Douglas County joined the tri-county in 1966, replacing Jefferson County.
At last week’s board of commissioners meeting, Layden compared the separation to an “empty-nest” situation.
“It’s okay for kids to grow up, move on and do new things,” he said. “A theme that is clearly clear to all of us—regardless of your background as residents of Douglas County—local control of your public health decisions is paramount.”
There were zero pediatric hospitalizations for COVID-19 in Douglas County last week and only one child in the county has died of the virus in 18 months, leading a mother at the commissioners’ meeting to note that “our children are suffering from this disease.” are least vulnerable to, yet somehow they are most punished.”
Its partnership with Tri-County – the state’s largest local public health agency – will go through at least the end of 2021, giving it some time to figure out the costs and logistics of setting up its own health department. Douglas County contributes $2.5 million to the agency annually, and Layden said it has very little debt, strong reserves, and about $70 million coming into the US Rescue Plan COVID-19 relief money, which he said is the health agency. can be directed towards launch.
But Glenn Mays, a professor of health policy at the Colorado School of Public Health, said starting a new health department would simply cost more. Not to mention, he said, “You’re going to build that plane while you’re flying it.”
Lost with the dissolution of the tri-county would be the “economies of scale” that an agency of that size could bring to the table, Mace said. According to Tri-County, the department provides services at a cost of $7.10 per person per year.
Douglas County will also face challenges in the kind of medical and technical expertise that Tri-County has managed to attract with its 368 full-time employees. That total includes physicians, nurses, nurse practitioners, social workers, dentists, and dentists.
Douglas County deputy manager Barbara Drake, who is leading the transition, said it is not yet clear how much it will cost, adding that the county already owns one of the buildings in the tri-county loan tree. operates and leases to another in Castle Rock. . Douglas County would also be eligible for millions of dollars in state and federal grants, Drake said, just as Tri-County is today.
“My hope is that in a few years we will look back on this and realize the benefits we are getting from the single-county health department,” she said.
What’s next for Adams, Arapaho?
Breaking up with Tri-County would have spillover effects for Adams and Arapahoe counties. “Disappointed” is the word Arapahoe County Commissioner Nancy Jackson used to describe her reaction to the division.
“That’s one of the issues,” she said. “Will this cost us more money?”
Arapaho County contributed $4.8 million to Tri-County for services this year, and Jackson said the agency “has always been very sensitive to our needs.”
The county is working with Adams County to explore its options on what to do next, whether that be a two-county health agency or each closing on its own. An advisory report outlining possible paths for Adams and Arapaho counties is expected in October.
Earlier this month, Arapahoe County requested Douglas County to delay any departures until the three counties “are able to meet and discuss a mutually agreed early exit strategy for Douglas County.” ” One letter even threatened legal action over how much notice its neighbor had given about their impending split, noting concerns over the potential for “significant adverse effects” to Arapahoe County from a breakup. keeping.
Adams County appears to be more open to going it alone, an idea that longtime commissioner Eva Henry said she has pushed for years.
“People in Adams County have different health challenges than people in Douglas County,” she said, citing the Suncor oil refinery in Commerce City and the county’s extensive oil and gas production area that is exposed to air pollution and water pollution. presents concerns. She said suicide prevention and family planning, especially in communities of color, are louder issues for Adams County than its neighbor to the south.
Adams County pays Tri-County $3.8 million per year for services to Tri-County.
“It’s been very difficult over the years trying to figure out how to do justice to the three counties,” Henry said. “That gives us a real opportunity to see if we can re-imagine the health department.”
Aurora gets squeezed
Aurora is literally stuck in the midst of isolation. Mayor Mike Kaufman said his city is spread across all three counties, adding he worries about “additional administrative costs to taxpayers to pay to break up tri-county health and create three new bureaucracies.”
“It’s just inefficient,” the mayor wrote in an email on his return from a trip to Central America. “The pandemic has been difficult for everyone, difficult to navigate from a public health standpoint, and has led to tough decisions that are unpopular and easy to second guess by elected officials, who will never have the responsibility to make these decisions. “
Ludwig, with Tri-County, said the timing of the Douglas County decision – and the suddenness with which it happened – is problematic.
“Because it was so reactive and we were in the middle of this pandemic, I think it’s unfortunate not to have the opportunity to collectively work more cooperatively and look at it with more time,” she said. “If it weren’t for COVID, we wouldn’t be having this conversation today.”