Arapahoe County takes first steps in setting up health department after leaving Tri-County


AURORA | The Arapahoe County Commissioners will form a board of health for its new health department this summer, at which point it can then begin the process of hiring a health director and establishing a budget.

The county commissioners shared the update Wednesday evening in a virtual town hall where they briefed community members on their progress in forming a single-county health department. Despite the progress, questions raised by audience members pointed to the reality that much is still uncertain regarding how the agency will take shape.

Arapahoe County commissioners officially voted to leave the Tri-County Health Department in December, after Douglas and Adams counties both decided to leave the joint department. Douglas County was the first to exit, formally voting to leave in September after more than a year of political disagreements over pandemic health measures. A month later, Adams County also decided to leave.

The decision seemed to catch Arapahoe County, which had initially floated the idea of maintaining a two-county partnership with Adams, off guard. 

“The Arapahoe County Board of Commissioners is saddened that our neighboring counties have chosen to end the productive 55-year partnership with the Tri-County Health Department,” the board said in an October statement before ultimately deciding to also leave.

The split has prompted a flood of questions about the future of public health in the region, particularly for Aurora, which exists in all three counties. Tri-County will cease to exist in its current form at the end of 2022, at which point Arapahoe County is required by law to be ready to stand up its own health department. 

By the end of March the county will have finished prioritizing services to be provided by the health department, solicited feedback from residents and business owners and begun determining how to best provide public health services, according to a timeline on the county’s website.

In the next three months, the county will be responsible for determining how the board of health will be administered and finalize how to provide services related to nursing and nutrition, community health, environmental health, emergency preparedness and planning and information management.

Implementation work will continue in the third quarter and services will start going live in the fourth quarter of the year, according to the county’s timeline.

Health departments are legally required by the state to provide services around communicable disease control, vital records such as birth and death certificates, child fatality case reviews and immunizations required for school-aged children, Arapahoe County Commissioner Carrie Warren-Gully said at the town hall.

“Public health is focused on prevention,” she said.

As part of its preventative focus, the new department will prioritize restaurant and other health inspections, STI and Hepatitis testing and health focused on mothers and children, she said.

It will also prioritize behavioral health services and substance abuse prevention and harm reduction, she said, as those are issues the community has expressed a need for in surveys and informal communication. (Both overdose deaths and mental health issues have been significant topics of concern statewide throughout the pandemic.)

The commissioners decided to create a health department that will operate as part of the county, and share some functions such as information technology and human resources, but other than that operate independently.

The county is in the process of determining which services the department will provide directly, and which it would make more sense to partner with local organizations for or contract out for, Warren-Gully said. The idea of having Tri-County continue on as an organization that Adams and Arapahoe could contract services for has been floated in the past, but was not mentioned during the town hall.

At a study session on Tuesday, the commissioners voted to establish a founding board of health with five members, including two commissioners, which will be empaneled in the summer. 

Tri-County will still be in charge of public health decisions in 2022, Commissioner Jeff Baker said on Wednesday, but the founding board will be responsible for establishing the new department’s budget and hiring a public health director. If the health director is a licensed physician, such as Tri-County director Dr. John Douglas, he or she can also serve as the department’s chief medical officer. If not, the department must have an additional person serve in that role.

Public health directors are not required to be physicians, but information on the county’s public health webpage said that it “hopes for a public health director that exceeds the minimum qualifications laid out in state law.”

Baker said it is currently unclear how much the split will affect the county’s budget, but there is a concern it could impact the department’s purchasing power. As before, the health department will be funded by a combination of federal, state and county dollars along with grants.

During the audience Q&A portion of the town hall, several people raised concerns about retaining employees from Tri-County after the split. Jackson said that no hiring can take place until the new board of health is selected, but that they hope that many Tri-County employees “will consider bringing their expertise to us” once the year is over.

Another participant appeared confused about why Arapahoe County was leaving the health department, thinking it was a voluntary decision.

“I think it’s been working really well for a lot of years,” the question asker said of Tri-County.

Despite the split, Baker said that the counties will continue to talk to one another about public health issues, noting that the pandemic showed everyone that health problems don’t observe municipal boundaries.

 “This is not going to be a family feud type situation between the three counties…we will continue to be collaborative,” he said.