The demise of Tri-County Health could be hazardous to your wallet

The dissection of the organization that has safeguarded the health and safety of 1.5 million Coloradans is now gathering speed. In its place, three smaller, untested county health departments are being patched together in haste – three agencies that may well provide fewer services, at least at first, and could cost taxpayers millions more.

And it all started with a wrongheaded fit of political pique in opposition to reasonable efforts to save lives.

Since 1948, Tri-County Health has provided public-health services in Adams and Arapahoe counties, adding Douglas County in 1966. Over the years it has gained vast experience, achieving economies of scale and efficiencies as it expanded to serve a fast-growing population.

It has inspected restaurants and child-care centers, provided cancer screenings and maternal health services, tracked diseases and offered nutrition counseling and immunizations. And it has helped to combat the deadly COVID-19 pandemic – a diligent effort that, like other Colorado health agencies, has earned it threats and angry responses from some of the very people it is protecting.

Now, as The Post’s John Aguilar reports, Tri-County will go out of business Dec. 31. Many of its employees are already leaving. And the three counties that have relied on the agency for decades are now scrambling to stand up three separate health departments, each competing for the best staffers and undoubtedly duplicating services in some cases.

Officials warn of potential gaps in service and unpredictable new costs – not to mention a looming lawsuit over the breakup that seeks $50 million from the three counties.

Or as Shawn Davis, just appointed to Arapahoe County’s new health board, put it to Robert Tann of Colorado Community Media: “Do we think it’s going to be a smooth transition and issues won’t come up? Absolutely not.”

Douglas County’s conservative leaders started this absurd mess. Long before they launched their current head-scratching attempt to grab control of a Denver-owned park in a tantrum over gun policy, they decided that Tri-County was too strict about mask-wearing rules and other life-saving policies during the peak of the pandemic.

No reminder should be needed, but COVID is one of the greatest health emergencies this nation has ever faced. It has killed more than 1 million Americans to date, nearly 13,000 of them in Colorado and almost 3,200 of them in Adams, Arapahoe and Douglas counties. In those counties alone, COVID has sent nearly 18,000 people to the hospital.

In the face of this disaster, Tri-County Health – following recommendations from state, federal and global health experts – issued a series of temporary safety orders, including a stay-at-home rule in the early weeks of the pandemic followed by mask mandates in public indoor spaces and school classrooms.

There was widespread grumbling over the rules – after all, few of us enjoy wearing masks – but Douglas County officials went further, accusing the health agency’s “unelected bureaucrats” of ignoring the will of elected county officials (who, by the way, appointed all of Tri-County Health’s governing board members).

When that board ended the counties’ ability to opt-out of its COVID safety orders in August 2021, that was the last straw for Dougco leaders, who voted the following month to divorce Tri-County and launch a county health department.

“Today is about local control over public health orders,” Dougco Commissioner Abe Laydon said at the time.

With Tri-County’s financial framework threatened by Douglas County’s pullout, commissioners in Adams and Arapahoe counties began making their own plans for public-health services, even though most of their leaders insisted they did not object to the agency’s COVID orders.

The breakup is “not something that Arapahoe County actually wanted,” county Commissioner Nancy Sharpe said.

Arapahoe County named its new board of health in mid-June, just over six months before Tri-County goes away; Adams County isn’t even that far along. Douglas County, with its head start, has begun hiring health department employees but still needs dozens more.

And the challenge they face is daunting, as is the potential hit for taxpayers.

Otowi Group, a consultant, predicted in a report for Adams and Arapahoe county commissioners last October that the breakup of Tri-County Health could mean millions of dollars in extra costs for those two counties alone as they add needed organizational infrastructure. Counties also may pay more as they compete to hire highly skilled staff from the current Tri-County agency and elsewhere.

Otowi’s report also warned that, “in the short term, separate, single county public health agencies would have access to less public health revenue, and perhaps services, and would incur transition costs for startup and dissolution of (Tri-County Health).”

And here’s the key passage in the report: Tri-County Health “has the size, breadth and depth of staff expertise, good reputation, grant writing and management capacity, and status as Colorado’s largest health department that allows the agency to procure funding not generally available to other health departments in Colorado.”

Otowi projects transition costs of $61.6 million for the two counties. Part of that is related to the $50 million fee that the Colorado Public Employees’ Retirement Association (PERA) says it is owed by all three counties to cover benefits for Tri-County employees once the agency expires. PERA has sued to collect the fee.

As The Post’s Aguilar reports, officials express hope that the new trio of county health departments will be better able to address the distinctive health needs of each county’s growing, diverse populations.

Fine, but how much more prudent and less expensive it would have been to work to make Tri-County Health better and more responsive than to tear it apart and start from scratch.

Mark Harden has been a Colorado journalist for three decades, serving as an editor and reporter at The Denver Post, the Denver Business Journal, Colorado Politics magazine, Colorado Community Media, The Colorado Sun and Rocky Mountain PBS.

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