Counties juggle costs to replace tri-county health department

Adams, Arapahoe and Douglas counties should have new health departments by January 2023.

CASTLE ROCK, Colo. – Three counties have two months to form one new health department each. On January 1, 2023, the Tri-County Health Department will officially dissolve, leaving Adams, Arapahoe and Douglas Counties to create new public health infrastructures for themselves.

Creating a new department from scratch costs money, a cost borne by taxpayers, but how the three counties shape the departments will determine how much.

Douglas County, the first to leave the health triumvirate, said its new public health system will save taxpayers money. It previously wrote a check to Tri-County Health for about $2.8 million. The new director of the Douglas County Health Department said taxpayers will be on the hook for $2 million next year, $800,000 less. A spokesman said the county also incurred about $250,000 in one-time start-up costs.

“A lot of it is just scaling back and doing what our community needs and wants,” Douglas County Health Department Director Michael Hill said. “County residents lost nothing and maybe saved a few dollars.”

He said Douglas County has cut some services in three counties that few residents used, such as a workplace health program and a healthy beverage program, focused on another county. In addition, the new department outsourced its clinical care to a private contractor that will provide services such as immunizations and family planning.

Hill said Douglas County was able to make these changes because only 200 people routinely used Tri-County Health’s clinical services provided at DougCo, and about 80 percent of the county’s citizens have health insurance.

“If things change to the point where it looks like something will be needed in the future, I’ll take it back to the board of health and they’ll decide if we can add services,” Hill said.

Arapahoe County’s public health program will provide essentially the same services offered by Tri-County, its new director said. It will add some tuberculosis screenings and a dental program for adults, for example.

“Our goal is that the community doesn’t notice a lot of different things,” Jennifer Ludwig said. “We don’t want this to double the cost for our residents.”

Creating a new department in Arapahoe County will cost taxpayers more, a spokesman said. Instead of the $5.2 million Arapahoe sent Tri-County this year, it plans to spend $6 million next year. Most of the spending is for salaries and employee benefits, the spokesman said.

Arapahoe County also committed $2.9 million in one-time funding to get the new department up and running in January.

“Even though we’ve tried to keep it close to what the annual distribution would be for Tri-County, there’s still a loss of economies of scale,” Ludwig explained. “It’s a small increase, but not astronomical.”

In Adams County, budget funds are more difficult to determine. It previously paid Tri-County Health $4 million a year. A budget presentation in October outlined a $10 million gap between operating costs and revenue, with plans for more staff in mental health, justice, harm reduction and more.

A county spokesman said taxpayers would only cover minimal costs, if any, for the new department in next year’s budget.

“Because of the one-time revenue that has been available to the county, the net effect on the county’s general fund is expected to be minimal,” he explained.

The county hopes to get other grants next year so taxpayers aren’t on the hook to make up the difference. “In 2024 and beyond, we will have a better picture of future impacts on the general fund,” the spokesman said.

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