Public Health

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Arapahoe County is examining how best to serve the public health needs of residents and businesses. To make that happen, the County is seeking resident input that will help us prioritize the services offered by the public health department beginning Jan. 1, 2023. 

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Telephone Town Hall

On March 30, the County held a telephone town hall to provide an update on the formation of a single-county public health department. The event covered the process overview, work completed to date, ways residents can provide input, and answered questions from the audience. Watch a recording of the event.


Since the mid-1900s, Arapahoe, Douglas, and Adams counties have partnered with the Tri-County Health Department (TCHD) for public health services. In 2021, Douglas County, followed by Adams County, announced their intention to leave the TCHD partnership. With those departures, it became necessary for Arapahoe County to examine how best to serve the public health needs of residents and businesses. As required by law, Arapahoe County must have a health department in place once TCHD ceases to exist, in its current form, on Dec. 31, 2022. Arapahoe County residents will continue to receive all public health services from TCHD through the end of 2022. 

Building a Public Health Department

The County is committed to using a methodical and educated process to create a strong and stable health department. Services may be provided by partnering with other entities. Who provides services and how they will be provided will be determined during 2022. Learn more about how a public health department determines which services to provide by watching the video below.

A core project team is now in place to provide the Board of County Commissioners with the framework, data and information necessary to make decisions. The project team meets on a regular basis to complete the following tasks to bring to the Board:

  • Develop a transition plan for all public health services.
  • Establish communications with stakeholders, including those identified below.
  • Understand and define the public health services within the County
  • Prioritize a list of services for consideration.
  • Identify the structure of desired services and determine who will deliver those services.
  • Identify expense and revenue resources.
  • Propose plan to rollout health department.

Commissioners will hear regular updates from the project team and will take voting action in a public forum.

For more background, read the Health Department Creation one-page summary.

Guiding Principles

The Board has adopted the following principles to guide our work over the coming year:

  • This will be a consultative and collaborative process. We will make decisions by consulting with appropriate stakeholders and industry leaders at the local, state, and national levels.
  • We will listen. We value community and stakeholder input and will design appropriate opportunities for the community to provide input and feedback, including listening sessions with TCHD employees.  
  • Decisions we make will be fiscally sound and based on industry best practices.
  • We will communicate. We will produce regular communications to inform and engage stakeholders at every appropriate opportunity.

For information on health department news, as well as on other critical County projects, sign up to receive the commissioners’ weekly newsletter.


1st Quarter 2022

  • Build a stronger understanding of the services provided by TCHD.
  • Prioritize services to be provided by the health department.
  • Gather feedback from residents on businesses on public health service needs.
  • Begin to determine how best to provide public health services.

Watch March 29 Board of County Commissioners Study Session below to understand the results of 1st quarter activities:

2nd Quarter 2022

  • Finalize how to provide the following services in the following broad categories:
    1. Nursing and nutrition
    2. Community health
    3. Environmental health
    4. Emergency preparedness and response
    5. Planning and information management
  • Continue gathering feedback from residents, businesses and other community partners
  • Determine how the board of health will be administered

3rd Quarter 2022

  • Continue implementation work to complete transition to single-county model.

4th Quarter 2022

  • Go live, as appropriate, for the services in the categories above.

1st Quarter 2023

  • Arapahoe County health department is in place by Jan. 1, 2023.

Public Health Department Structure and Board of Health

A public health department can be structured in a myriad ways to best serve its constituents. At a basic level, the governing structure of the health department is specified in law to include:

  • Board of health with at least five members. At a meeting on March 29, Commissioners approved the establishment of a founding board of health. The board would have five members, including two commissioners. The founding board will be empaneled in summer 2022 to complete operational items associated with establishing the health department prior to Jan. 1, 2023. During April, commissioners will hold study sessions to finalize the approach and timeline. Once the health department is operational, the County intends to transition to a board of health with a wider variety of expertise.
  • Public health director, selected by the board of health. The County hopes for a public health director that exceeds the minimum qualifications laid out in state law.
  • Medical officer (if the public health director is not a physician). The County intends to contract with a qualified medical officer with public health expertise.

These entities oversee public health services, which can be provided by utilizing health department employees and by contracting with other entities. Colorado’s Public Health Act  provides a framework/requirements for the types of programs required or encouraged for public health departments to deliver, ranging from immunizations and childcare facility safety inspections to emergency preparedness and support for parents of special needs children.


In 2021, Arapahoe and Adams counties hired Otowi Group, a local consultant, to research potential options in the wake of Douglas County’s impending departure from the 55-year-old TCHD partnership. Otowi Group interviewed stakeholders and community leaders across both counties and gathered and analyzed relevant financial data. Now that Arapahoe County is moving toward a single-county health department after the departure of Adams County, Arapahoe continues to work with Otowi Group to look at forward-thinking, affordable options.

The County will seek community and stakeholder input by developing opportunities to provide feedback. Input from municipalities, residents, businesses, nonprofits, and TCHD employees will guide us as we move through the processes of developing a single-county health department.  

For information on health department news, as well as on other critical County projects, sign up to receive the commissioners’ weekly newsletter.


The County is evaluating staffing needs based on services to be provided by Arapahoe County Public Health. Colorado law gives the board of health exclusive right to select a public health director. The public health director may then facilitate the hire of additional staff members.

Public Input

For information on health department news, as well as on other critical County projects, sign up to receive the commissioners’ weekly newsletter.

Board Meetings

County Commissioner study sessions (except for executive sessions) and business meetings are open to the public. You can view upcoming meeting agendas and minutes in Legistar.