On Tuesday, Oct. 12, the Arapahoe County Board of Commissioners heard a presentation that will help determine the best path forward for the County’s future public health agency operations. 

Earlier this year, 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 Tri-County Health Department partnership. Otowi has been interviewing stakeholders and community leaders across both counties as part of this process, as well as gathering and analyzing relevant financial data.

Otowi delivered the same presentation in a study session with the Adams County Board this week, and both counties will use this information to determine next steps in the process. The primary consideration will be whether a single- or dual-county (or “district”) public health partnership makes the most financial and logistical sense going forward. A single-county agency could include a commissioner-appointed board of health that selects or contracts with either internal or external public health directors, officers, staff and services; a district agency could look similar to the existing Tri-County structure.

Both counties’ will use the Otowi information to inform next steps in the process. “While neither county is prepared to make a final decision about this issue right now, Otowi’s work adds important information that will help us determine the best public health approach for Arapahoe County’s residents,” said Arapahoe County Board Chair Nancy Jackson. “Our Board will continue to evaluate all relevant considerations with the primary objective of providing cost-effective public health services with no gaps in coverage.”

This was the second report Otowi has presented to the two counties in the past month. Among the key takeaways from Tuesday’s meeting:

• The costs of a single-county or district public health department would be relatively similar, primarily because whatever savings a single-county agency might provide would be somewhat mitigated by the adjacent counties competing for talent and driving up wages, and by each county having to create its own infrastructure around a new agency.
• A district approach would be able to rely on the existing multi-county infrastructure rather than having to create a single-county infrastructure nearly from scratch. A single-county agency would also need time to establish funding resources and qualifications.
• A single-county agency would provide more local control, which might appeal to communities with unique public health needs, but a district approach would continue the Tri-County legacy as the largest public health agency in Colorado, with the resulting influence over statewide issues.
• For both structures, the practices, projects and relationships created as a result of battling the COVID pandemic can be built upon.

Other considerations the counties must weigh revolve around their differences and similarities. Adams and Arapahoe both have a mix of urban, suburban and rural populations, and both are projected to continue growing rapidly. The two do have slightly different governance structures, and Adams County is “de-bruced” from TABOR, while Arapahoe County is not.

The Arapahoe Board will continue to investigate specific questions and concerns and hopes to make a decision on a new public health authority in early November.