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Counties face costs to replace the Tri-County Health Department

Adams, Arapahoe and Douglas counties must have new health departments in place by January 2023.

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

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

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

 "A lot of it is just trimming down and doing what our community needs and wants," Douglas County Health Department Director Michael Hill said. "The residents of the county lost nothing and maybe saved a few dollars."

He said Douglas County cut some Tri-County services that few residents used, like 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 who will provide services like immunizations and family planning.

Hill said Douglas County could make those changes because just 200 people routinely used clinical services Tri-County Health provided in DougCo, and about 80% of the county's citizens have health insurance. 

"If things change to where something appears to be needed in the future, I’ll bring it back to the board of health and they’ll determine if we can add services," Hill said. 

The Arapahoe County 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 sunset dental program for seniors, for example. 

"Our goal is that the community doesn't notice a whole lot that's different," 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 spokesperson said. Instead of the $5.2 million Arapahoe sent Tri-County this year, it plans to spend $6 million for next year. The majority of the expenses are for employee salaries and benefits, the spokesperson said. 

Arapahoe County also allocated $2.9 million in one-time funds to get the new department on its feet come January. 

"While we tried to keep it close to what an annual allocation would have been to Tri-County, there is still a loss of economies of scale," Ludwig explained. "It is a little bit of an increase but not astronomical." 

In Adams County, the budget allocations are harder to nail down. Previously, it paid Tri-County Health $4 million per year. An October budget presentation outlines a $10 million gap between operating expenses and revenue, with plans for more staff in mental health, equity, harm reduction and more.

A county spokesperson said taxpayers will bear only minimal cost, if any, for the new department in next year's budget. 

"Due to one-time revenues that were 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 are not on the hook to make up the difference. "Come 2024 and beyond, we will have a better picture around future impacts the general fund," the spokesperson said.

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