Some local leaders in Arapahoe County fear that the decision to separate from the Tri-County Health Department in the wake of decisions by neighboring Douglas County to leave the agency may be influenced by “politicization of public health.”
“There was this question about what the message is to our residents about the politicization of public health and trust and accountability in government if there is a perception that this decision is being made because of the politics around COVID. ? What do we tell our residents? said Lisa VanRaemdonck, a consultant who collects opinions to guide Arapahoe County’s decision whether or not to form its own health service following Douglas County’s release from Tri-County Health.
Douglas County has long been considering leaving Tri-County Health amid a disagreement over the health agency’s coronavirus safety orders. Douglas County Commissioners formalized the decision to leave Tri-County at a meeting on September 7, choosing to form its own health department.
In early September, Arapahoe County confirmed that Arapahoe and Adams counties were also considering parting ways with Tri-County Health, among other options, motivated by Douglas County’s intention to leave. A county spokesperson at the time said a separation would not be driven by political disagreement with the agency, but rather by potential financial or budgetary issues for the other two counties caused by Dougco’s exit.
Tri-County is the local public health agency serving Adams, Arapahoe, and Douglas counties. Arapahoe has been with the agency since its founding in 1948.
VanRaemdonck spoke to Arapahoe County commissioners-elect at a meeting on September 14, relaying what she heard in talks with various local leaders about their health care concerns and preferences public as Arapahoe weighs the decision to maintain a partnership with Adams County or form his own health service like Douglas.
Arapahoe County leaders who provided opinions included:
• The five departmental commissioners
• Three members who represent Arapahoe County on the Tri-County Board of Health
• 12 department directors
• Nine municipal council members and municipal administrators from five towns and villages
• Four mayors
• Four municipal directors
• 12 “business partners”
• Two representatives of the superintendents of two school districts
The names of those who provided opinions – and the jurisdictions they serve – were not listed during the September 14 presentation, which took place at a study meeting of Arapahoe commissioners. The meeting provided some of the information that the consultants had gathered, and some had to be included in a full report.
Commissioners were due to hear more details around mid-October, according to VanRaemdonck.
Consideration of impacts
A majority of local elected officials, city directors and administrators, and representatives of the Arapahoe superintendents who were interviewed were in favor of “staying together and making improvements” through the Tri-County Health Department, depending on the presentation.
The members of the superintendent teams “were very specific that it helps to have an independent health authority when we have to close a school building or when we have to say that we cannot drink from the fountains today because that there was a main water pipe. break, ”said VanRaemdonck. “They felt it was helpful to have this external voice which seemed to be a less integrated voice in the county government in their work.”
Another concern heard, she said, was about what could be seen as more bureaucracy: moving from a health department to one in Adams and one in Arapahoe, as well as the impending one in Douglas.
“So, in particular, people who value less government in their lives kind of have this (thought) like, ‘Isn’t that just more government? ”, Said VanRaemdonck.
Meanwhile, the “size and complexity of the jurisdiction” was a concern that surfaced in discussions about maintaining the district – or combined – structure of Tri-County, according to the presentation.
Some people who interact with Tri-County on a business basis and “kind of feel like it’s a one-stop shop” because they do business in both Adams and Arapahoe would have to adapt. there were two health agencies, she added.
An owner who has a restaurant in both counties should interact with both health departments for restaurant inspections, for example, VanRaemdonck said.
Some were curious about the impact on the existing staff at Tri-County.
“You’ve heard the respect and belief that they are a high quality bunch of people, so what does that mean for them and for ourselves? (Some interviewees also asked) Does this mean we lose access to staff expertise and potentially lose economies of scale? VanRaemdonck said, using a term for financial efficiency.
The team of consultants also spoke to department directors in Tri-County, the kind of staff who have conversations with their funders, including grant sources and other government funders.
“There is a feeling that the Tri-County Health Department is more competitive because you can say that we are the largest health department in the state of Colorado – we serve (a large chunk) of the population,” he said. said VanRaemdonck. “Those kinds of things, they said, made them more influential and more competitive for grants and federal funds.”
The team also heard “deep concern” about the clients they serve and any potential impact on residents of Arapahoe County, VanRaemdonck said.
This topic included thoughts such as, “We just brought in this WIC mother and saw each other again, and what will happen with this relationship and this person?” VanRaemdonck said, appearing to use an acronym for the Special Supplemental Nutrition Program for Women, Infants and Children, a federal grant program.
Arapahoe County Commissioner Nancy Sharpe expressed surprise that there had not been more discussion from the community and community leaders on the governance of Tri-County.
“That’s a lot of what we’ve been hearing for over a year, it’s… about governance and who makes the decisions and, in quotes, unelected people,” said Sharpe, who seemed to favor “more of diversity ”on the Tri-County Board of Health. This could mean a larger board of directors with input from the business community or an elected official, she said.
The Board of Health is the policy-making body of Tri-County Health, made up of nine members – three from Adams, Arapahoe and Douglas.
Amid some of the public health orders during the pandemic, many of the “good things” that Tri-County does on a regular basis haven’t garnered as much attention in the public eye, Sharpe said. Tri-County is doing “a great job,” she added.
In addition to issuing public health orders in the midst of the pandemic, Tri-County responds to epidemics of all kinds, monitors infectious diseases, provides parenting and child health services, and offers training and services regarding drug use and drug abuse, according to an Arapahoe County spokesperson. .