Aurora assesses public health future as Tri-County slowly collapses after more than 70 years

As the Tri-County Health Department goes its separate ways, Aurora finds itself in the middle of the wreckage – a city of nearly 400,000 people straddling the three counties that for decades made up Colorado’s largest public health agency. .

And this diverse and fast-growing city east of Denver is starting to consider how it will deliver public health services – vaccinations, restaurant inspections, contagious disease control – to its residents once Tri-County is finally dissolved, probably by the end of next year.

The city has several options: to enter into service contracts with each of the counties that were once part of Tri-County (Douglas, Arapahoe and Adams), to create its own public health service or to continue the arduous and ambitious path of transformation in the Colorado’s 65th county.

“This could be a major factor in pushing the city of Aurora to become a city and a form of county government,” said Aurora Mayor Mike Coffman.

Forming your own county, instead of floating in amorphous common ground beholden to three county governments, is an idea that has been discussed many times in Aurora but never gained enough ground to go from there. ‘before. Coffman said his city’s need for reliable public health services may be the nudge needed to bring the concept from rhetoric to reality, “since the responsibility for creating local health services is at the county level.” .

To form her own county, Aurora would have to change her city charter and then get voters across the state to approve her formation. Broomfield, which was in four different counties, was the most recent Colorado county to form in 2001, with voters approving its formation three years earlier.

But any discussion of public health services in Aurora is still in its early stages, given that the dismantling of the Tri-County Health Department began less than two months ago when Douglas County broke up. to form his own public health agency after coming across with COVID-19 policies from Tri-County.

Adams County announced last week that it would echo the Douglas County decision, with a formal vote scheduled for Tuesday to notify Tri-County of its intention to go its own way at the end of 2022. The county Arapahoe, who hasn’t said what he would do about it, will almost certainly be forced to go solo by default.

Tri-County has been in existence since 1948 and, until last month, served 1.5 million people in the metro area.

There is still time to figure things out. Tri-County is engaged to provide services to the three counties until the end of next year. But Glen Mays, professor of health policy at the Colorado School of Public Health, said Aurora “needs to be in active discussions” with the three counties about her unique needs.

“As the most diverse city in Colorado and one of the most demographically diverse cities in the United States, Aurora faces significant challenges as to whether the three counties can fully and fairly meet the needs of health of its people, ”Mays said. “I think of the more than 160 languages ​​spoken among the residents of Aurora, the many cultures and norms, the unique professional and business environments, the environmental dangers and risks, the vast medically underserved areas of the city, the problems of law enforcement and his health. effects in the city.

Andy Cross, The Denver Post

Vaccinations and vaccines offered at Tri-County Health Department on Friday, October 22, 2021.

If the three new public health agencies in Douglas, Adams and Arapahoe counties are broadly sensitive to the population and demographics of their own county, he said, “this would create difficult problems for Aurora in terms of protection. uneven “, depending on the location of the city. live.

Dealing with separate health services “will clearly create transition challenges” for Aurora, said Tri-County spokeswoman Becky O’Guin, but it is not an unprecedented situation. Look at Westminster, she said, which is in two counties and is served by Tri-County in Adams County and Jefferson County Public Health on its west side.

“(They) figured out how to navigate such a landscape,” O’Guin said.

There has been little friction in the delivery of public health services in the city of 116,000 people, Westminster spokesman Ryan Hegreness said.

“For us, that’s always how it was,” he said.

The pandemic has forced the city to work a little harder to get its messages across to residents regarding various COVID policies, like masking or capacity limits in buildings, between the two counties, Hegreness said. But there is also cooperation between counties, with coordinated testing sites and vaccination clinics.

“In addition, both agencies have a physical presence in Westminster carrying out street awareness activities for homeless people,” he said. “Tri-County is focused on reducing the harm surrounding drug use and COVID testing. JCPH focuses on general health assessments, including COVID screenings, as well as the distribution of hygiene items. “

But Coffman, who has denounced the dissolution of Tri-County, is concerned about contracting out with three counties for health services.

“Not only do I think it will cost our taxpayers more and be less efficient to set up three separate bureaucracies, but none of them will have the depth of expertise that Tri-County had due to its size, ”he said.

Tri-County has 397 employees and its budget this year is just over $ 55 million.

This leaves Aurora with the flexibility to form her own municipal health department, as Denver did, without necessarily going through the hoops of becoming her own county. Coffman said the legal minds of city staff have indicated that as a self-governing city, Aurora has the capacity to take this course.

While this is an intimidating time for Colorado’s third largest city, Mays said, it is an opportunity for Aurora to “rethink and reinvent public health for its jurisdiction.” It houses the University of Colorado’s Anschutz medical campus and the Colorado School of Public Health within its borders, which could “open up some very exciting possibilities for Aurora.”

“With a little creativity, Aurora could emerge as a new national model of public health that is uniquely focused on equity, intergovernmental and multisectoral in its organization, funding and delivery,” said Mays.

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