DENVER — The start of the new year marks a new beginning of three new health departments in Colorado. Adams, Arapahoe and Douglas counties have spent the past year forming their own public health departments after deciding to break away from Tri-County Public Health.
The health department, called TCHD for short, opened on Jan. 1, 1948 and closed one day short of its 75th birthday.
In September 2021, Douglas County left the health department over COVID-related public health orders and measures. It opted to create its own, with far fewer restrictions involving masks and other mitigation measures.
The following month, on Oct. 26, 2021, Adams County left the health department, citing Douglas County's move among its reasons.
Arapahoe County became the third and final county to leave the TCHD in December 2021.
The Arapahoe County Transition
At the Arapahoe County Fairgrounds, it looked a bit like a holiday party on Tuesday as new public health employees went through orientation, tested out their laptops, set up emails, checked their phones and more.
The department officially took over services on Jan. 1 but will have employees in the offices for the first time this week.
The department will consist of 182 total employees, 176 of which have already been hired. Many of the new employees are coming from the former TCHD.
The new health department will cost a bit more.
“The budget is very similar to what Arapahoe County would have paid Tri-County. So, in 2022 it was $5.3 million and our budget was approved for $6 million,” said Jennifer Ludwig, the new Arapahoe County public health director.
At the same time, Ludwig said the formation of this new health department is an opportunity to be responsive to the county’s individual needs.
“One thing that we will be looking at is there's growth in Arapahoe County. It is one of the fastest-growing counties and a lot of growth out toward the east. So what does that mean? What does it mean for public health and environmental health?” Ludwig said.
The county will offer many of the same services as Tri-County, including environmental health, restaurant inspections, childcare inspections, emergency preparedness, WIC programs, sexual health programs, communicable disease response, birth and death certificates, and more.
Next year, the county will also create a community health improvement plan. Ludwig said she is hoping for a seamless transition for residents and businesses.
The Adams County Transition
In Adams County, orientation also kicked off on Tuesday. The public health department is onboarding about 160 staff with the goal of officially opening its doors Wednesday.
The department will have a total of roughly 180 employees and says the new department will end up costing the county more than it would have contributed to Tri-County.
However, Dr. Kelly Weidenbach, the new executive director of Adams County Health, said the individual health department will be able to better focus on the unique needs and demographics of the county.
“The single county focus really allows us to tailor our programs and services to the unique needs of Adams County's communities,” Weidenbach said. “We're really looking at staffing up and per capita, putting more resources into things like environmental health and environmental conditions.”
Unlike the other counties, Adams County has robust oil and gas operations, posing its own set of air quality challenges.
Another focus for the county: mental health services, diabetes education and bolstering the county’s health equity. The health department has created a new division to address health equity.
Weidenbach said she wants to lean into those differences but also focus on regaining public trust.
“I think one of the most prominent things coming out of the COVID-19 pandemic was just the the lack of trust or disintegration of trust of local public health agencies, and so we have a lot of work to do to rebuild that trust with our communities,” she said.
The transition comes at a time when health departments across the state are still dealing with the aftermath of public backlash from their decisions related to the COVID pandemic.
Many health departments reported threats to their employees that caused the state legislature to pass laws offering more protections.
“What we saw with COVID-19 was really unprecedented in terms of attacks and threats against local and state and federal level public health officials,” she said.
Weidenbach knows all too well about the challenges and dangers faced by public health employees but said they didn’t deter her from taking the position.
The public health department is focused on employee safety but also reaching out to the community to build that trust and explain why certain decisions, even unpopular ones, are made.
The Challenges Ahead
With any new beginning, there will always be challenges, even after a year of preparation to get to this point.
Dr. John Douglas, the executive director of the now defunct Tri-County Health Department, has been working with the counties to help the transition go smoothly and said he has confidence in the new health leaders.
However, he knows there will be hiccups. Douglas expects the biggest challenges to be working through all of the minute details of each program, as well as the lack of experience.
“They'll all have to deal with the loss of efficiencies that they had when we had a shared set of services for three counties,” he said.
The tripledemic between COVID, RSV and influenza is also posing major challenges to any health department, let alone a new one.
“My career in public health was 40 years, and it's certainly the most challenging respiratory and flu season I've ever seen,” Douglas said.
He said he would like to see the health departments focus on boosting their vaccine numbers to help.
Douglas predicts that the individual health departments might have an easier time working with their county governments to get results. He would also like to see more community engagement.
“One thing we probably didn't do as well as I would have liked — we learned this through the pandemic — was strengthening our, what we call, community engagement in the parlance of public health,” Douglas said.
Douglas County was not able to provide anyone for an interview Tuesday but in a statement said that it plans to spend $700,000 less than its previous annual investment in Tri-County Health.
It is also planning on contracting out some of its services to focus on environmental health, such as restaurant and childcare inspections.
“Because 95% of our residents have health insurance, we’re focused on population health that leads to individual health improvements and contracting clinical services to the population in our county that needs individual services,” the statement read.
In the end, all three counties are hoping for a seamless transition and new departments that will better suit the needs of their individual residents.