Douglas County Commissioners Unanimously Vote To Exit Tri-County Health Department

Commissioners in Douglas County voted unanimously to leave the Tri-County Health Department, after a protracted disagreement over COVID-19 pandemic-related health measures backed by the health department.

The three members of the board voted Monday evening to form their own health department. Last week, Tri-County passed a mask mandate for students in Douglas, Arapahoe and Adams counties in response to an increase in COVID-19 cases as schools opened.

The two sides have been at odds for months and the new requirements caused commissioners to push for a divorce, after a 55-year union.

“They (Tri-County Health) have decided we are them, we're not us anymore,” Commissioner George Teal said. “This is a deal that's gone sideways, that has gone wrong.”

Throughout the pandemic, the tension between public health and personal freedom has been pronounced. Commissioners on the board in the conservative and booming community have resisted tougher measures the health department believed are critical to protecting hundreds of thousands of lives in all three counties.

County residents were split on the move at the commissioners' meeting on Monday.  

Josh Dickens, a father from Castle Rock, said “we are adamantly against any mask mandates in the schools.” He said one of his daughters has special needs and can only communicate through facial expression. The family pulled her out of Douglas County Schools when the district chose to follow Tri-County’s lead and enacted mask requirements for students and staff. 

“We highly encourage you to continue forward on this path. We will support you a hundred percent,” Dickens said.

But Brandi Bradley, a mother from Littleton, said she'd pulled her sons out of the Douglas County district-run schools and put them in charter schools, "because I am completely disappointed in the Douglas county school board again and again and again." Bradley said she favored "freedom of choice" when it came to public health measures. She questioned the metrics Tri-County health officials have used to back their decisions.

"Where's the data and the statistics?" she asked.

The data shows how the pandemic is affecting children more as schools return and younger kids remain unvaccinated

Viral transmission is classified as "high" in Douglas County. According to Tri-County’s data dashboard, DougCo’s 7-day cumulative incidence rate is 215 per 100,000 - or more than two times the rate needed to be included in the highest category by the federal Centers for Disease Control and Prevention. The percent of COVID-19 tests registering as positive now stands at 6.28 in Douglas County, an indicator of both community spread, and the likelihood that some infections are being missed through testing.

To date, the burden of pandemic illness has generally been borne by older adults, both in Colorado and nationally, and hospitalizations and deaths in children have been rare. But the risk is there, and now growing, according to public health experts, with hundreds of thousands of unvaccinated children heading back to school this fall. Only students 12 and older are currently eligible for vaccination.

According to the state’s dashboard, of nearly 900 people now in the hospital, about 2 percent are ages 10-19, with those younger than 9 accounting for 1 percent. As of last month, there have been 15 deaths among cases of COVID-19 in Coloradans between the ages of 0 and 17, according to the state health department. 

With school back in session, cases and hospitalizations among children have risen sharply nationally, climbing five-fold late August and hitting a pandemic high in early September.

The governor and state public health leaders have urged vaccinations and masking in schools, but not mandated either yet, so conflicts over these public health measures have spilled out at the local level.

Tri-County’s coronavirus dashboard is one of the state’s most robust, with county by county pediatric data on case counts, incidence, positivity rate, testing, outbreaks, vaccination and more. According to the website, the incidence rate for children 6 to 17 has been rising each week.

For Aug. 29, the rate in DougCo for kids 6-11, unable to be vaccinated yet, was 509 per 100,000, more than triple the number from 3 weeks earlier. For those 12-17, who have a vaccination rate of 64 percent, the rate was 272, more than double the number from early August.

The agency recorded one child under 18 in Douglas as a COVID-related death during the pandemic.

The health department also documented 12 outbreaks so far in Douglas County schools this school year.

Being part of Tri-County cut down costs, and establishing a new health department will be expensive

Proponents of keeping Tri-County Health whole instead of splitting apart wondered if the costs of creating a brand new department outweigh the benefits.

“Is all of this really worth it? I just have to ask that question. Is it worth it?” said James Poplawski of Parker. 

Douglas County contributes about $2.5 million to Tri-County’s annual budget. Setting up their own health department could lead to a duplication of some of the costs now shared with two other counties.

“We're getting for a fraction of what we pay, we're getting a tremendous amount of services,” Poplawski said. “So we get 60 programs and services for a fraction of the cost and pretty much the whole purpose of Tri-County health is for Adams, Arapahoe and Douglas to split that cost of those three counties.”

He urged commissioners to listen to public health experts.

“Let's mask up, keep our taxes low and keep our children safe,” he said.

Another resident, Robin Mendelson, said masking shouldn't be so contentious.

“You ski, you wear a helmet, and many people wear a face shield if it's cold or if it's icy. So this has been completely blown out of proportion,” Mendelson said.

The change takes effect at year's end. Also, earlier in the day on Monday, the board agreed to create a five-member board of health, which includes two commissioners themselves. 

Some Douglas County officials say they've been exploring an exit for more than a year

Just how much it’ll cost Douglas County to create its own health department isn’t clear. A DougCo staffer laid out the county’s efforts to date and plan moving forward, describing a survey of residents and the hiring of a health management contractor and an environmental public health services consulting firm.

She said the county has also contracted with the non-profit Colorado Health Institute to develop a roadmap for the transition to an independent local public health agency.

“In a lot of ways, Douglas County is just too big to be small,” Commissioner Abe Laydon said. “We joined Tri-County when we were 4,000 people. We’re 357,000. This isn't a divorce from Tri-County Health. It's just an empty nest and that's okay. It's okay for kids to grow up and to move on and to do new things.” 

He noted the county has paid for Tri-County’s services through the end of the year. He portrayed DougCo as being responsible stewards of taxpayer money, saying it will have millions in federal funds at its disposal in the future.

“I will say this county, through conservative budgeting, doesn't have virtually any debt whatsoever. We have reserves,” Laydon said.

Commissioner also discussed a letter sent by Arapahoe County detailing its concerns about the split.

But the board said it’s been weighing the move for months.

“We have not taken this lightly,” said Commissioner Lora Thomas, who added staff had been studying it since last July, compiling their findings in a thick binder. “It will be done right. And I believe people will look back years from now and think they did a great job.”

The contentious DougCo/Tri-County split has become a bit of a Colorado pandemic flashpoint, with two divergent competing worldviews offering two different responses to the deadly and contagious virus, mirroring a divided nation. 

When Arapahoe County’s commissioners asked for public feedback, residents were closely split. The county’s communications director said it had received more than 18,000 responses, but only 6,300 were valid. Nearly 11,000 came from IP addresses that entered two or more responses, and more than a thousand of the disqualified responses came from out of state or out of the county.