As Douglas County breaks away from the Tri-County Health Department to build its own public health agency, the next major step for the agency will be selecting a public health director.
The director, who will serve as the head of the county health department, will be required by state statute to hire all personnel for the new department, issue public health emergency orders and enforce all public health laws, among other duties.
Both the county director’s responsibilities and qualifications for the role are specifically detailed in Colorado law. Finding someone who fits those requirements will be one of the primary tasks for Douglas County’s new board of health.
Douglas County commissioners voted to officially form their own health department on Sept. 7 after more than a year of considering the action amid county leaders’ long-standing objections to Tri-County Health’s COVID-safety rules, including mask-wearing mandates.
Requirements for new director
Colorado’s Public Health Act of 2008 provides specific guidelines for local health departments, which each county is required by law to have through either a county-specific department or an agency representing multiple areas, like Tri-County.
One section of the law is dedicated to the selection of a public health director, who serves at the pleasure of the local board of health and as the head of the department.
The board of health can choose among physicians, physician assistants, public health nurses or other qualified public health professionals to act in the role. Whomever is chosen must have at least five of the past 10 years “of successful and responsible administrative experience in public health or a closely related field, including at least two years experience in supervising public health professionals,” according to the statute.
If the director is a physician — an M.D. or a D.O. — they must have attended a certified medical school and must be licensed to practice medicine in the state of Colorado.
If the board of health chooses someone other than a physician as the director, they must also choose at least one physician to advise the public health director on medical decisions, according to the statute. A non-physician director must have a master’s degree in a public health field.
In the Sept. 7 work session, Douglas County staff presented this information to the commissioners.
In response to a question from Commissioner Abe Laydon about the selection process, County Attorney Lance Ingalls clarified that unless the commissioners themselves were on a board of health, they “wouldn’t have any say” in who is chosen as the public health director. Later in that meeting, commissioners selected their board of health members, including Teal and Thomas.
Paying for a department
The new board of health will also be required to present a health department budget to the full board of county commissioners.
The county has not yet determined how the new health department will provide all of the required services to residents but it could be some combination of county-level services, contracted services with an entity such as Tri-County and other community partnerships.
County staff is also exploring how the county’s already-existing mental health initiative could take on some of the services of a public health agency, said Barbara Drake, the deputy Douglas County manager.
As far as costs go, Drake said the county is still “trying to figure that out” as it looks at what state and federal dollars could help fund the department. One thing that makes that a challenge is different budget cycles for those entities, the county and Tri-County.
“An awful lot of public health funding is state funded or federally funded. What that means is you can have a county budget that includes all that state and federal funding as your budget, but that does not mean that the county is putting in that much money,” Drake said. “There’s no reason to think that we wouldn’t be eligible for that, what we have to figure out and sort out is the timing for those different sources of funds.”
While the county has paid for Tri-County services until the end of the year, Drake and her team are in talks with the agency about how to continue at least some of those services beyond 2021.
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