The Arapahoe County Commission voted Tuesday morning to withdraw from the Tri-County Health Department next year, marking the final departure from what was once the state’s largest county-level public health agency.

The board approved a resolution to withdraw from Tri-County effective Dec. 31, 2022, mirroring action taken by the Adams County Commission in October. Both of those moves were precipitated in large part by Douglas County, whose leaders voted unanimously in September to pull out of the agency after a spat over mask orders in schools. Arapahoe County will now form its own agency and accompanying board of health.

“Arapahoe County is indebted to the TCHD staff for the first-class health programs and services the agency has provided to millions of residents over the course of our partnership,” Nancy Jackson, chairwoman of the Arapahoe County Commission, said in a statement. “They are a first-rate example of how public health services should be modeled and we will continue to work with them over the coming months to find a workable solution for all involved parties and stakeholders.”

In its own statement, Tri-County wrote that its officials “certainly understand Arapahoe County’s decision to give formal notice of their intention to exit our partnership.”

“We look forward to the opportunity over the next year to share what a continued relationship with a ‘new’ health department serving our counties would look like,” the statement read, “including potential financial and operational benefits.”

The Arapahoe County vote came after more than an hour of public comment Tuesday, which was unanimously in favor of departing Tri-County and against mask mandates. The health agency instituted an indoor face-covering requirement late last month, as COVID-19 cases continued to climb and hospitals sounded increasingly dire alarms about their capacity. 

Arapahoe County’s decision does not mean the county is now exempt from the mask order. It will remain under the umbrella and authority of Tri-County for one more year, just as Adams County does.

In its statement, the commission said the decisions by Adams and Douglas counties made “it necessary for Arapahoe County to explore its future options and develop a transition plan” to forming its own agency. 

The vote solidifies the collapse of what was the largest county-level public health agency in the state. What happens to the agency in 12 months is unclear. The Arapahoe County commissioners wrote in their resolution that “one of the options being considered includes continuing the Tri-County Health Department as a legal entity in some form other than a multi-county district public health agency … so that it may continue to exist and continue to provide public health services to one or more counties after December 31, 2022.” 

In its statement, Tri-County wrote that its top priority “will be our employees and providing excellent public health services for Adams, Arapahoe and Douglas Counties as we consider options for the future.”

All three counties will now be faced with standing up their own health departments, ending a decades-long partnership that joined at times politically opposed entities under one public health roof. It’s the highest-profile breakup of the pandemic, which has seen trust in public health officials erode in many parts of the state and country.

Members of Tri-County’s leadership, especially executive director John Douglas, have been frequent targets of criticism and caustic comments at public health meetings.

The seeds for the dissolution were planted a year ago, when Tri-County agreed to give Arapahoe, Adams and Douglas counties’ officials the ability to opt-out of orders. When the agency’s board of health instituted a limited school-masking requirement in August, Douglas County’s commission swiftly chose to carve itself out. Adams County followed suit, though its commissioners criticized Tri-County’s decision to let anyone opt out. 

The saga continued to unfold in Douglas County, pitting the commissioners against the school district and escalating into a lawsuit. The infighting ended earlier this month, when a new school board majority voted to end required masking in the district.