The Douglas County Board of Health voted unanimously on Thursday to extend a public health order requiring health information disclosure from organizations transporting immigrants into the county. 

Board members originally voted on the order in December, deciding to extend it Thursday as a precaution, the officials said in a news release.

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The order requires that any organization or person bringing immigrants into the county report those peoples’ health information to the Douglas County Health Department, with the intention of addressing “potential and actual communicable disease and emergency situations” in the county, according to a statement from officials.

DCHD Executive Director Michael Hill said the order was initially a proactive measure when it was passed in December. While the board does not necessarily foresee an influx of immigrants brought into Douglas County, Hill said extending the health order is still necessary “in the unlikely event that migrants are placed in Douglas County.”

The health order states that there is “sufficient cause to believe” that the city and county of Denver has and might continue to house immigrants in facilities outside of the city and said that immigrants are a particularly “vulnerable” population in terms of health concerns. 

Since December 2022, nearly 40,000 immigrants – many whom illegally crossed America’s southern border – arrived in Denver, a sanctuary city where officials decided earlier in the crisis to provide shelter, feed and transport immigrants to their final destination.

Several jurisdictions surrounding Denver, including Douglas County, have adopted resolutions to distance themselves from the “sanctuary” jurisdiction label.  

Last October, Douglas County, located just south of Denver, adopted a resolution saying it is “not a sheltering solution to Denver’s migrant population crisis.” The resolution affirmed that the county is not a “sanctuary” jurisdiction and called on cities and counties in the metro area, including Denver, to publicly do the same.

And this month, commissioners directed the county attorney to “pursue legal action to permit the county to fully cooperate with federal law enforcement” in what amounts to a legal challenge to Colorado’s “sanctuary” laws amid the surge in illegal immigration that has already cost Denver – the epicenter of the crisis – tens of millions of dollars. The commissioners also advanced a proposed ordinance that bars commercial buses from unloading passengers “other than at a planned and scheduled documented destination,” a clear attempt to stop immigrants from arriving at the county’s doors unannounced.

According to Douglas County’s public health order, immigrants have traveled from countries with limited or no access to routine healthcare, traveled for long time periods in settings without proper hygiene and through countries with possible disease exposure. They may not have had access to vaccines and have experienced “significant trauma,” such as unstable housing and lack of access to food and medical care, the order states. 

Shelter settings often increase the risk of communicable diseases, as well, the order says, meaning that sheltering people could increase the demand on public health services in the county.

To address these concerns, the order requires anyone transporting immigrants into the county to provide information to the county health department, including each individual’s date of arrival into the country and state, as well as name, origin country, and a list of other information.

In addition, the person or organization transporting immigrants has to take a series of actions to create a plan in the case that an immigrant has a communicable disease. 

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This includes providing immigrants with instructions on seeking medical care, transporting them to and from medical care, and having a written plan for alternative shelters for anyone who may have to isolate themselves.

Commissioner Lora Thomas said Monday the health order was initiated when county officials learned that Adams County had put out a similar public health order after a group of immigrants was brought into the county without their knowledge. 

The order, which is now permanent, is a proactive measure, Thomas said, adding it will remain in place as long as need be.

“It would seem to me that, as long as the southern border is open and people are coming in, we have a responsibility to our residents of Douglas County to protect and care for them,” she said. 

The health department “will attempt to seek voluntary compliance through education, technical assistance, and warning notices,” the order reads, adding it can be enforced through legal means in case of noncompliance. 

Thomas said she is not aware of any shelters or places immigrants could be brought to in the county to begin with, but that officials have talked to hotel owners to explain the health order for educational purposes.

Health departments, like DCHD, are exempt from Health Insurance Portability and Accountability Act (HIPAA), which protects individuals’ medical records and other health information, Thomas said. The act would only become an issue if the party housing or sending immigrants to Douglas County is a covered entity, such as a healthcare provider. 

This would be an unlikely scenario, she said. 

Hill said in Thursday’s meeting that he did not find any stakeholders who objected to the decision to extend the health order. 

Prior to voting on the extension Thursday, the board opened the floor to public comment and heard none.

Board member Linda Fielding said she’s been in Denver recently and has seen the problems Denver Health has faced. 

“The city is in financial distress,” Fielding said Thursday. “I could easily see an NGO trying to bring people in with good intentions but not necessarily following the rules. I think we have to have this order and I think we have to address concerns.”

Fielding was referring to a $10 million spike in “uncompensated care” for Denver Health in the last year, which the health system largely attributed to the tens of thousands of medical visits from immigrant patients from South and Central America.

Health care providers at Denver Health have also seen chickenpox cases among immigrants, many of whom have lived in congregate settings that can foster the spread of the disease.

Chickenpox is a highly contagious disease that causes itchy, blister-like rashes and requires about 82% of the population to be inoculated.

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Denver Gazette reporter Nico Brambila contributed to this report.