Wednesday, November 4, 2026, 10:30 a.m. (Denver time), City & County Building, Room 391
The Health and Safety Committee, chaired by Council Member Darrell Watson, considered one action item: the 2027 annual operating agreement between the City and Denver Health (record 26.16.022). DDPHE staff presented the agreement's structure, the roughly $48 million proposed 2027 budget (down from prior years because the jail medical contract was separated out), language changes, and sections removed after a $5 million budget reduction. Denver Health representatives discussed Denver Cares, which remains funded at one dollar for 2027, and warned of significant impacts from the federal HR 1 Medicaid changes, including a potential loss of up to 20,000 Medicaid patients and $65 million. Council members asked about a pension-related lawsuit, multi-year agreements, Denver Cares funding timelines, and community health planning. A motion (by Council Member Flynn) passed on a voice vote with no dissent, sending the item to the floor.
0:01 the menu. All of us here
0:01 make sure safety the top of
0:03 Denver wants you to be safe.
0:04 And that includes knowing some
0:06 of the risks of permitted.
0:08 Vendors MAY sometimes cause
0:10 fire hazards and in some cases
0:11 explosions. So look for the
0:12 license carts. License carts
0:15 are inspected for fire safety.
0:16 Properly licensed hot dog
0:17 vendors. Also keep you safe
0:19 from getting sick, proper food
0:21 handling and storage is
0:23 important. You wouldn't want
0:23 to eat a hot dog someone who
0:25 was unable to wash your hands.
0:26 That's why you look for the
0:28 light keep you healthy. Look
0:29 for the license. Has license
0:32 carts are permitted by dieting
0:33 to operate in safe locations,
0:35 license and permit parts won't
0:36 block the sidewalk or forced
0:37 people to walk into the
0:40 street. Leave a clear walkway.
0:41 The people we get by and
0:41 hermit injuries were here to
0:45 help all food vendors. We want
0:46 to see food vendors get
0:47 licensed and get on the right
0:48 side of the grill. We work
0:50 with all city agencies to make
0:52 sure that inspections occur
0:54 and food businesses get
0:55 licensed proper licensing
0:57 everyone's safety in the Mile.
0:59 High city visitors and
1:01 residents and with stronger
1:02 enforcement coming in the
1:03 weeks ahead. This is also
1:05 warning for vendors so they
1:07 can avoid any type of
1:10 citations for violations from
1:12 the city. It's beginning come
1:13 his hands up. I do. But I
1:14 quite can't people they will
1:15 says the committee that in
1:16 them. You know, focus the
1:16 kitten mean, I love my job,
1:19 but didn't It's our duty to
1:20 keep residents and visitors
1:23 safe. So look for the license.
1:25 Look for the license. Look for
1:30 licensed look for the licensed
1:30 the licensed look for the
1:32 was kinda you since
1:42 Just hearing cancer is here
1:43 Minding Mid. Was the most
1:44 difficult time ever gone
1:48 through. My name is Catherine
1:52 Thompson and I am 45 years
1:55 old. I'm healthy and active.
1:56 Itand coming to Denver health,
1:58 her mammograms. I came to
2:01 Denver health just for routine
2:02 screening during that visit,
2:07 it was determined that I
2:08 became some more pictures.
2:10 They did a biopsy started
2:12 rest. Cancer stage, one b#
2:15 cancer. And then she came to
2:17 It was within 10 days of when
2:19 they did the biopsy. And so we
2:20 hold spots for cancer patients
2:21 so that when a new diagnosis
2:22 of cancer occurs, I could see
2:24 those patients as soon as
2:26 possible to help reduce any
2:27 anxiety during that waiting
2:29 period. I don't have a family
2:32 history. So it surprising
2:34 news. It's not unusual to have
2:35 a b#
2:38 cancer, even if you
2:39 have no they're recommended
2:40 screenings starting for all
2:42 women, regardless of family
2:43 history, Dr Leonard was an
2:47 amazing, very Very kind. She
2:50 took her time to explain to go
2:53 over the diagnosis to talk
2:54 about the surgery. What life
2:56 would look like for me moving
2:57 forward. We had a lot of great
2:58 discussions about what kind of
2:59 surgery would be the right
3:04 surgery for her auction chance
3:05 to have options. It's their
3:07 choice and I'll support them
3:08 in whatever choice they make.
3:09 I'm feeling great today. I'm
3:12 doing really well. Had 2
3:14 surgeries that have been
3:16 successful at Denver Health. I
3:18 completed radiation and I'm
3:19 moving forward with my next
3:21 killing really good patients
3:23 can expect the best quality
3:23 care for b#
3:25 cancer care at
3:27 Denver Health because we
3:28 strive to meet the highest
3:29 standards. We've recently been
3:30 accredited by the national
3:32 Accreditation program for
3:32 b#
3:34 Centers and that
3:35 ensures our patients get the
3:36 best care possible. Early
3:38 detection and regular
3:40 screenings are so important
3:41 for b#
3:41 cancer because
3:42 catching b#
3:42 cancer early
3:44 really makes a difference. One
3:45 in 8 women will develop b#
3:48 cancer in their lifetime. And
3:51 if we catch it early when it's
3:52 still localize, the five-year
3:56 survival is 99%. So by
3:58 catching cancers earlier we
4:00 are saving lives. I would
4:02 absolutely recommend the
4:02 Denver Health b#
4:03 Care
4:04 Center it so easy to get exam.
4:07 Lifesaving.
4:53 Welcome back to this weekly
4:55 meeting of the Health and
4:55 Safety Committee with Denver
5:01 City Council. Coverage of the
5:02 Health and Safety Committee
5:05 starts now.
5:15 Feels a little down is because
5:16 there is a lot of people
5:18 staying up beyond their
5:20 bedtimes last night watching
5:22 television. Congratulations to
5:24 all the candidates that across
5:27 the state looking forward to
5:28 working with folks as City
5:28 with any of the new folks that
5:31 are coming in. My name there a
5:32 lot. And I'm honored to serve
5:34 as the chair of the Health and
5:35 Safety Committee. I'm also
5:35 honored to serve all the
5:37 residents of the fine District
5:40 9. We have one action-packed
5:41 action on the agenda this
5:43 morning. 26 16. 22 to Denver
5:45 Health operating agreement.
5:46 Before we jump into that when
5:47 we have counsel introductions
5:52 starting right. Can Kevin
5:53 Flynn, southwest Demars is
5:56 sure to wish happy birthday
6:03 MARCH Thank you The birthday
6:05 boy. Representative shoaf
6:08 destruction. That's Good
6:11 morning. So that can get is at
6:12 large. All right. One might
6:16 check for anyone that's
6:16 online. I'm hearing footsteps,
6:20 but not seeing anyone online.
6:25 Pa Cosmo down. We have a lot
6:28 of stuff are talking about
6:29 love council member who wants.
6:30 And just do introductions
6:33 PRESIDENT. Diane Rivera
6:36 campus, southeast number. Just
6:38 4 and with that, we'll kick it
6:41 over to our team for
6:42 presentation of the Denver
6:44 Health Operating agreement.
6:45 Please introduce yourselves
6:46 and their folks that you want
6:47 interest before you kick off
6:49 the lead presentation. Please
6:52 do so for Thank you so much.
6:53 Megan presented him with the
6:57 Department of Public Health
6:59 and Environment annual
7:00 operating agreement with
7:03 tender. Thank having us this.
7:08 Dana, when there's a lot of
7:09 late nights last happen,
7:10 firsthand accounts Appreciate
7:13 the time on the agenda. Donna
7:14 and Donald in the U.S. To out
7:19 to see everybody. Lot of folks
7:20 in audience here to help us
7:21 out. If we need to phone a
7:22 friend today. So thank you all
7:25 for being here. As you all
7:26 know, the operating agreement
7:28 is a really think agreement
7:30 across many, many agencies and
7:31 the city takes a whole kind
7:36 see of folks too. Chief it
7:37 every year. So thanks,
7:37 everyone here and online and
7:38 in the background that helped
7:43 us get today. All we'll talk a
7:45 little bit about the
7:46 background, the negotiating
7:47 schedule on the structure of
7:50 the agreement. A lot of this
7:51 is stuff you all have seen in
7:53 previous years or we several
7:55 creek briefings before today.
7:57 So many of you have seen We'll
8:01 talk about the changes to the
8:02 2027 contract language tech
8:03 that the budget changes and
8:06 implications for 2027. Just
8:07 briefly touch on reporting and
8:08 have sounds like plenty of
8:12 time for questions today.
8:13 Alright, as you all and recall
8:17 the operating agreement its
8:21 way back into the late 90's.
8:21 You know, heard this for
8:24 several years now, in 1996, 97
8:27 timeframe with the Denver
8:28 Health and Hospital Authority
8:33 was created by state was the
8:36 former Denver General
8:37 Hospital. The operating
8:38 agreement was created back in
8:40 the late nineties and has
8:42 still stands today in relation
8:45 to that. It has shifted and
8:46 changed over. Changed over the
8:48 years and 2018 was the last
8:49 time the entirety of the basin
8:50 cream. And there's a basic
8:51 agreement that talks about
8:51 general terms and conditions
8:56 of the agreement. The last
8:57 time it was negotiated, it's
8:59 entirely with Teddy was 2018
9:01 and annually. We negotiate the
9:02 appendices. Talk a little more
9:08 about second. Reminder of the
9:09 negotiating schedule JANUARY
9:09 through APRIL, there's any
9:10 obstacle negotiations that
9:13 need to happen soon as we
9:13 finish here and get
9:14 signatures, we start over
9:17 again start thinking about
9:19 anything prep work that needs
9:21 to happen early in the year.
9:22 And then in APRIL, we formally
9:24 kick off the negotiations
9:25 APRIL through JULY has when we
9:27 do the majority of the
9:29 negotiations, it aligns with
9:32 the budget cycle for the city
9:32 and so budget happens
9:34 alongside the city budget
9:36 process, the legal drafting
9:39 and final budget numbers come
9:41 through OCTOBER. And here we
9:42 are committee and getting
9:42 through the final steps of the
9:47 process. Reminder about the
9:48 structure of the agreement. It
9:53 said divided into 3 separate
9:54 pen to appendix a and our core
9:55 services. We have 7 core
9:57 services and the agreement in
10:00 2027. These are things that
10:01 you know and love and hear
10:02 about pretty frequently the my
10:04 payment patient care payment,
10:05 Emergency Medical services
10:08 public health clinics the
10:13 cares, et cetera. Appendix b
10:14 are non core services. There
10:15 are 13 non-core services in
10:17 the agreement this year. Nurse
10:18 line Cosh the Outlander some
10:22 of the larger sections and
10:24 Appendix b and then Appendix c
10:24 are services that the city
10:26 provides to the Denver
10:28 Health's. There are 12 of
10:29 those in the agreement this
10:30 year. A lot of those are
10:33 related to the remaining
10:33 career Service authority
10:34 employees that are at Denver
10:38 Health when the hospital
10:39 separated from the city of
10:41 those folks had the option
10:43 retaining their career service
10:45 authority status. And so there
10:47 are 19 remaining men. Timber
10:49 help today, along with few
10:49 other supports that the city
10:53 provides did and the House.
10:54 This is new this year and a
10:58 little busy. We try to do take
10:58 some feedback from some
10:59 council members and provide as
11:01 much detail as we could on
11:03 this. That essentially this is
11:04 showing you all where all of
11:05 the sections in the operating
11:07 agreement live across the
11:10 city, the Blue Bar at the
11:12 bottom are the dp ag Services
11:13 and the print, the seas, the
11:14 talks a little bit because the
11:15 little bit of a clue as to
11:18 what services are ddphe
11:19 specific. I think the green
11:21 and yellow bars at the bottom.
11:24 If you lump all of the safety
11:25 agencies together, they have
11:27 11 sections in the agreement
11:29 and then the majority of the
11:31 others above are one or 2
11:33 sections per agencies across
11:34 the city. Everything in the
11:37 yellow is a service represents
11:38 a service that the city
11:41 provides to Denver health. So
11:44 when you see the Department of
11:45 Finance line having for
11:46 technically 3 of those are
11:47 services. The city is
11:48 providing to Denver health and
11:52 only one of them as
11:53 representative of the opposite
11:54 direction. So a little busy
11:57 but wanted you all to see the
11:59 variety of services and
12:00 supports across a variety what
12:05 those look like. Talking about
12:08 the language changes in the
12:10 agreement 33 services total in
12:11 the 2027 agreement. 3 of them
12:12 received language changes will
12:13 talk about those in a little
12:16 more daytime. The next slide.
12:17 And then 3 sections were
12:18 removed from the agreement.
12:19 And we'll also talk about
12:20 those could come in that
12:24 haven't. The sections that
12:26 have had language changes my
12:28 payment section patient care
12:30 section often has minor
12:32 revisions to the metrics that
12:33 happens to keep up with
12:35 national standards. Best
12:37 practices. And so those are
12:38 just changing of some metrics
12:39 in that section. Nothing
12:42 major, the emergency Medical
12:44 Services section. There was
12:47 some updated language around a
12:47 pilot related to the Ddr the
12:51 Denver dynamic response model
12:54 and trying to get mask too.
12:55 The right location at the
12:56 right time with the right
12:57 level of care. And so that's
13:03 being piloted in 27. And then
13:04 there were language changes
13:05 around the den. The airport
13:08 ems section around additional
13:11 ambulance coverage in command
13:13 staff at and a few other small
13:15 changes there. And then the
13:16 3rd section there are some
13:18 very minor changes, too. The
13:19 public health clinical
13:22 services, it was more around
13:24 making sure acronyms were
13:25 cleaned up in the hours of
13:25 operation for the clinics were
13:29 cleaned up, but nothing major
13:29 from a language perspective,
13:34 operational perspective. The 3
13:35 sections of the agreement that
13:38 were removed in 2027, the
13:40 Rocky Mountain Poison and Drug
13:42 Center and treatment on demand
13:45 who are both sections of the
13:46 agreement. Believe you are a
13:47 call 2026 budget as we were
13:50 negotiating that in 2025.
13:51 Similar to all city agencies.
13:53 Denver Health was asked to
13:54 reduce the operating agreement
13:56 budget by 5 million dollars.
13:59 And these 2 sections, the
14:02 funding was eliminated in
14:03 2026. So our recommended
14:03 placing trucks entering
14:07 treatment on demand for 2027
14:08 similar to city agencies. That
14:11 funding will not be restored.
14:12 My understanding and talking
14:15 with Denver Health, the
14:16 recommended placing Drug
14:17 Center gets a significant
14:18 amount of funding from the
14:20 state for that. And so that
14:22 will remain at full capacity
14:24 in the service where a man and
14:25 then treatment on demand will
14:26 no longer become treatment on
14:27 demand. But I believe thrive.
14:31 7, you. To drive. It's part of
14:35 the threat granted shifting to
14:36 a different model but similar
14:38 services and will be grant
14:40 funded. And so those services
14:42 will be eliminated and want to
14:45 make sure we appreciate them
14:46 for help for retaining those
14:47 in finding ways to keep the
14:50 service is going to. And then
14:51 the 3rd section that will be
14:53 removed from the agreement is
14:55 not one that will be dropped
14:57 out. I'm sure remember, just
14:58 recently jail medical contract
15:01 that came through council
15:02 recently has been separated
15:04 out of the operating
15:04 agreement. That's 20 plus
15:06 million. I think it's 25