Denver's yearly deal with Denver Health drops to $48.8 million, from $69.3 million. A Council committee takes it up Wednesday
The city's annual operating agreement with its public hospital pays for emergency medical services, public health clinics, care for people in custody and more. The 2027 version is about $20.5 million smaller than this year's. Here is what the records say, and what they don't explain.
Every year, Denver signs an operating agreement with Denver Health and Hospital Authority, the city's public safety-net hospital. It covers services the city buys from the hospital, from 911 medical response to public health clinics, and services the city provides back.
The 2027 agreement, 26-1622, is set for the Council's Health and Safety Committee on Wednesday, Nov. 4. It would pay Denver Health $48,796,698 for the year. This year's agreement, approved last November, was for $69,332,488 (25-1637). That is a drop of about $20.5 million, or roughly 30%.
Why it matters: Denver Health treats a large share of the city's uninsured and low-income patients and runs its ambulance service. How much the city pays, and for what, affects services residents rely on in an emergency.
What the 2027 agreement covers
According to the city's bill request from the Department of Public Health and Environment:
- Core services include the "Patient Care (MI) Payment," emergency medical services, public health clinics and medical services for people in custody at Denver Health.
- Non-core services include the NurseLine and occupational health services for city workers.
- The city provides payroll and legal support for the remaining city career-service employees who work at Denver Health, radio support, fuel and 911 call-taking. Denver Health would pay the city $2,755,503 for those.
The request says Denver Health was chosen without a competitive process because it is the single source for these services. It does not explain why the total is lower than in 2026.
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What our records add
Several other city deals with Denver Health have been approved separately this year, which may account for some of the difference. We could not confirm that from the documents, and it is a question for Wednesday's committee.
- Jail health care, $55 million. In August, the Council approved 26-1036, a separate contract of $55,031,460 through 2028 for comprehensive health care for people held at the Denver County Jail and the Downtown Detention Center. At a Sept. 23 budget hearing, the Sheriff Department said its Denver Health jail medical contract would grow by $4.8 million in 2027 (meeting).
- The Denver Health sales tax. The Council referred a 0.34% sales tax for Denver Health to the ballot in 2024 (24-0717), and voters approved it that November. In September, the Council extended the agreement that carries out that tax through 2029 (26-1186). It funds emergency and trauma care, primary care, mental health, addiction recovery and pediatric care.
How last year's agreement passed. The 2026 operating agreement passed final consideration Nov. 24, 2025, with 10 yes votes and no opposition. Stacie Gilmore, Shontel Lewis and Sarah Parady were absent (roll call). The 2025 version was 24-1473.
What's next
- Nov. 4, 10:30 a.m.: Health and Safety Committee. The agreement is listed as an action item, so members are expected to discuss it.
- Then: If the committee approves it, it goes to the full Council for two readings. The agreement would run Jan. 1 through Dec. 31, 2027.
- The full city budget vote is Nov. 9. See our coverage of the budget amendments.