A bill for an ordinance approving a proposed Fiscal Year 2026 Amendment to the…

This ordinance approves a Fiscal Year 2026 amendment to the Second Amended and Restated Operating Agreement between the City and County of Denver and the Denver Health and Hospital Authority. The total contract value is $69,332,488, covering services rendered through December 31, 2026. DHHA is a quasi-governmental entity established under Colorado state law to provide comprehensive healthcare services to Denver residents, particularly those who are uninsured, underinsured, or enrolled in Medicaid. The operating agreement is the primary mechanism through which the city funds DHHA for services that align with Denver's public health obligations.

The constitutional and legal basis for this agreement rests on Colorado statutes governing intergovernmental agreements and the enabling legislation that created DHHA as an independent authority in 1997. Denver regularly enters into such agreements with DHHA to fulfill its duty to provide public health services to its residents, particularly those who cannot afford private care. The city's home-rule charter also authorizes such intergovernmental arrangements.

Fiscally, $69.3 million is a significant municipal commitment. This funding supplements DHHA's other revenue streams, which include Medicaid and Medicare reimbursements, commercial insurance payments, and state and federal grants. Without city funding, DHHA would face serious financial pressure to reduce services or shift costs, potentially impacting access to care for tens of thousands of Denver residents. The agreement essentially subsidizes services that the market alone would not support at the scale needed.

Historically, Denver has maintained a long-standing partnership with DHHA since its creation as a safety-net hospital system. DHHA operates Denver Health Medical Center, multiple community health centers, and a school-based health program, making it one of the most comprehensive urban safety-net systems in the country. These annual operating agreements have been routine but are reviewed and updated each fiscal year to reflect changing service volumes, costs, and city budget priorities.

Stakeholders most directly affected include low-income Denver residents who depend on DHHA for primary care, emergency services, behavioral health, and specialty care. Taxpayers fund the agreement and have an interest in cost efficiency and accountability. DHHA employees and administrators depend on this funding for operational stability. The broader Denver healthcare ecosystem is also affected, as DHHA's safety-net role reduces uncompensated care burdens on private hospitals.

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The Denver City Council is weighing a $69,332,488 intergovernmental agreement with Denver Health and Hospital Authority that would fund a broad range of medical services for city residents through December 31, 2026. The agreement is an annual renewal of a longstanding operating contract between Denver and DHHA, a quasi-governmental entity created by the state in 1997 to serve as the city's primary safety-net healthcare system. DHHA operates Denver Health Medical Center, community health clinics, school-based health programs, and behavioral health services, with a particular focus on patients who are uninsured, underinsured, or enrolled in public insurance programs.

Supporters of the agreement, including the council committee that approved it for filing in November 2025, point to DHHA's essential role in Denver's healthcare infrastructure. Proponents argue that without city funding, DHHA would be unable to sustain the level of services it provides to low-income and vulnerable populations, many of whom have no other access to regular medical care. They also note that investing in preventive and primary care through DHHA reduces long-term costs associated with emergency care and untreated chronic illness.

Critics and fiscal watchdogs have raised questions about the size of the city's annual commitment and whether sufficient accountability mechanisms ensure that the funds are spent efficiently and effectively. Some observers have noted that DHHA also receives significant federal and state funding through Medicaid and other programs, prompting questions about whether the city's contribution is appropriately calibrated to avoid duplication. Others have pointed to the multi-year agreement structure as potentially limiting council flexibility to respond to budget pressures or changes in DHHA's financial condition.

For ordinary Denver residents, the practical stakes are straightforward. DHHA is the provider of last resort for a significant portion of the city's population, and the operating agreement is the financial foundation that keeps that system running. A disruption in city funding would likely translate into reduced clinic hours, longer wait times, or scaled-back services at facilities that many low-income families depend on for everything from routine checkups to emergency care. The council's final vote, expected by December 8, 2025, will determine whether that funding continues uninterrupted into 2026.