THE TALHO INSIDERPresidentEduardo OlivarezHidalgo County Health and Human Sercives

President-ElectLou KreidlerWichita Falls-Wichita County Public Health District

Vice-PresidentDr. Bing BurtonDenton County Health Department

Past PresidentCelestino GarciaMidland Health Department

Secretary / TreasurerDr. Matt RichardsonAmarillo Department of Public Health

Chief Executive OfficerMichael Hill

Members-At-LargeGeorge T. Roberts, JrNortheast Texas Public Health Disttrict

Stephen L. WilliamsHouston Department of Health and Human Services

Sharon Shaw Angelina County and Cities Health District

Local Public Health Department News

Public Health Programs

TB Funding Formula

Tech Update

and more...

Volume V, Issue I

January - April 2013

MESSAGE FROM THE CHIEF EXECUTIVE OFFICER

1

We have faced some financial challenges in 2013, resulting in a 40% reduction in staff at TALHO; the remaining staff are committed to turning our financial picture around to ensure that our organization is financially viable and able to provide quality services to our members. TALHO is continuing to market our Rollcall and TPHIMS products around Texas and nationally. Please remember to add TALHO to the potential bidders list if your jurisdiction is seeking public health related soft-ware or systems; our Environmental Health and Communicable Disease Reporting modules are among the best available in the country and our billing system or services can help most health departments double the revenue from their clinics.

We are also expanding our services in the training and consulting areas, there will be another billing training in late June that will get more in-depth on how to do

billing. We are proposing to host several training and planning conferences in the coming months too, please watch for announcements of these events. TALHO staff is available to consult with you on accreditation, or any aspect of a local health department. You can hire TALHO to act as your accreditation or epidemiology staff, aside from doing your billing, or other services. If you are putting together next year’s budget and do not have enough money for full-time staff in these areas, consider contracting with TALHO.

Please enjoy the coming warm weather but remember to watch out for mosquitoes, there are already reports of West Nile positive mosquito pools in our state.

Michael Hill

Enhance Public Health Opportunities for Members

Identify, promote, educate and train on best practices

Identify and engage new partnerships to enhance local public health

Advance the Development of Voluntary Public Health Accreditation

Enhance Organization and Membership

Recruit new and maintain current members

Identify and establish sustainable funding for the organization

Engage TALHO Membership in organization activities

Maintain updated member directory

Represent the Collective Interest of Local Public Health

Maintain a lobbyist for TALHO

Identify priority issues for a Legislative Agenda

Continue work with Public Health Funding and Policy Council

Enhance the Use of Technology Services

Enhance the use of technology by members

Identify outside technology opportunities that will generate revenue for TALHO

Enhance TALHO’s Relationship with Partners

Enhance communications with partners

Identify mutually agreed upon priorities and actions with partners

TALHO Strategic Map 2013 - 2015

MESSAGE FROM THE TALHO PRESIDENT

2

Hello TALHO members we all have been working very hard in adjusting to the various changes in Healthcare i.e. managed care, EMR, E-Billing, 1115 Waiver, and ACA. This is the primary reason that our association is essential to Public Health in Texas. However, our association has been faced with difficult times and many changes. Currently the future sustainability of TALHO is in our hands as members. Please consider TALHO for any type of technological functions reviewed above or technical assistance in any of the “Core Public Health Functions” and accredita-tion infrastructure support, please contact Mike Hill for any additional guidance. I would like to acknowledge the TALHO Board members for their commitment and dedication to TALHO. Each of them have been working diligently to expand the reach and enhance the influence of TALHO, but more importantly have been seek-ing additional business for the association.

The Legislative session is quickly coming to an end, and there are still many Public Health and Healthcare piec-es of legislation yet to be resolved. Please check with your local officials for updates. I am proud to say that several of our members have testified at various hearings at the State Capital. I will be looking forward to see what the outcomes will be. I would like to encourage any of our members who may be interested in serving on the TALHO Board or any committees please contact Mike or any Board Member.

Best Wishes Eddie Olivarez

Eddie Olivarez

“The I in illness is isolation, and the crucial letters in wellness are we.”

-Author unknown, as quoted in Mimi Guarneri, The Heart Speaks: A Cardiologist Reveals the

Secret Language of Healing

ADVOCACY

3

TALHO’s Legislative Agenda for 2013

]

February 7, 2013 – TALHO Advocacy Event at the Capitol.

Success! A TALHO Advocacy Event was hosted in Austin on February 7 from 8:00am – 11:30am at the Capitol. TALHO members brought 15 posters on current local health department activities to display in the room. The morning began at 8:00am in the Capitol Legislative Conference Center, Capitol Extension with a breakfast for 20 TALHO members. Eddie Olivarez, Director of Hidalgo County Health and Hu-man Services and President of TALHO opened the event. The featured speaker was the Honorable John Zerwas, Chairman of the House Ap-propriations Subcommittee on Health and Human Services. Represen-tative Zerwas updated the members, and took questions on, the current temperature at the Capitol on matters pertaining to health, public health and health care. Lou Kreidler, Director of Wichita Falls-Wichita County Public Health District and TALHO Legislative Committee Chair provided an update on TALHO’s current priority legisla-tive issues. Duane Galligher, Texas Strategy Group, then provided a brief session on best approaches for edu-cating the legislators and their staff. TALHO members were provided handout packets and made visits with 12 Senators and 26 Representatives offices.

150 Bills Tracked

TALHO noted 150 bills of interest to LHDs. The TALHO Legislative Committee met weekly to discuss each bill and determine a level of support as either Monitor, Support or Oppose. A tracking list is provided on the TAL-HO Dashboard. TALHO is working closely with the Texas Environmental Health Association and the Texas Public Health Coalition to review bills concerning food safety, particularly around raw milk and cottage foods.

Contact Lou Kreidler, Wichita Falls – Wichita County Public Health District, at lou.kreidler@wichitafallstx.org for more informa-tion.

Support DSHS Exceptional Item Requests Support Population Safety Issues• LifeProtectingImmunizations• ControlandTreatmentofTuberculosis• PreventandRespondtoFoodborneDiseaseOutbreaks• ProvideEssentialPublicHealthFunctions• EnhanceEnvironmentalHealth• RegulatoryFunctions• TobaccoPreventionandControl

• RawMilk• CottageFood• Farmer’sMarket• TobaccoPreventionandControl• ObesityPreventionandControl• CancerPreventionandControl

PUBLIC HEALTH PROGRAMS

4

News from the Chief Public Health Officer:

County Health Rankings (CHRs) and Roadmap - 2013

The University of Wisconsin Population Health Insti-tute released the 2013 County Health Rankings on March 20. We received inquiries from the media in Houston, San Antonio, and Lubbock asking for com-ments on the results. Certain counties seem to stay at the top and the bottom of the list, others jockeyed around from last year’s rankings. As mentioned to the media, the rankings are not necessarily surprising, since much of the data comes from sources already gathered at a national, state or local level. It is also difficult to compare year to year since the list of indi-cators has been changed each year.

To take the Rankings local, TALHO, the Texas Public Health Institute and the Texas Department of State Health Services are working collaboratively with the local health departments in Ector County, Midland County, Andrews County, and Cherokee County to hold a local stakeholder meeting. The first meeting will be held in Odessa on April 30 and the second meeting in Cherokee County in May. The agenda includes allowing time for the community representa-tives from each county the opportunity to talk with the local health department representatives about the priority health issues in their community and de-velop an action step they can take back and work on during the next year. LHDs are using the Rankings to stimulate discussion in their community. A big Thank You goes to the host LHD Directors - Gino Solla – Ec-tor County HD, Deb McCullough - Andrews County HD, Sal Garcia - Midland Health and Senior Services

and Chris Taylor – Cherokee County HD!

Public Health Project Ready – Get-ting Texas in the ActionA Texas Project Public Health Ready (PPHR) model is moving forward. A Flow Sheet was created and presented to local health department (LHD) prepared-ness staff. The sheet outlines the process for LHDs to determine if they are ready to seek the recognition at this time. The first step in the process is for LHDs to use the NACCHO PPHR Gap Analysis Tool to identify how closely they meet or do not meet the PPHR re-quirements. If the analysis shows a state of readiness, the LHD should contact TALHO to start the Intent to Apply process. If more work needs to be done, the LHD can contact TALHO to discuss the gaps identified and potential assistance to move to a state of readi-ness.

A Texas PPHR webpage contains the information and links needed to help you determine how ready you are to be recognized for the preparedness work you are doing! Go to http://www.talho.org/project-pub-lic-health-ready. If you are interested in being nationally recognized for your preparedness capacity and capability, send an email to jennifer.smith@talho.org!

PUBLIC HEALTH PROGRAMS

5

A Relook at the TB FUNDING FORMULA in TexasTALHO has long recognized the importance of the ability for both state and local health departments to be able to respond to testing, treating, investigating and conducting case management for TB and LTBI cases. For many years, a call has been made to review the current funding scheme and consider new approaches for providing effective and efficient TB services. This fall, both TALHO and DSHS answered that call. TALHO created a resolu-tion statement to be used with policymakers as a way to educate on the issues surrounding TB. It provided background issues on TB and Latent TB Infections, ending with a statement of support for increased funding and a more proactive, collaborative working relationship with DSHS. DSHS conducted regional focus group meetings around the state and established a TB Funding Formula Workgroup. The goal, “to develop a Service Delivery and Funding Strategy Model for TB Services in the state of Texas.”

In September 2012, DSHS requested participation from local health departments, TALHO, the Public Health Funding and Policy Committee and DSHS Regional offices to review the current funding formula. For the next five months conference calls and in person meetings were held. The group reviewed the current funding for-mula model, gathered state and local data to help inform decision-making, laid out state and local differences in funding mechanisms, and reached final recommendations (in box) to be presented to the DSHS Commis-sioner of Health by February 2013. Some issues were not resolved during the meetings and were placed in a Parking Lot document for further discussion. However, through this convening of multiple state and local public health stakeholders a constructive dialogue process was created, with the intent to proactively continue these discussions.

From left to right (back row): Juanita Salinas, Cynthia Lewis, Dr. Brian Smith, Saeed Azadi, Maria Rodriguez, Dr. Paul McGaha, Katherine Wells, Stephen Williams, Deborah Evans, Matt Richardson, Dan Smith, Dr. Lillian Ringsdorf, Eddie Olivarez, Dr. Lisa Cornelius, Risha Jones, Richard Stancil, Danny Corprew, Jennifer Smith and Michael Hill. Front row, left to right: Dr. Charles Wallace, Kitten Holloway, Janna Zumbrun and Felipe Rocha.

6

PUBLIC HEALTH PROGRAMS

TB Funding Formula Workgroup Final Recommendations

RECOMMENDED ELIGIBILITY1. Localhealthdepartment(LHD)agreementtocontributeaminimumof20%matchesoftheirformulaaward.2. FundedprogramsmustmeetalloftheCDC‘EssentialComponentsofaTuberculosisPreventionandControlProgram’.http://www.cdc.gov/mmwr/preview/mmwrhtml/00038823.htm)

RECOMMENDED FORMULA VARIABLES AND WEIGHTS1. Includes current funding formula variables (*See Table)2. Adds latent tuberculosis infection (LTBI) variable ➢Definedas(jurisdictionreporteddata)—patientswithlatentTBinfectionwhowereidentifiedas:contactstoacountedcaseinTexas,or➢asaspecialpopulation,oraspartofrefugeeresettlementprogram;AND➢completedLTBItherapywithaDSHSTBProgramapprovedregimen.3. Changes weights

*TABLE OF CURRENT AND RECOMMENDED VARIABLES AND WEIGHTS

Variable Current Weight Recommended WeightCases 40 38MDRCases 10 5Casescompletingtherapy 5 7Suspects 15 15HIV-TBCo-Infectedcasesandsuspects 10 10Specialpopulationandsuspects 10 10TotalPopulationinFundedArea 5 5TotalSquareMilesinFundedArea 5 5LTBIasdefinedin#2above 0 5

WORKFORCE DEVELOPMENT

7

Which Do You Like Better, Addi-tion or Multiplication?

Chris Taylor, Executive Director, Cherokee County Public Health TALHO Public Health Workforce Develop-ment Committee Chair

Amid our growing concerns about the state of health care and public health, one thing is for certain – we are going to need new strategies. And since people are at the heart of any organization, the best strategy we can employ is to leverage our workforce. There are a variety of ways we can do this, some of them very effective, others less so. For example, research by the Corporate Executive Board has demonstrated that the number one reason employees leave any organi-zation, is because of the leadership, or lack thereof. Another strategy, employee motivation, is often undercut by either raising the bar too high and letting it fall, (think – buying the employee of the year a car this year and a watch the next) or by thinking that the best way to reward good behavior is with food or a t-shirt alone. Similar research concluded that free gifts provide an excellent boost to motivation, but only temporarily, possibly even just hours.

Often when you think about workforce development, you might think about training. And when you think about training, you might think about a classroom, a teacher with a weird tie and funny shoes, and maybe now, you’re thinking how good a nap might sound.

But training is only a portion of good workforce devel-opment. Let’s quickly explore some other ideas you may or may not have addressed in your organization: • Do you have a workplace wellness policy? Do you allow and encourage staff to take part? As we all know, healthy people perform better.

• Do you have development plans for shift supervisors? Anyone considered “manage- ment” can often be lumped into a category together. Be sure you stay in touch with any one who is in a leadership role. • Do you make rounds every day you are in the office? John Maxwell tells the story of a man- ager that came in the office, got his coffee and locked himself in his office to “work.” John asked him what he was doing and the man- ager replied “working.” Maxwell said some thing to the effect of, “No! You passed your work coming in to the office. They were all at their desks outside your office!” • Do all of your employees have development plans that include the position they would like to have NEXT in your organization? • Have you conducted personality assessments in your organization? I recently did this for all of my staff and found that we each had one interpersonal trait that was the same for ev- eryone. How could this be?! We believe (with no real proof) that the person who hired everyone must have had the same trait and hired people just like themselves. Interesting observation anyway, right? • Is your performance measurement system a waste of time? As an example, appraisals should never include measurements of atten- dance. Why? Because appraisals are a time to share outcomes and goals – things that can be measured. I bet your attendance policy says that people are expected to be on time right? So why measure whether or not they broke the policy? Right! Instead, attendance should have a list of consequences that are followed. • Are you demotivating your employees on ac- cident? Anytime you promise something and don’t deliver, you are providing your employ- ees with building blocks that prevent them

from trusting you and your capabilities. A strategy I was always taught was to under- promise and over-deliver.

I have a sneaky suspicion that we in public health have not given as much time and attention to these issues as we should have. It’s hard to blame anyone really. We’ve had so much other stuff to focus on, with all the mosquitos causing problems, and bills that need filling and so on and so forth. But I person-ally don’t think we have that luxury any longer. We are going to face a new set of challenges and we have to have the people we need, in the places we need, doing the things we need them to do.

This is the part where I should insert a scare tactic, but instead I want to leave you with the words of John Maxwell, who I quoted earlier, but forgot to identify. John is a leadership expert, successful business owner and who really understands leadership at its core. “Leaders who develop followers grow their organi-zation only one person at a time. But leaders who develop leaders multiply their growth, because for every leader they develop, they also receive all of that leader’s followers. Add ten followers to your organiza-tion, and you have the power of ten people. Add ten leaders to your organization, and you have the power of ten leader’s times all the followers and leaders they influence. That’s the difference between addition and multiplication.”

By the Numbers* 46.6 Average age of the typical state public health workforce 45-50 Maximum percentage of workforce of federal and some state public health agencies eligible for retirement within the next few years. 20 Percentage vacancy rate in several state public health systems. 14 Percent annual turnover rate on the state level. 19 Percent of public health workforce that works for federal agencies. 33 Percent of public health workforce employed in state agencies. 34 Percent of public health workforce employed in local public health agencies. 14 Percentage that works in other settings, including teaching and research.

WORKFORCE DEVELOPMENT

8

May 31, 2013 is World

No Tobacco Day

* American Public Health Association, Issue Brief, September 06

http://www.trilogyir.com

Trilogy Integrated Resources

9

ACCREDITATION

10

2013 Local Health Department Accreditation Training

TALHO is once again serving as a co-host for the 2013 Local Health Department Accreditation Training to be held May 8-10 in Austin. The Texas Public Health Association applied for and received a small funding award from the American Public Health Association to work with partners on accreditation. Also serving as co-hosts are the University of North Texas Health Science Center School of Public Health, Texas Public Health Training Center and the Public Health Accreditation Council of Texas.

This year’s training is focused on helping LHDs conduct a gap analysis of their readiness to meet the accreditation requirements, learn how to integrate performance management and quality improvement processes into their daily business and hear from a newly Public Health Accreditation Board accredited LHD on their journey to accreditation.

Public Health Accreditation Council of Texas (PHACT)

Be sure to visit the PHACT website at phactx.org to access the Accreditation Toolkit developed by the Uni-versity of North Texas Health Science Center School of Public Health. The toolkit has alot of great examples and resources to help you down the path to accredita-tion.

TECHNOLOGY

11

Rollcall

Rollcall was on the road again this quarter, gaining publicity at the Public Health Preparedness Conference, the Texas Public Health Association Educational Conference, and the Oklahoma Public Health Conference. Gather-ing great input and ideas, seeding potential pilot projects in other states, we are happy to show off the fea-tures of Rollcall that seven health departments use to monitor over 700 schools across the state of Texas. With our demo site up and running, our new and reduced pricing structure, and all new features in full production, we are ready to demo it for any interested Local Health Department. Just let us know!

TALHO Tech Services

This quarter saw a lot of changes for TALHO, though we are happy to share that these changes mean only mi-nor changes to the services that we offer.

Audio/Video/Web Conferencing – We will continue to offer Adobe Connect full web con-ferencing services free for all our members. If you need to host web, video, or audio confer-ences, just send us an email with the meeting details and requirements at admins@talho.org and we can book your conference.

Help Desk – Call us for free IT support! We are no longer able to respond 24-7, but we do op-erate 8a-5p, M-F. Please contact our help desk with any questions at our main number 512-814-2546 or send us an email at admins@talho.org.

Email – Microsoft Exchange email hosting remains a free service to all member health departments. We up-dated our email servers this quarter and will be happy to help provide “@talho.org” email addresses to any of our member health departments.

TECHNOLOGY

12

Rollcall – Rollcall is our school surveillance tool we offer as a service to health departments wishing to monitor absenteeism and student symptom data in their jurisdictions. We have reached a solid develop-ment state with this tool; the latest feature additions include heat mapping absenteeism data, improved, automated reports, and tutorial videos. Our pricing has been dramatically reduced and revised from pre-vious years, so contact us for an updated estimate!

Syndromic Surveillance – We have and always will offer to host syndromic surveillance servers (RODS and ESSENCE) for our member health departments. These epi-

demiology tools monitor emergency room data and over the counter medication sales data for individual jurisdictions. Since our Surveillance is a software-as-a-service, for one standardized, and significantly re-duced, fee we can continue to provide the latest tools, upgrades, and ongoing server and connection support for no additional costs. Some jurisdictions have even worked with their facilities to co-fund Syndromic Sur-veillance in light of facilities goals towards Meaningful Use. Contact us for a strategy and estimate on getting your department set up with Syndromic Surveillance!

TPHIMS – The TALHO Public Health Information Man-agement System (TPHIMS) is a web-based tool that was developed specifically for local health depart-ment daily operations. This software provides capabil-ities such as Electronic Medical Records, Environmen-tal Health Functions, Billing and Fiscal Management, Chronic Disease and Case Management, Lab Informa-tion Management, Immunization Tracking, Communi-cable Disease Reporting, etc. This system is infinitely flexible and scalable, and it can easily adapt to exist-ing business processes, making implementation fast

and effortless. Let us know if you have processes you would like to streamline and digitalize, and we can customize a quote for you.

Website Development and Hosting – TALHO’s tech team can build you a customized website for your department, events, campaigns, etc. And the possi-bilities are endless! Whether you want a simple static site, a site with content we manage, or a way to edit or built content yourself, we can design and host it for you. Looking for a website with document man-agement, ability to take payments, forum discussion boards, etc? We can build that, too! Contact us to start the discussion on how we can help you have the website you need.

Customized Hardware, Software, and Network-ing Solutions – We’ve always recognized the need for Local Health Departments to have a knowledgeable IT advocate that can help you procure, build, and install computers or network-ing systems. Using our vendor network, discounted software and hardware capabilities as your membership non-profit, and our in-house expertise, we can build you a competitive quote for any of your technological needs.

Public Health Services – We still offer other Public Health Practice Support such as Accreditation Preparation, Strategic Planning Facilitation, Quality Improvement Processes, Organizational

Design Assistance, On-site Conference Hosting and Support. Contact us at info@talho.org to match your needs with our services.

TECHNOLOGY

13

14

LOCAL PUBLIC HEALTH NEWSNational Public Health Week

Texas Association of Local Health Officials

TALHO celebrated National Public Health Week (NPHW) by posting a daily pop-up on their website that presented the health facts of the day according to given themes. TALHO also posted NPHW materials from member health departments. These are archived at the TALHO website: http://www.talho.org/public-health-week#!__public-health-

week

See What Our Members Did!• Austin/Travis County Health & Human Services issued a press release.• Brazos County Health Department had a free food handler class, $5 private well water testing and free

rapid HIV testing.• Wichita Falls-Wichita County Public Health District held a free health

fair that provided education, free testing and screening, giveaways and more. They also held a Zumbathon on April 13.

Na�onal Public Health Week Brazos County Health Department

• Free Food Handler Class for the First

50 People to sign-up (Beginning April

1, 2013)

• $5 Private Well Water Testing (April 1-

4, 2013)

• Free Rapid HIV Testing (April 4, 2013

by appointment only between 8:30-11

a.m. & 1:15-4 p.m.)

Daily Themes

• Monday April1st: Ensuring a safe and

healthy home for your family

• Tuesday April 2nd : Providing a safe

environment for children at school

• Wednesday April 3rd : Creating a

healthy workplace

• Thursday April 4th : Protecting you

while you are on the move

• Friday April 5th : Empowering a

Healthy Community

Brazos County Health Department

201 North Texas Ave.

Bryan, Texas 77803

(979) 361-4440

www.brazoshealth.org

Ac�vi�es

Zumbathon9a.m.-1p.m.

Health District1700 3rd Street

Free

Can you get in shape while having fun? The YMCA is partnering with the Wichita Falls-Wichita County Public Health District to host a FREE Zumba event at 1700 3rd Street starting at 9:00 a.m.

The world's most popular fi tness craze is in the Falls so quit the workout and join the party!

PUBLIC HEALTH DISTRICT7th Annual Health Fair

PUBLIC HEALTH DISTRICT

HEALTH FAIR

7th AnnualWICHITA FALLSWICHITA COUNTY

1700 3rd StreetSaturday, April 13 2013

9:00 AM – 1:00 PM

Food Handler’s Class8 : 3 0 a . m . - 1 1 : 1 5 a . m .$20 per person.Class space limited to the first 40 people.Bicycle RodeoThe Traffic Safety Com-mission presents a bicycle rodeo for school aged chil-dren. Bring your bicycle to learn safety tips, mainte-nance and participate in the road course! Free t-shirts and bike helmets given away while supplies last. The win-ner will receive a free bicycle.

VIN EtchingThe WFPD will be available to etch vehicle ident i f icat ion numbers onto vehicle windows.

EducationImmunizations, WIC, Car Safety Seat information, Animal and Pet Safety Education & Microchipping

Free Testing/ScreeningFree Blood Pressure and Glucose Checks, Choles-terol Screening, Body Fat Testing and HIV TestingGiveawaysThere will be drawings for free car safety seats, a food handler’s card,

and a birth or death certificateMuch MoreTurn flyer over for a list of some of the c o m m u n i t y p a r t n e r s a t t e n d i n g !

PUBLIC HEALTH SAVES LIVES/SAVES MONEY

Free admission and fun activities and education for the whole family!

LOCAL PUBLIC HEALTH NEWS

15

Emergency Preparedness Plan-ning: Thinking Outside of the Box in Ector CountyAmanda Robison-Chadwell, MPHEctor County Health Department

Introduction

The population in West Texas has been on the rise due to the most recent oil boom. While the low unemployment rates and boost to the economy are not to be overlooked, there are still difficulties which arise

from the ever-growing population. There are a large number of challenges to public health that could be noted here, but Ector County Health Department has first chosen to address the challenges that we see with the Strategic National Stockpile (SNS) and Points of Dispensing Sites (PODS) planning.

Challenges Created by Increased Population

There has been lots of focus in Ector County (Odessa) put on getting PUBLIC PODS established. There is something to be said for the importance of these PODS. That said, the Health Department’s biggest challenge has been finding appropriate sites that can effectively service our population in the event of a public health emergency. This difficulty has arisen because, until fairly recently, the Odessa area did not have the population that we are seeing now. As such, the area is seeing problems with housing shortages and overcrowding. Attempt to go grocery shopping

mid-day on a Saturday in Odessa and one quickly realizes exactly what “overcrowding” really looks like. These problems arise because the city and county infrastructure cannot build fast enough to manage the surge in population. This has affected Ector County POD planning because there simply are not enough ideal structures that can manage throughput for our population. This is where we have quickly discovered that attempting to adhere too tightly to the recom-mendations from State and Federal levels with regard to PODS planning is unrealistic and, quite frankly, more of a hindrance than a help. That is why there are guidelines, and both the state and the federal government do encourage local health departments to “think outside of the box” when they need to. The guidelines for planning can be widely applied to the statistical majority of the nation, and it simplifies planning, but for statistical outliers like Odessa, that isn’t always easy.

Considering Alternatives

The Odessa area is the perfect example of the impor-tance of improvisation in public health emergency preparedness planning due to all of the aforemen-tioned reasons, and others. We need to get creative and find a way to utilize the infrastructure and sys-tems that we already have for our purposes even if they are not ideally fit to the guidelines we have handed down to us. We cannot expect--as a statisti-cal minority--that the higher echelons of government are going to tailor make plans for emergency pre-paredness with us in mind. If there was a one-way fits all planning possibility, then, let’s be honest with ourselves, there wouldn’t be a need for local health departments at all. We have to make those consid-erations ourselves. That said the federal government and state governments are aware that these planning guidelines will not always work for every locality and they make points of saying that explicitly. Government does encourage local health departments to “think

16

LOCAL PUBLIC HEALTH NEWSoutside of the box” when they need to. The guidelines for planning can be widely applied to the statistical ma-jority of the nation, and it simplifies planning, but for statistical outliers like Odessa, that isn’t always easy.

Thinking Outside the Box – Push Sites

So, for Ector County this means thinking outside of the box and putting more emphasis on the creation of push site agreements. We will still focus on establishment of PUBLIC PODS, but we will also be working on push sites more than we have in the past. We will begin working with local businesses/local partners who fit specific de-scriptions that (should they enter into an agreement) will be given an allotment of SNS materials by the health department in the event of an SNS deployment scenario. Those supplies would be used by these businesses/local partners in their own PRIVATE PODS in order to give prophylaxis to their employees and their families.

Expected Results

This will ideally allow for several things: 1) it will decrease the burden on public health and decrease the num-ber of PUBLIC PODS that we need to establish. 2) People in the community will be able to receive their medica-tions/supplies/etc. in a place where they feel more safe and secure. 3) It would allow for local businesses/local partners involved to operate as normal and diminish the negative effect on our local economy.

These plans are new and in their infancy so it will be some time before we see any real results, but hopefully in the next few months we will have some more strong foundations in place with community partners that we have yet to speak with and begin making headway so that in the event of an emergency we are able to help those in need rather than being the ones in need..

“Health is a large word. It embraces not the body only, but the mind and spirit as

well;... and not today’s pain or pleasure alone, but the whole being and outlook of a man.”

- James H. West

17

LOCAL PUBLIC HEALTH NEWSCounty Health Department Em-ployee Attends Homeland Secu-rity Training

Monica Stewart, from the Milam County Health Depart-ment, recently completed training offered by the Center for Domestic Preparedness (CDP), in Anniston, Alabama. The CDP is operated by the United States Department of Homeland Security’s Fed-eral Emergency Management Agency and is the only feder-

ally-chartered Weapons of Mass Destruction (WMD) training facility in the nation.

Monica attended a course designed for Public Health officials that would help coordinate the response to Pandemics, including Bird Flu. During the course, the students learned the science of Pandemics as well as the resources available to State and Local govern-ments to combat a Pandemic. Part of the course included the basics of Surge planning and select-ing alternative mass care sites if hospitals become overwhelmed with patients from the Pandemic. The course brought together people from a variety of disciplines including Public Health, Hospitals, Law Enforcement, Environmental Health, and Epidemiolo-gists. This diverse group allowed for shared insight into the topics.

The weeklong course culminated in live-agent train-ing at the COBRA training facility. During the two days spent at the COBRA facility, the class learned to miti-gate chemical agents that could be used in terrorist acts. For the course, the class wore HazMat suits and respirator masks and learned how to test for various substances. They also evacuated, decontaminated,

and cared for patients from a simulated mass casualty incident.

Monica looks forward to sharing the knowledge and skills gained at the CDP with other government and hospital representatives to make our region safer and more prepared. She also looks forward to returning to the CDP for future classes on a variety of additional topics.

The CDP develops and delivers advanced training for emergency response providers, emergency manag-ers, and other government officials from state, local, and tribal governments. The CDP offers more than 50 training courses focusing on incident management, mass casualty response, and emergency response to a catastrophic natural disaster or terrorist act. Train-ing at the CDP campus is federally funded at no cost to state, local, and tribal emergency response profes-sionals or their agency.

Resident training at the CDP includes healthcare and public health courses at the Noble Training Facility, the nation’s only hos-pital dedicated to training healthcare professionals in di-saster preparedness and response.

A number of resident training courses culminate at the CDP’s Chemical, Ordnance, Biological and Radio-logical Training Facility (COBRA). The COBRA is the nation’s only facility featuring civilian training exer-

18

LOCAL PUBLIC HEALTH NEWScises in a true toxic environment using chemical agents. The advanced hands-on training enables responders to effectively prevent, respond to, and recover from real-world incidents involving acts of terrorism and other hazardous materials.

Responders participating in CDP training gain critical skills and confidence to respond effectively to local inci-dents or potential WMD events.

Information about CDP training programs can be found at http://cdp.dhs.gov. Visit the “News & Media” tab at the -top of the site to download images, share CDP training articles, and find out what others are saying about CDP training. For more information about the CDP, contact the CDP External Affairs Office, at (256) 847-2212/ 2316 or e-mail pao@cdpemail.dhs.gov.

PUBLIC HEALTH HISTORY

19

First Food Handlers Schools Originated by Dodson in TexasReprint from Texas Health Bulletin, July 1979 - Volume XXXII No. 7

Editor’s note: The first Texas foodhandling schools were described in the September, 1949, Texas Health Bulletin. Part of that story appears here.

Food schools originated in Texas. That isn’t an idle boast – it’s an established fact.

Lewis Dodson, a consulting engineer in Amarillo, reasoned that bacteria have to be carried on some object or by some person, since they are incapable of transferring themselves from place to place. He know, of course, but did other people know, that surfaces of glasses, knives, forks, and all other eating utensils and food that contact the mouth should never be touched by hands?

Dodson at the time was a sanitary engineer for Ama-rillo, so he knew his way around in public health circles. He packed his gear, and hopped a train for Austin, where he talked to the top man in Texas public health – Dr. George W. Cox.

Dr. Cox just the year before had been named state health officers, and he was heartily in favor of pin-point sanitation.

The original plan called for six lessons – one very oth-er day - to complete the course. At first the schools were set up on a permanent basis, with teachers trained by the State Health Department and paid by the vocational education division of the State Depart-ment of Education.

That first school was something to see, but what the instructor and his audience lacked in refinement was

made up in enthusiasm. The absence of finesse in that first session is understandable, for the school was an innovation and innovations are seldom subtle.

Most of the instruction was carried on through lec-tures, supplemented by a few slides, which, when placed manually under a projector, would flash an ap-propriate picture onto a screen (of the type the army would refer to as ‘field expedient’).

Then the instructor would point out various what-is-wrong-with-this-picture, or what-is-right-about-this-picture. It wasn’t until a full year after that first class was held that the original print of “Hash Slingin’ to Food Handling” was made.

The original of that film was in black and white, and was silent.

20

PUBLIC HEALTH INFO

Steps forHealthySwimming

Protection Against Recreational Water Illnesses (RWIs)RWIs are illnesses caused by germs that can contaminate water in pools. Practice these six steps to protect yourself and others from getting sick.

Without your help, even the best-maintained pools can spread germs.

All S

wim

mer

sPa

rent

s of Yo

ung K

ids

THRE

E st

eps f

orTH

REE

step

s for

PLEASE don’t swim when you have diarrhea. You can spread germs in the water and make other people sick.

PLEASE don’t swallow pool water. Avoid getting water in your mouth.

PLEASE practice good hygiene. Shower with soap before swimming and wash your hands after using the toilet or changing diapers.Germs on your body end up in the water.

PLEASE take your kids on bathroom breaks or check diapers often. Waiting to hear “I have to go” may mean that it’s too late.

PLEASE change diapers in a bathroom or a diaper-changing area and not at poolside. Germs can be spread in and around the pool.

PLEASE wash your child thoroughly (especially the rear end) with soap and water before they go swimming. Invisible amounts of fecal matter can end up in the pool.

For more information visitwww.cdc.gov/healthyswimming

SIX

CS20

9878

-A

May 23, 2013: Creating a Roadmap to Health in Texas Communities (Bullard, TX)

June 4-5, 2013: Texas Project Public Health Ready Training (Austin, TX)

June 13, 2013: TALHO Membership Meeting: 8:30am - 4:30pm

June 14, 2013: Public Health Funding and Policy Committee Meeting: 9am - 1pm (Austin, TX)

June 28, 2013: Insurance Billing - Claims and Collections (Austin, TX)

The views expressed in the resources mentioned within do not necessarily reflect those of TALHO or the sponsors. Please direct comments or questions about The TALHO Insider to Jennifer Smith, MSHP

Chief Public Health Officer, at jennifer.smith@talho.org or 512-814-2546 ext. 1102. For a complete list of staff contacts, please visit www.TALHO.org

DO YOU HAVE NEWS TO SHARE? Send your articles and pictures to TALHO:

jennifer.smith@talho.org or ccass@talho.org.

The deadlines for submissions are July 1, 2013, October 1, 2013 and January 1, 2014

21

22

Sun

~ May 2013 ~

Sun Mon Tue Wed Thu Fri Sat

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

National Hurricane Preparedness Week

Heat Safety AwarenessDay

Hand Hygiene Day

National Alcohol - and Other Drug-Related Birth Defects Awareness Week

3rd Annual Texas Local Health Department Accreditation Workshop

Memorial Day

Mother’s Day

~ June 2013 ~

Sun Mon Tue Wed Thu Fri Sat

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

National HIV TestingDay

National Cancer Survivors Day

Father’s Day

TALHO Board ofDirectors Meeting

TALHO Membership Meeting

Creating a Roadmap to Health

in Northeast Texas Communities

Texas Project Public Health Ready Training

Insurance Billing 201:Claims & Collections

Public Health Funding&

Policy CommitteeMeeting

Texas Association of Local Health Officials2600 McHale Court, Suite 100Austin, Tx 78758