February 2012

THE TALHO INSIDER

Texas Health Care Transf- ormation and Quality Im- provement Program 1115 Waiver

The 2011 Texas Public Health Accreditation Conference

The new TALHO dashboard

Tech Tip

and more...

PresidentCelestino GarciaMidland Health Department

President-ElectEduardo OlivarezHidalgo County Health and Human Sercives

Vice-PresidentLou FranklinWichita Falls-Wichita County Public Health District

Past PresidentDr. Bing BurtonDenton County Health Department

Secretary / TreasurerDr. Matt RichardsonAmarillo Department of Public Health

Executive DirectorLee A. Lane

Members-At-LargeStephen L. WilliamsHouston Department of Health and Human Services

Michael HillCity of El Paso Department ofPublic Health

Sharon Shaw Angelina County and Cities Health District

Volume IV, Issue I

February 2012

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MESSAGE FROM THE EXECUTIVE DIRECTOR

For more than the previous decade the Texas Association of Local Health Officials (TALHO) has taken a leadership role in the development and management of the Tex-as Health Alert Network. With the combined partnerships of the Bell County Public Health District, the Department of State Health Services (DSHS) and TALHO, this sys-tem has evolved into a national emergency preparedness network model that protects the health and safety of every resident of the state. Millions of tax dollars have flowed through the Bell County Public Health District and TALHO for the development, opera-tion and maintenance of this network and the success of the Health Alert Network has become a model for other states to follow.

The Health Alert Network is a strong national program, providing vital health informa-tion and the infrastructure to support the dissemination of that information at the State and Local levels and beyond. The network ensures that each community has rapid and timely access to emergent health information. This messaging system directly and in-

directly transmits Health Alerts, Advisories, Updates, and Info Service Messages to over one million recipients.

The network has over 100 points of secure, remote access including a Texas military base, all which would be compromised, including State security should funding from DSHS terminate. It is important to keep our state connected for not only man-made disasters but also for major health outbreaks such as the various flu strains and other communicable diseases that can spread across the state. There are currently disease surveillance activities being provided through the TALHO network for local health departments and districts in partnership with more than 680 schools throughout Texas and more than 100 hospitals. Local epidemiologists, directors, health authorities, nurses, and other health professionals are dependent on this network for collecting data to more readily determine a major outbreak should one occur. The loss of these services would have a tremendous impact on the safety and health of our residents.

Senate Bill 9 of the 79th Regular Legislative Session was passed and signed into law in 2005, recognizing TALHO had already built a single point of entry system to distribute information, applications, processes, and commu-nications among Local Health Departments & Districts in the state and the importance to ensure that as long as federal funds for preparedness flow into the state, this network system would be maintained. It is critical that our members continue to remind their local and state officials the importance of TALHO and this network to detect, deter, and respond to acts of terrorism and disease outbreaks for the safety and security of all Texans.

Lee Lane

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MESSAGE FROM TALHO PRESIDENT

We know that - “We are judged by what we do, not what we say”President’s MessageCelestino (Sal) Garcia

Turn on your television or your radio, browse the web or pick up a newspaper and you will find the message all around - Healthcare costs continue to soar and greater numbers of our population are experiencing limitations in access to care. At the same time, headlines tell us that obesity and sedentary lifestyles are growing prob-lems and average life expectancy may, for the first time in recent history, begin to decline. Are these two phenomena related? Knowing I’m preaching to the choir, I rest assured that many of the TALHO members reading this publication are nodding

their heads in unison.

Manufacturers have known for years that small investments in research and development as well as preven-tion efforts translate into enormous savings related to averting costly warranty work. The same cannot be said for the healthcare industry. What healthcare has yet to commit to is what public health practices every day. Our product is prevention. That’s what we do well. Each of you in your varied capacities engage in programs and activities aimed at promoting wellness and preventing chronic diseases from taking a foothold. Despite these valiant efforts, the capital has not been forthcoming to make meaningful inroads into improving our na-tion’s health status and preventing massive public and private sector healthcare expenses from occurring.

We are committed to taking on the marketing of prevention to policymakers. A prime example of this commit-ment is to spotlight the work being done by local health departments in assessing their jurisdictions’ health status and developing public health system intervention approaches. Public health professionals have carried out these tasks virtually absent additional resources from the state, yet the need for increased effort has never been greater.

The State of Texas has enacted the Public Health Improvement Plan. As a public health community we now need to take the incremental steps to assure the plan vision is fulfilled. As President of the Texas Association of Local Health Officials, it is my intent to move our state association to take the lead in promoting a stable resource base for public health prevention and grants that provide flexible infrastructure funding for programs that protect the public. We need to establish a like commitment for health promotion and prevention. As members of TALHO, each of you can play a major role in seeing this vision come to fruition. It will start one step at a time. So, stay tuned to your e-mail and future issues of the TALHO Insider newsletter as we start our journey!!

Sal Garcia

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ADVOCACY

Observations from the Meetings of the Senate Bill 969 - The Public Health Funding and Policy Committee

The Public Health Funding and Policy Committee (committee) has been up and active since it was signed into law in June 2011. The committee met in October and December 2011, January and February, 2012. Five of the nine member committee represent local health departments or local health authorities (LHA) and are members of TALHO: Stephen Williams –Houston (Chair), Dr. Mark Guidry –Galveston (Vice-Chair) (LHA), Deb McCullough – Andrews, Dr. Chip Riggins – Williamson (LHA), and Victoria Yeatts- Garland. Additional members of the committee include: Dr. Paul McGaha – HSR 4/5N, Dr. Sandra Guerra – HSR 8, Dr. Craig Blakely – Texas A&M Health Science Center School of Rural Public Health, and Dr. Richard Kurz – University of North Texas Health Science Center Fort Worth.

The committee has begun discussions on its main duties: 1) Define the core public health services a local health entity should provide, 2) evaluate public health in this state and identify initiatives for areas that need improvement, 3) identify all funding sources available for use by local health entities to perform core public health functions, 4) establish public health policy priorities for this state and 5) make formal recommendations to the department regarding the use and allocation of funds available exclusively to local health entities to perform core public health functions, ways to improve the overall public health of citizens of this state, methods for transitioning from a contractual relationship between the department and the local health entities to a cooperative agreement relationship and methods for fostering a continuous collaborative relationship between the department and the local health entities.

Since December the committee has moved forward on the following:

1) Formed a Local Health Department Survey of Services/Funding Subcommittee chaired by Dr. Mark Guidry. This committee has begun development of a survey to determine the public health services and direct care services provided by local health entities, as well as the funding sources for those services.

2) Learned about the elements for entering into a cooperative agreement versus a contractual agreement. A list of all grants received by DSHS, as well as the funding amounts, which are sent out to local entities, was compiled for the committee. This list will help identify where potential flexibility exists within the grants to allow for cooperative agreements between DSHS and local health departments. DSHS is also conducting due diligence on the topic to assess potential unintended consequences.

3) Reviewed a survey to Evaluate Local Health Authorities that will identify who are the local health authorities in the state and what they do. Dr. Guidry is heading the work on the survey. As a Local Health Authority, he volunteered to serve as the committee liaison between the committee and the Local Health Authorities Steering Committee.

4) Began deeper discussions on the DSHS Tuberculosis Funding to Local Health Departments. Issues of concern included the non-clarity of TB funding at the local level, development of a clear vision of a cost effective model for TB and clarity of a state policy and funding for TB services. Dr. Craig Blakely and Deb McCullough were asked to

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ADVOCACY

serve as representatives/liaisons of the committee to DSHS on discussions of the state TB funding formula.5) Developed an initial strategy to get broader input from various interests. The committee will be conducting its monthly meetings in different locations across the state. The March 22 meeting will be held in conjunction with the Texas Public Health Association Annual Educational meeting in Arlington. The April 19 meeting will be held in conjunction with TALHO Membership meeting in Austin.

To follow the work of the committee, contact any of the committee members or go to the website: http://www.dshs.state.tx.us/phfpcommittee/default.aspx

*TALHO is participating with the TMA to conduct a series of policy meetings in Austin to introduce public health to new legislative staff. The first meeting will be held on February 23, 12PM – 2PM.

Enhance Public Health Opportunities for Members

Identify and promote best practices, funding and new relationships

Maintain updated member directory information

Identify and engage new partnerships to enhance local public

health

Advance Development of Voluntary Public Health Accreditation

Maintain a working relationship with the Public Health Accreditation Board (PHAB)

Maintain monthly meetings of the Public Health Accreditation Council of Texas

Engage TALHO Membership in PHACT

activities

Represent the Collective Interest of Local Public Health

Identify the potential for hiring a lobbyist

Identify priority issues

for a Legislative Agenda

Maintain a lobbyist for

TALHO

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 2010 - 2012

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TALHO Chief Public Health Officer Report

December 2011 – January 2012

TALHO Discussion Group Calls: a. Health Promotion Discussion Group Calls held in December and January. Topics included National Public Health Week and a coordinated promotional between effort TALHO and LHDs. Austin discussed the new Smoke-Free Public Parks ordinance. El Paso updated on their city Obesity Prevention Resolution activities and the development of an enhanced employee wellness program for city employees. Dr. Lauri Kalanges, Section Director, DSHS Health Promotion and Chronic Disease Prevention, updated on the organizational structure and priorities of the DSHS Section. Information on the Transforming Texas grants will be released in February. b. Public Health Preparedness Group Calls held in December and January. Topics included the completion of the Capability Assessment, Jurisdictional Risk Assessment (JRA) and DSHS LHD Guidance Document. After the rollout of the JRA in the January DSHS Quarterly meeting, LHDs identified two main issues: 1) Resources to complete the JRA and 2) Overlap of assessment with the TDEMS. Group is waiting for the re-release of the updated excel tool for the JRA. c. Accreditation Discussion Group Call held on January 18. Nineteen LHDs with 23 staff participated in identifying key topics of interest: CHA,CHIP, Strategic Plans; Development of QI processes; collection of sub-level data; measuring ROI; documentation organization of materials; general info on the accreditation process. Group suggested a quick survey be completed to identify current status level of LHDs in preparing for accreditation. TALHO is working with the University of North Texas Health Science Center School of Public Health (UNTHSCSPH) to survey TALHO members.

All group materials are in the TALHO Member Dashboard Documents Discussion Group Folder.

PHACT PHACT meeting was held in December. Dr. Richard Kurz at UNTHSC-Fort Worth is developing a session review of the Accreditation Conference. He is also developing a survey to determine LHD Accreditation Readiness. He will work with PHACT and TALHO to conduct the survey. Aggregated results will be shared with LHDs. The PHACT determined that it would be interested in participating in the Western States collaborative proposed at the conference, but on an informal case-by-case basis. PHACT is interested in having conversations with other states to support training and technical assistance on an informal, case-by-case basis.

PUBLIC HEALTH PROGRAMS

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County Health Rankings 2012: Gathering Consensus on Statewide Goal by CHR Statewide Stakeholder Group

On April 3, the University of Wisconsin (UOW) will release the 2012 County Health Rankings (CHRs) report, including the specific report for Texas. The Robert Wood Johnson Foundation (RWJF)-funded CHRs, the most comprehensive report of its kind, ranks the overall health of nearly every county in all 50 states by using a stan-dard way to measure how healthy people are and how long they live.

In 2011, the Texas CHR State Team (TALHO, Texas Health Institute (THI) and DSHS) convened 25 key stakehold-ers for a meeting on June 16 to review the CHRs, discuss the pros and cons of the rankings, determine if there are next steps to be done, gather commitment from group members to continue forward and identify 3-5 ac-tion steps for the group after the meeting (Article in last TALHO INSIDER).

There was great enthusiasm in the group to continue to work together through the following next steps:

1. Convene a diverse group of stakeholders in the next three months.2. Work to establish statewide goals that are achievable and targeted. 3. Craft State and Local Level Action Steps based on the goals. 4. Provide Group recommendations to put resources where the problems are.

In December 2011, TALHO worked with THI and DSHS to develop a new application to the UOW. By April 15, 2012, one priority goal and a specific action that will address the CHR Health Factors and Healthy People 2020 will be identified by the Texas CHR Statewide Stakeholder Group to take action on within the next year by each stakeholder. The Texas CHR Team will work with the 25 key stakeholders to 1) Convene a larger multi-stake-holder group to discuss the need to improve the public health infrastructure in the state and local communities to improve the health of the population and 2) Identify specific goals for future action as a group to begin work to improve the infrastructure.


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Texas Gets Approval for Cost-Saving Medicaid Improvements

In December 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a waiver that allows the state to expand Medicaid managed care while preserving hospital funding, provides incentive payments for health-care improvements and directs more funding to hospitals that serve large num-bers of uninsured patients. Called the Texas Health Care Transformation and Quality Improvement Program 1115 Waiver, this waiver replaces the current Upper Payment Limit (UPL) program and will be in effect until September 2016.

For the first year, no change is required for hospitals. They continue receiving funding as they had under the UPL program. Starting October 2012 (the second year), any entity that wants to continue with or begin par-ticipating in the waiver programs must engage in development and transition activities. This participation is a requirement for funding eligibility at any time in the waiver program.

Under the waiver, there are two funding pools – the Uncompensated Care (UC) and Delivery System Reform Incentive Payment (DSRIP) pools. As in the UPL program, receipt of funding from either pool requires a state match.

UC Pool Payments are designed to help offset uncompensated care costs provided by the hospital or other providers to Medicaid-eligible or uninsured individuals. To qualify for a UC payment, a hospital must submit an annual UC application providing cost and payment data on services eligible for reimbursement.

Uncompensated care amounts will be based on: • Uncompensated Medicaid costs and uninsured patients’ costs not covered by disproportionate share hospital. • Medicaid non-hospital uncompensated care costs (such as physician, clinic, and pharmacy defined by the UC Application).

*State proposed distribution of funding over the five year waiver period.

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DSRIP Pool Payments are hospital incentive payments to develop qualifying programs or strategies support-ing hospitals’ efforts to enhance access to health care and increase quality of care, cost-effectiveness of care provided, and the health of patients and families served. Programs or strategies eligible for incentive payments must be included in plans submitted to the state.

Eligibility to receive payments from either of these funding pools will require participation in a Regional Healthcare Partnership (RHP). Entities providing Intergovernmental Transfer (IGT) funding will work with other IGT-providing entities in geographical regions as Regional Healthcare Partnerships (RHPs). The RHP regions will be developed throughout the state. Each RHP is required to submit a RHP plan for the last four years of the waiver (October 2012 to September 2016) as a funding requirement.

Each RHP will include the IGT providers in an area and other hospital and health-care providers. Each RHP will be “anchored” by a public hospital or by the governmental entity providing IGT. The “anchor” will be respon-sible for administrative functions, including coordinating with other participating entities in the development of the RHP plan and serving as the single point of contact for HHSC reporting requirements. At a minimum, the RHP plans will identify the participating partners, community needs, proposed projects, and funding distribu-tion.

There are four program categories from which RHPs may select to receive DSRIP funding. HHSC is working collaboratively with hospitals and organiz-ations to create an expanded list of programs for each category. Once approved by CMS, the list will be made available to RHPs and serve as the basis for RHP plan development.

What does this new waiver mean to me (as a county, hospital authority or district, or Judge or Commissioner)?

If you currently participate in UPL, and want to continue doing so, you will need to join a RHP, participate in the process for developing a plan, and identify use of your ocal funding (for UC and/or DSRIP projects) under theplan, in place of the old UPL program.

If you do not currently participate in UPL, but want to participate in the waiver funding, you will need to join a RHP, participate in the process for developing a plan, identify what local funds you may want to use in the program, and identify use of your local funding (for UC and/or DSRIP projects) under the plan, in place of the old UPL program.

If you do not currently participate in UPL, but want to learn more, you should contact one of the groups at the bottom of this sheet for more information.


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What are the benefits of participating in a RHP?

By providing local funds as a state match under the waiver, you can allocate funding for qualifying local hospital providers to get paid for UC costs and improvements in health-care initiatives with federally-matched funds. This would help improve and increase access to care, quality and cost effectiveness of care, and health-care coordination in your community. The people in your community will have more health-care and supportive ser-vices available, which should increase the overall health of your community. DSRIP projects may result in less indigent dependency on hospital and emergency care.

If my community contributes local funding to the project, will someone else control how our community funds are spent?

No. Counties and other entities providing state share will control how their funds are used in the waiver. At the state level, Texas will need to have a specific distribution of funds between UC and DSRIP funding. This distri-bution will probably be required at the RHP level where each community’s funding choices would align. Oth-erwise, local communities choose projects from an approved list (e.g. increase primary care access) for their communities. The anchoring entity serves as the single point of contact for the RHP plan submission and HHSC reporting of metrics. It will also host meetings for IGT providers to discuss projects, public review of RHP plan, and other stakeholder engagement, and identify IGT funds for UC and DSRIP payments.

If we join, do we need to obligate funds for four years under the RHP plan?

No. You’ll need to estimate an annual amount for the four year plan. Both the state and CMS understand that counties cannot obligate funds for five years and the actual amount of IGT available may change from year to year. The waiver leverages county funds. There are no new funding requirements. How can I get more information? Is there someone or a group I can work with? For general information on the waiver and a link to waiver documents, please visit the HHSC website waiver section at: http://www.hhsc.state.tx.us/1115-waiver.html


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HHSC has been collaborating with certain groups to provide information and serve as conduit for questions and input. Contact information for these groups is below. You may also contact HHSC directly at [email protected].

County Indigent Health Care Program (CIHCP)Jan [email protected](512) 458-7728

Texas Organization of Rural & Community Hospitals (TORCH)David [email protected](512) 873-0045

Texas Association of Counties (TAC)Rick [email protected](512) 478-8753

Texas Hospital Association (THA)John [email protected](512) 465-1556

County Judges & Commissioners Association of Texas (CJCAT)Jim [email protected](512) 482-0701

Texas Indigent Health Care Association (TIHCA) Bride [email protected](512) 248-3252

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ACCREDITATION

2011 Texas Public Health Accreditation Conference

In 2007 TALHO convened representatives from the local health departments, state health department, schools of public health, and other public health organizations to review the topic of a national public health accreditation program and its implications for Texas. During a series of think tank meetings in 2008, it was determined that Texas would look into national accreditation, but also to continue with the valuable discussions held among the various stakeholders. The Public Health Accredi- tation Council of Texas (PHACT) was formed and has been meeting monthly ever since. TALHO continues to support and participate with the PHACT in promoting accreditation to local health departments.

During 2011, TALHO surveyed its membership to determine the level of interest in participating in a conference on accredit-ation. Using the feedback provided, TALHO and PHACT crafted the first Texas Public Health Accreditation Conference held October 11 and 12, 2011 at the J.J. Pickle Research Center in Austin. The meeting agenda included three plenary sessions and eight breakout sessions. Session presenters included representatives from the Public Health Accreditation Board, the national accreditation organization, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation and the National Association of County and City Health Officials. Staff from Texas local and state health departments presented on their experience with the Community Health Assessment, Community Health Improvement Plan and the Agency Strategic Plan. All sessions were taped and have been posted on the conference website.

The conference hosted 110 registrants from 27 Texas local health departments; 13 DSHS staff; 3 LHDs from Franklin Co., Kentucky; Adams Co., Illinois and San Diego, California; national organizations such as NACCHO, CDC, PHAB, RWJF and National Network of Public Health Institutes and state organizations from TPHA, THI, California Health Officers Association, Public Health Foundation Enterprise (CA), Utah SACCHO, UNTHSCSPH, UTHHSC, TAMSRPH, and the Missouri Institute.

To view content from the Texas Public Health Accreditation Conference please visit http://www.talho.org/#!media

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TECHNOLOGY

Real-Time Outbreak and Disease Surveillance (RODS) Training Seminar for LHD Staff

TALHO hosted a Real-time Outbreak and Disease Surveillance (RODS) Seminar at our office in Austin, Texas on January 9 and 10, 2012. Conducted by Dr. Fu-Chiang Tsui (Associate Director) and Dr. Jeremy Espino on behalf of the RODS Laboratory at the University of Pittsburgh Department of Biomedical Informatics, this two day seminar covered the functionality of the RODS Software Application and provided question-and-answer time for those with surveillance-related inquiries. Registrants provided their own laptop computer during training. Thirty-seven LHD staff from across Texas participated in developing additional knowledge and skills in using RODS for their surveillance needs.

On Day 1, Dr. Tsui and Dr. Espino provided an overview of RODS, recent developments, connections with hospitals and Q&A with the epidemiologists. Day 2 focused on administration of RODS with IT staff and Q&A.

Evaluations for those staying for both days were extremely positive, with staff noting that their knowledge and ability to work with RODS was increased on what the system can do, as well as informing on the type of work LHD staff would need to work on with TALHO in setting up the surveillance system.

Additional trainings are under consideration. Please send your ideas for future training needs or any surveillance related inquires to [email protected]

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TECHNOLOGY

Introducing the TALHO Dashboard

The New Year has brought about some major changes in the way of SaaS (Software as a Service) development over at TALHO. This year saw the launch of the TALHO Dashboard, a web application that gives TALHO members access to training material, request forms, support information, forums, and document sharing.

TALHO members can now visit dashboard.talho.org and sign-up for access based on their internal roles, be they Staff or Director. Once approved, TALHO members will have access to online training material for RODS, ESSENCE, Mobile Units, and Video Conferencing. TALHO members will also have access to online request forms allowing them to place a Help Desk ticket, request a videoconference, or request a teleconference. The TALHO Dashboard also provides users access to forums, which will provide a knowledge base for our members on a number of topics.Along with access to the TALHO Dashboard, members will be able to access the Documents portal, which allows for secure, cloud-based storage of documents. Members will be able to create personalized folders and share

them with any variety of users. Once access to a folder is shared, members will be able to set read and write permissions allowing for collaboration and co-authoring of documents.

We hope to continue to develop and expand the TALHO Dashboard so as to provide our members access to online tools that truly deliver. At TALHO we are always striving to bridge the gap between technology and health.

TECHNOLOGY

Introducing the TALHO Dashboard: How to Access & Share Documents

AccessingLocate the Menu item labeled “Documents” located on the bottom-left corner of your browser screen and click on it. This will open a Documents tab where youwill have access to your filesand any other documentfolders you have accessto.

SharingSelect the folder whose contents you want to share and click on the “Edit Folder”option located on the folder info panel on the right.

Click on the “Sharing” tab panel:

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You may choose to share with a set audience based on Organization or Role, and you may also choose individual users to share your folder with. Simply enter the name of the user you wish to share folder access with. Alternatively, you may choose the ‘Inherited’ share option. With the ‘Inherited’ option turned on, the folder will use the same permissions set forth in the parent directory. This option is intended for subfolders whose sharing permissions will directly mirror their parent, so as to cut down on the number of repetitive tasks performed by the user.

You can also set Read and Write permissions for individual users only. The “Reader” permission only allows users to download files. The “Author” permission allows users to download files, make local changes and then upload the changes, updating the content of the file. A third permission, “Admin”, allows users to administer files, such as renaming, moving, and deleting files.

Click on the “General Options” tab panel to set any further options. You can choose to notify users when a new file is shared with them, receiveemail alerts when users upload files into your folder, and notify users when they have beenadded to a shared folder. Questions can be directed to [email protected]

TECHNOLOGY

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Tech Tip - Spring Cleaning

Over time our computers become bogged down with old files and registry errors. Not only can these issues threaten your privacy, they significantly reduce the performance of your computer. Lucky for us there is a free program out there for these very issues. CCleaner is a program that with the click of button can fix all these issues. For machines where disk space is an issue, CCleaner will erase all the old, unnecessary files that are taking up that valuable space. In addition to freeing up disk space, CCleaner will also scan your registry for errors and easily fix them. Registry errors can significantly slow down your machine and removing them will do wonders for your speed. CCleaner also provides you with tools to uninstall programs and adjust which programs automatically start up with your computer. Unlike most cleaners, CCleaner is spyware/adware free and will not hassle you with constant advertisement.

CCleaner can be downloaded at www.ccleaner.com

TECHNOLOGY

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LOCAL PUBLIC HEALTH NEwS

Restaurant Inspection Scores – There’s an App for That!

Plano’s Environmental Health Department is giving the public power to access food establishment inspection reports through their “smart” phones and other data devices. The Department prints a small square Quick Reference (QR) Code on all food establishment health permits. QR Codes are a simple way to link offline printed material to online content with the least effort.

Any phone or data device that can take a picture and surf the Internet can download a QR code reader application allowing use of the camera feature to scan the box and access the City’s webpage.

A wide variety of scanning software is available for free download or a small fee. Scanning a health permit QR code sends the viewer to the City of Plano Restaurant Score page. There, the establishment’s most recent score, past three inspection reports and a

variety of other information can be accessed.

“Use of QR codes on restaurant permits provides our public yet another tool to assist prudent consumer health and food safety decision-making. They also raise the level of accountability for our food safety program and food establishments” said Brian Collins, Director of Environmental Health.

Waco-McLennan County Public Health District’s Eat Well Waco Dining GuideMargo Moran Shanks, MPHHealth Services Coordinator/Health EducatorWaco-McLennan County Public Health District

In January 2010, the Waco-McLennan County Public Health District initiated Eat Well Waco as a new community health promotion program. The goal of the program is to improve menu options in restaurants and to empower consumers to make healthier choices when dining out. This program is designed to work with restaurants to highlight healthier options, and to support

and promote restaurants that offer healthy food choices. Restaurants must meet a set of criteria to participate in the program and in return, the restaurant receives free publicity in the form of Eat Well Waco advertising such as billboards, magazine articles, and the health district website. Participating restaurants are also recognized with door and menu decals.

Recently, the program has been extended to include the Eat Well Waco Dining Guide. The Guide highlights healthier menu items at 40 local restaurants. The booklets were printed and distributed throughout the community and

an online version, to be updated regularly, is posted on our website. Funding for this project was provided by Texas Council on CVD and Stroke. Feedback

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from community organizations and residents has been positive. In the future, we hope to provide a Spanish version online and increase the number of participating restaurants.

For more information visit our website at www.mclennanpublichealth.org or contact Margo Shanks at 254-750-5481 or [email protected].

Mother-Friendly Worksite Initiative LaunchedThe City of El Paso Department of Public Health

The City of El Paso Department of Public Health (DPH) WIC program received a $10,200 grant form the Texas Department of State Health Services (DSHS) to expand and enhance “Mother-Friendly” benefits to DPH employees. Through a systematic program of assessments, surveys and

team building, the DPH will bring together key players to develop a comprehensive policy that will support mothers who are returning to work with the opportunities to continue providing breast milk to their infants through pumping and storing at work while separated.

The project will provide vital information about the importance of breastfeeding to DPH employees via a website for parents, informative video, and greater access to breastfeeding opportunities through two roving pumping units to be made available to all DPH locations throughout the City of El Paso and County. These roving stations will include the use of hospital grade multi-user pumps, private area with lounge chairs, tables and lamps. Dividers will be available to build a private space if a private room is not available at the facility.

In addition, the project will heighten breastfeeding awareness within City officials through lectures provided by subject matter experts.

Since over 65% of all mothers with young children return to work soon after their infants are born (United States Breastfeeding Committee), the DPH deems it critical to work toward accommodating the needs of young families, and this is a

considerable step in that direction.

Prior to this DSHS grant opportunity, the DPH WIC program has already envisioned a pump room in the administration building. This was installed in 2011 yielding extremely positive acceptance within administration staff. Below are some of their statements:

“The Breastfeeding Pumping Room is very comfortable, cozy and a great support for WIC employees when they are at administration.” Rebeca Rodriguez

New employees going through the orientation phase have stated, “We are extremely impressed with the support by WIC to allow employees to continue breastfeeding after returning to work.” “If we would have had this support with our previous employer, we would have continued to breastfeed after returning to work.”

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President Obama Appoints Harris County Executive Director to Key Administration PostThe White House, Office of the Press Secretary

Dr. Herminia Palacio, Executive Director of Harris County Public Health and Environmental Services, was appointed by President Obama for Member, Advisory Group on Prevention, Health Promotion, and Integrative and Public Health.

Harris County Public Health and Environmental Services is a local health department assisting approximately 2 million people. Dr. Palacio is also an adjunct faculty member of the Baylor College of Medicine and the University of Texas School of Public Health. Dr. Palacio previously served as Special Policy Advisor to the Director for the San Francisco Department of Public Health; and before that, she worked as an attending physician in various departments of San Francisco General Hospital. She has served on the advisory committee of the Centers for Disease Control and Prevention (CDC) Preparedness and Emergency Response Research Center at

UC Berkeley, the CDC Advisory Committee to the Director, and the Institute of Medicine’s Committee on Prepositioned Medical Countermeasures for the Public. Dr. Palacio has served on the Boards of the National Association of County and City Health Officials, the Leland National Urban Air Toxics Research Center, the Texas Association of Local Health Officials, and the Harris County Healthcare Alliance. She was awarded the Excellence in Health Administration Award by the American Public Health Association in 2007. Dr. Palacio received her M.D. from Mount Sinai School of Medicine, her M.P.H. from the University of California, Berkeley School of Public Health and her B.A. from Barnard College, Columbia University.

Others appointed to Administrative posts are:

• Jerry L. Johnson - (Principle Partner, Heffler, Radetick & Saitta, LLP) Member, Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

• Jacob Lozada - (American Association of Retired Persons, the National Medical Music Group the Budget Committee of Andrews Federal Credita Union) Member, Advisory Group on Prevention, Health

Promotion, and Integrative and Public Health

• Dean Ornish - (President, Preventive Medicine Research Institute; Clinical Professor of Medicine, University of California, San Francisco) Member, Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

• Kent A. Salazar – (Owner, Kent Salazar Co.) Member, Board of Directors of the Valles Caldera Trust

President Obama said, “I am honored that these talented individuals have decided to join this Administration and serve our country. I look forward to working with them in the months and years ahead.”

Laredo Health Department Director Joins the Local Government Advisory Committee

Doctor Hector Gonzalez, Director of the Laredo Health Department is on the Local Government Advisory Committee that reports to the Environmental Protection Agency (EPA) administrator Lisa Jackson specifically. He is there to assure

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public health and environmental justice. If you or your department has any public health and environmental concerns, please feel free to contact Doctor Gonzalez directly and he will be happy to present the concerns to the committee.

His email address is: [email protected]

MeAndMyDoctor.com--Write for Us!

As you know, Texas Medical Association is providing a spot for patients and their physicians to have a say on a myriad of health care issues. Check out www.MeAndMyDoctor.com. It’s a brand new blog that gives Texas patients, health care experts, policymakers, physicians, and other health care providers a place to discuss any health care issue.

As a Coalition member, we invite you to contribute to MeAndMyDoctor as well. You can start today by reading the blog. Then sign up to receive blog articles as they are posted, by subscribing on the blog home page. Share MeAndMyDoctor with your colleagues and friends. And post your own comments and ideas about health care in Texas. Thanks for joining the discussion. Thank you!

Karen Batory, MPAVice President

Division of Public Health and Medical EducationTexas Medical Association401 W 15th StreetAustin, Texas 78701T: 512-370-1405, FX: 512-370-1693

RetirementsIngrid HolmesPublic Health DirectorBeaumont Public Health Department

Judith BeckDirector Cherokee County Health Department

New DirectorsPenny Wilson, MPADirector of Health Care ServicesMontgomery County Public Health District

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April 18: PHACT Meeting, TALHO Board Meeting

April 19: TALHO Membership Meeting, Public Health Funding & Policy Committee Meeting

June 13: PHACT Meeting, TALHO Board Meeting

June 14: TALHO Membership Meeting

August 8: PHACT Meeting, TALHO Board Meeting

August 9: TALHO Membership Meeting

October 10: PHACT Meeting, TALHO Board Meeting

October 11: TALHO Membership Meeting

December 12: PHACT Meeting, TALHO Board Meeting

December 13: TALHO Membership Meeting

UPCOMING EVENTS

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 [email protected] or 512-814-2546 ext. 1102. For a complete list of staff contacts, please visit www.TALHO.org

GOLD STANDARD FRIENDS OF LOCAL PUBLIC HEALTH SPONSORS2011 Texas Public Health Accreditation Conference