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

The Results are in! National Immunization Survey

HealthyLiving Matters

Texas Public Health Information Management System (TPHIMS)

Tech Tip

and more...

Volume IV, Issue IV

October - December 2012

MESSAGE FROM THE CHIEF EXECUTIVE OFFICER

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2012 was a busy year for TALHO as we went through staffing changes and some financial turmoil; 2013 should bring great opportunities for our association. In De-cember, we began to market our Rollcall product nationally and are participating as an exhibitor in several epidemiology and public health related conferences over the next few months. We also completed the legal agreements needed to begin marketing our new Public Health Information Management System and have al-ready responded to one large Request For Proposals (please remember to add TALHO to the potential bidders list if your jurisdiction is seeking public health re-lated software or systems).

The biennial legislative session begins January 8th and we are already busy work-ing with the TALHO Legislative Committee to monitor bills as they are filed to see

which have public health impact. We encourage all of our members to develop good working relationships with the elected officials from their areas. Please schedule visits with your representatives and with their staff that handle health issues, either when they are home in their district or when you are in Austin. It is important to the future of local public health that legislators understand who we are and what we do for the residents of Texas.

The TALHO staff and I look forward to a successful 2013 for all of us as we work toward making Texas the healthi-est state in the nation.

Michael Hill

“Health is the soul that animates all the enjoyments of life, which fade and are tasteless without it.”

- Lucius Annaeus Seneca

MESSAGE FROM THE TALHO PRESIDENT

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Happy New Year! – TALHO members; wow, it is 2013 and only a few years ago we were worrying about Y2K. The Texas Association of Local Health Officials (TALHO) has a very busy year in store for its members, when considering this is a State Leg-islative year. We encourage each of our members to take time and visit with your local State Legislative Officials, expressing the importance of Public Health in your community. TALHO’s Legislative Committee developed a Legislative Agenda that highlights topics of importance to Public Health. It is vital to stress that our efforts positively impact our community’s health, but also enhance our local economy and workforce. TALHO will be sponsoring a “Local Public Health Advocacy Event” at the State Capitol on February 7, 2013; I urge each of you to attend.

I would like to thank the TALHO members who are serving on various Legislative and DSHS Committees representing Local Public Health views; we are all faced with

many funding and programmatic changes, or should I say “Challenges”. TALHO stands ready to assist all its members and their communities. I hope to see you in Austin on February 7th.

Eddie Olivarez

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 information

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

ADVOCACY

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TALHO’s Legislative Agenda for 2013The TALHO Legislative Committee has met regularly to confirm the key priority issues to follow during the 2013 Legislative Session. During the December TALHO Membership meeting the following topics were approved as priority issues:

One page handouts have been crafted for TALHO members to use during their conversations, either in Austin or at home, with their legislative offices. Legislators respond to the visits and calls made by their local constitu-ents. These handouts can assist members in identifying general talking points on each issue, however your lo-cal stories that accompany the conversation can make an even bigger impact on the legislators. The handouts are located on the TALHO Dashboard, Document Folder, TALHO, 2013 83rd Legislative Session.

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

A TALHO Advocacy Event will be hosted in Austin on February 7 from 7:30am – 11:30am at the Capitol. The morning will begin at 7:30am in the Capitol Legislative Conference Center, Capitol Extension, Main Conference Room E2.002A, with a breakfast for TALHO members. Presentations will be made by invited policy makers, followed by a short training session with tips on how a visit may go and best methods for presenting your issues to legislators. TALHO members will be provided handout packets to begin the visits with local Senators and Representatives. TALHO is prepared to assist you, as needed, in scheduling your visits. We look forward to a large gathering of local public health leaders at this event to canvas the capitol! The TALHO Membership meeting will follow this event, starting with lunch at 12pm back at the TALHO office.

Contact Lou Kreidler, Wichita Falls – Wichita County Public Health District, at lou.kreidler@wichitafallstx.org for legislative issues.

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

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

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ADVOCACY

Support DSHS Exceptional Item RequestsLife Saving Immunizations: TALHO supports the DSHS Exceptional Item request for funding to purchase vac-cines for adult vaccine preventable diseases to the extent that these vaccines are made available to local health departments. Un-insured and underinsured persons turn to the local health department as the safety net provider of health services in the community. Vaccine-preventable diseases have many social and econom-ic costs: sick children miss school and can cause parents to lose time from work. These diseases also result in doctor’s visits, hospitalizations, and even premature deaths. (CDC)

Control and Treatment of Tuberculosis: TALHO supports the DSHS Exceptional Item request for funding to purchase medications and supplies, and staff to monitor cases. However increased funding is necessary to support the local health departments’ responsibility to test, treat, investigate and conduct case-management. Local health department staff work within their jurisdictional area, expanding out to other communities as needed, to identify infected persons and their contacts and begin treatment and case-management to stop the spread of one of the world’s most deadliest diseases.

Prevent and Respond to Foodborne Disease Outbreaks: TALHO supports the DSHS Exceptional Item request that includes funding local health departments to coordinate surveillance, identify possible cases for food-borne illness, investigate reports of foodborne illnesses and to conduct outbreak investigations. Communities rely on local health departments to ensure that food establishments are maintaining clean facilities and proper handling of food and to respond to reports of illness thought to have been caused by food consumption.

Provide Essential Public Health Functions: TALHO is supportive of continued, and increased, funding provided by the DSHS Regional/Local Health Services Division through the Local Public Health Services Grant. This fund-ing allows local health departments the opportunity to enhance the core public health functions and services most needed within their community. Such functions include epidemiology to track outbreaks, food safety inspections and response to complaints, chronic disease prevention and more.

Enhance Food, Drug and Environmental Health Regulatory Functions: TALHO supports the reinvestment of food, drug and environmental health regulatory fees assessed by the DSHS to license and monitor mandated business practices that affect the health of the public, back to the DSHS regulatory division for use in hiring an appropriate number of staff, or to contract with local health departments, to provide a reasonable and consis-tent follow-up to licensees required to adhere to state laws.

Tobacco, Obesity and Cancer Prevention and Control: TALHO supports the DSHS Exceptional Item requests for funding to increase tobacco prevention and cessation funding for the Quitline counseling services, nicotine replacement therapy (NRT) and media outreach to targeted communities and rural areas of the state, as well as to provide funding to conduct high impact, evidence-based chronic disease reduction interventions and improve access to breast and cervical cancer screening and detection for uninsured women.

ADVOCACY

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Support Population Safety IssuesRaw Milk: TALHO supports requirements for pasteurization of milk prior to sale or distribution to the consumer and therefore does not support any provisions which would allow the sale or distribution of raw, unpasteurized milk to the consumer. TALHO also supports efforts to educate consumers of dangers inherent in consuming unpasteurized milk or products made from raw milk.

Cottage Foods: TALHO supports cottage food production to the extent that it does not compromise the pro-tection of public health. However, exemptions from public health standards and/or environmental health inspection should not be extended to potentially hazardous food (PHF)/temperature control for safety (TCS) foods and should include a requirement for prominent disclosure to the consuming public that the product has NOT been produced or prepared in accordance with federal, state or local public health requirements or oversight. Businesses or any individual engaged in production of non-PHF/TCS food as part of a defined cottage foods industry should be registered with the appropriate regulatory food safety agency. Registration, permit-ting, and product labeling enables trace back when public health issues arise.

Farmer’s Markets: TALHO supports the promotion of food at farmer’s markets as long as appropriate safety measures are in place and adhered to by the vendors to protect the public’s health, including following proce-dures to be used in preparation, carriage to the market, taste testing, display and storage.

Tobacco Prevention and Control: TALHO supports comprehensive statewide, smoke-free legislation that eliminates secondhand smoke in all workplaces throughout Texas and the use of a significantly appropriated amount of Tobacco Settlement funds to implement smoking cessation and evidence-based prevention pro-grams. A statewide ban on secondhand smoke in workplaces provides an equal playing field for businesses within a community and protects the employees they hire.

Obesity Prevention and Control: TALHO supports the implementation of evidence-based strategies to reduce obesity and its related costs from chronic disease, including interventions to increase access to healthier foods within schools, worksites, grocery stores and restaurants and decrease consumption of sugar-sweetened bev-erages, salt and saturated fat. TALHO also supports implementation of evidence-based strategies to increase access to opportunities within the community, worksites and schools that assists a person’s choice to live a more physically active lifestyle.

Cancer Prevention and Control: TALHO supports adequate funding be appreciated specifically for the purpose of investing in community-based prevention programs that institute a coordinated and comprehensive ap-proach to education, screening, detection, referral and treatment services between public health and medicine at the state and local level.

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PUBLIC HEALTH PROGRAMS

HEALTHY LIVING MATTERS A HOUSTON/HARRIS COUNTY CHILDHOOD OBESITY PREVENTION COLLABORATIVE

2525 ROBINHOOD STREET, SUITE 1100, HOUSTON, TX 77005 PHONE: 281.953.7451 WWW.HEALTHYLIVINGMATTERS.NET INFO@HEALTHYLIVINGMATTERS.NET

In 2011, The Houston Endowment awarded $2.5 million dollars to The Harris County Healthcare Alliance for a two-year planning initiative to curb childhood obesity in Houston/Harris County by using policy action to enact system and environmental change. Through assessment and collaboration, Healthy Living Matters (HLM) will develop a strategic Community Action Plan with input from a multi-sector group of local leaders and the community.

CALLING ALL TALHO MEMBERS INVOLVED IN PUBLIC HEALTH & OBESITY PREVENTION!

As we move forward, we may contact you to obtain your expertise and recommendations as we work to:

build a set of policy recommendations to reduce childhood obesity,

increase access to healthy foods and opportunities for physical activity in Houston/Harris County, and

identify applicable policy-based initiatives/plans that could impact childhood obesity.

We also ask for your support of the State and Federal policy recommendations in the Community Action Plan developed by HLM to reduce childhood obesity (projected to be released late 2013).

HEALTHY LIVING MATTERS COLLABORATIVE MEMBER MEETING BREAK OUT SESSION - JULY 2012

HEALTHY LIVING MATTERS LEADERSHIP

Healthy Living Matters Leadership includes representation from independent school districts, law enforcement, economic and community development, health departments, public infrastructure, business, community and faith based organizations, academia, parks, transportation, healthcare providers, health insurance plans, elected officials, early childhood centers and after-school programs. HLM hosts ongoing meetings engaging these stakeholders in developing the best strategies to effectively reduce childhood obesity in our community.

Implementation, analysis and review of the recommended strategies are managed by the four planning teams: assessment, policy scan, community and stakeholder engagement, and evaluation.

COMMUNITY ACTION PLAN

Community &

Stakeholder Engagement

Policy Scan

Assessment

Evaluation

HLM aims to assess the food and built environment, provide learning opportunities related to childhood obesity and its impact on the community, scan and monitor federal, state and local policy trends, and develop a Community Action Plan.

CONTACT TORAL SINDHA OR SUSAN LACKEY AT 281.953.7451

PUBLIC HEALTH PROGRAMS

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Texas Findings from the 2011 National Immunization Survey – Immunization Levels Increased!Taken from a presentation made at the October 11, 2012 TALHO Membership Meeting by Monica Gamez, DSHS Infec-tious Disease Control Unit

Based on results from the 2011 NIS for children aged 19–35 months, Texas reported statistically significant increases in coverage for the 4:3:1:3:3:1:4 series, in-cluding full series of Hib, varicella, hepatitis B vaccine birth dose, and rotavirus vaccines.

What is the National Immunization Survey (NIS)?

The NIS is a national survey conducted annually by the Centers for Disease Control and Prevention to as-sess immunization levels among pre-school children, ages 19 through 35 months old. The NIS is the only population-based survey to provide national, state, local area, and territorial estimates of vaccination coverage among children aged 19–35 months in the United States. The NIS provides national and state estimates of vaccination coverage, including new vaccines as they are licensed and recommended for use. The survey also tracks progress towards Healthy People goals.

How is vaccine coverage defined?

As in 2010, the 4:3:1:3:3:1:4 series was reported, along with the 4:3:1:0:3:1:4 series. The Hib vaccine shortage from December 2007 through September 2009 led to the exclusion of Hib from the 4:3:1:3:3:1:4 series to create the 4:3:1:0:3:1:4 series in 2009. The temporary suspension of the Hib booster dose at 12-15 months had a major effect on coverage estimates in most states. The 4:3:1:3:3:1:4 series includes 4 doses of diphtheria-tetanus-pertussis (DTaP), 3 doses of Polio, 1 dose of measles-mumps-rubella (MMR), 3 doses of Hib or 4 depending on the product, 3 doses of hepatitis B, 1 dose of varicella and 4 doses of pneumococcal conjugate vaccine (PCV).

What is the take-home message for the 2011 NIS? • Challenges remain. The biggest challenge con- tinues to be for families to understand the importance of children receiving all doses in each vaccine series, particularly four doses of pertussis vaccine, before the child turns 19 months of age. • A multi-pronged approach that incorporates proven strategies must be sustained over a long period of time to increase vaccine cover age levels further. • Coverage continued to meet or exceed nation- al Healthy People 2020 objectives of 90 per-

Table 1. 2011 NIS Coverage Levels in the State of Texas and US

Vaccine (children age 19 to 35 months)

2011 Texas Coverage

Level

Increase from 2010 Texas

Coverage Level

2011 US Coverage

Level

Statistically Significant from

2010FullseriesofHib 84.1% 14.9% 80.4% YHepatitusBbirthdose 78.6% 9% 68.6% YRotavirus 72.3% 10.4% 67.3% Y4:3:1:0:3:1:4series(withoutHib) 74.9% 4% 73.6% N4:3:1:3:3:1:4series(withHib) 72.7% 14.1% 68.5% Y

PUBLIC HEALTH PROGRAMS

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cent for MMR, hepatitis B, poliovirus, and varicella vaccine. • Coverage for the full series of Hib is increas- ing, likely reflecting a recovery from the effect of the recommendation to defer the booster Hib dose during the Hib shortage that oc- curred during December 2007–June 2009.

What are some of the challenges to increas-ing vaccine coverage levels in Texas?

Significant risk factors for low immunizations continue to be those related to low socioeconomic status, low-er education rates, single parent households, and ac-cess to health care. Being uninsured or underinsured are also significant risk factors to obtaining timely and appropriate health care. Finally, the beliefs, attitudes, and lack of knowledge of parents can be important barriers to vaccinations. Some parents do not under-stand the importance of the timing of vaccinations or know when vaccines are due.

DSHS plays a leadership role in the statewide immuni-zation system, and has worked with stakeholders, in-

cluding local health departments, to improve vaccine coverage levels in all children in Texas by implement-ing proven strategies according to the Centers for Dis-ease Control and Prevention, the Advisory Committee on Immunization Practices, and Texas state leadership that are consistent with high vaccine coverage levels.

Figure 1. Graphical comparison of the 4:3:1:3:3:1:4 vaccine series that includes the full Hib series in the state of Texas.

Celebrate American Heart Month

February 1st, 2013 is National Wear Red Day!

www.goredforwomen.org

PUBLIC HEALTH PROGRAMS

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News from the Chief Public Health Officer:

County Health Rankings (CHRs) and Roadmap - 2013The University of Wisconsin Population Health Insti-tute released the first funding opportunity in 2010 to state teams to increase awareness of, and move com-munities to action related to improving population health. This is the third year of funding made avail-able to states to conduct state or local activities using a team approach with the state association of county and city health official (SACCHO), state public health institutes (PHI) and state health departments (SHDs). TALHO, the Texas Health Institute and the Texas Department of State Health Services have worked col-laboratively since 2010 to hold state and local meet-ings with various stakeholders to highlight the public health issues in Texas. During 2013 the Texas State CHR team will continue to educate state and local policy makers and the public on effective, evidence-based public health programs and policies that can be implemented to make real change possible. Learn more about the CHRs and Roadmap at www.county-healthrankings.org where tools will help you plan to take action in your community. The 2013 CHRs will be released in late March.

Project Public Health Ready - Getting Texas in the ActionProject Public Health Ready (PPHR) is a competency-based training and recognition program administered by the National Association of County and City Health Officials (NACCHO) that assesses preparedness and assist local health departments (LHDs), or groups of LHDs working collaboratively as a region, to respond to emergencies. The PPHR Criteria are nationally-recognized standards for local public health prepared-

ness and are updated annually to incorporate the most recent federal initiatives. Each of the three PPHR project goals – all-hazards preparedness planning, workforce capacity development, and demonstration of readiness through exercises or real events – has a comprehensive list of standards that must be met in order to achieve PPHR recognition.

All new LHDs seeking PPHR recognition must imple-ment the program through the state-supported model. This model requires that the PPHR application process for all LHDs within the state be coordinated by a state level entity, such as a state health depart-ment or SACCHO (State Association of City and County Health Officials), such as TALHO. It also requires that a state level entity identify a minimum number of ap-plicants to submit applications to NACCHO. The entire PPHR process for each applicant lasts approximately a year, and for new states involved in PPHR, an ad-ditional year is typically necessary to lay the ground-work before LHDs can begin the application process. http://www.naccho.org/topics/emergency/PPHR/index.cfm

Texas has had two LHDs recognized for PPHR. If you are ready to receive the benefits of participating in PPHR (such as initiating measurable standards and benchmarks for local and regional emergency pre-paredness), now is the time to be part of an applica-tion process for submission in 2014. If you are interested in being nationally recognized for your preparedness capacity and capability, send an email to jennifer.smith@talho.org!

http://www.trilogyir.com

Trilogy Integrated Resources

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ACCREDITATION

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2012 Local Health Department Accreditation Skill Building Conference

TALHO co-hosted the 2012 Local Health Department Accreditation Skill Building Conference on September 24-25 with the Texas Public Health Association, University of North Texas Health Science Center School of Public Health and the Texas Public Health Training Center. Of the 60 attendees, fourteen local health departments (LHDs) sent staff to share and learn about collecting and analyzing data, how to conduct large group facilita-tion processes, and details from LHDs on developing a community health needs assessment (CHA) and com-munity health improvement plan (CHIP). During the CHA/CHIP session, LHDs expressed concern with limited availability to time, staff and staff with expertise in accreditation processes to move forward in preparing for accreditation. The meeting materials and videos are located on the TALHO website at www.talho.org, click on the Education tab, and the Public Health Accreditation Council of Texas (PHACT) website at www.phactx.org, click on the PHACT activities tab.

Public Health Accreditation Council of Texas (PHACT)PHACT meets monthly to discuss ways to assist LHDs in preparing for accreditation. The Public Health Accreditation Board has reported that no applica-tions have been submitted from Texas. However, it is anticipated that some LHDs will submit an intent to apply during 2013. The University of North Texas Health Science Center School of Public Health (UN-THSC), a member of PHACT, has completed work on an Accreditation Toolkit that contains a collection of valuable resources and information that can be used by LHDs in preparing for accreditation. DSHS provided the funding to UNT. This toolkit is located on the PHACT website.

ACCREDITATION

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National Network of Public Health Institute (NNPHI) 2012 Open Forum

The TALHO Chief Public Health Officer and four local health departments attended the NNPHI 2012 Open Forum Meeting for Quality Improvement in Public Health on December 6-7 in Charlotte, North Caro-lina. The Texas Public Health Association provided the opportunity for the TALHO CPHO to attend as a joint representative of both organizations. The day and a half meeting provided excellent presentations on the use of performance management and quality improvement processes within state and local health departments, including a presentation by the Hous-ton Department of Health and Human Services. The Texas representatives took time to network together on accreditation activities in their local health depart-ments, as well as spoke with representatives from the Centers for Disease Control and Prevention and the Public Health Accreditation Board about the needs in

Texas. Visit the NNPHI website at www.nnphi.org for more information on the work NNPHI conducts on performance management and quality improvement. The Open Forum materials are located on the TALHO Dashboard at https://dashboard.talho.org/sign_in under the Document Folder feature - TALHO, TALHO Member Groups, Accreditation and QI.

Texas attendees sharing lunch together at the meeting: Back row standing: Victoria Bailey (Austin), Gary Tucker (Beaumont), Jennifer Smith (TALHO). Seated: Eileen Daley (Iowa), Bertha Amaya (El Paso), Angela Mora (El Paso), Sue Beatty (El Paso), Larissa Estes (Houston)

108 Heath Departments in

Public Health Accreditation Board (PHAB) Distribution of Health Departments: 94 Local 13 State 1 Tribal

TECHNOLOGY

13

Rollcall pushes forward

We are proud to announce exciting news this quar-ter for our TALHO-developed, school surveillance software: Rollcall. For the first time ever, Rollcall was exhibited at a na-tional, and international, level.

At the International Society for Disease Surveillance con-ference in early December, TALHO displayed Rollcall right along side all of the other latest tools in disease surveillance. Rollcall was the only tool showcased that offered attendence and school symptom data track-ing and analysis. Needless to say, we gathered a lot of attention.

We also developed an informative website that pro-videds screenshots, a demo video, history, updated features, future development information, and links to research in the field of school attendence and symptom tracking for epidemiological purposes.

We encourage everyone to check out the exciting things we are doing with Rollcall at rollcall.talho.org/info .

TALHO Public Health Infor-mation Management System (TPHIMS)

TALHO is proud to announce that it will be hosting a complete Public Health Information Management System on our newly installed, robust servers.

TPHIMS is a web-based tool that was developed for local health departments and provides capabilities such as EMR, Fiscal, Chronic Disease and Case Man-agement that meet all needs of various programs. The infinitely flexible and scalable system easily adapts to existing business processes, making imple-mentation fast and painless. This system is a complete and customizable solution. All applications within the program are modular and integrated, which reduces cost and also eliminates the need for duplicative data entry. Compliance with HIPAA security and confidentiality requirements is ensured by the unique, patent pend-ing information sharing methodology. The system is offered as an ASP hosted at the secure Texas Disas-ter Recovery Operations Center with a full, replicate server backup system in place.

Key features of the systems:

• Web-based design with access via a standard web browser • ASP.NET platform • Access to the demographics, clinical and case data at remote sites • Compliance with standards such as LOINC and SNOMED • Data exchange in HL7 and other formats • Robust reporting functionality

TECHNOLOGY

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• Role based security • Phased-in implementation and extensive capa- bility for future expansion

• Scalability and affordability

Software modules integrated within the system in-clude, but are not limited to:

• Electronic Medical Record configurable for various programs • Fiscal Management • Communicable Diseases Reporting, Surveil- lance and Investigations • Outbreak Management • Chronic Disease Management • Case Management configurable for various programs • Laboratory Information Management • Events Management configurable for various types of events • Personal Health Record • Clinics, Staff and Appointments Scheduling • Pharmacy • Dental Care

Email us at info@talho.org for more information!

Adobe Connect a better way to conference

We want to be the first to say that TALHO is pleased to offer free video, web, and audio conferencing services to our members.

In the past, we utilized Polycom technology over the private T1 lines. Now that it’s necessary to transition away from the T1 lines, we took the opportunity to contract with one of the best conferencing solutions available today: Adobe Connect.

For the December TALHO membership meeting, and all TALHO meetings in the future, we will be utilizing Adobe Connect, the web-based video conferencing tool. This software offers many easy to use, practi-cal features for TALHO members. It can be used to create and share information and any presentation, share training materials, and utilize learning modules like a shared whiteboard space, text chatting, open notes and user desktop sharing. With all this added functionality, TALHO now has the capacity to host many different kinds of conferences and trainings. It is a highly customizable tool with different formats and different participation methods, such as polls and quizzes that can be offered in the same window of the conference.

TALHO will be able to host up to 100 participants. Adobe Connect utilizes any webcam and there is no software setup for the user. Since this service is web-based, TALHO can host participants across any com-puter platform and even most mobile platforms. The best part is that this system is so functional with any level of technology that you don’t need a webcam to participate. You can still dial in and hear the presenta-tions as you view them online in real-time.

Let us know if we can host a meeting or training for you. It is just as simple as a few clicks and anyone, anywhere can connect and collaborate.

Email us at info@talho.org for more information!

TECHNOLOGY

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Tech Tip: Gadget GuideGadgets are a significant part of everyone’s life today. No matter how old, how young, or how technically inclined you are, it seems that each year we find cooler gadgets that make all of our lives easier and much more fun! Here are some of the latest and greatest trends in gadgets that also fit in with maintaining a healthy lifestyle!

Fitness Tech

Fitness gadgets can be a dime a dozen and equally as cheap or use-less. However, in the past few years, there have been some very cool improvements in the world of fitness technology. One tool that has become very popular and earns its high ratings is the Fitbit One ($99.95 Best Buy or Amazon). This robust pedometer does more than just track your steps and distance, it can track calories burned, stairs climbed, and personal goals. With small wristband, it tracks your length of sleep and has a gentile and silent alarm feature. It integrates with an iPhone or Android app. It allows you to share goals with friends and family, track food and weight, and log your activity automatically via Bluetooth with your phone or computer. It is super small and discrete (can be worn in a pocket). It is completely water resistant and rechargeable. The Fitbit One is a fantastic gift for anyone who is looking to easily track their daily fitness of any kind.

Camping/Green Tech

A solar charger for devices is a brilliant gift for anyone who loves to travel, camp, or be prepared for emergencies. However, in our experi-ence, portable solar technology can be VERY hit or miss. That’s why we are very thankful for the new, but tried and true, product: Joos Orange Solar Device Charger ($149.00 at REI or solarjoos.com). This device can charge all personal electronic devices (cell phones, smart phones, iPad, iPhone, MP3 players, GPS devices, portable game devic-es, Sat Phones etc.). It is the most efficient at sun to power conversion of all portable chargers, with one hour of sun giving enough charge for two hours of Smartphone talk time. It has an onboard battery that can store energy or be recharged via USB plug. It is small (11”x8”),

waterproof, and durable, able to capture energy even while under water. The new Joos Solar Device Charger is the ultimate traveling companion for the gadget lover on your list.

TECHNOLOGY

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iPad vs. Android Tablet?

The Apple iPad Mini will be a popular gift this year, and it really is a great little tablet. There are also great Android options out there, too. A rule of thumb we like to use when making an Apple vs. Android vs. Win-dows recommendation: consider what other devices the user of the tablet currently owns. If you’re buying for someone who loves their iPhone, stick with the iPad, if you’re buying for someone who loves their An-droid phone, stick with an Android tablet. Reason being, all of the apps they have purchased through iTunes

or Google Play can transfer over to their new tablet. Sticking to what you’ve grown to love and invested in is the safest option. Our favorite Android tablet this season is the Nexus 7. This device is made by both Google and Asus, and with a starting price of $199 (Office Depot or play.google.com), it is the most competi-tively priced tablet on the market today. It is roughly the same size as an iPad mini, and for the average user, they are about equally equipped in hardware. You really won’t be disappointed with either purchase, but a word of caution: whatever you do, avoid the Apple vs. Android debate over the holiday dinner table!

Need more ideas? Great Resource for Geeky Gifts: http://www.thinkgeek.com/holiday2012/Always a great gadget stop: http://www.sharperimage.com/

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We specialize in Medicaid Administrative Claiming (MAC): MAC is a federal quarterly program that reimburses Health Departments for certain Medicaid related activities. MAC reimbursable activities include:

o Medicaid Outreach o Medicaid Eligibility Determination o Referral, Coordination and Monitoring of Medicaid Services o Transportation and Translation o Medical Related Provider Relations o Program Planning, Development and Interagency Coordination

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LOCAL PUBLIC HEALTH NEWS

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Plano’s QR Coded Health Permits Win State Innovation AwardPress ReleaseAt the Texas Municipal League Annual Conference and Exhi-bition, held in Grapevine on November 14-16, the City of Plano was presented the 2012 Municipal Excellence Award in Management Innova-tions for cities of more than 25,000 in population. The award recognizes Plano for its project titled “Applica-tion of Quick Response (QR) Codes to Health Permits.”

To facilitate accessibility of food service inspection records, the City of Plano developed a QR code to include on Environmental Health Department permits issued to food establishments. When scanned using a smart phone application, the QR code directs a Web browser to the department’s website. Once individu-als are on the site, they can access up-to dateinspection details for that particular restaurant, in-cluding the current inspection information, history of compliance and the location of the establishment on a map. The QR code is a versatile and cost effective way to provide information to the consumer through a preferred delivery method, while also making it imperative that inspection reports are accurate and timely. Initial public response to the QR codes during the 2011 calendar year was positive, with restaurant Web page hits showing a 70 percent increase in activ-ity over the previous calendar year.

Accepting the award were Plano City Council Member Lissa Smith, City Manager Bruce Glasscock, Deputy City Manager Frank Turner, Environmental Health Director Brian Collins, Environmental Health Manager Geoffrey Heinicke and Director of Government Rela-tions, Policy & Community Outreach Mark Israelson.

The Texas Municipal League is a voluntary association of more than 1,120 Texas cities. Its primary objective is to serve the needs and advocate the interests of Texas cities. It is the largest organization of its kind in the United States. The City of Plano is a member of the Texas Municipal League.

Geoffrey Heinicke, Environmental Health ManagerRachel Pitts, Director of Member Services, Texas Municipal League

Galveston County Health District Plans for Emergencies December 13, 2012Galveston County and Cities – At a meeting held November 30th the Galveston County Health District, the City of League City and Galveston County kicked off the Galveston County Emergency Response Collaboration (GCERC). 115 individuals from more than 40 departments, agencies and community groups met to learn from past incidents and prepare for future health threats and disasters. In addition to small group sessions attendees also heard speakers on a variety of topics such as; A Review of Real-Life Public Health Emergencies, Effective Emergency Coordination and the Use of Web EOC, Effective Hospital Preparedness, Capabilities and Expectations of Public Health Preparedness, and Public Information During an Emergency. Presentations and photographs from the meeting can be found at www.gchd.org/bt/btgcerc2.html.

(News Media: For more information contact Kurt Koopmann, GCHD Public Information Officer, 409-938-2211 or kkoopman@gchd.org)

GCHD CEO Dr. Mark Guidry addresses the Galveston County Emergency Response Collaboration.

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LOCAL PUBLIC HEALTH NEWS

Hidalgo County:Immunization Efforts and Digital & Static Billboard MediaHidalgo County Health and Human Services Department (HCHHSD) works closely with the community to increase awareness on immunizations and vaccine preventable diseases.

HCHHSD partners with WIC, Head Start, local school districts, and local universities and colleges to educate, vaccinate, and increase awareness on the importance of vaccine preventable disease. Advertising is done through community health fairs, billboards, and on screen advertising at theaters on back to school immunizations, pertussis and flu.

HCHHSD is presently collaborating with University of Texas Pan American (UTPA) for the upcoming NIIW 2013 Immunization Conference. Dr. Ray Strikas from the CDC will be the keynote speaker. Materials are in English and Spanish. Contact Nelda Mendez: (956) 383-6221 or nelda.mendez@hchd.org

1st Annual MORE Health @ UTPAHCHHSD will collaborate with UTPA College of Health Sciences & Human Services (COHSHS) to initiate the 1st Annual MORE Health @ UTPA (Maximizing Opportunities in Research and Education for Better Health), April 25-27, 2013 and is themed “Diabetes, Obesity and their Complications.”

The schedule of events will include:

April 25, 2013 • Bi-national Immunization Conference (by special invitation only) • COHSHS Student Research DayApril 26, 2013 • Symposium: “Obesity and its Complications” • Keynote Speaker Dr. David Lakey, Commissioner of Texas Department of State Health Services (DSHS) • Breakout sessions for medical professionals and community membersApril 27, 2013 • Symposium: “Diabetes and its Complications” • Keynote Speaker: Admiral Epifanio Elizondo, PhD, PA-C, Regional Health Administrator, HHS Region VI • Breakout sessions for caretakers of diabetic children and for adults with diabetes and/or their caretakers • Community Health Fair • Wellness Camp for Youth at the UTPA Wellness and Recreational Sports Center

For registration information, please visit www.utpa.edu/cohshs

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LOCAL PUBLIC HEALTH NEWSHidalgo County Health and Human Services Upcoming Trainings

The Hidalgo County Health and Human Services Department (HCHHSD) understands the importance of being prepared for any natural and man-made disaster. Therefore, HCHHSD will be providing trainings throughout the year to stakeholders and partners on various areas of preparedness and response.

Upcoming Trainings:

January29-31,2013 IndividualandGroupCriticalIncedentStressManagementFebruary4-8,2013 HAMAmateurRadio(IndividualExamFee:$15)April15,2013 MGT319MassProphylaxisMay8-9,2013 SouthTexasHurricanConferenceMay27-29,2013 BasicDisasterLifeSupport

AdvancedDisasterLifeSupport

For more information, contact Rodney Elizondo at (956) 318-2426 or rodney.elizondo@hchd.org.

Hidalgo County Health and Human Services 1st Annual South Texas Hurricane Conference

The Hidalgo County Health and Human Services Department will be hosting the 1st Annual South Texas Hurricane Conference (STHC) on May 8-9, 2013 at the McAl-len Convention Center. This conference will provide a forum for current trends

and topics, information about the latest tools and technology in emergency preparedness management and homeland security, and advances the preparedness function for the region. This con-ference will encourage stakeholder at all levels of government, the private sector, public health related and related professions to exchange ideas on collaborating to protect lives and property from disaster.

If you are an emergency manager, homeland security official, first response coor-dinator, private industry risk manager or contingency planner, you will not want to miss the STHC.

For more information on the STXHC, feel free to contact the Hidalgo County Health and Human Services Department at (956) 318-2426.

LOCAL PUBLIC HEALTH NEWSTexas Family Physician Receives Public Health Award at American Academy of Family Physicians Annual MeetingTaken from a Press Release by the American Academy of Family Physi-cians

Philip Huang, MD, MPH, medical director and health authority for the Austin/Travis County Health and Humans Services Department (ATCHHS) and a family physician, was awarded the 2012 Public Health Award by the American Academy of Family Physicians (AAFP) at its annual meeting in Philadelphia. The AAFP’s Public Health Award recognizes individuals who have made or are making extraordinary contributions to the health of the American public. The award was one of seven presented for exceptional achievement in the field of family medicine at the AAFP’s Scientific Assembly, one of the largest gatherings of primary care providers in the country.

Throughout his career, Huang has shown extraordinary dedication to improving the health of the public through his coordination and implementation of a number of programs that have sought to reduce tobacco use and treat chronic disease.

After identifying tobacco use as the leading actual cause of death in Travis County in 2007 — more than alcohol, drugs, suicide, car accidents, HIV/AIDS, homicide and fire combined — Huang began actively pursuing funding for a comprehensive community tobacco cessation program. In 2010, the ATCHHS was awarded a $7.5 million grant from the Centers for Disease Control and Prevention to implement comprehensive community changes to

reduce tobacco use. Huang oversaw a campaign that promoted free community tobacco cessation resources, discouraged youth access to smoking products, and called for tobacco-free campus policies at area worksites, colleges and other public settings. This campaign has become a model for other communities across Texas and throughout the nation.

Huang’s commitment to tobacco use prevention and cessation began in medical school at the University of Texas Southwestern Medical School in Dallas, where he organized a student chapter of Doctors Ought to Care and presented the AAFP’s Tar Wars youth tobacco use prevention program at area schools. He even convinced a local advertising company to donate billboard signage to display their poster contest winner’s artwork, spreading Tar Wars’ tobacco-free message to countless commuters. And while earning his Masters of Public Health at Harvard University, he successfully led a movement to have the school divest of its tobacco stocks.

Dr. Huang currently serves on the CDC’s Interagency Committee on Smoking and Health, the National Association of Chronic Disease Directors and the board of directors for C-Change, a coalition of the nation’s key cancer leaders from government, business, and nonprofit sectors. Huang is an adjunct assistant professor at the University of Texas School of Public Health.

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LOCAL PUBLIC HEALTH NEWSVaccinate 2012 - San Antonio

First Vote and Vax Effort in Texas Deemed a Success

San Antonio Metropolitan Health District and other immunization partners organized the first-ever vac-cination event at polling sites last November, in-oculating hundreds of voters at several polling sites throughout San Antonio. More than 150 doses of vac-cines, including flu and Tdap, were conveniently given to voters who turned out at the polling sites during the one-day event held on the last day of early voting.

National elections, which draw a large number of voters, take place during flu vaccination season and represent an untapped opportunity for large-scale delivery of vaccines. In 2006, the Robert Wood John-son Foundation launched a program to evaluate the feasibility of delivering influenza vaccinations near polling places.

During the 2008 elections, 132 public health agencies facilitated the delivery of 21,434 flu vaccines at 331 locations in 42 states and the District of Columbia. The initiative reached a crucial at-risk population: two-thirds were in CDC-defined priority groups and 48 percent of those immunized had not received a flu

vaccine the previous year or would not have received a vaccination without the “Vote & Vax” program.

“We chose to hold this first event on the last day of early voting to test how well the community received the opportunity and, with our partners’ support, it turned out to be a success,” said Chris-tine Rutherford-Stu-art, assistant director for community health at Metro Health.

Metro Health partnered with the Bexar County Elec-tion Department, the Health Collaborative, Wal-greens, Passport Health and CVS Pharmacy to carry out the vaccine push in San Antonio. Election laws in Bexar County prohibit anyone from offering free incentives to voters. While the vaccines were not free to voters, hundreds of them took up the chance to get both voting and vaccinations done in a one-stop fash-ion. Approximately 64 percent of participants were age 50 or older and 25 percent reported at least one risk factor for being high risk for developing severe complications from flu (pregnant, chronic disease or over 65 years). And while 40 percent of voters had private insurance, nearly the same amount reported not getting a flu shot last year.

Number of Vaccine Doses By Type

Influenza Tdap

Northside Activity Center 45 3Castle Hills Fire Department 45 5St. Benedict Catholic Church 48 0Walgreens 7 0Total doses administered 145 8

“It is health that is real wealth and not pieces of gold and silver”

- Mahatma Gandhi

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LOCAL PUBLIC HEALTH NEWS

Immunizations partners also gathered demographic, influenza risk factor, and immunization background in-formation. The results of the 2012 San Antonio effort are summarized below and compared to 2006 national results.

2006 Vote & Vax Cumulative Data 2012 Bexar County Data

Age % Age %≥65 43.3 % ≥65 16.9 %50–64 31.3 % 50–64 51.5 %18–49 18.7 % 18–49 29.4 %<18 y 6.8 % <18 y 2.2 %Gender % Gender %Men 42.8 % Men 40.4%Women 57.2 % Women 59.6%

Total Respondents 13,790 Total Respondents 136

Additional 2012 Bexar County DataInsurance Status % Immunized 2011? % Vote Today? % High-Risk

Category %Lives with/Cares for High-Risk*? %

Medicaid 1.5 Yes 58.7 Yes 75.5 Pregnant 2.4 Yes 21.7Medicare 20.0 No 41.3 No 24.5 >65 44.0 No 78.3Private 43.0 At Risk* 53.7Other 14.8None 20.7

*At risk condition such as asthma, diabetes, and chronic lung disease.

PUBLIC HEALTH HISTORY

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These ARE the “Good Old Days”Article from:Bracy, LE. “These ARE the Good Old Days.” Texas Health Bulletin. Ed. Grant H Burton. March, 1956: 3-4

The “Captain of the Men of Death” had been reduced to the rank of Private in the short space of time from 1906 to 1956.

Tuberculosis was the leading cause of death in 1920 here in Texas. Gradually the death rate has been reduced until now it is not listed among the “Big Ten.” Fifty years ago the tuberculosis death rate was 204 per 100,000 population; now it is only 9.3 per 100,000.

In 1902 the Texas State Department of Health did not have the money to carry on any sort of a program for reducing the deaths caused by the Great White Plague. This work then was carried on by private tu-berculosis associations.

The 1920 educational program for preventing tuber-culosis consisted of teaching school children health habits, demonstration school nursing, lectures, mo-tion pictures and an occasional chest clinic.

At that time diagnosis was made by physical examina-tion, sputum test, and occasional large x-ray picture. The majority of patients seen in clinics were moder-ately or far advanced cases.

To further see the educational program, a truck (see illustration) was purchased in 1922 and equipped. A special 32-volt generator was installed in order that motion pictures could be shown any place we could drive the truck. In the daytime an exhibit was dis-played and literature handed to all who stopped. At night motion pictures were shown in the open.

The first itinerary was made to cover all the counties east of the M.K. &T Railroad. At that time there were no highway signs as we know them now. There were two markings that could be seen on culverts, large rocks or posts: OST (Old Spanish Trail) and K-T (King’s Trail). However, in the main, merchant’s signs were the guide posts for travelers.

The splendid highway system we now enjoy was almost non-existent. To illustrate, when the writer asked about the road from Hearne to Bryan, he was told that the truck could not make it as the sand was a foot deep, but by way of Franklin there was a good gravel road. Or, you can never make it through the Trinity bottoms without an axe or shovel.

Well remembered is the Sunday between Fairfield and Palestine when the chug holes twisted the steer-ing column out of the wooden dash board and repairs were made on the spot; also, the morning after a heavy rain, coming from Hempstead to Brenham, the truck with locked wheels slid down the hill and almost across the ferry. Washington County had just opened a new concrete highway, and it looked beautiful on coming out of the Brazos bottoms. While giving a show on the courthouse square in Rusk, the program was disrupted when two Model T’s traveling in oppo-site directions, the drivers watching the pictures, col-

The author and his wife and the 1922 vintage tuberculosis exhibit truck in which they toured the state on nightmarish roads. PS: The truck was later sold to a Houston couple as a ‘honeymoon car.”

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PUBLIC HEALTH HISTORYlided and turned over. Programs were held in parks, schools, ranch houses, main streets, or any available space. However, courthouse lawns were the favorite meeting places.

In 1922, the 40-hour, 5 day week was unheard of in any line of work. A day’s schedule went something like this: leave the town you were in by 7:00 A.M., stop along the road to rewind and repair films, set up the exhibit upon reaching the next town on your schedule, call on officials to arrange a place of meet-ing, take down the exhibit in the late evening and move to the spot selected for the night show; if ev-erything went well you would be through about 10:30 P.M.

The fact that any member of a family had tuberculo-sis 30 years ago was kept secret. Constant education

that the disease could be arrested if discovered in its early stages gradually took hold, more beds for treat-ment became available, and the death rate gradually started downward.

Now, with mass tuberculosis x-ray clinics operating throughout the state, cases are being discovered earli-er than ever before. To the old regime of bed rest and good nutrition, there has been added surgery, newer methods of management, antibiotics, with the result that tuberculosis is not listed in the 10 leading causes of death and the promise that it will go still lower.

The phrase, “the good old days,” does not apply to tuberculosis patients, These are the good days.

Accredited Local Health Units - 1956

County Units

- Bell County Health Unit, Belton- Bexar County Health Unit, San Antonio- Texarkana-Bowie County Health Unit, Texarkana- Brazoria County Health Unit, Angleton- Bryan-Brazos County Health Unit, Bryan- Brownwood-Brown County Health Unit, Brownwood- Cameron County Health Unit, San Benito- Cass County Health Unity, Linden- McKinney-Collin County Health Unit, McKinney- Dallas County Health Unit, Dallas- El Paso-Hudspeth County Health Unit, El Paso- Fort Bend County Health Unit, Richmond- Galveston County Health Unit, La Marque- Denison-Sherman-Grayson County Health Unit, Sherman- Harris County Health Unity, Houston- Hidalgo County Health Unit, Edinburg- Hunt County Health Unit, Greenville- Jasper-Newton-Hardin County Health Unit, Jasper- Lubbock City-County Health Unit, Lubbock- Paris-Lamar County Health Unit, Paris- Waco-McLennan County Health Unit, Waco- Bay City-Matagorda County Health Unity, Bay City- Medina County Health Unit, Hondo

- Midland-Ector-Howard County Health Unit, Midland- Milam County Health Unit, Cameron- Corsicana-Navarro County Health Unit, Corsicana- Nolan-Scurry County Health Unit, Sweetwater- Corpus Christi-Nueces County Health Unit, Corpus Christi- Orange City-County Health Unit, Orange- San Patricio County Health Unit, Sinton- Tyler-Smith County Health Unit, Tyler- South Plains County Health Unit, Brownfield- Southwestern Texas Health Unit, Uvalde- Tarrant County Health Unit, Fort Worth- Abilene-Taylor County Health Unit, Abilene- San Angelo-Tom Green County Health Unit, San Angleo- Travis County Health Unit, Austin- Upshur County Health Unit, Gilmer- Victoria County Health Unit, Victoria- Webb County Health Unit, Laredo- Wichita Falls-Wichita County Health Unit, Wichita Falls- Williamson County Health Unit, Georgetown- Wood County Health Unit, Quitman

City Health Units

- Public Health Department, Dallas- Public Health and Welfare Department, Fort Worth- City Health Department, Houston- Port Arthur City Health Unit, Port Arthur- City Health Department, San Antonio

February 6, 2013: PHACT Meeting: 10am - 11:30am, TALHO Board Meeting: 1pm - 4pm

February 7, 2013 TALHO Advocacy Event at the State Capitol: 7:30am - 11:30am

February 7, 2013 TALHO Membership Meeting: 12pm - 4:30pm

March 1, 2013 “Billing From the Ground Up” - Medical Billing Training: 9am - 4pm

April 11, 2013: PHACT Meeting: 10am - 11:30am, TALHO Board Meeting: 1pm - 4pm

April 12, 2013 TALHO Membership Meeting: 8:30am - 4:30pm

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 April 1, 2013, July 1, 2013, October 1, 2013 and January 1, 2014

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TALHO Medical BillingTraining

National School Breakfast Week

American Diabetes AlertDay

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Public Health Preparedness Summit

Viva Public Health!TPHA Annual Professional

Education Conference

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