September 2012

Volume IV, Issue III

2012 Janet Emerson Award

Local Health Department News

Tech Tip

and more...

THE TALHO INSIDERPresidentEduardo OlivarezHidalgo Health andHuman Services

President-ElectLou KreidlerWichita Falls-WichitaCounty Public Health District

Vice-PresidentVacant

Past President

Midland Health andSenior Services

Secretary/Treasurer

Amarillo Department of Public Health

Michael Hill

Members-At-LargeGeorge T. Roberts, Jr.Northeast Texas Public Health District

Stephen L. WilliamsHouston Department of Health and Human Serivces

Sharon Shaw

Health District

MESSAGE FROM THE EXECUTIVE DIRECTORS

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Twelve years ago I was honored and humbled when provided the opportunity to serve as TAL-HO’s first Executive Director. I re-flect on both the excitement and trepidation I felt after accepting the position knowing that mem-bers had great expectations for their organization.

Today, I am incredibly proud of the organization’s many accomplishments and will re-main enthusiastic about the opportunities that still lie ahead.

I have been incredibly fortunate to work with an excep-tionally dedicated, skilled and professional staff here at TALHO and to represent the wonderful and important work of Local Public Health. My position has been chal-lenging at times but a tremendous amount of fun.

It has been my pleasure to work with and learn from all of you. Although I am retiring after almost 40 years in public health, I will not be riding off into the sunset. I will continue to be an advocate for Local Public Health, but at a much slower pace. Now, more time to spend with family and friends.

I leave TALHO a better person, and I thank each of you for allowing me to be a part of the TALHO and the Local Public Health Family.

I am excited to begin this new phase of my career as CEO of TALHO; this is a big change for me but one that I feel up to. TALHO has grown into a very successful organization under Lee Lane’s leadership and I hope that we can build upon that success for the benefit of our membership and of the

people of Texas. Lee and I have already begun work on some new product and service offerings for TALHO to save our members money while providing a reliable revenue stream for the association.

TALHO has a dedicated staff, board and membership; when all of us work together, there is little that we can-not accomplish. I look forward to the board’s continu-ing support as we focus on new projects. I also look forward to meeting those TALHO members that I have not met over the past few years and hope to have the opportunity to visit many of the local health depart-ments in the near future.

I plan to always be accessible to the board and the members, please feel free to contact me at any time if you have questions or suggestions, or if you need the help of TALHO. Please stay safe, happy and healthy and have fun as you build a healthier future for Texas.

Lee Lane Michael Hill

MESSAGE FROM THE TALHO PRESIDENT

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I just wanted to extend my thanks to all the TALHO members who have given me the honor as serving as TALHO’s President for this year. I would like to offer my thanks to Sal Garcia immediate past President for serving the members of TALHO and for his wonderful leadership.

The coming year will prove to be an exciting year for healthcare in Texas, and we as members must be aware of the many changes that are being proposed by our State and Federal partners. TALHO will commit to keep each of our members up-dated with the latest changes and information which may impact their local health departments. The primary focus will remain our core public health functions, Immunization / Safety Net programs, Tuberculosis Treatment and Prevention, and activities/funding with our Local Public Health Service (triple “O”) programs.

The Public Health Funding and Policy Committee, a.k.a. the 969 Senate committee, has been a tremendous success, conducting its meeting at various Health Departments around the State. Please make sure that you attend a meeting close to you or take part via video / telephone conference. In addition, the 1115 Waiver and its related activities are essential to public health’s expansion and sustainability. TALHO will keep the member-ship informed on any changes involving this topic. TALHO will continue to focus on the expansion of its digital based interaction and business, working with our State and Federal partners, along with some new out of state partners in evolving to our next level of public health digital programing, electronic medical records, and health information exchange.

Wow! – we have many things to work on this year and I look forward to assisting in any way possible to assure the ongoing success of TALHO and all its members.

Thank You,Eddie Olivarez

2011-2012 President, Sal Garcia presented with a plaque of appreciation by 2012-2013 President-Elect

Lou Kreidler

Eddie Olivarez

Eddie OlivarezHidalgo County Health & Human Services

President

Lou KreidlerWichita Falls-Wichita County Public

Health DistrictPresident-Elect

VacantVice President

Sal GarciaMidland Health & Senior Services

Past President

Dr. Matt RichardsonCity of Amarillo Department of Public

HealthTreasurer

Sharon ShawAngelina County & Cities Health

DistrictMember at Large

Stephen WilliamsHouston Department of Health &

Human ServicesMember at Large

George T. Roberts, Jr.Northeast Texas Public Health

DistrictMember at Large

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Jordan Head presents Lee Lane with a Proclamation from Sen. Nelson

Eddie Olivarez, Lee Lane, Rhonda Lane Nancy Fisher and Dr. David Lakey

Dr. Paul McGaha, Roger Barker , George Roberts

Bob Galvan, Dan Galindo, Steve McAndrews

Sal Garcia, Luanne Southern Bob Galvan, Stephen Williams, Lee Lane, Karen Wilson, Sal Garcia, Eduardo Sanchez,

Wayne Farrell, Dr. Matt Richardson

Stephen Williams presents Lee Lane with an Eagle of Appreciation

Gino Solla Jan Scott, Tammy Botkin, Patty Stone, Jennifer Smith

Lee Lane Retirement Celebration

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JANET EMERSON AWARD

2012 Janet Emerson Award RecognitionsOn Thursday, August 9th, 2012, TALHO held a Luncheon to recog-nize the nominees for the 2012 Janet Emerson Public Health Servant Award. The Janet Emerson Award is presented annually to an outstanding employee within a local Texas public health de-partment who has demonstrated extraordinary performance with an exemplary commitment to local public health. It serves as a living memorial to Janet Emerson. As TALHO’s highest honor, this award is a means of expressing gratitude, recognition and encouragement of professional accomplishment in public health at the local level. The Janet Emerson Public Health Servant Award assures a perpetual

capability for recognizing achievements while urging current enter-prise and new efforts.

The Awardee for 2012 is Wayne Farrell who served as the Director of the Bell County Public Health District in Temple, Texas since 1993. For the previous 41 years Mr. Farrell has been an advocate for advancing public health services at the local level. At the statewidelevel he assisted in the passage of HB 1444 and SB 204 which includ-ed the option for non-physician

persons to serve as local health department/district directors. Wayne was also responsible for en-abling the Health District to be the first and only fiscal agent for the Texas Health Alert Network which enabled all local public health agencies associated with TALHO to experience improvements in their IT systems over the past 12 years.

As nominator Judy Porubsky noted, “Mr. Farrell worked with 10 gov-ernmental entities to acquire new and larger facilities to increase the number of clients served by the District. He is not afraid to try new things, think outside the box

and be a leader among his peers in TAMHO and TALHO and staff through his passion for improving public health.”

Also recognized were Suzy Han-cock, Clinical Director for the Denton County Health Department who started her career in public health in the 1970’s, spanning over 5 decades, and Michele “Mickey” Maxwell, Public Health Nurse for the San Antonio Metropolitan Health District who has over 34 years of public health service at San Antonio.

2012 JEA winner Wayne Farrell with nomina-tor Judy Porubsky

From left to right: Nominee Michele “Mickey” Maxwell and her nominator Dr. Thomas

Schlenker, Awardee Wayne Farrell and his nominator Judy Porubsky, Nominee Suzy Han-

cock and her nominator Dr. Bing Burton

JEA Nominees with TALHO Executive Director Lee Lane (far left) and TALHO President Eddie

Olivarez (far right)

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TALHO NEWS

Meesage from New TALHO CFO/COO

I was raised all around the globe, but finished high school at St. Ed’s in Austin. I joined the military in 1968 and returned to Austin in 1970 to finish my degree in behavioral science. I worked as a carpenter for 20 years, then returned to school - Texas State, and got my accounting degree. I worked for a short time in public accounting and got my CPA license. I worked as a financial analyst for the City of Austin for 10 years, as CFO for People’s Community Clinic for 4 years, and as CFO for the Austin Children’s Shelter for 10 years.

I’m delighted to join the team at TALHO, and look forward to serving the members and citizens of Texas.

When not at work, I enjoy fishing in the bays, hunting, and hiking. I’m a ham radio operator and a pilot but my passion is riding off-road motorcycles exploring the American West, and I’ve ridden in Utah, Arizona, New Mexico and Big Bend, Texas.

I’m blessed with two grown children who live in Georgetown and Rockport and a wonderful wife who owns aflower shop in Georgetown. We spend our spare time spoiling our grand kids, Kade 5, Kam 4, and Davis 2.

Jerry Fye, CPA

ADVOCACY

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TALHO’s Legislative Agenda for 2013The TALHO Board of Directors began a strategic planning process in June 2012. A key strategy is to Represent the Collective Interest of Local Public Health. To do so the Board determined it was important to maintain the current lobbyist, identify priority issues for a Legislative Agenda and to continue working with the Public Health Funding and Policy Committee (PHFPC), created through TALHO’s advocacy efforts in 2011.

1. Maintain Lobbyist – TALHO employs the services of the Texas Strategy Group, part of a national United States Strategy Group whose purpose is to assist in pursuing governmental relations to make voices heard and issues known. Nancy Fisher is our Texas contact and strategically guides TALHO through the legislative and governmental processes.

2. Legislative Agenda – the Board brainstormed key legislative issues important to supporting the ability of LHDs to provide local public health services. Those issues were presented to the mem- bership at the June and August Membership meetings. They included: a. Legislative Priorities b. Use of the 1115 Waiver to enhance or expand LPH services c. Expanding the scope of the programs included in the contract bundling initiated at DSHS

3. Expanding the contract bundling scope to additional programs – DSHS responded to the SB 969 language to transition from a contractual agreement with LHDs to a cooperative agreement and included a mechanism to bundle certain contracts to LHDs into one written agreement. This has proven to be a positive change in which TALHO is supportive of adding additional funded pro- grams to the mix.

Legislative Priorities

During the August membership meeting, TALHO members generated the following PH issues: 1. Immunizations 2. Tuberculosis 3. Public Health Infrastructure A. Congenital Syphilis B. Oral Health

The TALHO Legislative Committee will continue work on the development of one page information sheets and talking points for members to use in educating local and state policy makers. TALHO attends the PHFPC meet-ings and maintains regular communications with LPH representatives on the committee. TALHO members are encouraged to participate in developing a strong advocacy agenda for the 83rd Legislative Session.

ADVOCACY

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TALHO 2013 Legislative Priority Issues Lead TALHO Member1. Immunizations – Restore funding for the Adult Safety Net Program

Matt Richardson – AmarilloEddie Olivarez – Hidalgo Co

2. Tuberculosis – Increase funding for TB services George Roberts – Northeast Texas Shannon Jones – Austin Travis Co HHSGino Sola – Ector Co

3. Public Health Infrastructure – Preserve GR funding for LPHS grant a. Congenital Syphilis – increase funding to test and treat pregnant women in 3rd trimester b. Oral Health – change Medicaid policy to allow billing for placement of oral sealants

Sal Garcia – MidlandEddie Olivarez – Hidalgo CoChris Taylor – Cherokee CoMatt Richardson – AmarilloThomas Schlenker – San Antonio Metro

For more information contact Lou Kreidler (Wichita Falls/Wichita County HD) lou.kreidler@wichitafallstx.gov, President Elect, Legislative Chairperson.

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

PUBLIC HEALTH PROGRAMS

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A Focus on LHDs Funded by the DSHS Community Transforma-tion Grant: Waco & Wichita Falls

Live Well Waco Project

Waco-McLennan County Public Health District along with the Power of Prevention Coalition have been working together since 2011 to create mean-ingful, accessible opportunities for community mem-bers to reduce their

risks for heart disease, stroke, cancer, asthma and other chronic conditions. The District received funding from the Texas Department of State Health Services to begin a project that would offer residents the option to access healthier food and places for physical activ-ity, stop using tobacco, and use of effective clinical preventive services.

Goal(s) of the Project:

The goal of Live Well Waco is to increase the com-munity’s knowledge of and opportunities for interac-tion with various aspects of wellness. The initiative is dedicated to improving the health and well-being of McLennan County residents through collaborative community action, education and prevention.

Brief Project Description:

The project is comprised of 5 categories which fall

under “Live Well Waco” including: • Eat Well (Healthy Dining Options and Commu-nity Gardening), • Be Well (Chronic Disease Management), • Think Well (Activities Impacting Positive Mental Health),• Work Well (Worksite Wellness), and • Play Well (Promotion of Community Physical Activity).

Brief Description of Current Status:

Live Well Waco will officially launch mid- September with an accompanying website serving as a resource for health information, while also promoting health events available throughout the county. Several activi-ties have already been initiated:

Eat Well Waco has taken off and is available to resi-dents. Seventeen restaurants have been “certified” as Eat Well Waco restaurants, displaying the logo at participating locations and the Community Gardens program has provided produce at low or no cost through area churches in areas of highest need. Be Well has established Health Discussion Panels be-tween area residents and local healthcare providers; Grand Rounds to educate local healthcare providers on practice standards; and Clinic Collaborations to dis-tribute culturally competent health literature packets at the FQHC.

Work Well has begun work offering the Live Well Waco County Wellness Program for county employ-ees. Area worksites are offered guidance and resourc-es to develop policies and programs that support healthier options such as better vending items, physi-cal activity time, no onsite tobacco use, etc.

Play Well has allowed health district staff and city planners to create bike lanes connecting a local school to area neighborhoods, and the development of joint

PUBLIC HEALTH PROGRAMSuse agreements between the schools and jurisdic-tions allowing access to the recreational facilities after school hours.

Lessons Learned/ Next Steps:

The coalition is dedicated to establishing and main-taining solid partnerships from community members and agencies to increase the success of this project.

Contact: Alicia Hernandez, AliciaH@ci.waco.tx.us

Transforming Texas Program for Wichita County

Goal(s) of the Project:

There are three goals for the program based on our three Strategic Directives.

1. Tobacco Free Living Strategic Directive - Decrease the proportion of adults in Transform- ing Texas communities who are employed out - side the home and who report exposure to sec- ondhand smoke in the workplace. 2. Healthy Eating and Active Living Strategic Direc- tive - Increase the number of policy and/or environmental changes in our community creat- ing opportunities for physical activity. 3. Chronic Disease Preventive Services Strategic Directive - Increase the percent of knowledge, skills, and self-efficacy to manage a chronic con- dition in patients receiving medical treatment for hypertension, high cholesterol and/or diabe- tes.

Brief Project Description:

Our project had several activities to implement during the first grant year. For Tobacco, we provide training and technical assistance to local stakeholder, employ-

ers, employees and civic groups to promote indoor clean air policies and tobacco-free campuses. For wellness, we review existing community design stan-dards and Safe Routes to School initiatives, support a Bike Rodeo and develop a series of health education classes in the underserved areas. Finally for Chronic Diseases, we collect baseline data for adult patients diagnosed with high blood pressure, high cholesterol and diabetes, conducts a media campaign centered on patient education and participate in a Health Fair to provide referral list of area medical providers.

Brief Description of Current Status:

To date we have been in contact with several local businesses and churches about implementing tobacco free policies. The Health Department, as an example, is in the process of becoming a tobacco-free campus. Additionally, we have worked with the Traffic Super-intendent reviewing existing community designs for both safe route and trail systems. We have plans for two bike rodeos and a ‘Walk to School’ day planned for October. Furthermore, we have planned, pre-sented and participated in several venues about the importance of exercise and good nutrition. Also, we have partaken in health fairs tailored to populations at risk for chronic diseases to distribute health infor-mation on self-care. Lastly, we have arranged for two of our staff members to attend the Stanford Chronic Disease Self-Management Program to be certified as Master Trainers.

Lessons learned/Next Steps:

1. Education takes time and patience. 2. The Tobacco-Free Living strategic directive will be our most challenging.3. Bridging the gap of health disparities will re- quire changing our point of view.

Contacts: Will Carter, William.carter@wichitafallstx.gov and Brenda Ballard

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PUBLIC HEALTH PROGRAMS

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News from the Chief Public Health Officer:

National Forum on Heart Disease and Stroke

The 10th National Forum on Heart Disease and Stroke Prevention will be held in Washington, D.C. on Octo-ber 17 and 18, 2012. The forum’s theme is “Working Together: Policies, Partners and Action”. I have had the good fortune to be a part of the National Fo-rum, and the Forum conference committee, since its beginning and by participating in developing the first A Public Health Action Plan to Prevent Heart Disease and Stroke. TALHO is a member of the Forum. This year the Annual Forum will include presentations on the Affordable Care Act, the Prevention Fund and Community Transformation Grants, Million Hearts, Successful Approaches to Hypertension, National Strategy on Disparities, National Forum’s Strategic Priorities and Introduction of the Policy Depot and a Call to Action. You can learn more about the Forum at http://hearthealthystrokefree.org/

Salt Reduction Strategies

Representing TALHO on the Texas CVD and Stroke Preven-tion Partnership, I have par-ticipated in Workgroup activi-ties to develop and promote sodium reduction strategies in the state. Recently our Workgroup completed development of a joint paper with the Texas School Health Advisory Committee recommending actions schools can take to support reducing sodium intake in the school setting. USDA published proposed rules in 2011, outlining the requirements for foods offered through the National Breakfast and School Lunch Programs. Our Workgroup provided comments sup-porting the updates to include healthy food items in

school meals. Final new rules were published in Janu-ary 2012. The guidelines allow a ten year phase in for sodium reduction targets. The recommendations made by our Workgroup encourage schools to adopt the newer guidelines as soon as feasible. Next steps include promoting to schools how they can adopt policies and programs to reduce sodium while provid-ing a satisfying meal plan to students. If you are inter-ested in working with us to support sodium reduction in your school districts, contact me at jennifer.smith@talho.org and visit the Texas Salt Reduction Collabora-tive website at http://www.dshs.state.tx.us/wellness/Texas-Salt-Reduction-Collaborative.doc

Healthy People 2020

As a member of the NACCHO Healthy People 2020 Advisory Group we are committed to promoting the resources offered to assist groups in using Healthy People 2020 within program planning and implemen-tation. If you are not familiar with HP2020 visit the website at http://www.healthypeople.gov/2020/about/default.aspx to take advantage of the informa-tion and tools available to help you make meaningful changes in your community. One of those resources is MAP-IT: A Guide to Using Healthy People 2020 in Your Community. MAP-IT stands for Mobilize, Assess, Plan, Implement, Track and is a framework to be used to plan and evaluate public health interventions and achieve HP 2020 objectives. If you are using HP 2020 objectives to plan and evaluate programs in your area, let us know!

ACCREDITATION

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To Register: www.texaspha.org

AGENDA

September 24, 2012

1pm – 5pm

Goal: Improve the ability of LHDS to collect and man-age data for the CHA

Objectives: By the end of the session, participants will be able to:

• list multiple types of data that inform a Commu- nity Health Assessment• cite national, state and local sources that pro- vide data for the CHA• analyze and organize the information available in small, medium and large LHD settings• prioritize the data to be used in the CHA

September 25, 2012

8:30am – 11:30am

Goal: Improve the ability of LHDs to facilitate stake-holder information gathering and planning sessions

Objectives: By the end of the session, participants will be able to:

• identify and engage key stakeholders from the community• use the CHA data with stakeholder input to pri- oritize community focus areas• facilitate a group prioritization and decision making process

12:30pm - 3:30pm

Goal: Improve the ability of LHDs to create meaning-ful and useable CHA and CHIP documents

Objectives: By the end of the session, participants will be able to:

• Effectivelysummarizeandreportkeyfindingsof the CHA• Create a CHIP: developing community health goals, measurable objectives, strategies, time- lines and responsible parties• Create meaningful, useable CHA and CHIP documentsforthecommunityandofficials• Implement the CHIP with engaged community members• Formulateanagencystrategicplanthatreflects the CHIP

3:30pm - 4:00 p.m.

Next Steps in the Puzzle

4:00 p.m.

Adjourn

ACCREDITATION

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Accreditation Highlight on Tarrant County Public Health

Tarrant County - Working with Communi-ty Stakeholders in Developing Your Com-munity Health Plans: “Using the MAPP Process to Guide Your Community Health Improvement Process (CHIP)”

Yvette M. Jones, MPA, Senior Policy Analyst/MAPP Coordinator with Tarrant County Public Health (TCPH) is moving TCPH toward accreditation readiness and shared her recent experiences on the various stages of planning and assessment being conducted, and completed, in Tarrant County. A key point was made that TCPH is pursuing this work without additional funding and using current staff.

Yvette noted that the Health Planning and Policy Divi-sion at TCPH is responsible for conducting the CHIP process. Leadership made the decision in August 2011 to conduct a two-year planning and implemen-tation process that would follow the Mobilizing for Action through Planning and Partnerships (MAPP) cre-ated by NACCHO. There are six phases in MAPP. TCPH has completed Phase 1 (organizing partnerships) and 2 (visioning) and is implementing Phase 3 (the four assessments). They plan to have completed the six phases by August 2013.

Tarrant County Public Health created the MAPP Core Support Team and partnership MAPP Steering Com-mittee structure to ensure there was both public health department and community support for the community health improvement process. Two meet-ings were held in February to introduce MAPP and be-gin organizing their partnership. Through a facilitated process, the community group developed a name and vision for the partnership – Tarrant County Voices for

Health, “Empowered people living healthy in a vibrant and safe community”.

Since then, various subcommittees have been cre-ated with local partners taking the lead in facilitating the groups. There are four subcommittees that cor-respond to the four local assessments in the MAPP process. Each group has made progress on their as-sessment.

• Local Public Health System Assessment Sub committee convened 51 partners throughout Tarrant County in a day long retreat to assess 1) the activities and capacities of the local public health system (LPHS) and 2) how well the LPHS is providing the Essential Public Health Services.• Community Themes and Strengths Assessment Subcommittee will have conducted two listen- ing sessions with more being scheduled and will use a youth photography group to help capture in pictures the community assets and conduct the interviews with Tarrant County residents.• Forces of Change Assessment Subcommittee held two of five sessions focusing on environ- mental and social forces with a combined total of 186 community members including college students in attendance. These sessions help the community to learn more about the threats and opportunities of the various factors that can impact the status of health in Tarrant County. • Community Health Status Assessment Sub committee is collecting and analyzing data on the expanded core health indicators list and will be reviewing the MAPP Steering Commit- tee’s responses to what is missing from the core health indicators summary.

In February or March of 2013, TCPH will convene the community to start Phases 4 and 5 to Identify Strate-

ACCREDITATION

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gic Issues and Develop Goals and Strategies. From that, a plan of action will be created for Phase 6 and imple-mentation will occur for the next 4-5 months after the plan is completed. Evaluation is incorporated into all the phases.

During the Accreditation Discussion Group call, a question was posed on the feasibility of a small to medium size LHD to conduct such a process. Both Yvette and Donald Fisher (TCPH Workforce Development Coordinator) emphasized that the phases can be adjusted to fit the needs of the LHDs. They have adjusted as needed for TC. Donald noted there were seven principles or critical elements that NACCHO identified for a LHD to successfully implement the MAPP:

1. Systems Thinking – to promote an appreciation for the dynamic interrelationship of all components of the local public health system required to develop a vision o f a healthy community. 2. Dialogue – to ensure respect for diverse voices and perspectives during the collaborative process.3. Shared Vision – to form the foundation for building a healthy future. 4. Data – to inform each step of the process.5. Partnerships and Collaboration – to optimize performance through shared resources and responsibility.6. Strategic Thinking – to foster a proactive response to the issues and opportunities facing the system.7. Celebration of Successes – to ensure that contributions are recognized and to sustain excitement for the process.

http://www.naccho.org/topics/infrastructure/mapp/framework/mappbasics.cfm

A question was asked about the ability to start the partnership with 30 stakeholders and then grow the par-ticipation in the group. Yvette stated that she is now making individual contacts with partners to talk about the process, their concerns, hopeful outcomes and contributions. This ensures that everyone is informed and knows their input is valuable to the process. They also offer different commitment levels to partners that allow passive participation to more active participation.

Midland, Milam County and Beaumont HDs noted that they are beginning to review how preparing for ac-creditation can work in their LHD. Midland is creating a crosswalk of the preparedness capabilities with the PHAB accreditation domains, standards and measures. Milam Co will be hiring additional staff and may be able to include accreditation activities in the job duties. Beaumont has been convening partners and reviewing the standards and measures to determine their level of readiness.

You can access the information on the MAPP process in Tarrant County at http://www.tarrantcounty.com/ehealth/cwp/view.asp?a=763&pm=1&Q=481127

All discussion group materials can be located on the TALHO Dashboard under the Document folder feature, TALHO Discussion Groups, Accreditation and QI Group. https://dashboard.talho.org

TECHNOLOGY

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RollcallFor the first time in August of this year, we are work-ing with over 700 schools in Texas. As the new school year starts up this fall, these schools will have com-plete, daily attendance data sent to their local health department in partnership with each independent school district. This attendance data undergoes graph-ing and analysis and assists the local health depart-ment and school district with surveillance for poten-tial outbreaks. Also this fall, we are helping more and more schools to send Influenza-Like-Illness (ILI) along

with attendance data, which will be utilized by many health departments as we approach flu season.Rollcall has always been a point of pride for the TALHO team and Rollcall users, as it is one of the only and most robust school attendance and ILI tracking tool for surveillance available today. As our dedicated programming team works hard to make this software better every day, we continue to see a growing inter-est from local health departments and independent school districts alike to implement this tool within their jurisdic-tions.

Rollcall Notes from our Senior Software Architect Speed, Speed, Speed

In the last few months, our primary focus with Rollcall has been speed. Every bit of code in Rollcall has been evaluated and we think we have identified and corrected the slowest methods. You should see a marked speed improvement when loading the school search, when searching for school data, and when performing advanced data functions on your chosen data. A tangential benefit of reworking the code is that inconsistencies where search options are displayed have been removed, leading to a more consistent user experience.

Data Functions

We reworked the data functions to not only return data faster, but also to ensure that accurate analysis was being returned. You can now use moving average, standard deviation, and CUSUM (or cumulative sum con- trol chart) with more confidence.

What’s Next?

For the next update, we’re busy working on improving Rollcall’s user interface, making controls more intui tive and ensuring that searches return exactly what you’re looking for. Additional speed improvements are also a priority. Down the road, we will be looking into providing outside data sources for baseline and com parison data, which will be integrated into the graphing functions.

As always, Rollcall is built based on user feedback, so please do contact us if there is anything you would like to see integrated into the project. Thank you for helping us to continue to build and improve one of the best school attendance and school outbreak surveillance programs available today!

TECHNOLOGY

The Importance of Having a Firewall

What is a firewall?

A firewall is a device or program that secures an internet connection by controlling and analyzing the incoming and outgoing network traffic. Firewalls have become advanced enough to recognize the difference between secure and unsecure sources of network use and data exchange, and they can block potential threats. This security measure is particularly crucial for private networks that handle sensitive data.

Here at TALHO we utilize, and highly recommend, Cisco ASAs (Adaptive Security Appliances) for our physical firewalls that protect our entire internal network from the public Internet. Cisco ASAs are built with a history of industry-leading experience and perform many functions. On top of the basic functions of a firewall, the Cisco ASA offers an integrated Intrusion Prevention System (IPS), strong anti-malware security, and it can act as a VPN concentrator.

As announced at the previous membership meeting, TALHO is willing to offer a free firewall to members who are transitioning from the secure T1 lines to a third-party internet provider (such as Time Warner, Sudden-Link, Comcast, etc.). We have a small stock of Cisco ASA 5505 base models that we are willing to individually configure and ship to you at no charge. It is absolutely critical to us that all of our members have the best secu-rity we can provide as fast as possible during this time of transition. We still have a handful of ASAs remaining, so if you would like to procure one for your department, please contact us as soon as possible!

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For any question regarding our technology department please contact Jackie Forbus at jforbus@talho.org

TECHNOLOGY

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Tech Tip:Cloud StorageIn an increasingly mobile and connected world, many programs and services are moving to a web-based environment. Now, even how we store our data can be web-based. Cloud storage is basically individualized online storage you can access from most anywhere. Your uploaded files will be stored by a hosting company on their own servers. Even though you are saving your files remotely, all data sent to your cloud storage is encrypted, and these services guarantee user privacy and security. So, no need to worry about the safety of personal data in the cloud. Beyond the security, the benefits of being able to backup and access data from almost anywhere are great. What if your hard drive crashes or a virus takes out critical files? How can you easily save a document on one computer and access it from another? Or, what do you do when you leave your flash drive at home and really need that PowerPoint for today’s meeting? No problem. Log into your cloud stor-age and access whatever you need at any time.

Depending on what you will be using your storage for, there are so many different options available. And now, there are so many free or very cheap options that there is no excuse not to give it a shot. Want to stream music from your collection from anywhere, even on your phone? There’s a free cloud storage option for that. Want to store all your photos in their original large size, organize albums, and provide selective access to other friends and family? There’s a free cloud storage option for that, too. Simply want to back up your entire hard drive every-so-often to keep yourself safe from data loss? There’s free and cheap options for that depending on how much space you need.

TECHNOLOGY

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We’ve done some of the research for you, and here are the latest and best cloud storage options out there today:

Host Free Storage Free Phone App Upgrade Options Unique Features

Google Drive 5 GB Android $30/year for 25GB$60/year for 100GB

Integrates well if you use other Google services

Amazon Cloud 5 GB None$20/year for 20GB$50/year for 50GB

$100/year for 100GB

Integrates with music streaming via Cloud Player

iCloud 5 GB iPhone 3GS or later$20/year for 10GB$40/year for 20GB

$100/year for 50GB

Integrates well if you use other Apple services

Dropbox 2 GB iPhone, Blackberry, Android

Free upgrades with referrals

$120/year for 100GB

Blackberry application available

Microsoft Sky-Drive 7 GB iPhone, Windows

Mobile, Android

$10/year for 20GB$25/year for 50GB

$100/year for 50GB

Biggest free storage option, most affordable upgrade

options

YouSendIt 2 GB iPhone, Android Unlimited data storage for $14.99/month

Most affordable for large amounts of data

Google Play (Music)

20,000 uploaded

songsAndroid No upgrade options Best free streaming option

Amazon Cloud Player (Music)

250 uploaded

songsiPhone, Android 250,000 songs for $25 a

year

Application within Amazon Cloud that lets you stream

stored music

Within the past year, the market for cloud storage has become more competitive. Today, they are all very similar, offer great options, and we’d have a hard time recommending one service over any other. So go ahead and pick one you like best, and give cloud storage a shot. And then pat yourself on the back for not only secur-ing your important files in a fail-safe way, but for being tech savvy enough to utilize this great tech trend at the right time.

TECHNOLOGY

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Syndromic Surveillance (RODS/ESSENSE)

This August also repre-sented a benchmark for our Syndromic Surveil-lance program. We helped to bring on eight new hospitals from four different counties in August alone, which brought us officially past the mark of 150 participating facilities across the state of Texas. As we continue to provide health departments with as close to real-time health data analysis as is possible, we are also beginning to work with other current surveil-lances tools, like BioSense. TALHO is positioned to be the manager of BioSense projects on behalf of key partner health departments, and we encourage other departments who would like to work with BioSense to contact the CDC to express interest in integrating into the BioSense system through TALHO. We hope to bring more hospitals on board with Syndromic Sur-veillance this fall to help participating facilities satisfy Meaningful Use while at the same time helping Local Health Departments have access to a complete and real-time view of their community’s health.

HAN Contract Deadline is PastNow that the Health Alert Network contract has ended, most health departments have already ar-ranged for alternative means to meet their needs that were previously provided for under the HAN contract. At TALHO we will continue to help those that are still pushing to make this transition.

To help answer some concerns about the Polycom video conferencing units, they are still useful, but will need to be transitioned over to an external line with a dedicated, static IP address. We have helped many

departments with this transition, so feel free to call us and work with our engineers to make sure your Polycoms are set up properly. With that said, we are looking at alternative, web-based video conferencing options that we may offer our members in the near future.

Considering the HelpDesk and IT support we had been providing for our members under the HAN contract, we have no intention of discontinuing these services despite the conclusion of our contract. It has always been our goal to help each of our members with their IT concerns however big or small. So please continue to let us know how we can help you!

National Health IT Week September 10-14, 2012Now in its seventh year, National Health IT Week is a collaborative forum assembling key healthcare constituents—vendors, provider organizations, pay-ers, pharmaceutical/biotech companies, government agencies, industry/professional associations, research foundations, and consumer protection groups— working together to elevate national attention to the necessity of advancing health IT. Log onto www.healthitweek.org for more information.

www.healthitweek.org

PROUD SUPPORTER

One Voice. One Vision.

September 10-14, 2012

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LOCAL PUBLIC HEALTH NEWS

Angelina County Survey of LHD Salary Range for Selected Staff Classifications – April 2012In March 2012, the Angelina County & Cities Health District initiated an electronic salary survey to compare salary data with our peers throughout Texas. ACCHD had begun to have difficulty in finding professional staff such as LVN’s, RN’s, and Registered Sanitarians – because our pay scale was outdated.

Surveys were sent to 60+ Local Health Departments throughout the State of Texas, categorized as Small, Medium, and Large. A range was established for “typical” public health positions – in a low, medium and high salary range.

Twenty Local Health Department and Health Districts responded to the survey.

Based on the results of the salary survey, ACCHD’s Board of Health voted to provide a market increase for FY 2013 to certain categories of professional staff – to include nursing, nutritionists, and environmental inspectors. This market increase will move ACCHD forward in attracting candidates for professional positions with our agency.

For more information, contact Sharon Shaw at sshaw@acchd.us

Staff Classification Annual Average Low Scale (in 1000’s)

Annual Average Medium Scale (in 1000’s)

Annual Average High Scale (in 1000’s)

Administrator/CEO $80 $88 $93Finance Director/CFO $61 $71 $79Health Program Managers/Supervisors $50 $60 $74Registered Nurses $42 $51 $62Licensed Vocational Nurses $31 $38 $46Physicians $93 $99 $100Mid-Level Providers (Pa’s, Np’s) $70 $83 $93Environmental Health Specialists (sanitarians) $36 $44 $54Environmental Health Inspector (non-registered) $31 $37 $44Epidemiologists $54 $64 $79Health Educators $36 $44 $54Clerical $24 $29 $36Information System Specialists $40 $49 $58Public Information Specialists $48 $61 $75Behavioral Health (counselor, social workers, etc.) $42 $53 $64Emergency Preparedness Coordinator $44 $52 $63Nutritionist $34 $43 $53Registered Dietician $41 $51 $61WIC Technician $25 $31 $37

LOCAL PUBLIC HEALTH NEWS

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Metro Health Helps Get San Antonians WalkingNew grant will fund walking groups throughout the communitySAN ANTONIO (Aug. 23, 2012) - The City of San Antonio Metropolitan Health District, in partnership with the Mayor’s Fitness Council, awarded a $50,000 grant to the South Texas Walking Club to increase the number of people getting physically active through walking.

The grant will fund the San Antonio Walks! program to enroll 10,000 walkers throughout San Antonio, as well as develop partnerships with local agencies to es-tablish and promote walking groups. The program will also train individuals to serve as leaders within each walking group and provide group support to maintain participation levels.

Walking is an excellent form of physical activity and the leading choice of exercise for Americans. A recent Centers for Disease Control and Prevention report noted that approximately 62% of adults say they walked at least 10 minutes or more in the past seven days, up from 56% in 2005. However, there is still room for improvement to increase the number of adults getting the recommended 2 ½ hours of aerobic

physical activ-ity each week, such as brisk walking.

“San Antonio Walks! will focus on simple athletic walking but in a recreational approach in neighbor-hoods and worksites so that all ages and abilities can experience similar health and wellness benefits,” said Bert Pickell, director of the South Texas Walking Club San Antonio chapter. “San Antonio Walks! will be

easy, safe, and mo-tivating,” Mr Pickell stated.

Founded in 1996 by former Mayor of Pharr, Mr. AC Jaime, the South Texas Walking Club’s mission is to promote health & wellness through competitive walking. Pickell’s experience spans more than 40 years in Racewalking as an athlete, coach, and official. His experience along with his extensive part-nerships and enthusiasm make him the ideal choice to lead this program in San Antonio.

The mission of the Mayor’s Fitness Council is to trans-form San Antonio into a healthier and more active community. The Mayor’s Fitness Council is the lead party for the SA2020 bold vision for making San Anto-nio’s residents among the healthiest in the nation by the year 2020.

For more information on this program, visit www.sabalance.org or contact Bert Pickell at bpickell@satx.rr.com or (210) 273-7983.

Don’t Forget

October is National Breast Cancer Awareness Month

www.nbcam.org

LOCAL PUBLIC HEALTH NEWS

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Operation Lone Star in Hidalgo CountyOperation Lone Star (OLS) is recognized as the largest humanitarian effort in the United States. OLS allows Hidalgo County Health and Human Services Department (HCHHSD) the opportunity to exercise their public health medical readiness capability. Free medical services are rendered to the community in two locations by Hidalgo County. This year free medical services were provided to 3,675 community members at two Hidalgo County locations: Palmview High School and PSJA High School. Services included immunizations, diabetic screenings, visual exams, hearing exams, behavioral health services, comprehensive physical exams, public health education, and hemoglobin screenings.

OLS has historically taken place during the entire last week of July for the past 13 years. OLS draws in large crowds from throughout the community. Other agencies that participate in OLS are: Cameron County Health Department, Starr County, Webb County, City of Laredo Health Department, Department of State Health Services, Texas State Guard, Texas Medical Brigade, Texas Military Forces, United States Public Health Services, local school districts, academic institutions, local health service organizations, and civilian volunteers.

Hidalgo County Health & Human Services Binational Table Top ExerciseHidalgo County Health and Human Services (HCHHS) held a Binational Table Top Exercise on August 15, 2012 at Quinta Mazatlan (McAllen, Texas). The purpose of this exercise was to develop a plan towards effective communication and biological specimen transportation across international borders to promote binational public health. This exercise provided our local binational

public health partners the appropriate setting to discuss the need to have a more effective and efficient public health response between Hidalgo County and Jurisdiccion Sanitaria No. IV (Reynosa).

The exercise was facilitated and evaluated by Texas A&M Engineering Extension Services (TEEX) and participants included representatives from HCHHS, Secretaria de Salud-Jurisdiccion Sanitaria No IV-Reynosa, US Customs and Border Protection Region VI-Office of Incident Management, US Customs and Border Protection-Office of Field Operations-Progreso, Department of State Health Services Region 11, Cameron County Health Department, Texas Commission on Environmental Quality, City of Mission Fire Department, Texas A&M University School of Rural Public Health-McAllen Campus, and Instituto Politecnico Nacional.

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LOCAL PUBLIC HEALTH NEWS2012 West Nile Outbreak in TexasThe 2012 West Nile Outbreak is the worst on record in Texas. As of this writing there have been over 1000 cases of the virus with 40 deaths, the majority in Dallas and Tarrant County.

To see a numbers breakdown by county visit: http://www.dshs.state.tx.us/news/updates.shtm

Important links:

Texas Department of Health and Human Serviceshttp://www.dshs.state.tx.us/idcu/disease/arboviral/westNile/

Dallas County Health and Human Serviceshttp://www.dallascounty.org/department/hhs/home.html

Tarrant County Public Health Departmenthttp://www.tarrantcounty.com/ehealth/site/default.asp

CDC - West Nile Virushttp://www.cdc.gov/ncidod/dvbid/westnile/

Helpful Tips:

The four “D”s of prevention: • DEET: use insect repellents that contain DEET, or any other EPA approved insect repellent• DRESS: Wear long sleeves and pants when you are outside• DUSK & DAWN: stay indoors at dusk and dawn, times when mosquitos are most active• DRAIN: drain standing water in your backyard and neighborhood; old tires, flowerpots, etc.

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Galveston County Health District to Assist Businesses to Become Designated Mother Friendly Worksites

Galveston County Health District was awarded funding to assist 10 businesses in Galveston County to become designated as a Mother Friendly Workplace by August 2013. The program is sponsored by Texas Department of State Health Services (DSHS) Healthy Texas Babies Initiative. Currently, there are no DSHS designated Mother Friendly Worksites in Galveston County. Mother-Friendly Worksites are businesses that proactively support employees who choose to breastfeed their infants. Breastfeeding has proven to be beneficial to the mother and child by preventing disease and reducing infant mortality. The potential benefits of a business being a Mother Friendly Worksite include, reduce turnover, shorter maternity leave, lower absenteeism due to a sick child, higher morale among employees, increased productivity among employees with new children and lower and fewer health insurance claims. Galveston County Health District will assist the employers of businesses throughout the county with implementing major components of the Mother Friendly Workplace designations ( flexible work schedules to provide time for milk expression; access to a private location for milk expression; access to a nearby clean and

safe water source and sink for washing hands and rinsing out any breast-pump equipment; and access to hygienic storage options for the mother to store breast milk). Currently, Galveston County Health District has set up a Mother Friendly Worksite for their employees to utilize and is in the process of registering with DSHS to become a designated site.

LOCAL PUBLIC HEALTH NEWS

LOCAL PUBLIC HEALTH NEWS

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2012 Model Practices Award

Northeast Texas Public Health District (NET Health) Honored for Excellence in Public HealthLocal Health Department Program is One of 39 Nationwide to Re-ceive “Model Practice Award” in 2012

Tyler, TX - NET Health was honored at the 2012 annual conference of the National Association of County and City Health Officials (NACCHO), a body of peers, for developing and implementing a program that demon-strates exemplary and replicable qualities in response to a local public health need. The Fit City Challenge was one of 39 public health pro-grams developed in conjunction with a local health department selected from across the nation to receive NACCHO’s Model Practice Award. The Fit City Challenge is a healthy living action-based program that is accepting the challenge to make Tyler a Fit City one step, one bite, and

one health-conscious decision at a time. The Fit City Challenge is not a diet or weight loss program, but a way to come together as a community and change the way we think about our health on a daily basis. To learn more about Fit City Challenge, visit www.fitcitytyler.com. “We are honored to be the recipient of the NACCHO Model Practice Award for the Fit City Challenge. We are blessed with the Partnership that we have with the Tyler Morning Telegraph, CBS 19, the City of Tyler, TISD, our physicians, hospitals, colleges and so many community partners on this important initiative. This project has generated such a positive buzz in our community, and we are excited about the future of this effort!” said George Roberts, Chief Executive Officer of NET Health. Each innovative project receiving the award was peer-reviewed (by other local health department profession-als) and selected from a group of 166 applications. Since 2003, NACCHO’s Model Practice Awards program has honored initiatives—including programs, resources, and tools—that demonstrate how local health depart-ments and their community partners can effectively collaborate to address local public health concerns. Fit City Challenge is now part of an online, searchable database of successful public health practices in areas rang-ing from immunization and maternal and child health to infectious diseases and emergency preparedness. The NACCHO Model Practice database allows users to benefit from colleagues’ experiences, to learn what works, and to ensure that resources are used wisely on effective programs that have been implemented with good results. It also enables NACCHO to share information with key stakeholders and media about the good work being done by local health departments across the country. This award puts NET Health into special company—a select group of health departments that exemplify a forward thinking, proactive attitude toward protecting and promoting the health of communities across the nation.

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LOCAL PUBLIC HEALTH NEWSFor more information about the NACCHO Model Practice Awards and to view a list of other award winners, go to www.naccho.org. About the National Association of County and City Health Officials: The National Asso-ciation of County and City Health Officials (NACCHO) represents the nation’s 2,800 local governmental health departments. These city, county, metropolitan, district and tribal departments work every day to protect and promote health and well-being for all people in their communities.

George T. Roberts, Jr.Chief Executive Officer

Press Contact: Stephanie Taylor, Public Information Officer (903) 216-7367

Additional Texas Local Health Departments who were recipients of a 2012 Model Practices Award include:

Harris County Public Health & Environmental Services - Advancing Environmental Equity Using PACE-EH

Houston Department of Health and Human Services - Community Nutrition Series

“Emergency preparedness is a team sport,”

- Eric Whitaker

Looking Back at Public Health - December, 1960

A Grass Roots AffairTexas State Department of Health-Texas Health Bulletin December 1960

Public health is basically a “grass roots” affair in Texas.

Over 75 percent of the population in Texas is now covered with local health units according to figures compiled by the State Health Department’s Division of Local Health Services.

Fifty separate and distinct local health units now cover 59 of the state’s counties. Most of the areas without the protection of full-time public health pro-grams are sparsely settled.

Only two cities in Texas with a population exceeding 25,000 are without State participating health units.

The Local Health Services Division hopes soon to cover these presently unprotected areas, under the provisions of Senate Bill 206, a forward-looking bill passed by the last session of the Texas Legislature.

This law made it possible for several counties in the sparsely-settled areas of Texas to combine their finan-cial resources in order to obtain the services of quali-fied professional public health personnel.

Financing of local health departments is largely a local matter, in keeping with the traditional Texas attitude of local control, autonomy and independence.

In many instances cities and counties share expenses of joint health units.

The size of the individual staffs depends on the local population and the magnitude of local health prob-lems.

In State participating health units there must be at least one full-time public health physician, a nurse, a sanitarian, and a clerk. Many areas also employ ad-ditional public health personnel such as health educa-tors and laboratory personnel.

The basic activities of a local health unit include: vital statistics, communicable disease control, environmen-tal sanitation, laboratory services, and health educa-tion.

In large units where more resources exist and there is a need for additional activities, additional programs such as maternal and infant hygiene, school health services, mental health services, hygiene of housing, and occupational health services, are carried out.

ACCREDITED LOCAL HEALTH DEPARTMENTS

Texas State Department of Health-Texas Health Bul-letin December 1960

COUNTY HEALTH DEPARMENTS- Abilene-Taylor County Health Dept., Abilene- Amarillo Bi-City-County Health Dept., (Potter and Randall Counties) Amarillo- Austin-Travis County Health Dept., Austin- Bell County Health Dept., Temple- Bexar County Health Dept., San Antonio- Brazoria County Health Dept., Angleton- Bryan-Brazos County Health Dept., Bryan- Brownwood-Brown County Health Dept., Brownwood

PUBLIC HEALTH HISTORY

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Click to Enlarge

- Cameron County Health Dept., San Benito- Cass County Health Dept., Linden- Corpus Christi-Nueces County Health Dept., Corpus Christi- Corsicana-Navarro County Health Dept., Corsicana- Dallas County Health Dept., Dallas- Denison-Sherman-Grayson County Health Dept., Sherman- El Paso-Hudspeth County Health Dept., El Paso- Fort Bend-Matagorda County Health Dept., Bay City- Galveston County Health Dept., LaMarque- Harris County Health Dept., Houston- Hidalgo County Health Dept., Edinburg- Hunt County Health Dept., Greenville- Jackson County Health Dept., Edna- Jasper-Newton-Hardin County Health Dept., Jasper- Laredo-Webb County Health Dept., Laredo- Lubbock City-County Health Dept., Lubbock- McKinney-Collin County Health Dept., KcKinney- Paris-Lamar County Health Dept., Paris- Medina County Health Dept., Hondo- Midland-Ector-Howard County Health Dept., Midland- Milam County Health Dept., Cameron

- Nolan-Scurry County Health Dept., Sweetwater- Orange City-County Health Dept., Orange- San Angelo-Tom Green County Health Dept., San Angelo- San Patricio County Health Dept., Sinton- South Plains County Health Dept., Brownfield- Southwestern Texas Health Dept., Uvalde- Tarrant County Health Dept., Fort Worth- Texarkana-Bowie County Health Dept., Texarkana- Tyler-Smith County Health Dept., Tyler- Upshur County Health Dept., Gilmer- Victoria County Health Dept., Victoria- Waco-McLennan County Health Dept., Waco- Wichita Falls-Wichita County Health Dept., Wichita Falls- Williamson County Health Dept., Georgetown- Wood County Health Dept., Quitman

CITY HEALTH DEPARTMENTS- Public Health Department, Dallas- Public Health and Welfare Department, Fort Worth- Galveston City Health Department, Galveston- City Health Department, Houston- Port Arthur City Health Dept., Port Arthur- City Health Department, San Antonio

PUBLIC HEALTH HISTORY

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September 24-25: Texas Public Health Accreditation Conference

October 10: PHACT Meeting, TALHO Board Meeting

October 11: TALHO Membership Meeting

December 12: PHACT Meeting, TALHO Board Meeting

December 13: TALHO Membership Meeting

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 August 1, 2012 and November 1, 2012

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9 10 11 12 13National Celiac

Disease Awareness Day

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23 24 25 26National Women’s

Health & Fitness Day

27 28 29Family Health &

Fitness Day

World Heart Day

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Sunday Monday Tuesday Wednesday Thursday Friday Saturday

September

Labor Day

Grandparent’s Day

First Day of Autumn

Patriot Day

October 2012August 2012

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National Rehabilitation Awareness Celebration

National Farm Safety & Health Week

Texas Obesity Awareness Week

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