Tulsa Health Department
Annual Report 2016 to 2017

A Letter from the Executive Director


It is my pleasure to submit to you the 2016 – 2017 Tulsa Health Department (THD) annual report. During the past year we have worked collaboratively and cohesively with community partners, decision makers and residents to change and improve the health status of Tulsa County. Inside this annual report, we identify how we are not only improving individual health but impacting population health as well. We work effectively and efficiently by:

Impacting population health through policy and partnerships.

We work with partners and policymakers on health issues and opportunities currently affecting large parts of our community—healthy eating and active living, emergency preparedness and response, access to healthcare, improved life expectancy, and quality of life issues to promote prevention and wellness across the community.

Responding to the needs of at-risk and vulnerable populations.

We have provided services to at-risk groups within our communities through a variety of programs such as WIC, family planning, nurse home visitation programs, and enrollment in public or private healthcare plans. At-risk and vulnerable groups often have a disproportionately high number of the poor health outcomes for the total population. Addressing these health concerns can reduce health care costs and improve overall community health status.

Preventing the spread of disease and ensuring healthy environments.

We address problems that can affect the entire community by providing control of communicable diseases and assuring safe conditions in facilities such as restaurants, childcare centers, swimming pools, and issues that become health nuisances in neighborhoods.

This report will show how THD has played a primary role in identifying important health issues that affect both vulnerable groups as well as the larger population. More importantly, we are serving as a catalyst to bring together a broad range of partners – including healthcare systems and providers, businesses, the educational community, community-based organizations, emergency response, local, state, and federal policymakers, individuals and families – to work cohesively to address them. This would not be possible without the tireless effort by each and every employee on staff. It is an honor to lead an exceptional team as we work to make Tulsa County the healthiest county in the country!

Bruce Dart, Ph.D.

Executive Director

Tulsa Health Department

We want to make Tulsa County the healthiest county in the country in ten years!

2017 Tulsa County Community Health Improvement Plan

In January, THD launched the 2017 Tulsa County Community Health Improvement Plan (CHIP). The launch was the culmination of months of collaboration with more than 65 community partners. The overall goal of the plan is to improve the health and well-being of Tulsa County residents. Most importantly, this plan will address health equity issues and the social determinants of health: the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

More than 100 community leaders came together for the launch of the plan held at the Central Library. City of Tulsa Mayor G.T. Bynum delivered the keynote address, and Tulsa Regional Chamber President & Chief Executive Officer Mike Neal also discussed the economic impact that health improvement can have on Tulsa County.

About THD

With its rich history, beautiful surroundings and friendly faces, Tulsa is a great place to call home. Community spirit runs deep here, and our residents take pride in taking care of each other. The same spirit to care and protect is found at the Tulsa Health Department, where we put the needs of the community first. We're committed to a constant pursuit of a healthier Tulsa.

Our Vision

We want to make Tulsa County the healthiest county in the country.

Our Mission

To improve the health and well-being of all Tulsa County residents.

Our Values

We're committed to a constant pursuit of a healthier Tulsa, and we do so by carrying out our core values:

Treat all people with dignity and respect – the THD Way.

Put the needs of a client ahead of anything and everything else – Community First.

Be accountable to each other and to the people we serve.

Empower residents to make healthy and safe choices.

About the Tulsa Health Department

Since its establishment in 1950, the Tulsa Health Department serves as the primary public health agency to more than 600,000 Tulsa County residents, including 13 municipalities and four unincorporated areas. The agency is one of two autonomous local health departments in Oklahoma, with statutory public health jurisdiction throughout Tulsa County and the City of Tulsa. THD’s mission is to improve the health and well-being of all Tulsa County residents, in order to make Tulsa County the healthiest county in the country. THD was among the first health departments in the U.S. to receive national accreditation through the Public Health Accreditation Board. For more information, please visit www.tulsa-health.org.

2016–2017 Tulsa City-County Board of Health

Kian Kamas, Chair

Chris Bell, R.N., J.D., Vice Chair

David Johnson

James Goodwin, J.D.

Deborah Greubel, DNP, APRN-CNP

Patrick Grogan, DVM

Larry Lander, D.D.S., J.D.

Regina Lewis, D.O.

Emily Odom

Ann Paul, MPH

Bill Schloss

Finance Department

Marketing & Creative Services

183

Media interviews conducted


$849,877.68

Earned media for FY 2016–17

Birth & Death Certificates

40,161

Certified birth certificates issued


65,469

Certified death certificates issued

Quality Improvement

Since October 2016, 68 THD team members completed QI Tool Training. The training offered objectives to ensure continuous improvement for THD program processes. Attendees learned and practiced how to develop AIM statements, brainstorming, affinitiy diagrams, cause and effect diagrams and flow charting.

Employee Resource and Development

39 

Organizational Development trainings


214

Employees participated in annual employee and health risk assessments


153

Employees participated in the annual wellness day


89% 

Retention rate. For the calculation process, the number represents all regular full time and regular part time employees who left the department, other than for retirement.  

Adolescent & Child Health

It's All About Kids

13,028

Students served through nutrition education. Nutrition education includes blender bike demos, IAK cooking demos and afterschool programs.

WIC

WIC is a supplemental nutrition program that serves to safeguard the health of income-eligible women, infants and children up to age five who are at nutritional risk. More than 7.5 million people benefit from WIC each month. THD provides WIC services to more than 23,000 Tulsa County residents.

Services include: Nutrition education for families, referrals to various social service agencies, and issuance of food benefits that can be used at various grocery stores for health foods such as milk, cheese, eggs, fruits, vegetables, beans, peanut butter, infant foods and formula, juice, and cereal. 

23,764

Combined clinic caseload unduplicated participants


37,093

Number of client visits (does not include online Nutrition education)


$12,253,954

WIC supplemental foods issued in dollars


3,601.06

Total hours breastfeeding peer counselors spent supporting prenatal and postpartum participants

37,093 client visits

Little by Little

THD launched the Little by Little School Readiness Program on June 12, 2017 to provide developmentally appropriate books to individuals who are participating in the WIC Program. Little by Little (LBL) is an evidenced- based early literacy program that strives to create a stimulating home environment, foster literacy, and improve school readiness for underserved children. This cost-effective program is delivered through THD WIC clinics. The program begins services in the second trimester of pregnancy and continues until the child’s fifth birthday with the opportunity to provide a high quality book and an age-appropriate handouts on reading, development, household safety, and family engagement to each WIC participant as often as once (1) per quarter or four (4) times per calendar year.

506

Books given out in the first week

5,864

Books given out in the first three months

Child Guidance & Audiology

Child Guidance is a statewide program that promotes and supports healthy family relationships and child development. Our caring staff of masters and doctoral degree-level professionals provide prevention, education, screenings, diagnostics, and treatment to children and their families.

5,623

Clients Served


970

Consultation Hours to Childcare Centers


127

Community Classes Conducted

5,623 clients served

Personal Responsibility Education Program (PREP)

In December 2016, PREP was awarded a $1,000.00 grant from Pathways to Health Foundation towards continued funding for Teen Zone events. One hundred and eighty-eight teens attended Teen Zone this year. Each month’s event was centered on a topic, many of which were determined by youth who participated in PREP programming offered in Tulsa County schools. Topics covered this past year include healthy relationships and teen dating violence, stress management, puberty and adolescent development, goal setting, healthy snack preparation, physical fitness and college readiness.

77.7%

of students in Making Proud Choices (MPC) curriculum indicated they were more likely to use birth control in the next six months upon completion of the MPC curriculum.

PREP Teen Zone

Preventive Health Services

Many essential health care services, from disease screening to immunizations, are available at our health centers located throughout Tulsa County. THD also offers comprehensive family planning services, including physical examinations, laboratory services, pregnancy testing, contraceptives, counseling, and referrals for other THD and community services.


Immunizations

14,910

Child client visits


7,707

Adult client visits


10,810

Vaccines given to adults receiving immunizations


1,487

Online shot records (new in 2016)

14,910 child client visits

Adult Health

We help promote and maintain adult health by providing breast exam checks, pap smears, and screenings for the following conditions: hypertension, diabetes, high cholesterol, anemia, breast cancer & cervical cancer.

1,244

Clients screened

Healthy Start

Healthy Start provides free and confidential clinic triage and home visitation case management services for expecting and postpartum moms and their babies up to age two

529

Families served

Sexually Transmitted Disease Clinic

As a preventative measure, THD provides condoms at no cost to anyone who requests them. These small and discreet bags are commonly referred to as a “brown bag special” and contain condoms and educational materials about proper use and STD prevention. Brown bag specials are available at all clinic locations.

5,000

Brown bags provided


4,434

Clients screened and tested for sexually transmitted disease

5,000 brown bags provided

Baby Shower

The Healthy Start programs of the Tulsa Health Department and Community Service Council partnered to host the second annual Community Baby Shower on September 24, 2016. More than 300 attendees had the opportunity to visit with 30 local vendors ranging from health resources to child care providers.

At the event, new and expecting mothers received gift bags with baby essentials like diapers and wipes as well as resources from local vendors. Attendees also had the opportunity to win a year supply of diapers. The goal of the Community Baby Shower is to educate 250 pregnant women and their family members about factors contributing to infant mortality and to connect families to local parenting support agencies/women’s health providers.

Dental

349

Children served

Family Planning

4,921

Clients served

Tuberculosis

3,460

Tuberculosis (TB) skin tests performed


270

Positive TB skin tests


387

Individuals provided preventive TB therapy

Children First

572

Families served


Maternal Child Health Outreach

2,810

Number of clients provided health prevention education, referrals, and assistance with SoonerCare application and advocacy

Health Data & Policy

THD works to investigate and provide information on the many diseases and conditions affecting the population. These efforts provide the foundation for developing public policy and regulations to promote healthy living for all Tulsa County residents.

Healthy Living Program

65

Certified Healthy Schools (K–12). 10 districts had at least 1 certified healthy school in the district


The 4th annual Fit 2 Learn Summit was held on June 6, 2017, at OSU-Tulsa. The summit focused on best practices from local and regional experts covering a wide variety of topics such as school food menus, safe routes to school, incorporation of nutrition and physical activity into the classroom, and wellness policies. More than 150 health educators in the community attended. There were individuals in attendance from at least eight public school districts in Tulsa County as well as at least two private schools. Fit 2 Learn was hosted by the Healthy Living Program serving Tulsa County, It’s All About Kids, Oklahoma State University Center for Health Sciences, Union Public Schools, Tulsa Public Schools, the Center for Family Resilience and the Oklahoma Tobacco Settlement Endowment Trust.

Substance Abuse Prevention

408

Responsible Beverage Sales and Service Training (RBSS) participation


1,825

Pounds of prescription drugs collected at take-back Events


The Tulsa Health Department’s Regional Prevention Coordinator (RPC) program partners with local police, ABLE agents, members of the Tulsa County Sherriff’s Office, and trained underage youth to conduct alcohol compliance checks at Tulsa County establishments that sell or serve beer or alcohol.

In this fiscal year, the team completed 125 compliance checks, resulting in 13 sales to minors and a 90% compliance rate. This reflects a consistent trend from last year’s 90% compliance rate.

While there are a variety of ways for young people to obtain alcohol, research has shown that youth who purchase their alcohol, as opposed to getting it free, are far more determined to drink it and consume it in larger quantities than those who do not pay. Compliance checks are an important tool used to determine if a licensed retail outlet is following state and local laws that regulate the sale of alcohol to minors.

— Marianne Long, RPC program manager

Epidemiology

The number of reported cases is reflective of suspect, confirmed or probable cases. This does not include all cases reported and investigated in Tulsa County.

Tulsa Fetal and Infant Mortality Review

116

Cases reviewed by Case Review Team


32

Recommendations forwarded to the Community Action Team

Emergency Preparedness and Response

Tulsa County Medical Reserve Corps (MRC) has 892 volunteers who supplement the public health workforce. In FY 2016–2017, MRC volunteers responded to two emergency activations and 13 non-emergency activations within Tulsa County.

Mumps Outbreak

The 2017 Tulsa County Company Associated Mumps (TuCo CAM) outbreak involved individuals employed at a private sector company with regional offices in Oklahoma and surrounding states and an associated student within a Tulsa County school district. THD established the Incident Command System (ICS) on March 7, 2017, due to the potential number of case contacts needing vaccination and the anticipation of exceeding day-to-day capabilities of the THD immunization clinics. During the investigation, 8 cases of mumps were identified that all shared a specific time and place needed for transmission of mumps for person to person. An immunization clinic was set up with a total of 13 vaccines provided to individuals. Twenty-five THD employees and four Oklahoma Medical Reserve Corps (OKMRC) volunteers were mobilized during the ICS activation. The estimated total cost of personnel and supplies was $13,590.78; utilization of OKMRC volunteers provided a cost savings of $822.31.

Environmental Health Services

THD works to enforce state laws and city and county regulations to decrease negative environmental factors. Environmental health services include a mosquito surveillance program, food protection services and an environmental water lab. Additionally, THD provides burning variance permits, helps enforce county and city public nuisance programs, and inspects public pools and spas.

Environmental Health Services: By the Numbers

582 

Food handler classes conducted


9,318 

Food sanitation inspections performed


25,977 Individuals trained through food handler classes


1,881

Swimming pool and spa inspections conducted


305

Construction plan reviews


729 Mosquito trap collections


195

Square miles sprayed for mosquito control


54

Sites treated with larvacide

54

Residential properties assessed for rat control


206

Gas vapor recovery system inspections conducted


10

Asbestos removal inspections


14,110 Water samples tested


1,697

Housing code inspections


183

Air quality permit inspections


26

Building plan inspections

Fight the Bite

THD partnered with the Oklahoma City-County Health Department and the Oklahoma State Department of health to promote Zika education and prevention in Oklahoma during the summer months. The public awareness campaign was funded through a grant received from the CDC.

The objectives included:

· Prevent locally originated cases of Zika by educating the public on the facts about Zika.

· Educate travelling public on how to prevent infection

· Alert pregnant women to the risks and dangers of Zika during pregnancy.

· Provide information on effective mosquito control strategies around workplaces and residences, appropriate use of repellant, as well as other precautions to take in areas where vector mosquitos are present

The campaign included a TV commercial, transit advertising, radio commercials, targeted digital advertising (web and mobile), targeted social media advertising and a microsite: www.FightTheBiteOK.com. The target audience for Zika prevention included pregnant women, unborn children, those traveling to high risk areas that may become pregnant or father a child within 6 months of travel. Additionally, digital advertising targeted individuals who were actively searching for travel-related purchases in Zika-affected areas.

Housing Task Force

Environmental Health Services has formed a Housing Strategies Task Force with a goal of decreasing poor housing stock in Tulsa County. The task force is made up of internal employees and external agencies with an interest in increasing affordable, safe housing choices. Environmental Health Services has also simplified processes to become more efficient, as well as working to be more proactive in healthy home education by engaging with tenants.