# Coordination of Environmental Public Health Services in Four Southeastern Oklahoma Counties

# 2005 - 2006 

# 

#  Environmental Public Health Leadership Institute Fellows:

# Montressa Jo Elder, MS, RPS

*Environmental Program Manager;* Oklahoma Department of Environmental
Quality

*P.O. Box 1677*

*Oklahoma City, OK 73101-1677*

*(405)702-1017*

[*monty.elder@deq.state.ok.us*](mailto:monty.elder@deq.state.ok.us)

# Rocky McElvany, MS,RPS

## Deputy Commissioner for Protective Health Services, Oklahoma State Department of Health

*1000 NE 10^th^ Street*

*Oklahoma City, OK 73117-1299*

*(405)271-5288*

[*rockym@health.ok.gov*](mailto:rockym@health.ok.gov)

# Michael Echelle, BS, RPS

## Administrative Director for Pittsburg, Coal, Atoka and Pontotoc County Health Departments, Oklahoma State Department of Health

*620 South Third Street*

*McAlester, Ok 74501*

*(918)423-1267*

[*michaele@health.ok.gov*](mailto:michaele@health.ok.gov)

# Ted Evans, BS, RPS

## Chief Consumer Health Services, Oklahoma State Department of Health

*1000 NE 10^th^ Street*

*Oklahoma City, OK 73117-1299*

*(405)271-5243*

[*tede@health.ok.gov*](mailto:tede@health.ok.gov)

# CDR Chris Buchanan, MPH, REHS

## District Environmental Health Officer, Oklahoma City Area, Indian Health Service

U.S. Public Health Service

*1515 Lawrie Tatum Road*

*Lawton, Oklahoma 73507*

*(580) 353-0350, extension 281*

[*chris.buchanan@mail.ihs.gov*](mailto:chris.buchanan@mail.ihs.gov)

# Mentor:

### **CAPT Patrick O. Bohan, USPHS (RET), RS, MS, MSEH**

*Assistant Professor, Department of Environmental Health Science;* East
Central University

# (Acknowledgements):

### **David Peter Stroh; MA**

*Partner;* Bridgeway Partners

### **CAPT John Sarisky; RS, MPH**

*Technical Assistance Team Leader, Environmental Health Services Branch,
Centers for Disease Control;* U.S. Public Health Service

> ![](media/image1.jpeg){width="1.3756944444444446in"
> height="0.6368055555555555in"}

# EXECUTIVE SUMMARY:

The Oklahoma State Department of Health (OSDH), Oklahoma Department of
Environmental Quality (DEQ), Indian Health Services (IHS) and several
tribal governments provide environmental health services in Southeastern
Oklahoma. In 1993, the Oklahoma legislature created the DEQ and
transferred many, but not all, environmental responsibilities from OSDH
to the new agency. This split created animosity between administration
and staff of both agencies. As a result, there was little or no
communication between the agencies for several years. In addition,
historically, IHS and the tribes had their own environmental programs
separate from the state. There was confusion between all these
environmental agencies about areas of jurisdiction. Lack of coordination
and communication among these agencies and governments resulted in
delays and unresponsiveness in addressing some environmental problems
where jurisdiction was unclear. These slow and uncoordinated responses
created confusion and frustration for the public. This article
demonstrates that Shifting the Burden and Quick Fix systems thinking
model archetypes^1^ can be used to describe the problems associated with
efforts to enhance coordination by rigidly defining jurisdictions. These
models found the underlying problem of gray areas of jurisdiction
remained unaddressed. This resulted in a lack of response to some
environmental issues by all three agencies, which in turn, lowered the
public's perception of the agencies. With support from agency
administration, the authors identified and achieved three objectives; an
updated interagency referral list of technical experts, a meeting
between managers and field staff of the 3 agencies in the 4 counties,
and establishment of a three agency workgroup charged with the
development and implementation of the service delivery coordination
process. Next steps include development of an interagency Outbreak
Response Plan, refinement of the coordination objectives, and
dissemination of the program statewide using a regionalized approach.
This project demonstrates delivery of environmental health services to
citizens can be improved by coordinating interagency responses. In
addition, the project supports six of the ten Essential Environmental
Services^2^ as well as the CDC Health Protection Goal of preparing for
emerging health threats^3^ along with addressing 2010 Health People
objectives of Environmental Health and Food Safety^4^. Components of the
National Strategy to Revitalize Public Health Services^5^ are
demonstrated in the project outcomes as well.

# INTRODUCTION/BACKGROUND:

Prior to 1993, environmental health programs for the State of Oklahoma
were primarily housed in the Oklahoma State Department of Health (OSDH).
In July1993, the Oklahoma Legislature created the Oklahoma Department of
Environmental Quality (DEQ). As a result, statutory jurisdictions for
areas of environmental health programs were moved out of OSDH and into
the new DEQ. However, many areas of environmental health were not
clearly assigned to either ODEQ or OSDH. This confusion, which was
created unintentionally by the new law, left the state agencies looking
for ways to address areas of over lapping jurisdiction as well as gray
areas in which there was no clear jurisdiction. During the
implementation phase of the new law, some deep seeded resentments were
formed between the two agency's management and staff. The result of the
lack of clarity concerning jurisdiction on some environmental health
issues, coupled with staff that were unwilling to work together, created
problems with the overall response to citizen environmental concerns.
Members of the public with specific environmental health issues were
often referred by staff of one agency to the other agency and then
referred back again. As a result, some environmental health issues
remained unresolved for long periods of time. Several failed attempts to
rectify this problem were initiated by both agencies. Repeatedly, the
agencies attempted to strictly define areas of environmental health
jurisdiction. Each time this was attempted, there was less attention
paid to the gray areas that still existed which caused the response
problems to continue. Additionally, the agencies attempted to develop an
interagency referral list. While this was helpful in the short term,
since responsibility for updating the list had not been
institutionalized, the list quickly became out of date and was actually
a hindrance in coordinating a response to citizen complaints.

In addition to the jurisdictional problems which existed between the two
state agencies, the jurisdiction for environmental health services on
Indian land falls to either Indian Health Service (IHS) or to individual
tribes. In Oklahoma, tribal reservations are not readily identifiable,
instead tribal land is scattered throughout the state in a patch work
manner. In many instances there is no easy way to differentiate tribal
land from state land. Certainly citizens are not always aware which
entity has jurisdiction for environmental public health issues in a
particular geographic area. To further compound the problem, IHS and the
two state agencies had little communication, certainly none on an
on-going basis. As a result, misperceptions about relative expertise,
jurisdiction, and program management existed not only between these
three groups but also to the public.

***Problem Statement:*** Environmental services are delivered by 3
different agencies in SE Oklahoma, Oklahoma State Department of Health
(OSDH), Oklahoma Department of Environmental Quality (DEQ), and Indian
Health Service (IHS) as well as tribal governments. Lack of coordination
and communication among these agencies and governments resulted in
delays and unresponsiveness in addressing some environmental problems
where jurisdiction was unclear. These slow and uncoordinated responses
created confusion and frustration for the public.

Behavior Over Time Graph:

####### ![](media/image2.jpeg){width="6.5in" height="4.875in"}

#######  

####### ***Causal Loop Diagrams and applicable archetypes:***

![](media/image3.jpeg){width="6.5in" height="4.875in"}

####### ***Ten Essential Environmental Health Services:***

This project seeks to enhance the following six Essential Environmental
Health Services in Oklahoma.

1.  Essential Environmental Health Service No. 3 - Inform, educate, and
    empower people

> Once the collaborative process is completed, environmental health
> professionals at the local, state, and federal/tribal levels will be
> better informed about each agency's roles and responsibilities as they
> relate to environmental public health issues and goals. As a result of
> this information sharing, environmental health professionals in all
> agencies will be better able to inform and educate citizens about
> environmental health issues, thus, empowering them to take steps to
> make their environment safer.

2.  Essential Environmental Health Service No. 4- Mobilize community
    partnerships

> Given today's public health concerns, it is essential that all
> community partners work collaboratively to identify and solve
> environmental health problems. Through agency cooperation, community
> partnerships will be enhanced to meet the environmental challenges of
> today. Mobilizing partnerships between all environmental health
> programs within the state of Oklahoma will provide a foundation for
> enhanced environmental health services because gray areas of
> jurisdiction will no longer be ignored, but rather used as a platform
> for designing collaborative responses to problems which include
> working with community groups.

3.  Essential Environmental Health Service No. 7- Link people to
    environmental health services This project is focused on filling
    "the missing links" in the environmental health communication chain.
    For example, on several occasions environmental health issues have
    risen at the county and state levels that affected the
    tribal/federal programs. In addition, lines of communication between
    county and state agencies have been fragmented. The project
    addresses the need for open dialogue between all agencies to deliver
    improved customer services. Citizens will no longer be transferred
    from agency to agency, but will be promptly linked either to the
    appropriate agency for response or to a coalition of agency partners
    in order to find solutions to environmental problems.

> 4\. Essential Environmental Health Service No. 5 -- Develop policies
> and plans The enhanced coordination between OSDH, DEQ and IHS will
> enable policies to be developed to address areas where state law does
> not designate specific jurisdiction. For example, indoor air and mold
> in private homes are not within the jurisdiction of either state
> agency or IHS for homes on tribal land. Through cooperation and
> collaboration, the agencies would be able to develop a policy for
> providing consistent guidance for homeowners regardless of which
> agency was contacted. Initially, the project plans to develop an
> "Outbreak Response Plan" for the four counties in Southeast Oklahoma
> which will include participation from the state agencies and IHS. The
> template for this plan will be disseminated statewide. Another goal of
> the project is to develop coordinated emergency response plans
> statewide involving all agencies with environmental health
> responsibilities.

5.  Essential Environmental Health Service No. 6 - Enforce laws and
    regulations Each agency respectively enforces the laws and
    regulation they govern. However, gray areas exist where
    environmental laws or regulations are not clear. With agency
    collaboration, environmental health agencies can fulfill their
    obligations to address these health issues, thereby, enhancing the
    health and safety of communities. For example, tattoo parlors are
    illegal in the state of Oklahoma; however, groups have attempted to
    use tribal sovereignty as an approach to conduct this illegal
    activity/business. County/state environmental health agencies have
    informed Indian Health Service about these illegal businesses. As a
    result, federal environmental health professionals have approached
    tribal officials about the public health impact these activities
    present. Tribes have concurrently held tattoo parlors as illegal and
    have closed existing facilities.

6.  Essential Environmental Health Services No. 8 - Assure a competent
    environmental health workforce In Oklahoma; three separate
    environment health organizations currently exist. Each agency
    educates and trains their workforce respectively to meet today's
    environmental challenges. Technical skills, experience and training
    existing in each of the environmental health workforces can be
    pooled to solve environmental health problems through collaboration.
    More importantly, in the event of public health emergencies it is
    essential that the environmental health professionals be able to
    work together combining knowledge and resources to solve problems.

####### ***National Goals Supported*** 

CDC Health Protection Goal -- People Prepared for Emerging Threats

Oklahoma's coordination and communication project seeks to support the
CDC Health Protection Goals by creating, increasing, and repairing
communications to improve working relationships between the individuals
and agencies who respond to environmental or natural threats in order to
protect the public. By reducing the confusion regarding gray areas of
responsibility and increasing the communication between agencies, we can
improve the timeliness and accuracy when investigating or responding to
natural or man made disasters. The increased ability to clearly
determine responsibility within their respective program jurisdictions,
will allow the Department of Environmental Quality, the Department of
Health and the United State Public Health Service to coordinate their
response and provide the greatest public health service and protection.
This goal can be achieved with the Outbreak Response Plan, which will be
developed during the next steps of the program.

Health People 2010 Objectives -- Number 8, Environmental Health and
Number 10, Food Safety

Oklahoma's communication and coordination project is designed to also
address the Healthy People 2010 Objectives. The communication and
coordination focus in response to complaints or reported incidents will
allow the three agencies to provide a coordinated response for focus
area number eight, Environmental Health, and number ten, Food Safety.
DEQ, OSDH and the PHS are programmatically responsible for responding to
traditional environmental health programs, complaints, and food safety.
The communication and coordination emphasized throughout the Oklahoma
project will focus this trained and experienced workforce to respond to
routine complaints and also to put in place effective public protection
levels for new or emerging environmental threats.

The Oklahoma project is also related to four goals outlined in the
National Strategy to Revitalize Environmental Public Health Services.

Goal I (Build Capacity)

In support of Goal 1, Oklahoma's project continues to develop the
statewide ability to prevent and respond to natural and manmade public
health issues. Effective coordination and communication on issues
within, as well as outside, of each agency's jurisdiction will greatly
enhance the state's response ability. The effort to involve each
agency's support staff to discuss and determine the most appropriate
method to address an issue will focus resources to tackle even the most
difficult environmental public health threat. One of the difficulties
created by the separation of the environmental agencies was the division
of resources. Before the division, environmental programs were housed in
one agency, therefore, cooperation on environmental public health issues
was routine. After the division, there was little communication
regarding the aspects of environmental public health issues between the
Health Department and the Department of Environmental Quality. With this
project, increasing focus on communication and coordination between the
Oklahoma State Department of Health, the Department of Environmental
Quality, and the United States Public Health Service, there is a pooling
of staff and best practices to most effectively respond to those issues
which pose a threat to the public health.

Goal III (Foster Leadership)

Oklahoma\'s project will support Goal III by developing strong working
relationships among the agencies responsible for response and regulation
of environmental public health issues. By involving environmental public
health individuals who are experienced and knowledgeable along side
those who have less experience, we can educate our workforce at all
levels to make sound decisions when responding to public health threats.

Goal IV (Communicate and Market)

Our Oklahoma project will support Goal IV by improving the communication
and information sharing between the Oklahoma Department of Environmental
Quality, the Oklahoma Department of Health and the U.S. Public Health
Service. The goal is to bring those individuals together when
environmental issues should be coordinated thus providing expertise from
environmental professionals with knowledge of the best practices to
respond to an environmental issue. This goal will be achieved by the
agencies sharing information and disseminating response or regulatory
strategies to bring issues of environmental public health to heightened
awareness among all agencies with a goal to provide the best response
available to environmental issues.

Goal V (Develop the Workforce)

The Oklahoma project will meet Goal V by promoting the development of a
competent and effective work force able to deliver the most effective
and appropriate response to environmental public health issues due to an
enhanced ability to communicate and coordinate environmental public
health issues. By defining parameters of responsibility for each agency
and agreeing to effectively coordinate a response to any issue not
clearly within the scope, each environmental professional will be able
to utilize their knowledge on environmental issues and provide the state
with the best available strategy to respond to any environmental issue
appropriately. By coordinating environmental responses in Oklahoma, the
environmental workforce status will be elevated when the state sees an
appropriate response to environmental issues.

####### 

####### 

####### 

####### 

####### 

####### ***Project Logic Model:***

See Appendix A

# PROJECT OBJECTIVES/DESCRIPTION/DELIVERABLES:

***Program Goal:*** To increase the coordination of environmental health
services delivered in 4 counties of Southeast region of Oklahoma.

***Health Problem:*** Environmental services are delivered by three
different agencies in Southeast Oklahoma, including the Oklahoma State
Department of Health (OSDH), Oklahoma Department of Environmental
Quality (DEQ), and Indian Health Service (IHS) as well as tribal
governments. Lack of coordination and communication among these agencies
and governments resulted in delays and unresponsiveness in addressing
some environmental problems where jurisdiction was unclear. These slow
and uncoordinated responses created confusion and frustration for the
public.

####### ***Outcome Objective:*** By December 30, 2005, the three agencies and two tribal governments that deliver environmental health services in Southeast Oklahoma will have met together to discuss coordination issues. In addition, they will have conducted a minimum of three joint on-site inspections and /or participated in the coordination of specific environmental issues in the area. As necessary, conference calls between all parties will be conducted to resolve issues of unclear jurisdiction.

***Determinant:*** A joint meeting between environmental health agencies
and tribal governments in Southeast Oklahoma.

The number of joint inspections conducted or environmental issues
coordinated by these entities in Southeast Oklahoma.

Occurrence of conference calls between all parties as needed.

####### ***Impact Objective:*** By January 1, 2006 the delivery of environmental health services will be effectively and successfully coordinated in Southeast Oklahoma.

####### ***Contributing Factors:***

1.  Oklahoma statute and tribal laws divide environmental health
    services jurisdiction in Southeast Oklahoma between agencies and
    tribal governments.

> 2 Personnel within three environmental health agencies are housed in
> different locations around Southeast Oklahoma.
>
> 3 Statutory division of environmental health services in 1993 created
> animosity between OSDH and DEQ personnel.
>
> 4\. OSDH and DEQ personnel are unclear on IHS and tribal jurisdiction
> including what properties fall under IHS jurisdiction.

5\. Statutory assignment of jurisdiction for environmental
responsibilities was not clearly delineated resulting in grey areas of
authority for certain environmental issues.

####### ***Process Objectives***

1.  Produce an accurate interagency referral list for program
    responsibilities.

> 2\. Facilitate a joint meeting between OSDH, DEQ and IHS managers and
> field staff for the four counties in Southeast Oklahoma.
>
> 3\. Follow up with agency managers and field staff to review progress
> in coordination.

# METHODOLOGY:

####### ***Events and Activities***

> 1**. *Event: ***Agency referral list updated and distributed in August
> 2005. Copies of the referral list and booklet describing each agency's
> programs can be obtained by contacting Montressa Jo Elder at the
> Oklahoma Department of Environmental Quality.

***Activities:***

a.  Team members from each agency evaluated program responsibilities.

b.  Team members from each agency made corrections to existing list
    based on current staff.

c.  Agency referral list formatted and distributed (Appendix A).

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2.  ***Event:*** Interagency meeting held in McAlester, Oklahoma on
    September 16, 2005

***Activities:***

a.  Team members met with mentor to discuss strategies for interagency
    meeting.

b.  Team members enlisted support for the project for respective agency
    leadership.

c.  Team members contacted respective area supervisors to schedule
    meeting and enlist support for the project.

d.  Team members met to prepare for the meeting which included facility
    location, meeting content and date.

e.  Meeting held on September 16, 2005.

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3.  ***Event**:* Team members contacted area managers to discuss changes
    in attitudes and opportunities for interagency coordination since
    September meeting.

***Activities*:**

a.  Team members held debriefing concerning the September meeting.

b.  Team members met with, phoned and e-mailed area managers to get
    their evaluation of meeting.

c.  Team members contacted the area managers on a regular basis to
    determine if grey areas had arisen or new environmental issues had
    emerged which necessitated a conference call or another face to face
    meeting.

d.  Based on the regular contact, as necessary conference calls or
    meetings will be scheduled.

# NEXT STEPS:

1.  Development of Outbreak Response Plan for the four Southeast
    Oklahoma counties.

    a.  Team members will review model plans supplied by CDC.

    b.  Team will draft Outbreak Response Plan for the four counties in
        Southeast Oklahoma.

    c.  Team will meet with managers and field staff from the four
        counties to refine and finalize plan.

2.  Observe and refine coordination of environmental public health
    services in the four Southeast Oklahoma counties.

    a.  Team members will meet with managers and field staff to discuss
        any specific examples of coordinated response or lack of
        coordinated response which occur over the next 12 months.

    b.  Team members will utilize feedback from managers and field staff
        along with systems thinking models to continue to develop
        interventions to promote coordination between agencies.

3.  Hold quarterly meetings between agency administration to discuss how
    to appropriately anticipate and respond to environmental public
    health issues

4.  Solicit executive level support from all three agencies for the
    expansion of the pilot coordination project statewide including
    delegation of accountability for decisions to promote the project.

5.  Begin the process of coordination between all three agencies
    statewide, using a regionalized approach.

# EXPECTED OUTCOMES

Maintaining a current referral list within OSDH and DEQ will ensure all
field staff, regardless of their agency, are provided technical experts
in which to call for assistance. This direct connection between agencies
will enable them to conduct joint inspections and coordinate responses
to environmental public health issues. The state of Oklahoma will have a
statewide Outbreak Response Plan which includes activities of the three
agencies. Field staff from different agencies will have the capability
to respond to an environmental public health issue in a collaborative
fashion which will result in seamless provision of services to the
public. This coordinated response will enable the State of Oklahoma to
improve delivery of Essential Environmental Health Services to all its
citizens as well as to meet the CDC Health Protection Goal of preparing
people for emerging threats. Additionally, it enables the three
environmental agencies to work toward achieving four of the goals
outlined in the National Strategy to Revitalize Environmental Public
Health Services and two of the objectives in Health People 2010.

# LEADERSHIP DEVELOPMENT OPPORTUNITIES:

####### ***Montressa Jo Elder***

It has been a privilege to participate in the first Environmental Public
Health Leadership Institute. The coursework has been challenging. This
was my first exposure to systems thinking and I have used it to clarify
my thinking about a number of problems in both my professional and
personal life. I experienced a number of "ah ha" moments during the
study of archetypes and mental models. It was particularly helpful to
use the diagrams to explain the underlying causes of a problem. I am
excited about continuing to develop an understanding of these tools. In
the personal leadership development phase of the institute, I am
appreciative of the opportunity to use the Skillscope 360 Assessment.
For a number of years, I struggled with no success to get just that kind
of feedback from the folks I supervise. I gained valuable insight into
specific areas of management and leadership skills that needed
improvement and I have been able to take concrete steps toward
improvement in those areas. I also was unaware of change style
preferences and how they relate to working relationships with others.
This has also been a valuable tool for working with others productively.
Finally, the best part of the institute was the opportunity to get to
meet so many wonderful people. The staff was not only extremely
knowledgeable but also very helpful. The other fellows had a wide
variety of experiences and skills, which added texture to the learning
environment. Plus, they were all really fun to get to know outside of
class. The institute has given me a network of colleagues, which I can
draw on for assistance in the future. The hard work of the institute has
resulted in the acquisition of priceless tools, experiences, and
friendships. I can't express enough my gratitude for the opportunity.

####### ***Rocky McElvany***

I am very pleased to have been a part of the training provided by the
National Public Health Leadership Institute.  This opportunity has
allowed me to meet and share work experiences, opportunities and
difficulties with others in the environmental/public health programs
across the nation.  I have been able to provide insight to some, but
more, I have been able to grow as an environmental public health
professional by experiencing the excitement of those who are new to our
field. 

 

We have experienced opportunities to evaluate our personal leadership
status and also to learn from some of the nations best educators.  The
excitement of this training staff is they not only teach leadership but
they have the prospective of our field which has caused their training
to be very much on point to our needs.  

 

I am appreciative of the support provided by the SLU.  They have
provided the focus for our projects and been available for consultation
on any of the projects assigned. I feel like the opportunities we have
experienced as the first group of the EPHLI have allowed me to progress
as a leader in Environmental Public Health.

####### ***Michael A. Echelle***

I feel privileged to have had the opportunity to participate in EPHLI.
It's not often that one has the opportunity to network and collaborate
with environmental health professionals from across the country. While
our geographic regions may differ, it was enlightening to hear that many
of us face similar problems and issues.

The institute challenged me to think more broadly by using a systems
approach to solving environmental health or public health issues. I feel
the curriculum presented was informative and appropriate with regard to
enhancing leadership and management skills. Collaboration is the key to
solving problems; the institute focuses on improving networking skills
and abilities in order to take a holistic approach to addressing the
problems. I have worked in the public health field for nearly
twenty-four years, beginning my career as an environmental specialist
and currently serving as a county health director for four counties.
Over the years I have participated in a number of management courses,
focused on team-building, leadership, conflict resolution, etc. They
were all applicable and beneficial, however, none were as diverse or
leadership focused as this one. The institute challenges participants to
assess their abilities, values, and personal commitment and at the same
time, helps guide individuals to improve themselves on a professional
level. Overall, attending this institute has provided me the ability to
include a systems approach process in order to more effectively solve
problems.

####### ***Ted Evans***

Before Environmental Public Health Leadership Institute I had attended
the Oklahoma Public Health Leadership Institute and gained some
leadership skills. I had been using many of the principles taught at
EPHLI. However before I had not had a good grasp of how each component
would fit together to move ideas and projects forward. Systems' thinking
is a great tool for me. I had used some of these principles to manage
but never had a real clear picture of how everything fits together. The
section on unintended consequences was really helpful to me. I will use
those ideas daily on all decisions. Attending the institute has enhanced
my ability to follow a process in order to more effectively solve
problems.

The institute has allowed me to meet environmental health professionals
from other states that have similar issues. These contacts will be
valuable resources because many have already addressed issues that I
will face in the future. I will have resources to contact to see what
did and didn't work.

I am very fortunate to have been selected to attend EPHLI. The citizens
of Oklahoma will benefit from the knowledge that I have gained from the
institute for many years.

####### ***Chris Buchanan***

The Oklahoma Environmental Health Communication Project (OEHCP) has
created working connections with the Oklahoma State Health Department
(OSHD), Oklahoma Division of Environmental Quality (ODEQ), and County
Health Departments. Working with these agencies has created a
relationship with Indian Health Service and tribal governments that will
continue long after the project has been completed and could be used as
a model for others to follow. Not only have contacts been made with
agency personnel, but a better understanding of the challenges affecting
each environmental health agency. This project has been a truly
rewarding experience.

When a project such as the OEHCP is a success, the credit starts with
planning and coordination of each member of the team and all
participants associated with EPHLI and CDC. This fellowship process has
been the result of excellent planning and realistic scheduling resulting
in an informative and smooth operation. The EHPLI and CDC has an
outstanding model to follow next year and a template for other fellows
to utilize.

# ABOUT THE EPHLI FELLOWS

**Biographical Sketch - Montressa \"Monty\" Elder, M.S., R.P.S.,
R.E.H.P.**

Ms. Elder is currently the Risk Communication Manager and Media
Spokesperson for the Oklahoma Department of Environmental Quality. She
provides risk communication and community education for the State
Superfund sites as well as for high profile complaint situations
including emergency response. She was instrumental in developing the
National EPA Pilot Program for Superfund State Delegation. In addition,
she manages the state SARA Title III Program including Community
Right-to-Know, Toxic Release Inventory, and LEPC coordination. Ms. Elder
serves as the Public Information Officer for DEQ. She currently
coordinates risk assessment and public participation across media for
DEQ. Ms. Elder supervises the statewide Laboratory Certification program
as well as Graphic Arts for DEQ. She is responsible for the Customer
Services Division budget and divisional coordination with Information
Technology. Ms. Elder is a Registered Sanitarian and Environmental
Health Professional. She is a member of several National organizations
including President of the National Association of SARA Title III
Program Officials, TRI Committee of the Interstate Oil and Gas Compact
Commission, the Bioavailability workgroup of the National Environmental
Policy Institute, and the ECOS steering committee on Childhood Asthma.
Ms. Elder was selected in 1994, the Lloyd Pummill, Sanitarian of the
Year Award, given to a sanitarian in a mono-program area.

In 1997, Ms. Elder received a Governor's commendation as the Outstanding
State Employee. Twice, in 1993 and 2001, she was honored by the US
Environmental Protection Agency as a member of a Superfund Team of the
Year. In the fall of 2005, Monty was detailed by the Federal Emergency
Management Agency to Alabama to provide public information expertise as
part of the recovery efforts from Hurricane Katrina.

Ms. Elder's previous experience includes 15 years as a science educator
at the secondary as well as college level and 5 years experience in
research labs. Her educational background includes a bachelor\'s and
master\'s degree in microbiology from Oklahoma State University.

**Biographical Sketch -- Rocky D. McElvany, B.S., M.E.S.**

Rocky McElvany is the Deputy Commissioner for Protective Health Service
of the Oklahoma State Department of Health. He began his career in
Public Health in 1975 as a laboratory analyst in the State Environmental
Laboratory while completing his undergraduate degree.

Protective Health Service is the regulatory arm of the Oklahoma State
Department of Health and employs 230 staff with a service budget
allocation of 56 million dollars. Protective Health Service consists of
more than fifty regulatory programs which license, inspect, and
investigate complaints in facilities such as long-term care homes,
hospitals, emergency medical services, dialysis units, trauma care,
jails, and retail food.

Prior to being selected deputy, Mr. McElvany was the Chief of Consumer
Health Services for fifteen years. Consumer Health Service was created
when the Department of Health and the Department of Environmental
Quality separated into two agencies. Consumer Health Service was
responsible for program guidance, licensing and inspecting the
traditional Environmental Health Programs such as retail food
establishment, nuisance complaints, public bathing places, and lodging
facilities. Consumer Health Service was also responsible for supervision
of other non-traditional licensing and inspection programs including
barbers, body piercers, burglar/fire alarm installers, x-ray equipment,
home inspectors, and professional counselors. Before his selection as
Chief of Consumer Health Service, Mr. McElvany worked fourteen years in
the State Environmental Laboratory where he supervised the environmental
monitoring laboratory.

Mr. McElvany has served as the Health Department representative to the
Oklahoma Emergency Management Division for more than fifteen years.
During that time he has participated in annual preparedness exercises
and also served as a team member in the state responses to the Murrah
Federal Building bombing, three major tornado and two major ice storm
response efforts.

During his employment with the Department of Health, Mr. McElvany has
also been a member and participated in the Oklahoma Public Health
Association. He has served as the Chairman of the Environmental Section
for the association. Mr. McElvany has also been a member of the Oklahoma
Society for Environmental Health Professionals, where he has provided an
annual update for Oklahoma's Environmental programs for the last three
years. Mr. McElvany was selected in 1986, the Lloyd Pummill, Sanitarian
of the Year Award, given to a sanitarian in a mono-program area.

Rocky McElvany has a Bachelor of Science in Chemistry from the
University of Central Oklahoma and a Master of Environmental Science
from the University of Oklahoma.

**Biographical Sketch - Michael A. Echelle, B.S., R.P.S.**

Michael Echelle is the Administrative Director for the Pittsburg,
Pontotoc, Coal and Atoka County Health Departments. He earned a
Bachelor's Degree in Animal Science from Oklahoma State University. He
received his Certificate in Public Health from the University of
Oklahoma, and is currently attending graduate classes at the OU College
of Public Health to complete his Master's Degree in Public Health.

Mr. Echelle has served as District Delegate, Vice President and
President for the Oklahoma Society of Professional Sanitarians. He has
completed the Oklahoma Public Health Leadership Institute training. Mr.
Echelle has received the Environmental Health Achievement Award and two
Exceptional Merit Awards from the Oklahoma Public Health Association
Conference. At the National Restaurant Association Conference in
Chicago, Illinois and the National Environmental Health Association
Conference in Denver, Colorado, Mr. Echelle presented Oklahoma's
initiative to vaccinate food workers for Hepatitis A. He has received
two Governor's commendations; one for coordinating Sooner Spring, the
most extensive bio-terrorism drill ever conducted, and a second for
providing volunteer relief services to the state of Florida following
the destruction left by Hurricane Ivan. At the annual OPHA Conference,
Mr. Echelle received a Special Recognition Award for exceptional
contributions toward the dental health of Oklahomans. The State
Commissioner of Health also appointed him to the Oklahoma Food Advisory
Council, a position he holds currently.

Mr. Echelle has been married to his wife Caroline for 24 years. They
have two children, Joseph and Kristen who are currently both students at
Oklahoma State University.

**Biographical Sketch -** **Ted Evans, B.S., R.P.S, R.E.H.S.**

Ted Evans is currently the Chief of Consumer Health Service at the
Oklahoma State Department of Health. Consumer Health Service regulates
23 licensing programs. He earned a Bachelor's of Science Degree in
Biology with a minor in Chemistry from Cameron University in Lawton,
Oklahoma.

Mr. Evans has served as district delegate for the Oklahoma Society of
Environmental Health Professional. He is a fellow of the Oklahoma Public
Health Leadership Institute since 1998. Mr. Evans has received the
Environmental Health Achievement Award from the Oklahoma Public Health
Association. He has served on the Oklahoma Food Advisory Council, the
Oklahoma Integrity Task Force, County Emergency Operation Planning
Committee, and County Medical Emergence Response Center. Mr. Evans has
been FDA standardized and is commissioned officer for FDA and the
Federal Consumer Product Safety Commission. He has been employed as a
county sanitarian, regional and quadrant environmental health
supervisor, division director and service chief for 25 years.

Mr. Evans is a loving husband, father of 4 and grandfather. He is also
an avid racer of homing pigeons, hunter and fisherman.

**Biographical Sketch -** **CDR Christopher Buchanan, MPH, REHS**

In 2002, CDR Chris Buchanan came to the Oklahoma City Area Indian Health
Service (OCAIHS) with nearly twelve years of public health service
experience. Since coming to the OCAIHS Lawton Service Unit, he has
served as Field Sanitarian, Service Unit Environmental Health Officer,
Health Center Director, and District Environmental Health Officer. He
currently serves as the District Injury Prevention Specialist providing
environmental health and injury prevention services to the Apache,
Caddo, Comanche, Delaware, Fort Sill Apache, Kiowa, Kickapoo of Texas,
and Wichita, Tribes. In addition, he provides injury prevention
assistance to tribes throughout the OCAIHS and serves in many
administrative positions both locally and nationally.

A member of the Seminole Nation and a native of Konawa, Oklahoma, CDR
Buchanan is one of over 6,000 Commissioned Corps Officers of the U.S.
Public Health Service. These health professionals are stationed in all
50 states in more than 550 locations working in all six agencies of the
Public Health Service (PHS) as well as other federal agencies. CDR
Buchanan has conducted tours of duty in: Atlanta, Georgia; Kingman,
Arizona; Durango, Colorado; and Santa Fe, New Mexico serving more than
25 different tribes and two different agencies.

> CDR Buchanan received a Bachelor of Science degree in environmental
> science from East Central University, Ada, Oklahoma. Also, CDR
> Buchanan received a Master of Public Health degree in health policy
> and administration from the University of North Carolina-Chapel Hill.
> In addition, he has completed the comprehensive IHS, Injury Prevention
> Specialist Program. He is the recipient of several professional awards
> including the USPHS Commendation (twice) and the Achievement Medal
> (twice).

# REFERENCES

1.  Senge PM, Kleiner A, Roberts C, Ross RB, Smith BJ. *The Fifth
    Discipline Fieldbook.* New York, NY: Doubleday; 1994; 135-140.

2.  Institute of Medicine. *The Future of Public Health.* Washington,
    DC: National Academy Press; 1988.

3.  Centers for Disease Protection Goals. *Fact Sheet.* U.S. Department
    of Health and Human Services; 2005.

4.  National Center for Health Statistics. *About Healthy People 2010.*
    U.S. Department of Health and Human Services; 2004.

5.  Centers for Disease Protection. *A National Strategy to Revitalize
    Environmental Public Health Services.* U.S. Department of Health and
    Human Services; 2003.

A**ppendix A**

LOGIC MODEL WORKSHEET

**Program Goal:** To increase the coordination of environmental health
services delivered in 4 counties of Southeast region of Oklahoma

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Appendix B

Interagency Contact List and Program Descriptions

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