OKC-County Health Department Northeast Regional Health and Wellness Campus 2600 NE 63rd Street, Oklahoma City, OK, 73111 September 29, 2017 Dr. Terry Cline, Commissioner Oklahoma State Department of Health 1000 NE 10th Street Oklahoma City, OK 73117 Dear Commissioner Cline, We are in receipt of a request from Julie Cox‐Kain (attached) regarding OCCHD paying OSDH for STD lab and medication annual costs estimated by OSDH of approximately $868,000, starting November 1, 2017. This request is based on the premise that certain citizens with Oklahoma City addresses are presenting to surrounding counties for service. The Oklahoma City‐County Board of Health discussed this matter on September 29, 2017 and unanimously voted that the assignment of these costs of $868,000 to OCCHD is not appropriate. The Board also unanimously voted for the following actions: 1. When a resident with an Oklahoma City address presents to a county other than Oklahoma County, we would request that OSDH determine if they are a resident of Oklahoma County. Our preference would be for OSDH to serve them in any case since they are present at your clinic and because OSDH is getting funds from the Oklahoma Legislature as well as federal grants for service to the entire state. 2. If OSDH does not desire to act above, then please refer them to one of the three sites in Oklahoma County operated by OCCHD. We are ready and willing to serve them all. 3. We request a copy of OSDH Federal and state appropriations and grants, budget, and how OSDH resources are distributed to all 77 counties. We think it important to not only look at STD funding but all public health funding to get an overall accurate financial and service delivery picture. 4. While these are challenging times, it is also a time of great opportunity to take a critical look at how public health services are delivered and prioritized in Oklahoma to see how we can improve operations and be more effective in protecting and improving health in Oklahoma. 5. Since there appears to be a financial crisis at OSDH, we recommend the immediate establishment of a joint commission with representatives from OSDH, County Health Departments, Tulsa Health Department, and Oklahoma City‐County Health Department, to look at public health delivery in Oklahoma, prioritization of core public health and shared services in both rural and metro regions. Bruce Dart, Executive Director, Tulsa Health Department, and I have conferred and are both in agreement on this matter. OCCHD.ORG 405.427.8651 facebook.com/OCCHD @okchealth We recognize that OSDH has had several cuts in funding and OCCHD has as well. OCCHD has been preparing for challenging cuts in funding for several years and each year have become more efficient and lean, placing more emphasis on private/public partnerships to improve health in Oklahoma with considerable success. There are over 120,000 citizens of Oklahoma City who do not reside in Oklahoma County. These citizens would pay property taxes to Cleveland, Canadian, Logan or Pottawatomie Counties, whose taxes support OSDH. OSDH receives State Appropriations to serve public health in the entire state, not just 75 counties, and would include Oklahoma County. There are programs other than STD, where OCCHD subsidizes OSDH, for example, FIMR and Family Planning. We have taken care of many citizens from surrounding counties for years when they present for services. Moving forward, we would welcome the opportunity for discussion and collaboration as a partner and stakeholder to problem‐solve in advance. We look at this as an opportunity to improve health by looking at forward thinking ideas and new and improved ways of doing business to serve the great people of the State of Oklahoma. Sincerely, Gary Cox, JD Executive Director OCCHD Dr. Gary Raskob Chairman, Board of Health OCCHD