1 Lessons In Community Servant Leadership: Public Health, Pimps and Pit Bulls Gerard Clancy, M.D. President, University of Oklahoma, Tulsa campus

2 Tulsa, Oklahoma  MSA almost 1,000,000  3 rd component of University of Oklahoma is the OU Tulsa campus with undergraduate and graduate programs in health sciences, engineering, architecture, social sciences, urban design, public administration and more…  OU School of Community Medicine – practice plan, PAs, medical student track, residency and fellowship programs. A regional campus of OU College of Medicine. August 2011: “Oklahoma will start at No. 1 in USA TODAY preseason poll”

3 The State’s Next Challenge - Securing Primary Care for Expanded Medicaid Populations Leighton Ku, Ph.D., M.P.H., Karen Jones, M.S., Peter Shin, Ph.D., M.P.H., Brian Bruen, M.S., and Katherine Hayes, J.D. # 1

4 An Engineering Project = “Democratization ” “In the 20 th century, science and medicine combined to create great benefit for humankind leading to a 30 year expanded life expectancy. The imperative of the 21 st century is the democratization of those benefits.” Mullan, AAMC 2010 Democratize This !

design rendering Fall 2011 progress NORTH TULSA - 14 year difference in life expectancy, 40% of regional population but only 4% of physicians...so we put up new clinics in schools, apartment complexes, raised $20,000,000 for a new specialty clinic and changed our name…. Age Adjusted Death Rates by Zip Code: 14 Year Difference Between North and South

6 “Is Tulsa North Being Pimped by OU?” January 2010 “To Tulsa north’s ‘rescue,’ Oklahoma University has come. Unquestionably, medical care is needed in Tulsa north. Why then, pose such a negative question when OU appears to be doing the right thing?” “Our answer….Pimps use the bodies of women to make money. For whatever reason, the women are vulnerable. The residents of Tulsa north are very vulnerable because of their poor health outcomes. Hundreds of millions of dollars will be spent ostensibly for better health care for Tulsa north residents. Who gets the money for such an endeavor? OU will. Who receives $20 million dollars for building the facility? Manhattan Construction has been selected as the contractor.” “If a healthy community is the goal of OU, does it not recognize that a healthy community involves more than improving traditional healthcare facilities and services? A healthy community must have a good economy and a chance for good jobs for its residents. Tulsa north’s personal sense of well-being and its ability to thrive socially and economically are tied together. It is impossible to have a healthy community without a strong educational and economic engine in its midst.” “Why do we pose the question, “Is Tulsa north being pimped by OU?” Do not pimps use bodies to get income? OU will receive income from treating sick bodies. When will OU learn that the elimination of healthcare disparities among population groups is not a zero sum game?”

7 Our history (1921) is the key to understanding our health disparities. Only recently moves towards reconciliation, leaves Tulsa with lingering mistrust and separation.

8 OU Architecture and Engineering – 24% local construction Recruited new Pharmacy next door OU Nursing - Taste of North Tulsa OU College of Education - Early Childhood Education Center Focused work in North Tulsa to “improve health” … pushed us as a campus to a community servant model.

9 OU Urban Design Studio Faculty and students led a planning initiative for neighborhood redesign - Gray are existing buildings - White are planned new buildings

10 1.Medical Education and Health Workforce -Physician Assistant program – established, HRSA grant for expansion, partnership with FQHCs -Teaching Health Center planning -School of Community Medicine track -Summer Institute 2.Team Care –Patient Centered Medical Home payment from Oklahoma Medicaid and Blue Cross for primary care, severe mental illness, pediatric diabetes, palliative care 3.Care Coordination –Partnership with Oklahoma Medicaid for patient navigation, web-based consultations. –3026 grant application for “rehospitalization avoidance” 4.High Cost Patient Pilot planning grant with CMS Innovation Center –1 of 15 pilots across the US with Oklahoma Medicaid for Mini ACO for Medicare – Medicaid high cost patients 5.Health Information Exchange (ARRA) –1 of 15 across US - $ 12,000,000 infrastructure grant (Beacon)  tracks community’s health 6.Oklahoma Center for Healthcare Improvement –Takes community’s health measures and puts improvement actions in place 7.Sent OU team to Dartmouth’s Masters in Health Delivery Sciences 8.LEAN Grant (US Dept of Labor) –Toyota LEAN strategies in health care, streamline administrative and care processes A Unique Window in Time for Building Community Servant Infrastructure: A Unique Window in Time for Building Community Servant Infrastructure: Increasing region’s capacity (not just OU) to care for underserved populations under a value-based (outcomes) payment model:

11 Two Very Short Stories from our OU Students I.The Power of Public Health Data and Honesty II.It is Hard to Exercise when you are Face to Face with Pit Bulls OU School of Community Medicine Summer Institute - Photo Voice Exhibit

12 Lessons Learned : 1.Honesty about “what is not right.” 2.History – understanding what drove division and mistrust. 3.Broader views of health. 4.Takes more than medicine, clinics and hospitals to actually improve health. 5.Health reform programs offer great opportunities for change pilots. 6.You will be tested. 7.Quote from faculty recruit: “This is why we went to medical school in the first place….and this is why we work at medical schools…” SUMMER INSTITUTE 2011 SUMMER INSTITUTE 2011 Green – Medicine, Yellow, Physician’s Assistants, Orange – Social Work, Apricot – Nursing, White – Human Relations, Tan – Business, Lavender – Urban Design, Gray – Pharmacy, Yellow – Library Sciences, Blue – Allied Health, Black – Fine Arts, Pink – Public Health We begin the year with the Summer Institute – followed by Faculty, Staff and Student Leadership Academies throughout the year.