The Clean Sheet Exercise: A Tool for Local Health Department Planning


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View the first webcast in this series, Public Health Survival: Leadership in a Falling Market

The economic downturn has resulted in significant declines in revenue available for local public health programs. At the same time, the number of persons adversely affected the economic crisis continues to rise, increasing demands on public health at all levels.

The Tulsa City-County Health Department leadership has recognized that the threat of declining resources also provides an opportunity to shift priorities and improve efficiencies.  The department developed the "Clean Sheet Exercise" to guide their planning efforts.  The exercise, which utilizes community health data, is framed by the question: "If we were to create a local health department from scratch today, how would we organize ourselves and allocate resources, and what would our community priorities be?" 

In this webcast, originally presented March 24, 2009, Gary Cox, director of the Tulsa City County Health Department and president of NACCHO, was interviewed by Gene Matthews about this cutting-edge exercise. Mr. Cox described the four specific initiatives that resulted from the exercise, and Dr. Stephanie Baliey, CDC’s Chief of Public Health Practice, commented on the implications of such projects during hard economic times.

Following the webcast, Gary Cox and Gene Matthews joined viewers for a live online discussion in order to respond to participant comments and questions.


  1. Describe the Tulsa "Clean Sheet Exercise".
  2. Explain the initial results of the exercise.
  3. Outline the lessons learned from the exercise.


Public health leaders and policy-makers, managers and supervisors, agency planners, community leaders, and anyone concerned about public health in tough economic times.


Please note that continuing education credit is not available for this program.