The Tobacco Settlement Endowment Trust (TSET) has unveiled a landmark investment package totalling almost $150m as part of its first-ever Legacy Grants programme, marking a significant milestone in the organisation’s 25-year history. The awards, approved by the TSET Board of Directors in Oklahoma City on 9 December, are designed to transform health outcomes across the state, particularly in rural and underserved areas.
The funding spans 14 major projects focused on expanding healthcare access, strengthening the medical workforce, advancing clinical research and improving nutrition provision. The announcement coincides with the 25th anniversary of Oklahoma voters approving the ballot measure that created TSET.
TSET leadership highlights long-term vision
Ken Rowe, chair of the TSET Board of Directors, emphasised the urgency of addressing the state’s chronic health challenges. “Oklahoma ranks near the bottom in most health indicators and the TSET Legacy Grants are an opportunity to make transformational moves to improve health for generations to come,” he said. “We received many outstanding proposals in response to this funding opportunity and I’m proud of the work the TSET Board of Directors did to select these 14 awardees. I’m excited to see these projects get started and I know Oklahomans will benefit from this investment for years to come.”
Demand far outstripped available funding, with 167 applications totalling $1.5bn. Ultimately, the Board awarded $149,989,000, prioritising projects with measurable impact, sustainability and the potential to reshape Oklahoma’s health landscape.
Julie Bisbee, TSET’s executive director, said the scale of funding reflects decades of prudent oversight. “TSET’s ability to offer these Legacy Grants to improve health is a testament to the wisdom of the public officials who framed the agency and the Oklahoma voters who approved the state question 25 years ago this month,” she said. “TSET is truly unique in the nation and it’s only through the smart stewardship of our tobacco settlement dollars that TSET is able to make such a substantial investment in improving health.”
Investment in research and clinical access
Several recipients will direct substantial funds toward expanding clinical trials and research capacity.
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University of Oklahoma Health Sciences was awarded $25m to support construction of a new Stephenson Cancer Center facility in Tulsa, improving trial access across northeast Oklahoma.
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Oklahoma Medical Research Foundation received $9.9m for its TSET Institute for a Healthier Oklahoma, which will expand laboratory capacity, telehealth, distributed trials and clinical research targeting chronic disease drivers such as inflammation and accelerated ageing.
Strengthening healthcare access and workforce
Healthcare workforce development forms the largest share of funding:
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Oklahoma State University Medical Center secured $30m to build an advanced educational facility and add 100 new physician residency positions across eastern and northeastern Oklahoma.
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East Central University received $13.1m to complete the Dan Hays STEM Center and School of Nursing.
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The Chickasaw Foundation was awarded $6.78m to launch new residency and fellowship programmes aligned with the Chickasaw Nation’s major new health complex.
Access-driven initiatives also gained substantial backing:
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Community Health Connection received $4.4m to expand maternal and child health services in Tulsa County.
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Durant Family Medicine Clinic will use $3m to support telehealth expansion, prevention-focused care and rural workforce development.
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Healthy Minds Policy Initiative secured $5.57m to integrate behavioural health into primary care through its Oklahoma Integrated Care Resource Center.
The Oklahoma Hospital Association received two notable awards:
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$3.22m for the Healthy Oklahoma Communities Initiative involving community health workers.
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$18.69m for the HOPE Initiative to expand lung cancer screening and tobacco cessation access.
Nutrition and student support
The Community Food Bank of Eastern Oklahoma was awarded $9.43m to launch the Feeding Futures Initiative, which will provide ready-made nutritious meals to food-insecure students during periods when school meals are unavailable. The programme aims to reach 200 school districts across all 77 counties.
Community-led health transformation in Tulsa
One of the largest individual awards, $17.36m, was granted to the City of Tulsa for the North Tulsa Wellness Initiative. The programme targets health disparities in the Hawthorne and Whitman neighbourhoods, where life expectancy is six years below the county average. The initiative brings together non-profits, city agencies and community groups to enhance prevention, expand access to care and deliver wellbeing programmes tailored to both young people and older adults.
A long-term investment in Oklahoma’s health future
TSET’s Legacy Grants represent one of the most substantial public health investments in Oklahoma’s history. With projects spanning clinical research, medical training, nutrition support and community wellbeing, the initiative is positioned to reshape health outcomes for generations to come.
