FDOH-Escambia 2020 Year in Review

2020

YEAR IN REVIEW

From the Health Officer

AsthenewHealthOzcerandAdministrator forFDOH-Escambia,lookforwardtoleading FDOH-Escambiaintoourthirdcenturyofpublic healthservicetotheresidentsandvisito EscambiaCounty.amexcitedtotakeonthis newroleandtobepartofsuchagreatteam! wouldliketocongratulateDr.JohnLanzaon hisretirementafter27yearswiththeState ofFlorida,andthankhimforhis24yearsof leadershipandserviceastheHealthOzceran DirectorforFDOH-Escambia.

FDOH-Escambiasawyetanotherimpactfulyear inpublichealth.Thisyear$sreportaccountsa varietyofchangesandchallenges,including respondingtotheCOVD-19pandemicand HurricaneSally$sdirecthittoourarea.

MarieMottbeganhercareerwiththe Departmentin207asaseniorpublic Theaccomplishmentsdescribedinthe20 healthnutritionistforFDOH-Escambia.

YearinReviewaretheresultofthecombined SheservedasFDOH-Escambia$spublic eortsofourdedicatedemployeesandour healthcommunicationsmanageruntil partnerorganizations.Workingtogether,we 2019,andthenastheCommunications, standcommittedtoprotecting,promoting, HealthEducation,andNutritionDivision$sandimprovingthehealthofourcommunity directoruntilherappointmentasthe andbeyond.( HealthOzcerandAdministratorfor EscambiaCounty.Priortoenteringthe publichealthQeld,Mottpracticedclinical dieteticsintheareasofcriticalcare nutrition,nutritionsupport,andmedical nutritiontherapyforchronicdisease managementandprevention.

MottholdsaBachelorofArtsdegreein bothHistoryandPoliticalSciencefrom theUniversityofMontevallo,aDoctor ofJurisprudencefromtheUniversityof AlabamaSchoolofLawandaMaster ofScienceinHumanNutritionfrom theUniversityofAlabamaCollegeof HumanEnvironmentalSciences.She maintainshercredentialsofattorney andcounseloratlaw,registereddietitian, licenseddietitian/nutritionist,andcertiQed specialistinsportsdietetics.

Mission Vision Values

MISSION

Toprotect,promote,andimprovethehealthofallpeopleinFloridathroughintegr state,county,andcommunityeorts.

VISION TobetheHealthiestStateintheNation.

VALUES Innovation Wesearchforcreativesolutionsandmanageresourceswisely.

Collaboration Weuseteamworktoachievecommongoalsandsolveproblems.

Accountability Weperformwithintegrityandrespect.

Responsiveness Weachieveourmissionbyservingourcustomersandengagingourpartners.

Excellence Wepromotequalityoutcomesthroughlearningandcontinuousperformance improvement.

Table of Contents

X Escambia County Florida 1 X COVID-19 Pandemic 5 X Clinical Health 11 X Wellness Programs 15 X Infectious Disease 21 X Environmental Health 27 X Preparedness 29 X HIGHLIGHT: Hurricane Sally

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X Communications 33 X Accreditation 35 X Accounting 36 X Facilities and Information Technology

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X Best People 39 X Locations 41

Escambia County, FL Protecting, Promoting, Community Health and Improving Planning During the Health of Our COVID-19 Community OnFebruary20,theUniversity

20YearinReview

ofWestFlorida(UWF)hostedover Whereweareborn,grow,live,work, 20communitymembersina play,learn,andageallimpactour conversationabouthealthand health.Thesesocialdeterminants equity.TheAchieve Healthy EscaRosa ofhealthincludesocioeconomic datawalkbeganaconversationthat status,education,employment, hascarriedusthroughthecorona neighborhoodandphysical viruspandemicandontotheZoom environment,andaccesstohealthplatform.Continuedconversationof careandsocialsupportnetworks. healthequitywasexpandedasthe Eachofthesefactorstogethercreate pandemicbroughttotheforefront, uniquecommunityhealthservice thehealthdisparitiesandinequit needs. thattheminoritycommunitieshave

1

dealtwithforgenerations. nordertorespondtothe needsofthecommunity,FDOHDespitethecoronavirusrestrictio Escambiapartnerswithnumerous planningeortscontinuedasAchieve governmentalandnon-governmental HealthyEscaRosasubmittedagrant organizationstoprotectand applicationthataimedtocreatea improvethepublic$shealth.Notable MinorityHealthAdvisoryCouncil.This partnershipsincludeareahospitals councilaimstoworkwiththeFaithandmedicalfacilities,infectious BasedOrganizationsinEscambia diseasepractitioners,theUniversity andSantaRosaCountiestoeducate ofWestFlorida,PensacolaState thecommunityaboutstayingsafe College,theEscambiaCounty andhealthyduringaglobalhealth SchoolDistrictandEarlyLearning pandemic.Unfortunately,dueto Coalition,emergencymanagement, impactsfromHurricaneSallyin lawenforcement,CityofPensacola, September20,thegrantdatewas EmeraldCoastUtilitiesAuthority, pushedback.Theeducation-focused HealthyStartCoalition,Opening collectiveimpactorganization DoorsNorthwestFlorida,NavalAir (AchieveEscambia)didreceiveagrant StationPensacola,CommunityHealth toworkwithUWF$sHAASCenterto NorthwestFlorida,Boys$andGirls$ developanEscambiaandSantaRosa Club,andmanymore.

CountyHealthEquityDashboard.

Births and Deaths in 2020

Vitalstatisticsplayanimportantrole incommunityhealthassessmentand improvement.FDOH-Escambia$svital statisticsozcemaintainstheserecordsby bothreportingandissuingbirthanddeath certiQcates.Thedatacollectedfromthese certiQcatesisusedtotrackdeathanddisea forEscambiaCountyresidents.Data,likewhat isindicatedbelow,wasusedintheHealth Assessmentprocesstodeterminepriority areasforthecurrenthealthimprovement eorts.

X X X X

3,71residentbirths 4,219residentdeaths 30deathsunderage1 20fetaldeaths(20weeksgestationor greater)

PCTURED: AchieveHealthyEscaRosanteractiveDataWalk onFebruary20,.

20YearinReview

*2020 Provisional Numbers from flhealthcharts.com

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Demographics

EscambiaCounty,Floridaisthe20th(outof67)mostpopulouscountyinthestate,with1.5% ofFlorida$spopulation.EscambiaCountyboastsastrongmilitarypresencewithfou facilitieslocatedwithinthecounty,includingNavalAirStationPensacola,Cor SauReyFieldStation,andNavalHospitalPensacola.MilitaryandCivilService,edu healthcare,andretailareprimaryemploymentindustries.

324,620 Escambia County Residents 492.7 Persons per Square Mile

PICTURED ABOVE: “The Sanctuary” Lost and Missing Children Memorial across from Vetrans Memorial Park.

Other 7.9% (25,526) Black 23.3% (75,540)

20YearinReview

Race

3

<14 17.5% (56,939)

65+ 17.1% (66,653)

45-64 24.8% (80,396)

Age

White 68.9% (223,554)

*data sources: edr.state.fl.us/Content/area-profiles/county/escambia.pdf and flhealthcharts.com

15-19 6.7% (21,795)

20-44 33.8% (109,837)

Social and Economic Characteristics

MEDIAN HOUSEHOLD INCOME

90.5% GRADUATED HIGH SCHOOL

7% UNEMPLOYMENT RATE

APPROXIMATELY 1 OUT OF 8 RESIDENTS DO NOT HAVE HEALTH INSURANCE

57.3% LABOR FORCE as % of population 18+

26.5%

HAVE AT LEAST A BACHELOR’S DEGREE

3181.24

CRIME RATE (index crimes** per 100,000 population)

ALMOST 1 IN 4 CHILDREN ARE LIVING IN POVERTY (under age 18)

20YearinReview

$50,915 per year

4

COVID-19 Pandemic

Theyear20willberememberedasatimeofunprecedentedchallengesandchanges forFDOH-Escambia.Wefacedanunimaginablethreat,asthecoronavirusdisease2019 (COVD-19)dominatedtheyear20.Wordslikequarantine,PPE,socialdistancing, andmaskingbecamewordsofeverydayconversation.TheimpactofCOVD-19has demonstratedFDOH-Escambia$scontinuedcommitmenttopublichealth.FDOH-Escambia stahavehadandcontinuetohaveanimportantroleinkeepingthepublicsafean healthyamidtheCOVD-19pandemic.

ThisisalookathowthepandemicprogressedandhowFDOH-Escambiarespondedto COVD-19inourcommunity.

DOH Declaration of Public Health Emergency as Virus Reaches Florida

WHO Issues Global Health Emergency

WHO Announces Mysterious Coronavirus-Related Pneumonia in Wuhan, China

January 2020

2020

9

21

The Florida Department of Health announced there were two presumptive positive cases of COVID-19 in Florida.

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CDC Confirms First US Coronavirus Case

February

2020

3

US Declares Public Health Emergency

2020

1

5

First Press Conference in Escambia County and COVID Information Line Established

by FDOH Baptist Health Care hosted a press conference related to the first case in Escambia County, Florida. Dr. Lanza participated and provided disease surveillance and contact tracing plans.

20YearinReview

5

March

PICTURED ABOVE: Dr. John Lanza participated in Baptist Health Care’s press conference related to COVID-19 on March 5, 2020.

Interstate COVID-19 Checkpoint Trump Declares COVID-19 a National Emergency and Escambia County Establishes JIC

FDOH-Escambia’s team members worked at the I-10 COVID-19 Checkpoint in collaboration with FHP and FDOT. Motorists were screened as they entered Florida. All travelers that were coming from states with known community spread of COVID-19 were informed of the Governor’s executive order to self-isolate for 14 days. An estimated 420 drivers went through a level 2 screening during this time.

Escambia County established a Joint Information Center.

In 2020, ESF-8 was activated and filled over 450 resource requests from LTCs/ALFs, Hospitals, physician’s offices and clinics, and other healthcare facilities. Requests included PPE, COVID-19 testing kits, and infection control specialist to limit the spread.

FDOHEscambia Continues to Provide Services with limited public access to buildings

WHO Declares COVID-19 a Pandemic

10

11

First Community Partnership Presentation.

Dr. Lanza gave a community presentation on COVID-19 in a meeting of community partners.

Dr. Lanza’s presentation addressed preparedness, containment, and mitigation strategies for COVID-19.

PICTURED BELOW: FDOH-Escambia’s Environmental Health and Public Health Preparedness team members worked at the I-10 COVID-19 Checkpoint Team members included: Aric Porter, Shane Bragg, James Brough, Dennis Bratten, Chris Bavuso, Jimmy Petty, Don Moore, Greg Berrian, Josh Richards, Jake Gallman, Nik Hicks, and LeeAnn Lutz.

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24

25

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FDOHEscambia Implements Telework Measures to Mitigate Spread

Public Health Advisory for COVID-19 as a result of Executive Order 20-83

Executive Order 20-83 re: Protective Measures for Vulnerable Populations, Gatherings of Private Citizens and Density of the Workforce

28

April

2020

1

Measures to Support LongTerm Care Facilities

COVID-19 long-term care facilities outreach began to 50 LTC facilities.

FDOH-Escambia monitors implementation of the CDC’s guidelines by facilitating daily communication and conducting readiness assessments with each Escambia County longterm care facility

20YearinReview

PICTURED ABOVE: ESF-8 desk at the EOC.

6

FDOH-Escambia Opens Testing in Pensacola

FDOH-Escambia Modified Clinic Workstations with Protective Glass Barriers

FDOH-Escambia coordinated with community partners to expand specimen collection for COVID-19 to meet daily targets.

FDOH-Escambia began testing via point of testing sites to exceed the goal of the May2Day program set by Florida’s Governor. The goal was for CHDs to test 2% of their county’s population each month, 235/day for Escambia County. Escambia managed to maintain 2%-4.2% of residents tested. FDOHEscambia’s testing site tested 13,819 Florida residents in the 7-month span.

Public Health Advisory for COVID-19 re: Updated Measures to Ensure Protection of Public Health in Response to COVID-19

PICTURED RIGHT: FDOH-Escambia team members at the COVID-19 drive-thru testing site at PSC.

May

2020

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June

2020

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July

2020

21

August

2020

PICTURED ABOVE: Immunization check-in with new protective glass barriers.

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September

2020

20YearinReview

Hurricane Sally Made Landfall

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Public Health Advisory for COVID-19 re: Updated Measures to Ensure Protection of Public Health in Response to COVID-19

COVID-19 protocols at the shelters made hurricane response a little different this year.

See page 31 for more on Hurricane Sally.

PICTURED RIGHT: Satellite image of Hurricane Sally.

PICTURED LEFT: Drive-thru flu vaccination event.

Drive Thru Flu Vaccination Event Prepping for COVID-19 Vaccine

FDA Signs Off on EUA for Moderna’s COVID-19 Vaccine

2020

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December

2020

11

18

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FDA Agrees to EUA for COVID-19 Vaccine from Pfizer, BioNTech

FDOHEscambia Began Administration of COVID-19 Vaccine

PICTURED ABOVE: Moderna COVID-19 Vaccine in clinic refrigerators.

FDOH-Escambia received the COVID-19 Moderna vaccine by mid-December and vaccinated 484 people before the New Year. The target population vaccinated were residents 65+ and healthcare personnel with direct patient contact.

20YearinReview

November

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June 4, 2020 Patty Dwiggins and Denielle Satterfield at the COVID-19 drive-thru testing site at DTC.

March 17, 2020 Dr. John Lanza participated in a COVID-19 press conference.

April 23, 2020 Dr. John Lanza participated in a virtual COVID-19 press conference.

April 4, 2020 Long Term Care Facility COVID-19 Level 2 Respons Team.

December 29, 2020 Florida National Guard transporting COVID-19 vaccine.

20YearinReview

May 21, 2020

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COVID-19 drive-thru testing site and Pensacola State College.

May 21, 2020 Ashley Majors at the COVID-19 drive-thru testing site at PSC.

April 2, 2020 Dr. John Lanza participated in a COVID-19 press conference.

May 27, 2020 FDOH-Escambia staff at the COVID-19 drive-thru testing site at DTC.

May 27, 2020 FDOH-Escambia staff at the COVID-19 drive-thru testing site at DTC.

April 9, 2020

20YearinReview

Alyssa Hudson and Dr. Angel Bradley at the EOC ES8 desk.

FDOH-Escambia staff at the COVID-19 drive-thru testing site at DTC. From left to right: Tammy Jackson, DeUndre Atkins, Dr. Vanessa Phillips, and Ashley Majors.

20YearinReview

May 27, 2020

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Clinical Health

Clinicalhealthprogramslinkpeopletothepersonalhealthservicest eitherbydirectlyprovidingthoseservicesorbymakingreferralstoothe communityresources.Programsincludeamedicalclinicprovidingprimaryca forchildrenandadults,familyplanningservices,immunizations,andsexua transmitteddisease(STD)testingandtreatment.

Family Health Clinic

Immunizations Clinic

TheFamilyHealthClinicprovides ThemmunizationsClinicprovides primarycareforchildrenandadults. vaccinesforchildren,adolescents, Servicesincludesickandwellchild andadults.PriortoentryintoFlorid exams,adultannualcheck-ups, childcarefacilitiesorattending managementofchronicdiseases, school(kindergartenthrough12th suchashighbloodpressureand grade),eachchildisrequiredtohave type2diabetes,andleadtesting. aFloridaCertiQcateofmmunizations, Appointmentsforpreschooland orDH680form,onQledocumenting schoolentrancephysicalsare age-appropriateimmunizations. mmunizationsforadolescents alsoavailable. includeshotsrequiredforentering 7thgradeandcollege.TheFDOHEscambiammunizationClinicisalso adesignatedtravelcenter,providin consultationsandimmunizations CLINIC VISITS totravelers.mmunizationrecords FROM 1,177 CLIENTS mayalsobeobtainedforstudents transferringoutofstate,childcare,o schoolenrollment.

2,216

18,236

IMMUNIZATIONS GIVEN TO 4,630 CLIENTS 2-Year-Old Immunization Rates Goal 90.0%

PICTURED ABOVE: FDOH-Escambia Employee receives Flu Vaccine.

Escambia 94.2%

Florida 90.0%

Florida Department of Health, Bureau of Immunizations

20YearinReview

Labs Processed by Clinical Laboratory Adult Health Family Planning Hepatitis

3,693 18

HIV Refugee Health

1,008 75

STD Clinic

Tuberculosis

11

1,227

2,985 651

Sexually-Transmitted Disease (STD) Clinic

OnMarch31,20theDepartment$s mmunizationSectionrecognizedFDOHEscambiaasaVaccines for Children Program Platinum Providerforexemplary immunizationcoverageratesinthe2-yearoldvaccineseries.FDOH-Escambia$s practicecompletedthe2-year-oldseries (4DTaP,3Polio,1MMR,3Hib,3HepB, 1Varicella,and4PCV)for9.1percentof eligiblepatientsasofOctober1,209.The achievementoutlinesFDOH-Escambia$s dedicationtoprotectingchildreninthe communityfromvaccine-preventable diseaseswhilehelpingFloridareach statewideimmunizationgoals.

TheSTDClinicprovidestestingand treatmentforindividualsexposedto sexually-transmitteddiseases,suchas syphilis,HV,chlamydia,andgonorrhea.

Registerednursesandcliniciansalso providepreventioneducationand counselinginaconQdentialsetting.The clinichastwocredentialedSTDnurse clinicianstofacilitatefast-trackservic whenneeded.

1,327 91%

CLINIC VISITS FROM 996 CLIENTS

OF CLIENTS WITH STDS WERE TREATED WITHIN 14 DAYS

20YearinReview

FDOH-Escambia Recognized as Vaccines for Children Platinum Level Provider

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PICTURED ABOVE: FDOH-Escambia’s Immunization Section recognized as a Vaccines for Children Program Platinum Provider From left to right: Dr. John Lanza, Christy Brantley, Leigh Willoughby, Beate Bolton, Peggy Abbott, Linda Kent, Suzanne Jeffers.

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Florida Breast and Cervical Cancer Early Detection Program (FBCCEDP)

Family Planning Clinic

TheFamilyPlanningClinicoersavariety ofmodernbirthcontrolmethods,annual women$shealthexams,counseling,and referrals.Abstinencecounselingand informationaboutNaturalFamilyPlanning TheFloridaBreastandCervicalCancerEarly isalsoprovided.Clinicalexams,including DetectionProgram(FBCCEDP)provides apelvicexamandpaptest(ifdue),are educationonbreastandcervicalcancer,the providedtoscreenforcervicalcancer. importanceofgettingregularbreastand Availablebirthcontrolmethodsinclude cervicalcancerscreeningexams,andthe condoms,birthcontrolpillsorshots,and HumanPapillomavirus(HPV)vaccination. long-actingreversiblecontraceptives(LARC).

Servicesoeredincludereferralsfor screeninganddiagnosticmammograms, papsmears,andassistancewithmedical CLINIC VISITS insuranceacrossthreecounties.

FROM 1,141 CLIENTS

607

REFERRAL SERVICES PROVIDED FOR WOMEN IN ESCAMBIA, OKALOOSA, AND SANTA ROSA COUNTIES

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OF THOSE REFERRALS PROVIDED BY OUR CLINICIANS

We Care Referral

2,310

Improved Pregnancy Outcome Program (IPOP)

POPlinkspregnantwomentomedicalcare andotherservicesinthecommunity.Nurses screenwomenforpotentialproblemsor risksandprovideeducationtopromote healthybehaviorsduringpregnancy.Sta assistwomenwithMedicaidapplicationsfor PresumptiveEligibilityforPregnantWomen (PEPW),providereferralstotheWomen, nfantsandChildren(WC)program,and assistanceinestablishingregularprenat carewithalocalphysicianorclinic.Longactingreversiblecontraceptives(LARC).

TheWeCareReferralprogramwasfounded bytheEscambiaCountyMedicalSociety Foundationtoaddressthespecialty medicalneedsofuninsuredresidents.

Theprogramhelpsmeetacriticalgapin healthcareaccesstothosewhootherwise wouldnotreceivecareorwouldseekcare inemergencydepartmentsandfurther contributetothecurrenthealthcare burdenofhospitalsandtheircommunities.

Potentialclientsarescreenedforresidency andincome.feligible,clientsarereferred toaparticipatingphysicianorhospital toreceivecare.n20,5physicians participatedintheWeCarenetwork.

20YearinReview

207 148

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CLIENTS SERVED

CLIENTS QUALIFIED FOR PEPW

WiseWoman/ FL Healthy Woman

112

INDIVIDUALS REFERRED FOR ASSISTANCE

FDOH-EscambiaadministerstheCDC$s WiseWomanProgram,namedFLHealthy Woman.Thisprogramserveslowincome, uninsuredwomenaged40-6inEscambia

initialenrollment.Ofthosefollow-up assessments,wefoundthatnearly everyonehadreducedatleastone PICTURED RIGHT: Mary Nell Adams was recognized as FDOH-Escambia’s first riskfactorforcardiovasculardisease WISEWOMAN Program Champion. Pictured

from left to right: Denielle Satterfield and Mary Nell Adams

20YearinReview

classcurriculum(formerlyHealthy MaryNellAdamswasrecognizedas University)hasevolvedintoindividual FDOH-Escambia$sQrstWSEWOMAN healthcoachingforsupporttoclients ProgramChampion.Throughherhard whoparticipateinself-monitored workandparticipationintheprogram, bloodpressure.Healthcoaching MarysigniQcantlyreducedherBM isconductedbothinpersonand whileaddressingother telephonically.Wehavealsopartnered healthobjectivestosustain withtheTakingOPoundsSensibly herlong-termwellness.

GroupandtheYMCAwhooer Maryparticipatesin virtualmeetings,outdoorexercise,theonlineDiabetes andadditionalguidancetosupportPrevention andreinforceourWSEWOMAN Programwhere participants. shecontinues toshareher Thelong-termsuccessofWSEWOMAN experiencesand participantsisshowcasedwith follow-upassessmentsconducted supportother women. between6-9and12-8monthsafter

20YearinReview

County,Florida.WSEWOMANaimsto and/orstrokei.e.;loweredblood improvecardiovascularhealthwithin pressure,reductioninBM,medication ourcommunitybyhelpingwomen compliancewithcardiovascular makelongstandinglifestylechanges.medication,increasedexercise, Wecontinuetoovercomecommon closelymonitoredcaloricintake,etc. barrierstohealthincludinghealth FDOH-Escambiaisshapingahealthier literacy,lackofmotivationandphysical communityofwomenthroughthe orQnanciallimitationsevenintheWSEWOMANprogram. midstoftheCOVD-19pandemic.

WISEWOMAN Program Champion 20sawenrollmentintheEscambia Initiative CountyWSEWOMANprogram increaseby80newparticipants! n20,FDOH-Escambialaunched HealthyBehaviorSupportSystems theWSEWOMANProgramChampion (HBSS)providershavedemonstrated nitiative.ModeledaftertheCDC$s theircreativityandRexibilityin PreventType2DiabetesProgram Championnitiative,theWSEWOMAN assuringthathealthylifestylechange ProgramChampionstrategyis supportisavailabletoourtargeted population.ClinicalNursingandCHENdesignedtosupportrecruitmentand (Communications,HealthEducation outreachactivitiesoftheWSEWOMAN program.Thisdesignationrecognizes andNutrition)stahaveworked andshowsappreciationforthehard togethertodelivertheCDC$sNational workandaccomplishmentsofour DiabetesPreventionProgram(DPP) virtually.ThishasbeenofparamountWSEWOMANparticipants.tserves tokeepthemengagedinthehealthy importanceinkeepingourclientssafe lifestylechangestheyhavelearned whilestilldeliveringnecessaryservices andadoptedthroughWSEWOMAN. duringCOVD.TheMillionHearts

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Wellness Programs Health Information (HI) Network

WellnessProgramsfocuson preventingchronicdiseasessuchas diabetes,heartdisease,andcancer.

Manyofourprogramspromote TheHNetworkaimstoimprovethe healthybehaviorssuchasquitting healthofourcommunitybyproviding tobaccoproducts,eatingabalanced residentswithevidence-based diet,andbeingphysicallyactive. informationonfactorsthatcanaect FDOH-Escambiahasateamofsubject health.Faith-basedorganizationspla matterspecialistsconsistingofhealth akeyroleinimprovingthehealth educators,nutritioneducators,and oftheircongregationmembersas registereddietitiansworkingtocreate wellascommunityresidentsthrough informationalmaterialsanddeliver healthpromotionanddisease presentationstothecommunity. prevention.Since2016,HNetwork Staprovidescreenings,education, programstaprovidefaith-based organizationsimportanthealth interventions,referrals,andother supportservicesforindividuals informationintheformoftoolkit andfamilies.Servicesareaimedat modules,featuringeducational reducingriskfactorsandmodifying presentations,printmaterials, andshortmessagestosharewith behaviorstopreventchronicdisease andpromoteoptimalhealthforallmembersviasocialmedia,email,or churchbulletins. residents.Theseprograms,aimed atearlydetectionandprevention HI-NETWORK ofcommonhealthproblems,serve PARTNERS peoplethroughouteachlifestage, withspecialservicesforpregnant women,infants,andchildren.

COMMUNITY

47 7

20YearinReview

PRESENTATIONS

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PICTURED ABOVE: Heath Educators at Reimagine Outreach on October 17, 2020. From left to right: Frankie Walker, Skye Owens, Tanisha Thompson, and Kaili Calasso.

Diabetes Prevention Program

ThePreventT2LifestyleChangeprogram beganin2016andispartoftheCDC$sNational Planning to Pilot Virtual DPP DiabetesPreventionProgram(DPP),which hasbeenproventohelppeoplemakemodest In December 2020, FDOH-Escambia obtained lifestylechangesandreducetheriskoftypeapprovaltobeginoeringtheCDC$s National Diabetes Prevention Program 2diabetesbymorethan50percent.The program$sgoalsaretoreduceparticipants$ (DP) completely online in January 2021.

Tofacilitatetheprogramonline,FDOHbodyweightbyatleastQvepercentandfor Escambia$sDPPcohortswillbeutilizing participantstoreachaminimumofminutes 150 theHealthandLifestyleTraining(HALT) ofmoderate-to-intensephysicalactivityper Diabetessoftwareplatform,provided week.FDOH-Escambia$sprogramachievedfull bytheProVentionHealthFoundation,in recognitionthroughtheCDCin2018,which withtheNationalAssociation signiQesthat,onaverage,theparticipantspartnership who of Chronic Disease Directors(NACDD). enrolledmeettheprogramgoalsofregular The platform includes theCDC-approved attendance,physicalactivity,andweightloss.

National DP video-based curriculum, Forthethirdconsecutiveyear,FDOHparticipantandcoachingdashboards, EscambiahasearnedCDCFullRecognition mobileapps,photofood-logging,anddata forthediabetespreventionprogram, collectionandreportingfunctionality.This PreventT2LifestyleChangeProgram.This newplatformallowsourorganizationto designationisreservedforprogramsthat continueoeringtheprogramsafelytothe haveeectivelydeliveredaquality,evidencecommunity at a distance. basedprogramthatmeetsallofthestandards forCDCrecognition.PreventT2ispartofthe NationalDiabetesPreventionProgram,led bytheCDCandproventohelppeoplewith prediabetespreventordelaydevelopmentof type2diabetes.Thiscontinuedachievement demonstratesthesuccessofthelifestyle SESSIONS HELD changeprogram,withacommitmentto reducingthepreventableburdenofdiabetes withinthecommunityandnationally.Since January20,5participantsenrolledand PARTICIPANTS attendedatleastonesession.

POUNDS LOST 20YearinReview

37 25 69.9

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5-2-1-0 Healthy Escambia!

SchoolHealthnursesalsoassistedthe Aspartofourlocalchronicdiseaseprevention EscambiaCountySchoolDistrictinmeeting eorts,the5-210HealthyEscambia!Program mandatedKindergartenand7thgrade activelypromotesdailyhealthybehaviorstheir of immunization recordreviewrequirementsby 5fruitsandvegetables,2hoursorlessscreen completing5,740recordreviews.Thishelps time,1hourofphysicalactivity,and0sugary assurestudentsareup-to-datewiththeir drinksinvariouscommunitysettings,reaching immunizationsandallowsthestudentstobe audiencesofallages. inschoolandreadytolearn.FDOH-Escambia SchoolHealthnursesalsotranscribeout-ofstateimmunizationrecordsfornewstudents throughouttheschoolyear.

1,919

PEOPLE RECEIVED 5-2-1-0 EDUCATION AT 18 EVENTS, OUTREACHES, AND PRESENTATIONS

School Health Education

FDOH-EscambiaSchoolHealthnurses collaboratedwiththeEscambiaCounty SchoolDistricttoadministerFlu-Mistvaccin at20elementaryschools.Theywereable tovaccinate615studentsthisyearwhich demonstratesFDOH-Escambia$sdedication toprotectingchildreninourcommunity fromvaccine-preventablediseaseswhilealso helpingthestateofFloridareachstatewide immunizationgoals.

20YearinReview

SchoolHealtheducationhelpschildren, families,andschoolpersonnelincrease physicalactivity,improvenutrition,preventthe School Health COVID-19 Response spreadofinfectiousdisease,andreduceteen pregnancy.OurteamofRegisteredNurses deliverpresentationsonavarietyoftopicsto elementary,middle,andhighschoolstudents inEscambiaCounty.FDOH-EscambiaSchool Healthnursestaught760healtheducation classesduringthe2019-schoolyear.

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SchoolHealthimplementedour5210 HealthyEscambia!Educationprogramat (publicandprivate)toconQrm KingsQeldElementarySchoolforallchildrenschools in Kindergarten5thgrade.SchoolHealthalso sta.SchoolHealthnursesassistedin returnedtoschoolswehadpresentedtheand 5210 HealthyEscambia!Programinyearspastand taughttheirKindergartenstudents.The5210 HealthyEscambia!Programactivelypromotes healthybehaviorsofeating5ormorefruits nursesalsoensuredasafeandeective andvegetableseveryday,2hoursorless tosupportschoolsdailybyconQrming ofscreentimeperday,1hourormoreof physicalactivityperday,and0sugarydrinks!

Thisprogramisalsopromotedinvarious communitysettings,whichallowsustoreach audiencesofallages.

Tobacco Free Florida Escambia

Store Assessment TheTobaccoFreeFloridainEscambiaCounty Tobaccocompaniesunreasonablytarget (TFF-Escambia)programencouragestobacco speciQcdemographicgroupssuchasyouth, usepreventionandbehaviorchangethrough racialandethnicminorities,andthoseoflow mediaandmarketing,policychange,group counseling,communitypresentations,and incomeoreducation.Marketingoftobacco productsispurposelydesignedtorecruit activitiesthatengageyouth.Amidtheglobal pandemic,TFF-Escambiaswitchedtoavirtual smokersatanearlyageandmaintaincurrent basedworkplanandadaptedtochangesin smokers.Whilepracticingmeasuresin accordancewithCDCguidelines,TFF-Escambia COVD-19protocols.Stahavecontinuedto workcloselyanddiligentlywithPensacola stawasabletoassessover50retailers StateCollege(PSC)toincreaseeducationoninEscambiacountytoverifysafetobacco marketingpractices. theimportanceofatobaccofreecampus.TFFEscambiaisnowonestepclosertohelpingPSC achieveatobaccofreegroundspolicywiththe establishmentandcontinuationofthetobacco freetaskforce.

Association of Smoking and COVID-19 TFF-Escambia was able to reach 30+ farmers and immigrant workers (Spanish speaking population) to educate on the association of smoking and COVID-19. This was a new initiative as a result of additional funding to focus on COVID-19 and tobacco prevention.

PICTURED ABOVE: SWAT youth, Nakyah Phillips (left) and Kristen Harris (right) completed the “Truth Initiative” trivia portion of the Region 1 SWAT Retreat. This group answered the most difficult questions correctly and were rewarded with Tobacco Free swag.

20YearinReview

Students Working Against Tobacco SinceJanuary20,TFF-Escambiahasreached 35,0youthviasocialmediacampaigns, marketingadsthroughoutthecounty,orvirtual meetingsandtrainings.AStudentsWorking AgainstTobacco(SWAT)regionaltraining washeldatLagunaBeachChristianRetreat February29-March1,20.TwoEscambia Countyyouthattendedtheregionaltraining, providingthemwithup-to-dateinformationon ElectronicsNicotineDeliverySystems(ENDS), TobaccoFreeObservances,mediaadvocacy andpublicspeaking.nOctobertwo 20, SWAT youthattendedavirtualtraining.Throughthe useoftechnologyandthestudent$swillingness toparticipate,9SWATmeetingswereheld virtuallyviaZoomandGoToWebinar.

18

Healthy Start

TheHealthyStartprogramaimstoreduce Healthy Start Services infantmortality,reducethenumberoflow SinceJanuary20,HealthyStarthasprovided weightbabies,andimprovethehealthand servicesto608prenatal/postpartumwomen and420infants/children,withatotalof8,43 developmentaloutcomesforallFloridababies. directservicesprovided.Theseservices Carecoordinatorsprovideeducation,support, andguidancetopregnantandpostpartum includecarecoordination,education,suppor andguidance.HealthyStartalsomade1,7 women,womenwhohaveexperiencedaloss, andwomenwhohaveachildunderagethree. referralstocommunityresourcestohelp Programstaalsoworkstoconnectfamilies meetouraimofreducinginfantmortalityand tocommunityresources.Anywomancanelect reducingthenumberoflowweightbabies. tobescreenedbytheirOBprovider,orcan Safe Sleep Environment self-referforeligibilityduringpregnancy,at the Healthy Startcontinuedthemissionto timeofdelivery,orbeforetheirchildreaches help prevent sleep-relatedinfantdeathsby agethree.TheconQdentialscreeninghelpsto educatingparentsandcaregiversonthe identifywomenandinfantswhomayhavea importanceofpracticingsafesleep.The greaterriskforpoorhealthoutcomes.

HealthyStartProgramandtheHealthyStart Coalitioncollaboratedtoprovide82pack andplaycribsandsafesleepkitstofamilies atnocost,allowingthesefamiliestoprovide safesleepingenvironmentsfortheirinfants PRENATAL/POSTPARTUM HealthyStartCareCoordinatorsprovidedn WOMEN AND contactdeliveriestotheclienthomeandus INFANTS/CHILDREN textlinkstodemonstratepackandplaycrib RECEIVED SERVICES set-upandsafesleepeducation.Theprogram aimstoreducesleep-relateddeaths.

1,028

20YearinReview

Adapting Services Amid COVID-19

19

The Healthy Start program was able to adapt to the COVID-19 pandemic by making virtual and telephonic visits with clients instead of home visits. The Healthy Start program was able to make a comprehensive plan that allowedstatoteleworkwhilecontinuingto provide Healthy Start services. Additionally, Healthy Start nurses were able to distribute the Healthy Start Coalition’s donation of diapers, wipes and formula to our clients.

This donation helped clients who had lost homes and/or jobs from Hurricane Sally and the COVID-19 pandemic.

PICTURED ABOVE: Healthy Start Cribbettes and Safe Sleep Kits.

WIC TheWCprogramservespregnant andbreastfeedingwomen,infants, andchildrenuptoageQve.Each participantiscounseledbya registereddietitian,orothertrained nutritionsta,andprovidedan electronicbeneQtstransfer(EBT) cardtopurchaseprescribedhealthy foods.Foodsareselectedbased onindividualneedsandinclude milk,cheese,juice,eggs,fruitsand vegetables,wholegrainbreadsand pasta,brownrice,yogurt,andbaby foodandinfantformula.Participants mayusetheEBTcardsatlocal participatinggrocerystoresand farmer$smarkets.

7,655

AVERAGE WIC ENROLLMENT

6,423

BREASTFEEDING COUNSELING CONTACTS COUNSELED

668

BREASTPUMPS PROVIDED

Breastfeeding Support Everypregnantwomanenrolledin WCreceivesinformationregarding thebeneQtsofbreastfeeding.Peer counselorsareassignedtowomen whoexpressaninterestinongoing support.Counselorsremainwith thesewomenthroughoutpregnancy andduringtheQrstfewmonths followingbirth.Breastpumpsare loanedtonursingmotherswho returntoworkorschoolorhave aninfantinthehospital.Staalso workwithbusinessesandchild carecentersonhowtodevelop breastfeeding-friendlypolicies andsupportnursingwomenin theirorganizations.

20YearinReview

Face-to-faceserviceswerelimited duetoCOVD-19in20.FDOHPICTURED ABOVE: Community Baby Shower on January 25, 2020. From left to right: Elsena EscambiacontinuedtoprovideWC Lamar, Kharrie Patton, Ashley Majors, and Natalie Steingruber. nutritioncounseling,breastfeeding counseling,andcertiQcationsvia telephoneandemail.

20

Infectious Diseases Ourinfectiousdiseaseservicesta2020 Reportable Diseases membersidentifyandmonitor in Escambia County infectiousdiseaseoutbreaksin thecommunity.Workingwitharea Disease

Cases physiciansandothercommunity partners,ourstainvestigate Animal Bite (PEP recommended) 142 outbreaksoffood-borneillness,as Animal Rabies 1 wellaslocateandreferpeoplewho havebeenpotentiallyexposedto Campylobacteriosis 55 Carbon Monoxide Poisoning 12 tuberculosis(TB),HV, orothersexually-transmitted Crytosporidium 1 diseasestolocalservices.Staalso Cyclosporiasis 1 monitordiseaseoutbreaksinthe E. Coli (O157:H7) 6 community,suchasRuandother respiratoryillnesses.

Giardiasis (acute) 3 Haemophilusn5uenzae

9

Hepatitis A 126

Epidemiology

Hepatitis B (acute)

10

TheEpidemiologyprogramseeksto Hepatitis B (chronic) 54 preventdiseasetransmissioninthe Hepatitis C (acute) 32 communitythroughsurveillance, Hepatitis C (chronic) 317 contactinvestigations,andeducation.

Stainvestigatereportablediseases Lead Level (greater than orequalto5g/dL) 57 todeterminethesourceofthe disease,thetimeandmodeof Legionellosis 11 transmission,andthenumber Listeriosis 2 ofpeoplepotentiallyexposedor impacted.Therearecurrentlymore Lyme Disease 5 than80reportablediseases.

Meningitis (Bact, Cryto, Mycotic) 2 Pertussis 5

STDs in Escambia County, FL 2014-2020

Rocky Mountain Spotted Fever

3000

2000

1839

1998

2015

2136

2224

2080

1209

1000

20YearinReview

21

0

527 66

588 133

737

100

829

110

996 695

94

81

101

2014 2015 2016 2017 2018 2019 2020

Syphilis Gonorrhea Chlamydia

Shigella 15 Streptococcus Pneumoniae (invasive) 29

1500

500

Salmonella 54

2575

2500

1

Varicella (Chickenpox)

8

Vibrio(vulniQcus)

3

Vibrio (other) 3 Total Reported Cases

969

FloridaDepartmentofHealth, Bureauof Epidemiology Reportable diseases in Escambia County excludes HIV, AIDS, TB, gonorrhea, chlamydia, and syphilis, and any reportable diseases with no reported cases. The current data is provisional and subject to change.

Counts reflect reported cases and have not necessarily been confirmed.

Many cases might not meet case definition criteria upon further investigation or may be unconfirmable. This document is meant to surveil broad trends.

Area 1 STD

STD Age Breakdown

AGE TheArea1STDprogramprovidesmany 3 cases 0-4 servicestopersonsinEscambia,SantaRosa, Okaloosa,andWaltoncountiesinNorthwest 10-4 cases 48 Florida,includingpreventionservices,disease surveillance,education,testing,andtreatment.

15-9 1 ,053cases DiseasenterventionSpecialists(DS)serveas front-linedefenseincontactinvestigations20-4 and ,17cases partnerelicitationtointerveneinthespread ofSTDs.Staalsocollaboratewithpublic 25-9 62cases andprivatehealthcareprovidersregarding diagnosisandtreatmentofallreportableSTDs.30-4 3 14cases 35-9 40-

82cases

EDUCATIONAL TRAINING ACTIVITIES PROVIDED 45-

83cases

193cases

5-64

DISEASE INTERVENTION SPECIALISTS (DIS) 65-120

DScontinuedprovidinginterviews/ investigationsforpositiveindividualsand partnerserviceswithoutinterruption.

ResumedtheAfter-HoursHV/Syphilisclinic asquicklyaspossiblesoitwasonlycanceled fromAprilAugustforatotalof7Nightclinic outreaches.

2020 Reported STDs

2500

7cases STD Gender Breakdown Female2,091 Male1,482

American Indian/ Alaskan Native Other 7 cases 63 cases 0.20% Native Hawaiian/ 1.76% Pacific Islander 10 cases 0.28% Asian 26 cases 0.73%

2,4

2000 1500

47cases

1,209

1000 500 10

0

Chlamydia Gonorrhea Total: 3,573 new cases

Syphilis

39

HIV

Black 2,112 cases 59.11%

STD Race Breakdown

White 1,072 cases 30% Unknown 283 cases 7.92%

20YearinReview

12 9

MONTHLY OUTREACHES TO TEEN CHALLENGE

22

Area 1 HIV/AIDS

Patientsarethenreferredtolocalinfecti diseasephysiciansforfollow-upand continuedcare.

TheArea1HV/ADSprogramprovidesdisease surveillance,preventionservices,education, counselingandtesting,referral,contractn20,theTnTinitiativeprovided12 uninsuredorunder-insuredpatientswith management,technicalassistance,andsupport tocommunity-basedorganizations.Services immediateaccesstoHVmedicationsinan eorttoachieveviralsuppressionandbette forHVpositiveindividualswhoareuninsured orunder-insuredareprovidedthroughthe healthoutcomes.

ADSDrugAssistanceProgram(ADAP),which PrEP and PEP Program oerslife-savingmedicationsandadherencePrEP(Pre-exposureProphylaxis)becameafullcounseling.naddition,theHV/ADSprogram serviceprogramin2019.PrEPistreatmentwith overseesRyanWhitePartBcontracted medicationsthatmaypreventinfectionbefor providersfordirectcareandsupportservices beingexposedtoHV.PEP(post-exposure suchasHVspecialtycare,healthinsurance prophylaxis)becameafull-serviceprogramin premiumandcostsharingassistance,oral 20.PEPisimmediatetreatmentthatmay health,andothersdependingonneeds preventinfectionafterbeingexposedtoHV. assessmentresultsandfunding.

PEPtreatmentmuststartwithin72hoursof

theexposure,ideally,withintheQrst24hours.

TheCOVD-19pandemiccreatedchallenges PEPtreatmentinvolvestakingHVmedication fortheArea1HV/ADSProgram.Thenumber for28daysandismosteective(upto9%) ofHVtestsconductedbyourArea1network iftakenwithin2-3hoursafterexposure.na ofregisteredtestsitesin20(6,17)was singlevisit,anewPrEP/PEPclientcanreceive downby39%from2019(,4).Thenumber comprehensivecounselingandeducation ofcondomsdistributedtovariouslocations fromthePrEP/PEPNavigator,requiredlab throughoutArea1during20(16,)was work,amedicalvisitwithaclinician,and alsodownfrom2019(83,4). leavewithmedication.PrEPpatientsreturn everythreemonthsforfollow-uplabwork, PERSONS LIVING riskreductioneducationandassistancewi WITH HIV OR AIDS IN PatientAssistanceProgramrequirements.PEP ESCAMBIA COUNTY patientsreturnamonthlatertohaveanot *NumberreRectsDecember31,209.Yearend20 HVtestperformedanddiscussthepossibilit numberswereunavailableatthetimeofpublishing. ofbecomingaPrEPpatient.

1,365

20YearinReview

93.89%

23

VIRALLY SUPPRESSED

Mostpatientsareabletoreceiveservicesa medicationfor$0out-of-pocket.nadditionto HVprevention,thebeneQtofbeingapatientin thePrEP/PEPprogramincludesearlydetection Test and Treat Initiative andtreatmentofSTDs,increasedimmunization TheTestandTreat(TnT)initiativeisakey ratesforat-riskpatientsandroutinemedic componentofFlorida$splantoeliminateHV visitstoimproveoverallhealth.FDOH-Escambia transmissionandreduceHV-relateddeaths. partnerswithCurantHealthFlorida,aSpecia Testingisavailableon-siteatFDOH-Escambia$s Pharmacy,toprovidehomedeliveryof clinicorduringvariousoutreacheventswhere medicationsandaccesstorebatestoincrea rapidtestsprovideresultswithinminutes. fundsavailablefortheprogram.

TheTnTinitiativeisaclinicalprogramproviding immediatelinkagetoHVcareandinitiationReferralsforthePrEP/PEPprogramcome ofantiretroviraltreatment(ART)duringthat fromFDOH-Escambia$sSTDprogram,Family Qrstvisit,ifbothpatientandphysicianagree.

PlanningClinicandothercommunity-based

organizationsinvolvedinoutreachHV testing.ThePrEPprogrammaintainsanactive patientrosterof32+lowincomeuninsured individualsandfollowseachforcompliance withquarterlyrequirementsforparticipation.

ThePEPprogramprovidedservicesto8clients in20.Additionally,theprogramconducts trainingswithlocalPhysicianozces,Emergency DepartmentsandUrgentCareCentersto increaseaccesstoPrEPandPEPthroughout thecounty.

HIV SURVEILLANCE SinceJanuary20,FDOH-Escambia$sArea1 HVprogramozcehasheldatotalof5night clinics(conductingatotalof38rapidHV screenings.HVeducationpresentationsand highimpactpreventionoutreacheventswere alsoheldthroughoutthisyearconducting9 rapidHVscreenings.

14 42 27.6%q 26.2%

HIGH IMPACT PREVENTION EVENTS REACHING 340+ PEOPLE NEW HIV CASES REPORTED IN ESCAMBIA IN 2019* FOUR-YEAR TREND IN NEW CASES FROM 2015-2019

BETWEEN THE AGE OF 25-29

PICTURED ABOVE: Maurice Moody at an outreach promoting HIV prevention.

10 9 29

EXPOSED BABIES BORN TO HIV POSITIVE MOTHERS IN AREA 1

OF THOSE BABIES WERE BORN IN ESCAMBIA WAS THE AVERAGE AGE OF MOTHERS. AGES RANGED FROM 22 TO 40

73.8% WERE MALE 26.2% WERE FEMALE

PICTURED ABOVE: FDOH-Escambia’s HIV/AIDS team members celebrating Halloween on October 30, 2020.

20YearinReview

*Number reflects December 31, 2019. Year end 2020 numbers were unavailable at the time of publishing.

24

T H G TLI

SPO

HEPATITIS A Hepatitis A is a contagious liver disease that results from infection with the hepatitis A virus (HAV). It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.

Hepatitis A is usually spread when a person ingests fecal matter—even in microscopic amounts—from contact with objects, food, or drinks contaminated by feces (stool) of an infected person. Vaccination is the best way to prevent hepatitis A. 2020 saw an increase in the number of Hepatitis A cases in Escambia CountyinanoutbreakwhichwasQrstidentiQedin2017.Statewide, reported cases of Hepatitis A decreased from 3,408 in 2019 to 1,028 in 2020. In Escambia County, the number of cases rose from 9 in 2019 to 126 in 2020. Vaccination and education initiatives were expanded to prevent the spread of the HAV. FDOH-Escambia implemented a targeted communicationscampaignandvaccinationeortaimedatreaching personsatgreatestriskforcontractingthevirus.Stacollaboratedwith local homeless shelters and resources such as clinics, food pantries, etc. to reach populations of persons experiencing homelessness, addiction, and other high-risk lifestyle situations known to increase a person’s chance for HAV infection. Our team administered 2,176 Hepatitis A vaccinations in adults in Escambia County in 2020, an increase from 1,458 Hepatitis A vaccinations administered in 2019.

Hepatitis A Outreach in Pensacola

20YearinReview

FDOH-Escambia held a Hepatitis A Outreach event on November 7, 2020 at the Charity Chapel Church in Pensacola, Florida. The event featured Hepatitis A prevention and vaccinations. In addition to providing Hepatitis A information, rapid HIV test kits were available along with the Florida Breast and Cervical Cancer Early Detection Program information.

In total, the team administered 7 Hepatitis A vaccinations and delivered prevention information to approximately 75 homes, 1 mobile home community, 2 churches, and 10 businesses in the Bellview area.

25

PICTURED ABOVE: DOH-Escambia staff at the Hepatitis A Outreach on November 7, 2020.

Tuberculosis Prevention and Control TheTuberculosis(TB)PreventionandCounty$shomelesspopulation.We Controlprogramstacollaborate tested64individualsthatwere contactstoanactivePulmonaryTB withcliniciansthroughoutEscambia caseinourhomelesspopulation.This County,Floridatoensurethat personsdiagnosedwithTBreceive investigationwasdizcult,and manychallengeswerefacedwith eectiveandtimelytreatment andadditionalcontactswhoare theCOVD-19pandemic.Many community serviceswerelimitedor potentiallyexposedtothedisease are evaluatedandtreatedasneeded.shutdownwhichmadeitdizcultto locateandtestcontacts.

TheTBcaseratefortheStateof Floridahadanunprecedented ACTIVE TB CASES REPORTED 26%dropinTBcasesfrom2019to AND TREATED 20.n2019,theStateofFlorida Wehadtwointer-jurisdictional reported58TBcasesandin20, 413TBcaseswerereported.Thestate transfersfromGeorgia.Wehad atotalofsixTBcasesthatwere TBozceinTallahasseeissuspecting transferredtoShandsHospitalin thatthehugedropinTBcasesis Jacksonville,FLformedicalstability. relatedtotheCOVD-19pandemic.

RegisteredNurse,PamelaNelson, n20,theTBprogramcreated completed683nursingassessments. apresentationforWorldTBDay Therewasatotalof1,27directly thattargetedSheltersandtheclinic observedorvideoobservedtherapies thatservesthisveryvulnerablecompletedwithmajorityintheQeld. population.Additionally,FDOHTwelveTuberculinSkinTestswere Escambiahadaverylargecontact administeredand160GRAblood investigationinvolvingEscambia testswerecollected.

20YearinReview

10

PICTURED ABOVE: Tuberculosis Morbidity Graph.

26

ENVIRONMENTAL

EnvironmentalHealth(EH)programs complaintsandsanitarynuisances. conductinspections,issuepermits andlicenses,enforcestatutesand codes,andrespondtoquestions regardingenvironmentalconcerns.

Stauseeducationandtrainingin natural,physical,andenvironmental TheWaterQuality,HealthyBeaches, sciencestopromoteandimprove andSwimmingPoolsprogramregulates thecommunity$shealththrough drinkingwaterforresidentialandmu monitoringandcontrolling familyunitsandlimited-usedrinking environmentalfactors. watersystemsundertheprovisions ofChapter64E-8,F.A.C.aswellasthe constructionandoperationofpublic swimmingpools.Thisprogramalso monitorsbacteriologicalwaterqual ofEscambiaCounty,Florida$sbeaches, bays,andbayous.

TheEnvironmentalHealthFacilities PUBLIC SWIMMING POOLS, programroutinelyinspects SPAS, AND WATER communityfacilitiestopromote ATTRACTIONS INSPECTED andensuresafepracticesand HEALTHY BEACHES preventthespreadofinfectious WATER SAMPLES diseasesofenvironmentalorigins.

Stamembersmonitorandinspect TAKEN AND TESTED certainfoodservicefacilities,group carefacilities,mobilehomeand recreationalvehicle(RV)parks, biomedicalwastegenerators, storagefacilities,andtransporters.

Staalsoinvestigaterabiesand animalbitesandrespondto

Water Quality, Healthy Beaches, and Swimming Pools

Environmental Health Facilities

387 331

Investigations and Inspections Programs Totals FoodHygienenspections

625

GroupCareFacilitynspections 368 LimitedUseWells

3

MobileHomeandRVParknspections

645

20YearinReview

BiomedicalWastenspections 706

27

BodyPiercing

16

Tanning

50

Tattoo

21

Rabiesnvestigations 15 Total Investigations and Inspections

4467

PICTURED ABOVE: EH Outreach event on March 3, 2020. From left to right: Rick O’Conner, Joe Hardin, Louviminda Donado, Dr. Andrea Albertin.

HEALTH Onsite Sewage Treatment and Disposal Systems (OSTDS)

Petroleum Cleanup Section

FDOH-Escambia$sEnvironmental HealthDivision$sPetroleumCleanup Sectionmaintainsacontractwith Onsitesewagetreatmentanddisposal theFDEPentailingtheassessment systems,commonlyreferredtoas andremediationofpetroleumsepticsystems,areasafeandeective contaminatedsitesacrossseven(7) meansofwastewaterdisposalfor countiesincludingEscambia,Santa 30percentofFlorida$spopulation.

Rosa,Okaloosa,Walton,Holmes, TheOSTDSprogramensuresthat Washington,andBaycounties.The thesystemsareproperlydesigned, PetroleumCleanupSectionisactively constructed,andmaintainedthrough working423petroleum-contaminated permittingandinspection,and sites,with28ofthosesitesreceivinga contributestosafegroundwater, SiteRehabilitationCompletionOrder whichprovides90percentofFlorida$s (SRCO)sinceJanuary20.Thegoal drinkingwater. ofthePetroleumCleanupProgram encompassesboththeFDOH$smission toprotect,promote,andimprovethe ODTDS INSPECTIONS healthofallpeopleinFloridaandthe FDEP$sgoalofprotectingourvaluable groundwaterresources.

PROCESSED OSTDS

60 993

APPLICATION

423 28

PETROLEUM CLEANUP SITES MANAGED

PETROLEUM SITES CLEANED UP AND CLOSED

TheStorageTankComplianceprogramisdesignedtoprotectourdrinkingwater aquiferandsurfacewaterbodiesinFloridafromrisksassociatedwithregulated storagetanks,speciQcally,petroleumtanks.nspectionsareperformedin Escambia,SantaRosa,Okaloosa,Walton,Bay,Holmes,andWashingtoncounties.

TheEscambiaPetroleumCleanupprogramcoversthesamesevenNorthwest Floridacounties.StaworkwiththeFloridaDepartmentofEnvironmental Protection(FDEP)toensurethatallcontaminationiseliminated.

644

STORAGE TANK COMPLIANCE INSPECTIONS (515 ROUTINE and 129 VARIABLE)

96.66%

ANNUAL DEP POLLUTANT STORAGE SYSTEM COMPLIANCE VERIFICATION PROGRAM SCORE

20YearinReview

Storage Tank Compliance and Petroleum Cleanup

28

PREPAREDNESS

U-Count Event Providing Anaturalorman-madedisaster canoccuratanymoment,and Vaccinations for the Homeless thedepartmentiscommittedto OnJanuary23,0FDOHpreparednessandresponseeortsEscambiaparticipatedinthe20 toprotectourcommunityaswellasU-CountHomelessResourceDay othercommunitiesacrossthestate. eventsponsoredbyOpeningDoors ThePublicHealthPreparedness NorthwestFlorida,ourHomeless programassistscommunity Coalition.U-Countisasingle-day, organizationsindevelopingformalonestopshop(eventthatprovides disasterpreparednessplansandcareandservicesforindividuals participatesastheEmergency experiencinghomelessness.Over30 SupportFunction(ESF)8leadagency participantsreceivedservicesatth intheEscambiaCountyEmergency event.

OperationsCenter.Duringdisasters, FDOH-EscambiaoeredHepatitisA staworktoensureadequate andnRuenzavaccinations.Student shelterforvulnerablepopulations andmonitorthesafetyofthefood nursesfromtheUniversityofWest FloridaandPensacolaStateCollege andwatersupply. volunteeredtohelpvaccinate participants.

Working to Respond Faster TheFloridaDepartmentof HealthusestheEverbridge PARTICIPANTS MassNotiQcationSystemto REGISTERED FOR providequickcommunicationsto VACCINATIONS employees,volunteers,andpartner organizations.Thissystemalso RECEIVED THE supportsavarietyofpersonnel HEPATITIS A VACCINE whomaybecalledtoactionduring disasters,all-hazardsresponse RECEIVED THE eorts,andotherpublichealth activities.Quarterlydrillsare INFLUENZA VACCINE executedtomeasurehowezciently wecanrespondwithinonehour.

78 67 51

20YearinReview

Everbridge Drill Response

29

Q3 Jan – Mar 2020

88.0%

Q4AprJun20*

N/A

Q1 Jul – Sep 2020

96.2%

Q2 Oct – Dec 2020

94.6%

*EverbridgeDrillwasnotconductedassta werededicatedtoCOVD-19testsite.

PICTURED ABOVE: U-Count Homeless Resource Day event on January 23, 2020.

Record-Breaking Hurricane Season The20AtlanticHurricaneseasonwashistoricallyactive.Therewere30named stormswith13producinghurricanesand6ofthosebecomingMajorhurricanes.

Twelve(12)stormsmadelandfallintheUnitedStates.FDOH-Escambia$sESF-8 teamwasonstand-byforeachstorm,andwereozciallyactivatedforthree inEscambia.

Hurricane Laura

Hurricane Zeta

Activated09/162 for240hours (lastday09/25)

Activated09/28 for24hours

Activated10/24 for24hours

20YearinReview

Hurricane Sally

PICTURED ABOVE: Christie Gillenwater, DOH-Escambia Environmental Specialist, at the Community Outreach Resource Fair on September 26, 2020.

30

Highlight

Hurricane Sally

20YearinReview

HurricaneSallymadelandfall timelyinformationtothepublic. asaCategory2hurricane MarieMott,FDOH-Escambia onSeptember16,20near AdministratorandHealthOzcer GulfShores,Alabamaleading participatedinseveralEOCpress tosigniQcantdamageand conferences.FDOH-Escambia$s Roodingasitmovedthroughthe PublicnformationOzceensured FloridaPanhandle.Thestorm thatthepublicwaswellinformed substantiallyimpactedEscambia onrelevanthealthadvisoriesvi County,causing90%ofresidents variouscommunicationschannels tolosepower.Duringthis includingpressreleasesandsocia publichealthemergency,FDOHmediaplatforms.

Escambiarespondedtomeetthe needsofthecommunity.

Community Outreach

31

ActivationoftheCounty Resource Fair for EmergencyOperationsCenter Renters Impacted by (EOC)promptedFDOHEscambia$sresponsibilityasthe Hurricane Sally leadcoordinatingagencyfor nresponsetothedevastating EmergencySupportFunction(ESF) impactofHurricaneSally 8.FDOH-Escambiastaprovided toEscambiaCounty,team leadershipincoordinatingand membersfromdivisionsacross integratingoverallCountyeorts FDOH-Escambiavolunteeredto toprovidehealthandmedical participateina3-daycommunity assistancetoaectedareas outreachevent.Theeventwas andpopulations.nanticipation heldfromSeptember25through ofHurricaneSally$spotential September27,0andwas impacts,Escambiaopened tailoredforrentersimpactedby sheltersonSeptember14.

HurricaneSally.DOH-Escambia DisasterTeam7wasactivatedto teammembersfromCHEN,EH stathespecialneedsshelter, andWCwereabletoprovide whichwasco-locatedwiththe resourcesonRooding,drainand generalpopulationshelterat cover,healthyeating,available thePensacolaBayCenter.Sta services,etc.toeventattendees completed35writtenrequests fromLTCs/ALFs,hospitals, physician$sozcesandclinics,and funeralhomes.Additionally,an EnvironmentalHealthStrikeTeam wasutilizedandconductedover 320environmentalassessments withinthecommunity.

FDOH-Escambiaprovided appropriate,coordinated,and

20YearinReview

PICTURED: FDOH-Escambia Staff responding to Hurricane Sally.

32

COMMUNICATIONS

108 170

Thecommunicationsteamdevelops contentanddistributeshealth messagestothepublicandmedia outletsthroughawidevarietyof methods,includingprintandweb advertisements,newsinterviews andpressreleases,socialmedia, e-newsletters,videos,community presentations,andothershareable resourcesforbusinessesandfaithbasedorganizations.

MEDIA RELEASES ISSUED. 70 WERE COVID-19 RELATED RESPONSES TO MEDIA REQUEST, 146 WERE COVID-19 RELATED

Campaigns

Public Information Office • 5-2-1-0 ThePublicnformationOzcers • Breast Cancer Awareness (POs)interfacewithlocaland • COVID-19 Testing regionalmediaoutletstoprovide • Ciclovía accurate,timely,andrelevanthealth • Diabetes Prevention informationtothepublic.nformation • Drain & Cover is Mosquito Prevention issharedthroughnewsmedia,social • Flu Prevention media,digitalandprintpublications, • Hand-washing andEscambiaHealth.com.POsalso • Hepatitis A Prevention coordinatepublichealth-related • HIV/AIDS Prevention communicationsduringdisaster • Rabies Prevention responseandworkcloselywith • Stay Home (COVID-19 Prevention) partnerorganizationsaswellas • Sun’s Up, Cover Up theDepartment$sCentralOzceof • Touch Supervision is Drowning CommunicationsinTallahassee.

Prevention • WIC

20YearinReview

COVID-19 Response

33

Our media partnes play a vital role in our public healt sytem; FDOHEscambi colabrtes with media profesinal to inform, educat, and empowr peol about healt isue by providng acurte, timely informat. Since the onset of the Corna virus outbreak, FDOH-Escambi has contiusly worked with comunity partnes and loca governmts to combat the spread of COVID-19. FDOH-Escambi has particed in severalpressconferencesinaneorttoencouragepreventioneorts, such as social distancg, and share updates on case counts.

PICTURED LEFT: September 2, 2020: Leigh Willoughby and Marie Mott discussed the importance of vaccination in the Coming of Age Segment with Josh Newby of the Council on Aging of West Florida.

PICTURED RIGHT: June 22, 2020: Maurice Moody discussed HIV prevention, testing and the NHTD event in an on-camera interview with WEAR-TV ABC 3.

PICTURED RIGHT: March 26, 2020: Dr. John Lanza participated in a Coffee with the Commissioner Facebook Live and provided COVID-19 updates.

20YearinReview

PICTURED LEFT: September 23, 2020: Marie Mott participated in a Hurricane Sally press conference at the EOC.

34

ACCREDITATION

20YearinReview

During20,FDOH-Escambia willevaluateandupdateannuallyt begantheRe-Accreditationprocess. addressnewchallengesposedbythe SelectedasaPHAB15County$,the changingpublichealthenvironment. performancemanagementteam FDOH-Escambiapublishedthe201wasrequiredtowriteandsubmit89 203StrategicPlanJanuary1,20. documentsthatcorrespondtothe TenPublicHealthServicesframeworkQuality Improvement and Workforce Development andprovidedevidencethatwe,as acountyhealthdepartment,have ThePerformanceManagement andQualitymprovement(PMQ) beenmeetingnationalpublichealth accreditationstandards.Public PlansummarizesFDOH-Escambia$s comprehensive approachto healthaccreditationalsorequires the improving outcomes through implementationofaperformance evidence-baseddecision-making, managementsystemandthe creationanduseofthestrategic continuousorganizationallearnin plan,qualityimprovementplan,and andperformanceimprovement.

Additionally,thepurposeofthe workforcedevelopmentplan.

WorkForceDevelopmentPlanis Promoting a Culture of Quality toensurethattheDOHworkforce ThePerformanceManagement hastheknowledge,skills,abilities, Systemdevelopsandimplements andcompetenciesneededtocarry acomprehensiveapproachto outtheDepartment$smissionand monitoring,assessing,andimproving achieveitsstrategicobjectives.n thequalityofFDOH-Escambia$s addition,thePlanislinkedtoand work.tencompassesallaspects supportsthePMQPlantohelp oforganizationaldevelopmentand ensurethatstahaveaccesstothe qualityimprovement,includingstate trainingneededtosupportongoing andlocalmeasuringandreporting, PMQactivities. nationalaccreditation,andstrategic planning.Throughquarterlytracking ofourStrategicPlanobjectives, correctiveactionsaretakeniftargets arenotbeingmet.

35

Strategic Planning FDOH-Escambiainitiatedanew strategicplanningprocessinJune of20.Thestrategicplansets thedirectionforactionforFDOHEscambiafora3-yearcycle.Aspartof thePerformanceManagement(PM) system,itidentiQesthepriorityfocus areasforthedepartment,andaligns withstateandnationalpriorities.The planwillpositionFDOH-Escambiato operateasasustainableintegrated publichealthsystemandprovide FDOH-Escambiacustomerswith qualitypublichealthservices.tisa livingdocumentthatFDOH-Escambia

PICTURED ABOVE: Kimberly Pace finalizing strategic plan training day presentation on October 22, 2020.

ACCOUNTING Striving Toward Operational Excellence TheAccountingOzceprovidesbudgetingandaccountingservicestoallprograms withinFDOH-Escambia.Thecategoriesofresponsibilityincludeaccountspayable, accountsreceivable,assetmanagement,banking,billing,budget,contracts, procurement,purchasingcardmanagement,andprovidercredentialing.

County Government Funding 2.6%

Other 1.5%

Fee Revenue 11.5% Grants and Contracts 8.3% Statewide Medicaid Managed Care 4.3%

Revenues $13,135,399

State Funding 46.9%

Federal Funding 24.9%

Other 1.2% Other Personal Services 3.5%

Operating Capital Outlay .3% General Insurance 1.5%

Expenses 7.2%

Expenditures $12,604,884

Salaries and BeneQts 77%

NOTE:FinancialreportingforthisreportisbyQscalyear,July1,209throughJune30,2; therefore,thefullamountofCOVD-19fundingandexpendituresfor20isnotreportedinthis AnnualReport.ExpendituresforCOVD-19activitiestotaled$458,0throughJune30,2.Some programsdidnotspendtheirtotalprogramfundingallocationsinceemployeeswereredirectedto COVD-19response.

20YearinReview

Contracted Services 9.2%

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FACILITIES AND IT

Information Technology Facilities and Maintenance OurnformationTechnology TheFacilitiesandMaintenance (T)programsupportsFDOHprogramensuresaclean,safe, Escambia$stechnologicalneeds andwell-maintainedworking environment.Stainspectbuildings andinfrastructure.TheTHelp Deskservesastheprimarycontact andstructurestodetectmalfunctions forallissuesrelatedtocomputer, andperformroutinemaintenance network,andtelecommunications atthreedierentlocations.Facilities systems,allowingTstatoprovide supportstheday-to-dayneedsof thehighestlevelofsupportand thedepartmentbyperformingozce workquicklytoresolvereported moves,minorrepairsandanyother needsthroughtheHelpDesksystem. technologyissues.operateasa sustainableintegratedpublichea systemandprovideFDOH-Escambia customerswithqualitypublichealt services.tisalivingdocumentthat FDOH-Escambia FACILITIES HELP DESK

2,000

TICKETS COMPLETED

2020 Special Projects All Sites: X HurricaneSallyRecovery

2,879

IT HELP DESK TICKETS COMPLETED

X COVD-19LogisticSupport Fairfield: X rrigationPumpReplacement X Renovated23ClinicRoomsafter CommunityHealthofNorthwest FloridaPediatricsVacated Downtown Center X rrigationPumpReplacement

20YearinReview

X ExteriorPaintingonSecond Floor

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PICTURED ABOVE: Rudy Lopez programming the street sign to promote COVID-19 services.

PICTURED ABOVE: Patrick Fike, and Anthony Caudle building plexiglass and wood barriers at window check-ins.

20YearinReview

PICTURED ABOVE: 1st Quarter 2020-2021 Employee Group of the Quarter recipients from left to right Anthony Caudle, Patrick Fike, and Joseph Ignotis.

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BEST PEOPLE

FDOH-Escambiaemploysawidevarietyofpublichealthprofessionals,includi nurses,physicians,dietitians,epidemiologists,geologists,andplanners supportprofessionals,suchasaccountants,Tprofessionals,customerse representatives,trainingandpersonnelsta,andcommunicationsprofe FDOH-Escambiaalsoprovidesawidevarietyofinternshipopportunitiesin Qelds.

22 Interns Trained in Key Areas X ClinicalNursing X CommunicableDiseases X EnvironmentalHealth X Epidemiology X HealthEducation X nfectiousDisease X Nutrition X PediatricMedicine X Pharmacy

Participating Schools X CDC$sPublicHealthAssociate Program X FloridaStateUniversity X PensacolaStateCollege X SouthernMethodistUniversity X UniversityofFlorida X UniversityofSouthAlabama X UniversityofSouthFlorida X UniversityofWestFlorida

X Phlebotomy

X WellnessWorkdaysDietetic nternship,nc.

X PublicHealthPreparedness

X WestFloridaPharmacySchool

Note:ThenternshipProgramwastemporarilyinactivefromAugustuntil Decemberof20duringthetransitionfromDr.LanzatoMarieMott.

100% 20YearinReview

192

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EMPLOYEES

OF EMPLOYEES COMPLETED ANNUAL MANDATORY TRAINING

96% Full Time

79% Women

Employee Wellness Oneofthemanywaysouremployeeslivethedepartmentmissiontoprotect, promote,andimprovehealthisbyparticipatinginemployeewellnessactivities.

Awell-designedemployeewellnessprogramcanhavemanybeneQts,suchas increasedproductivityandmorale,anddecreasedabsenteeism.FDOH-Escambia oersquarterlywellnesschallengestoencourageemployeestoengagein healthybehaviors,likeeatinghealthyduringtheholidaysormeetingphysical activitygoals.

2020 Employee Wellness Highlights Wear Green for Mental Health Awareness Month

30-Day Water Challenge

X 20employeesworegreento raiseawarenessformental health.

X Employeesweregivenwater recipestoencouragestaying hydrated.

X Employeeswereencouraged X totakepostitnotesfromthe bulletinboardswithpositive mentalhealthmessaging.

X

Race to the North Pole Walking Challenge

25employeeskepttrackand loggedtheirwaterintakefor the30days.

54gallonswereconsumed duringthe30-dayperiod.

Dental Health Awareness Month

X Divisionscompetedagainst X Employeescompleted eachothereachweektosee crosswordpuzzlesrelatedto whoturnedinthemoststeps theinformationontheboards. tohelpSantasaveChristmas.

X Wordsearcheswerealso X 25employeesturnedintheir providedtoemployees. stepseveryotherweekforthe 3-monthreportingperiod.

X Alldivisionscombinedwalked over15,0steps!

20YearinReview

X Employeesineachdivision X Thebulletinboardeducated werechallengedtowalktothe employeesaboutsomekey NorthPole. factsrelatedtodentalhygiene.

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LOCATIONS Fairfield 1295 West Fairfield Drive Pensacola, FL 32501 850-595-6500 Hours of Operation Monday thru Friday 8 a.m. to 5 p.m.

Programs and Services 3 BreastfeedingSupportand Education

3 mmunizationsClinic 3 mprovedPregnancyOutcome Program(POP)

3 CommunityHealthNorthwest FloridaDentalandPediatricClinics 3 MedicalRecords 3 CommunityHealthPlanningand 3 Statistics 3 3 Epidemiology 3 3 FamilyHealthClinic 3 3 FamilyPlanningClinic

PublicHealthPreparedness Publicnformation NutritionServices STD,TB,HV/ADSScreeningand Treatment

3 FloridaBreastandCervicalCancer 3 TobaccoFreeFlorida-Escambia EarlyDetectionProgram 3 VitalStatistics 3 HealthEducation 3 WeCareReferralProgram 3 HealthyStart 3 Women,nfantsandChildren(WC)

WIC Clinic: Northside Services Center 8390 North Palafox Street Pensacola, FL 32534 20YearinReview

850-484-5121

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Hours of Operation Monday thru Thursday Walk-in Clinic

Downtown Services Center 1300 West Gregory Street Pensacola, FL 32502 850-595-6700 Hours of Operation Monday thru Friday 9:00 a.m. to 4:30 p.m

3 Beaches 3 BiomedicalWaste

3 PublicPoolsandSpas 3 PublicandPrivateSchools

3 3 BodyPiercingandTattooParlors 3 3 Fiscal 3 3 FoodHygiene 3 MobileHomeParks 3 OnsiteSewageTreatmentand DisposalSystems

RabiesSurveillance SchoolHealth StorageTankComplianceand PetroleumCleanup

3 TanningSalons 3 WaterQualityResearch

WIC Clinic: Naval Hospital Pensacola 6000 Highway 98 Pensacola, FL 32512 850-595-6670 Hours of Operation Wednesday thru Friday Appointments Only

20YearinReview

Programs and Services

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1295 West Fairfield Drive | Pensacola, Florida 32501 | 850-595-6500 www.EscambiaHealth.com

20YearinReview

@HealthyEscambia

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