2020
YEAR IN REVIEW
From the Health Officer “As the new Health Officer and Administrator for FDOH-Escambia, I look forward to leading FDOH-Escambia into our third century of public health service to the residents and visitors of Escambia County. I am excited to take on this new role and to be part of such a great team! I would like to congratulate Dr. John Lanza on his retirement after 27 years with the State of Florida, and thank him for his 24 years of leadership and service as the Health Officer and Director for FDOH-Escambia.
Marie Mott began her career with the Department in 2007 as a senior public health nutritionist for FDOH-Escambia. She served as FDOH-Escambia’s public health communications manager until 2019, and then as the Communications, Health Education, and Nutrition Division’s director until her appointment as the Health Officer and Administrator for Escambia County. Prior to entering the public health field, Mott practiced clinical dietetics in the areas of critical care nutrition, nutrition support, and medical nutrition therapy for chronic disease management and prevention. Mott holds a Bachelor of Arts degree in both History and Political Science from the University of Montevallo, a Doctor of Jurisprudence from the University of Alabama School of Law and a Master of Science in Human Nutrition from the University of Alabama College of Human Environmental Sciences. She maintains her credentials of attorney and counselor at law, registered dietitian, licensed dietitian/nutritionist, and certified specialist in sports dietetics.
FDOH-Escambia saw yet another impactful year in public health. This year’s report accounts a variety of changes and challenges, including responding to the COVID-19 pandemic and Hurricane Sally’s direct hit to our area. The accomplishments described in the 2020 Year in Review are the result of the combined efforts of our dedicated employees and our partner organizations. Working together, we stand committed to protecting, promoting, and improving the health of our community and beyond.”
Mission Vision Values
MISSION To protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.
VISION To be the Healthiest State in the Nation.
VALUES Innovation We search for creative solutions and manage resources wisely. Collaboration We use teamwork to achieve common goals and solve problems. Accountability We perform with integrity and respect. Responsiveness We achieve our mission by serving our customers and engaging our partners. Excellence We promote quality outcomes through learning and continuous performance 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 On February 20, 2020, the University
2020 Year in Review
Where we are born, grow, live, work, play, learn, and age all impact our health. These social determinants of health include socioeconomic status, education, employment, neighborhood and physical environment, and access to health care and social support networks. Each of these factors together create unique community health service needs.
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In order to respond to the needs of the community, FDOHEscambia partners with numerous governmental and non-governmental organizations to protect and improve the public’s health. Notable partnerships include area hospitals and medical facilities, infectious disease practitioners, the University of West Florida, Pensacola State College, the Escambia County School District and Early Learning Coalition, emergency management, law enforcement, City of Pensacola, Emerald Coast Utilities Authority, Healthy Start Coalition, Opening Doors Northwest Florida, Naval Air Station Pensacola, Community Health Northwest Florida, Boys’ and Girls’ Club, and many more.
of West Florida (UWF) hosted over 200 community members in a conversation about health and equity. The Achieve Healthy EscaRosa data walk began a conversation that has carried us through the corona virus pandemic and onto the Zoom platform. Continued conversation of health equity was expanded as the pandemic brought to the forefront, the health disparities and inequities that the minority communities have dealt with for generations.
Despite the coronavirus restrictions, planning efforts continued as Achieve Healthy EscaRosa submitted a grant application that aimed to create a Minority Health Advisory Council. This council aims to work with the FaithBased Organizations in Escambia and Santa Rosa Counties to educate the community about staying safe and healthy during a global health pandemic. Unfortunately, due to impacts from Hurricane Sally in September 2020, the grant date was pushed back. The education-focused collective impact organization (Achieve Escambia) did receive a grant to work with UWF’s HAAS Center to develop an Escambia and Santa Rosa County Health Equity Dashboard.
Births and Deaths in 2020 Vital statistics play an important role in community health assessment and improvement. FDOH-Escambia’s vital statistics office maintains these records by both reporting and issuing birth and death certificates. The data collected from these certificates is used to track death and disease for Escambia County residents. Data, like what is indicated below, was used in the Health Assessment process to determine priority areas for the current health improvement efforts.
X 3,731 resident births X 4,219 resident deaths X 30 deaths under age 1 X 20 fetal deaths (20 weeks gestation or greater)
PICTURED: Achieve Healthy EscaRosa Interactive Data Walk on February 20, 2020.
2020 Year in Review
*2020 Provisional Numbers from flhealthcharts.com
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Demographics Escambia County, Florida is the 20th (out of 67) most populous county in the state, with 1.5% of Florida’s population. Escambia County boasts a strong military presence with four naval facilities located within the county, including Naval Air Station Pensacola, Corry Field Station, Saufley Field Station, and Naval Hospital Pensacola. Military and Civil Service, education, health care, and retail are primary employment industries.
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)
2020 Year in Review
Race
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<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)
2020 Year in Review
$50,915 per year
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COVID-19 Pandemic The year 2020 will be remembered as a time of unprecedented challenges and changes for FDOH-Escambia. We faced an unimaginable threat, as the coronavirus disease 2019 (COVID-19) dominated the year 2020. Words like quarantine, PPE, social distancing, and masking became words of everyday conversation. The impact of COVID-19 has demonstrated FDOH-Escambia’s continued commitment to public health. FDOH-Escambia staff have had and continue to have an important role in keeping the public safe and healthy amid the COVID-19 pandemic. This is a look at how the pandemic progressed and how FDOH-Escambia responded to COVID-19 in our community.
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
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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
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US Declares Public Health Emergency
2020
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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.
2020 Year in Review
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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
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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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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
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April
2020
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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
2020 Year in Review
PICTURED ABOVE: ESF-8 desk at the EOC.
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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
2020 Year in Review
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.
2020 Year in Review
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
2020 Year in Review
Florida National Guard transporting COVID-19 vaccine.
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May 21, 2020 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
2020 Year in Review
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.
2020 Year in Review
May 27, 2020
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Clinical Health Clinical health programs link people to the personal health services they need either by directly providing those services or by making referrals to other community resources. Programs include a medical clinic providing primary care for children and adults, family planning services, immunizations, and sexuallytransmitted disease (STD) testing and treatment.
Family Health Clinic
Immunizations Clinic
The Family Health Clinic provides primary care for children and adults. Services include sick and well child exams, adult annual check-ups, management of chronic diseases, such as high blood pressure and type 2 diabetes, and lead testing. Appointments for preschool and school entrance physicals are also available.
2,216
CLINIC VISITS FROM 1,177 CLIENTS
The Immunizations Clinic provides vaccines for children, adolescents, and adults. Prior to entry into Florida child care facilities or attending school (kindergarten through 12th grade), each child is required to have a Florida Certificate of Immunizations, or DH 680 form, on file documenting age-appropriate immunizations. Immunizations for adolescents include shots required for entering 7th grade and college. The FDOHEscambia Immunization Clinic is also a designated travel center, providing consultations and immunizations to travelers. Immunization records may also be obtained for students transferring out of state, child care, or school enrollment.
18,236
IMMUNIZATIONS GIVEN TO 4,630 CLIENTS 2-Year-Old Immunization Rates Goal 90.0%
2020 Year in Review
PICTURED ABOVE: FDOH-Escambia Employee receives Flu Vaccine.
Florida 90.0%
Florida Department of Health, Bureau of Immunizations
Labs Processed by Clinical Laboratory Adult Health Family Planning Hepatitis
1,227 3,693 18
HIV Refugee Health
1,008 75
STD Clinic
Tuberculosis
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Escambia 94.2%
2,985 651
On March 31, 2020, the Department’s Immunization Section recognized FDOHEscambia as a Vaccines for Children Program Platinum Provider for exemplary immunization coverage rates in the 2-yearold vaccine series. FDOH-Escambia’s practice completed the 2-year-old series (4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 Hep B, 1 Varicella, and 4 PCV) for 99.1 percent of eligible patients as of October 1, 2019. The achievement outlines FDOH-Escambia’s dedication to protecting children in the community from vaccine-preventable diseases while helping Florida reach statewide immunization goals.
Sexually-Transmitted Disease (STD) Clinic The STD Clinic provides testing and treatment for individuals exposed to sexually-transmitted diseases, such as syphilis, HIV, chlamydia, and gonorrhea. Registered nurses and clinicians also provide prevention education and counseling in a confidential setting. The clinic has two credentialed STD nurse clinicians to facilitate fast-track services when needed.
1,327 91%
CLINIC VISITS FROM 996 CLIENTS
OF CLIENTS WITH STDS WERE TREATED WITHIN 14 DAYS
2020 Year in Review
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) The Florida Breast and Cervical Cancer Early Detection Program (FBCCEDP) provides education on breast and cervical cancer, the importance of getting regular breast and cervical cancer screening exams, and the Human Papillomavirus (HPV) vaccination. Services offered include referrals for screening and diagnostic mammograms, pap smears, and assistance with medical insurance across three counties.
607
REFERRAL SERVICES PROVIDED FOR WOMEN IN ESCAMBIA, OKALOOSA, AND SANTA ROSA COUNTIES
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OF THOSE REFERRALS PROVIDED BY OUR CLINICIANS
2020 Year in Review
We Care Referral
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The We Care Referral program was founded by the Escambia County Medical Society Foundation to address the specialty medical needs of uninsured residents. The program helps meet a critical gap in health care access to those who otherwise would not receive care or would seek care in emergency departments and further contribute to the current health care burden of hospitals and their communities. Potential clients are screened for residency and income. If eligible, clients are referred to a participating physician or hospital to receive care. In 2020, 52 physicians participated in the We Care network.
112
INDIVIDUALS REFERRED FOR ASSISTANCE
Family Planning Clinic The Family Planning Clinic offers a variety of modern birth control methods, annual women’s health exams, counseling, and referrals. Abstinence counseling and information about Natural Family Planning is also provided. Clinical exams, including a pelvic exam and pap test (if due), are provided to screen for cervical cancer. Available birth control methods include condoms, birth control pills or shots, and long-acting reversible contraceptives (LARC).
2,310
CLINIC VISITS FROM 1,141 CLIENTS
Improved Pregnancy Outcome Program (IPOP) IPOP links pregnant women to medical care and other services in the community. Nurses screen women for potential problems or risks and provide education to promote healthy behaviors during pregnancy. Staff assist women with Medicaid applications for Presumptive Eligibility for Pregnant Women (PEPW), provide referrals to the Women, Infants and Children (WIC) program, and assistance in establishing regular prenatal care with a local physician or clinic. Longacting reversible contraceptives (LARC).
207 148
CLIENTS SERVED
CLIENTS QUALIFIED FOR PEPW
WiseWoman/ FL Healthy Woman FDOH-Escambia administers the CDC’s WiseWoman Program, named FL Healthy Woman. This program serves low income, uninsured women aged 40-64 in Escambia
The long-term success of WISEWOMAN participants is showcased with follow-up assessments conducted between 6-9 and 12-18 months after initial enrollment. Of those follow-up assessments, we found that nearly everyone had reduced at least one risk factor for cardiovascular disease
WISEWOMAN Program Champion Initiative In 2020, FDOH-Escambia launched the WISEWOMAN Program Champion Initiative. Modeled after the CDC’s Prevent Type 2 Diabetes Program Champion Initiative, the WISEWOMAN Program Champion strategy is designed to support recruitment and outreach activities of the WISEWOMAN program. This designation recognizes and shows appreciation for the hard work and accomplishments of our WISEWOMAN participants. It serves to keep them engaged in the healthy lifestyle changes they have learned and adopted through WISEWOMAN. Mary Nell Adams was recognized as FDOH-Escambia’s first WISEWOMAN Program Champion. Through her hard work and participation in the program, Mary significantly reduced her BMI while addressing other health objectives to sustain her long-term wellness. Mary participates in the online Diabetes Prevention Program where she continues to share her experiences and support other women.
PICTURED RIGHT: Mary Nell Adams was recognized as FDOH-Escambia’s first WISEWOMAN Program Champion. Pictured from left to right: Denielle Satterfield and Mary Nell Adams
2020 Year in Review
Healthy Behavior Support Systems (HBSS) providers have demonstrated their creativity and flexibility in assuring that healthy lifestyle change support is available to our targeted population. Clinical Nursing and CHEN (Communications, Health Education and Nutrition) staff have worked together to deliver the CDC’s National Diabetes Prevention Program (DPP) virtually. This has been of paramount importance in keeping our clients safe while still delivering necessary services during COVID. The Million Hearts class curriculum (formerly Healthy University) has evolved into individual health coaching for support to clients who participate in self-monitored blood pressure. Health coaching is conducted both in person and telephonically. We have also partnered with the Taking Off Pounds Sensibly Group and the YMCA who offer virtual meetings, outdoor exercise, and additional guidance to support and reinforce our WISEWOMAN participants.
and/or stroke i.e.; lowered blood pressure, reduction in BMI, medication compliance with cardiovascular medication, increased exercise, closely monitored caloric intake, etc. FDOH-Escambia is shaping a healthier community of women through the WISEWOMAN program.
2020 Year in Review
County, Florida. WISEWOMAN aims to improve cardiovascular health within our community by helping women make longstanding lifestyle changes. We continue to overcome common barriers to health including health literacy, lack of motivation and physical or financial limitations – even in the midst of the COVID-19 pandemic. 2020 saw enrollment in the Escambia County WISEWOMAN program increase by 80 new participants!
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Wellness Programs Wellness Programs focus on preventing chronic diseases such as diabetes, heart disease, and cancer. Many of our programs promote healthy behaviors such as quitting tobacco products, eating a balanced diet, and being physically active. FDOH-Escambia has a team of subject matter specialists consisting of health educators, nutrition educators, and registered dietitians working to create informational materials and deliver presentations to the community.
2020 Year in Review
Staff provide screenings, education, interventions, referrals, and other support services for individuals and families. Services are aimed at reducing risk factors and modifying behaviors to prevent chronic disease and promote optimal health for all residents. These programs, aimed at early detection and prevention of common health problems, serve people throughout each life stage, with special services for pregnant women, infants, and children.
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Health Information (HI) Network The HI Network aims to improve the health of our community by providing residents with evidence-based information on factors that can affect health. Faith-based organizations play a key role in improving the health of their congregation members as well as community residents through health promotion and disease prevention. Since 2016, HI Network program staff provide faith-based organizations important health information in the form of toolkit modules, featuring educational presentations, print materials, and short messages to share with members via social media, email, or church bulletins.
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HI-NETWORK PARTNERS
COMMUNITY PRESENTATIONS
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
For the third consecutive year, FDOHEscambia has earned CDC Full Recognition for the diabetes prevention program, PreventT2 Lifestyle Change Program. This designation is reserved for programs that have effectively delivered a quality, evidencebased program that meets all of the standards for CDC recognition. PreventT2 is part of the National Diabetes Prevention Program, led by the CDC and proven to help people with prediabetes prevent or delay development of type 2 diabetes. This continued achievement demonstrates the success of the lifestyle change program, with a commitment to reducing the preventable burden of diabetes within the community and nationally. Since January 2020, 25 participants enrolled and attended at least one session.
Planning to Pilot Virtual DPP In December 2020, FDOH-Escambia obtained approval to begin offering the CDC’s National Diabetes Prevention Program (DPP) completely online in January 2021. To facilitate the program online, FDOHEscambia’s DPP cohorts will be utilizing the Health and Lifestyle Training (HALT) Diabetes software platform, provided by the ProVention Health Foundation, in partnership with the National Association of Chronic Disease Directors (NACDD). The platform includes the CDC-approved National DPP video-based curriculum, participant and coaching dashboards, mobile apps, photo food-logging, and data collection and reporting functionality. This new platform allows our organization to continue offering the program safely to the community at a distance.
37 25 69.9
SESSIONS HELD PARTICIPANTS POUNDS LOST 2020 Year in Review
The PreventT2 Lifestyle Change program began in 2016 and is part of the CDC’s National Diabetes Prevention Program (DPP), which has been proven to help people make modest lifestyle changes and reduce the risk of type 2 diabetes by more than 50 percent. The program’s goals are to reduce participants’ body weight by at least five percent and for participants to reach a minimum of 150 minutes of moderate-to-intense physical activity per week. FDOH-Escambia’s program achieved full recognition through the CDC in 2018, which signifies that, on average, the participants who enrolled meet the program goals of regular attendance, physical activity, and weight loss.
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5-2-1-0 Healthy Escambia! As part of our local chronic disease prevention efforts, the 5-2-1-0 Healthy Escambia! Program actively promotes daily healthy behaviors of 5 fruits and vegetables, 2 hours or less screen time, 1 hour of physical activity, and 0 sugary drinks in various community settings, reaching audiences of all ages.
1,919
PEOPLE RECEIVED 5-2-1-0 EDUCATION AT 18 EVENTS, OUTREACHES, AND PRESENTATIONS
School Health Education
2020 Year in Review
School Health education helps children, families, and school personnel increase physical activity, improve nutrition, prevent the spread of infectious disease, and reduce teen pregnancy. Our team of Registered Nurses deliver presentations on a variety of topics to elementary, middle, and high school students in Escambia County. FDOH-Escambia School Health nurses taught 760 health education classes during the 2019-2020 school year.
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School Health implemented our 5210 Healthy Escambia! Education program at Kingsfield Elementary School for all children in Kindergarten – 5th grade. School Health also returned to schools we had presented the 5210 Healthy Escambia! Program in years past and taught their Kindergarten students. The 5210 Healthy Escambia! Program actively promotes healthy behaviors of eating 5 or more fruits and vegetables every day, 2 hours or less of screen time per day, 1 hour or more of physical activity per day, and 0 sugary drinks! This program is also promoted in various community settings, which allows us to reach audiences of all ages.
School Health nurses also assisted the Escambia County School District in meeting their mandated Kindergarten and 7th grade immunization record review requirements by completing 5,740 record reviews. This helps assure students are up-to-date with their immunizations and allows the students to be in school and ready to learn. FDOH-Escambia School Health nurses also transcribe out-ofstate immunization records for new students throughout the school year. FDOH-Escambia School Health nurses collaborated with the Escambia County School District to administer Flu-Mist vaccine at 20 elementary schools. They were able to vaccinate 615 students this year which demonstrates FDOH-Escambia’s dedication to protecting children in our community from vaccine-preventable diseases while also helping the state of Florida reach statewide immunization goals. School Health COVID-19 Response In March of 2020, FDOH-Escambia School Health nurses began assisting the Epidemiology program with positive COVID-19 cases. This required numerous trainings on how to use the Merlin program, notify positive cases, contact tracing, and answering calls from the public. Additionally, School Health worked closely with our local schools (public and private) to confirm positive cases of COVID-19 amongst students and staff. School Health nurses assisted in identifying close contacts of positive cases who needed to quarantine to help prevent the spread of COVID-19. School Health nurses also ensured a safe and effective reopening for the Fall of 2020 and continues to support schools daily by confirming positive cases, assisting with contact tracing and assuring that the schools are aware of any new updates from the CDC.
Tobacco Free Florida Escambia
Students Working Against Tobacco Since January 2020, TFF-Escambia has reached 35,000 youth via social media campaigns, marketing ads throughout the county, or virtual meetings and trainings. A Students Working Against Tobacco (SWAT) regional training was held at Laguna Beach Christian Retreat February 29-March 1, 2020. Two Escambia County youth attended the regional training, providing them with up-to-date information on Electronics Nicotine Delivery Systems (ENDS), Tobacco Free Observances, media advocacy and public speaking. In October 2020, two SWAT youth attended a virtual training. Through the use of technology and the student’s willingness to participate, 9 SWAT meetings were held virtually via Zoom and GoTo Webinar. 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.
Store Assessment Tobacco companies unreasonably target specific demographic groups such as youth, racial and ethnic minorities, and those of low income or education. Marketing of tobacco products is purposely designed to recruit smokers at an early age and maintain current smokers. While practicing measures in accordance with CDC guidelines, TFF-Escambia staff was able to assess over 50 retailers in Escambia county to verify safe tobacco marketing practices.
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.
2020 Year in Review
The Tobacco Free Florida in Escambia County (TFF-Escambia) program encourages tobacco use prevention and behavior change through media and marketing, policy change, group counseling, community presentations, and activities that engage youth. Amid the global pandemic, TFF-Escambia switched to a virtual based work plan and adapted to changes in COVID-19 protocols. Staff have continued to work closely and diligently with Pensacola State College (PSC) to increase education on the importance of a tobacco free campus. TFFEscambia is now one step closer to helping PSC achieve a tobacco free grounds policy with the establishment and continuation of the tobacco free task force.
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Healthy Start The Healthy Start program aims to reduce infant mortality, reduce the number of low weight babies, and improve the health and developmental outcomes for all Florida babies. Care coordinators provide education, support, and guidance to pregnant and postpartum women, women who have experienced a loss, and women who have a child under age three. Program staff also works to connect families to community resources. Any woman can elect to be screened by their OB provider, or can self-refer for eligibility during pregnancy, at the time of delivery, or before their child reaches age three. The confidential screening helps to identify women and infants who may have a greater risk for poor health outcomes.
1,028
PRENATAL/POSTPARTUM WOMEN AND INFANTS/CHILDREN RECEIVED SERVICES
Healthy Start Services Since January 2020, Healthy Start has provided services to 608 prenatal/postpartum women and 420 infants/children, with a total of 8,434 direct services provided. These services include care coordination, education, support, and guidance. Healthy Start also made 1,171 referrals to community resources to help meet our aim of reducing infant mortality and reducing the number of low weight babies. Safe Sleep Environment Healthy Start continued the mission to help prevent sleep-related infant deaths by educating parents and caregivers on the importance of practicing safe sleep. The Healthy Start Program and the Healthy Start Coalition collaborated to provide 82 pack and play cribs and safe sleep kits to families at no cost, allowing these families to provide safe sleeping environments for their infants. Healthy Start Care Coordinators provided noncontact deliveries to the client home and used text links to demonstrate pack and play crib set-up and safe sleep education. The program aims to reduce sleep-related deaths.
2020 Year in Review
Adapting Services Amid COVID-19
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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 allowed staff to telework while continuing to 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 The WIC program serves pregnant and breastfeeding women, infants, and children up to age five. Each participant is counseled by a registered dietitian, or other trained nutrition staff, and provided an electronic benefits transfer (EBT) card to purchase prescribed healthy foods. Foods are selected based on individual needs and include milk, cheese, juice, eggs, fruits and vegetables, whole grain breads and pasta, brown rice, yogurt, and baby food and infant formula. Participants may use the EBT cards at local participating grocery stores and farmer’s markets.
7,655
AVERAGE WIC ENROLLMENT
6,423
BREASTFEEDING COUNSELING CONTACTS COUNSELED
668
BREASTPUMPS PROVIDED
PICTURED ABOVE: Community Baby Shower on January 25, 2020. From left to right: Elsena Lamar, Kharrie Patton, Ashley Majors, and Natalie Steingruber.
Breastfeeding Support Every pregnant woman enrolled in WIC receives information regarding the benefits of breastfeeding. Peer counselors are assigned to women who express an interest in ongoing support. Counselors remain with these women throughout pregnancy and during the first few months following birth. Breast pumps are loaned to nursing mothers who return to work or school or have an infant in the hospital. Staff also work with businesses and child care centers on how to develop breastfeeding-friendly policies and support nursing women in their organizations.
2020 Year in Review
Face-to-face services were limited due to COVID-19 in 2020. FDOHEscambia continued to provide WIC nutrition counseling, breastfeeding counseling, and certifications via telephone and email.
20
Infectious Diseases Our infectious disease service staff members identify and monitor infectious disease outbreaks in the community. Working with area physicians and other community partners, our staff investigate outbreaks of food-borne illness, as well as locate and refer people who have been potentially exposed to tuberculosis (TB), HIV, or other sexually-transmitted diseases to local services. Staff also monitor disease outbreaks in the community, such as flu and other respiratory illnesses.
2020 Reportable Diseases in Escambia County Disease
Animal Rabies 1
2000
2020 Year in Review
500
21
0
66
588 133
737
100
2080
Gonorrhea Chlamydia
Giardiasis (acute)
3
Haemophilus Influenzae
9
Hepatitis B (acute)
10
Hepatitis B (chronic)
54
Hepatitis C (acute)
32
Hepatitis C (chronic)
317
Lead Level (greater than or equal to 5 μg/dL ‡)
57
Legionellosis 11 Listeriosis 2 Lyme Disease 5 Meningitis (Bact, Cryto, Mycotic) 2
Shigella 15 Streptococcus Pneumoniae (invasive) 29
829
110
996 695
94
81
101
2014 2015 2016 2017 2018 2019 2020
Syphilis
6
Salmonella 54
1209
527
E. Coli (O157:H7)
Rocky Mountain Spotted Fever 1 2224
1500 1000
12
Pertussis 5
2575
1839
Carbon Monoxide Poisoning
Hepatitis A 126
3000 2136
55
Cyclosporiasis 1
STDs in Escambia County, FL 2014-2020
2015
Campylobacteriosis
Crytosporidium 1
The Epidemiology program seeks to prevent disease transmission in the community through surveillance, contact investigations, and education. Staff investigate reportable diseases to determine the source of the disease, the time and mode of transmission, and the number of people potentially exposed or impacted. There are currently more than 80 reportable diseases.
1998
Cases
Animal Bite (PEP recommended) 142
Epidemiology
2500
Varicella (Chickenpox)
8
Vibrio (vulnificus)
3
Vibrio (other) 3 Total Reported Cases
969
Florida Department of Health, Bureau of 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 The Area 1 STD program provides many services to persons in Escambia, Santa Rosa, Okaloosa, and Walton counties in Northwest Florida, including prevention services, disease surveillance, education, testing, and treatment. Disease Intervention Specialists (DIS) serve as front-line defense in contact investigations and partner elicitation to intervene in the spread of STDs. Staff also collaborate with public and private health care providers regarding diagnosis and treatment of all reportable STDs.
EDUCATIONAL TRAINING ACTIVITIES PROVIDED
1,053 cases 1,117 cases
20-24 25-29
626 cases
30-34
314 cases 193 cases
40-44
82 cases
45-54
83 cases 47 cases
65-120 7 cases STD Gender Breakdown Female 2,091
Resumed the After-Hours HIV/Syphilis clinic as quickly as possible so it was only canceled from April – August for a total of 7 Night clinic outreaches. 2020 Reported STDs
48 cases
15-19
55-64
DIS continued providing interviews/ investigations for positive individuals and partner services without interruption.
Male 1,482
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%
2,224
2000 1500
10-14
35-39
MONTHLY OUTREACHES TO TEEN CHALLENGE
DISEASE INTERVENTION SPECIALISTS (DIS)
2500
0-4 3 cases
1,209
1000 500 101
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%
2020 Year in Review
12 9
AGE
STD Age Breakdown
22
Area 1 HIV/AIDS The Area 1 HIV/AIDS program provides disease surveillance, prevention services, education, counseling and testing, referral, contract management, technical assistance, and support to community-based organizations. Services for HIV positive individuals who are uninsured or under-insured are provided through the AIDS Drug Assistance Program (ADAP), which offers life-saving medications and adherence counseling. In addition, the HIV/AIDS program oversees Ryan White Part B contracted providers for direct care and support services such as HIV specialty care, health insurance premium and cost sharing assistance, oral health, and others depending on needs assessment results and funding. The COVID-19 pandemic created challenges for the Area 1 HIV/AIDS Program. The number of HIV tests conducted by our Area 1 network of registered test sites in 2020 (6,117) was down by 39% from 2019 (10,042). The number of condoms distributed to various locations throughout Area 1 during 2020 (166,000) was also down from 2019 (283,4000).
1,365
PERSONS LIVING WITH HIV OR AIDS IN ESCAMBIA COUNTY
*Number reflects December 31, 2019. Year end 2020 numbers were unavailable at the time of publishing.
2020 Year in Review
93.89%
23
VIRALLY SUPPRESSED
Test and Treat Initiative The Test and Treat (TnT) initiative is a key component of Florida’s plan to eliminate HIV transmission and reduce HIV-related deaths. Testing is available on-site at FDOH-Escambia’s clinic or during various outreach events where rapid tests provide results within minutes. The TnT initiative is a clinical program providing immediate linkage to HIV care and initiation of antiretroviral treatment (ART) during that first visit, if both patient and physician agree.
Patients are then referred to local infectious disease physicians for follow-up and continued care. In 2020, the TnT initiative provided 12 uninsured or under-insured patients with immediate access to HIV medications in an effort to achieve viral suppression and better health outcomes. PrEP and PEP Program PrEP (Pre-exposure Prophylaxis) became a fullservice program in 2019. PrEP is treatment with medications that may prevent infection before being exposed to HIV. PEP (post-exposure prophylaxis) became a full-service program in 2020. PEP is immediate treatment that may prevent infection after being exposed to HIV. PEP treatment must start within 72 hours of the exposure, ideally, within the first 24 hours. PEP treatment involves taking HIV medications for 28 days and is most effective (up to 99%) if taken within 2-3 hours after exposure. In a single visit, a new PrEP/PEP client can receive comprehensive counseling and education from the PrEP/PEP Navigator, required lab work, a medical visit with a clinician, and leave with medication. PrEP patients return every three months for follow-up lab work, risk reduction education and assistance with Patient Assistance Program requirements. PEP patients return a month later to have another HIV test performed and discuss the possibility of becoming a PrEP patient. Most patients are able to receive services and medication for $0 out-of-pocket. In addition to HIV prevention, the benefit of being a patient in the PrEP/PEP program includes early detection and treatment of STDs, increased immunization rates for at-risk patients and routine medical visits to improve overall health. FDOH-Escambia partners with Curant Health Florida, a Specialty Pharmacy, to provide home delivery of medications and access to rebates to increase funds available for the program. Referrals for the PrEP/PEP program come from FDOH-Escambia’s STD program, Family Planning Clinic and other community-based
organizations involved in outreach HIV testing. The PrEP program maintains an active patient roster of 32+ low income uninsured individuals and follows each for compliance with quarterly requirements for participation. The PEP program provided services to 8 clients in 2020. Additionally, the program conducts trainings with local Physician offices, Emergency Departments and Urgent Care Centers to increase access to PrEP and PEP throughout the county. HIV SURVEILLANCE Since January 2020, FDOH-Escambia’s Area 1 HIV program office has held a total of 5 “night clinics” conducting a total of 38 rapid HIV screenings. HIV education presentations and high impact prevention outreach events were also held throughout this year conducting 99 rapid HIV screenings.
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.
2020 Year in Review
*Number reflects December 31, 2019. Year end 2020 numbers were unavailable at the time of publishing.
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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 County in an outbreak which was first identified in 2017. 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 communications campaign and vaccination effort aimed at reaching persons at greatest risk for contracting the virus. Staff collaborated with 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
2020 Year in Review
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.
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PICTURED ABOVE: DOH-Escambia staff at the Hepatitis A Outreach on November 7, 2020.
Tuberculosis Prevention and Control The Tuberculosis (TB) Prevention and Control program staff collaborate with clinicians throughout Escambia County, Florida to ensure that persons diagnosed with TB receive effective and timely treatment and additional contacts who are potentially exposed to the disease are evaluated and treated as needed. The TB case rate for the State of Florida had an unprecedented 26% drop in TB cases from 2019 to 2020. In 2019, the State of Florida reported 558 TB cases and in 2020, 413 TB cases were reported. The state TB office in Tallahassee is suspecting that the huge drop in TB cases is related to the COVID-19 pandemic.
10
ACTIVE TB CASES REPORTED AND TREATED
We had two inter-jurisdictional transfers from Georgia. We had a total of six TB cases that were transferred to Shands Hospital in Jacksonville, FL for medical stability. Registered Nurse, Pamela Nelson, completed 683 nursing assessments. There was a total of 1,277 directly observed or video observed therapies completed with majority in the field. Twelve Tuberculin Skin Tests were administered and 160 IGRA blood tests were collected.
2020 Year in Review
In 2020, the TB program created a presentation for World TB Day that targeted Shelters and the clinic that serves this very vulnerable population. Additionally, FDOHEscambia had a very large contact investigation involving Escambia
County’s homeless population. We tested 64 individuals that were contacts to an active Pulmonary TB case in our homeless population. This investigation was difficult, and many challenges were faced with the COVID-19 pandemic. Many community services were limited or shut down which made it difficult to locate and test contacts.
PICTURED ABOVE: Tuberculosis Morbidity Graph.
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ENVIRONMENTAL Environmental Health (EH) programs conduct inspections, issue permits and licenses, enforce statutes and codes, and respond to questions regarding environmental concerns. Staff use education and training in natural, physical, and environmental sciences to promote and improve the community’s health through monitoring and controlling environmental factors.
Environmental Health Facilities The Environmental Health Facilities program routinely inspects community facilities to promote and ensure safe practices and prevent the spread of infectious diseases of environmental origins. Staff members monitor and inspect certain food service facilities, group care facilities, mobile home and recreational vehicle (RV) parks, biomedical waste generators, storage facilities, and transporters. Staff also investigate rabies and animal bites and respond to
complaints and sanitary nuisances.
Water Quality, Healthy Beaches, and Swimming Pools The Water Quality, Healthy Beaches, and Swimming Pools program regulates drinking water for residential and multifamily units and limited-use drinking water systems under the provisions of Chapter 64E-8, F.A.C. as well as the construction and operation of public swimming pools. This program also monitors bacteriological water quality of Escambia County, Florida’s beaches, bays, and bayous.
387 331
PUBLIC SWIMMING POOLS, SPAS, AND WATER ATTRACTIONS INSPECTED
HEALTHY BEACHES WATER SAMPLES TAKEN AND TESTED
Investigations and Inspections
2020 Year in Review
Programs Totals
27
Food Hygiene Inspections
625
Group Care Facility Inspections
368
Limited Use Wells
3
Mobile Home and RV Park Inspections
645
Biomedical Waste Inspections
706
Body Piercing
16
Tanning
50
Tattoo
221
Rabies Investigations
1115
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
Onsite sewage treatment and disposal systems, commonly referred to as septic systems, are a safe and effective means of wastewater disposal for 30 percent of Florida’s population. The OSTDS program ensures that the systems are properly designed, constructed, and maintained through permitting and inspection, and contributes to safe ground water, which provides 90 percent of Florida’s drinking water.
60 993
ODTDS INSPECTIONS PROCESSED OSTDS APPLICATION
FDOH-Escambia’s Environmental Health Division’s Petroleum Cleanup Section maintains a contract with the FDEP entailing the assessment and remediation of petroleumcontaminated sites across seven (7) counties including Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, and Bay counties. The Petroleum Cleanup Section is actively working 423 petroleum-contaminated sites, with 28 of those sites receiving a Site Rehabilitation Completion Order (SRCO) since January 2020. The goal of the Petroleum Cleanup Program encompasses both the FDOH’s mission to protect, promote, and improve the health of all people in Florida and the FDEP’s goal of protecting our valuable groundwater resources.
423 28
PETROLEUM CLEANUP SITES MANAGED
PETROLEUM SITES CLEANED UP AND CLOSED
The Storage Tank Compliance program is designed to protect our drinking water aquifer and surface water bodies in Florida from risks associated with regulated storage tanks, specifically, petroleum tanks. Inspections are performed in Escambia, Santa Rosa, Okaloosa, Walton, Bay, Holmes, and Washington counties. The Escambia Petroleum Cleanup program covers the same seven Northwest Florida counties. Staff work with the Florida Department of Environmental Protection (FDEP) to ensure that all contamination is eliminated.
644
STORAGE TANK COMPLIANCE INSPECTIONS (515 ROUTINE and 129 VARIABLE)
96.66%
ANNUAL DEP POLLUTANT STORAGE SYSTEM COMPLIANCE VERIFICATION PROGRAM SCORE
2020 Year in Review
Storage Tank Compliance and Petroleum Cleanup
28
PREPAREDNESS A natural or man-made disaster can occur at any moment, and the department is committed to preparedness and response efforts to protect our community as well as other communities across the state. The Public Health Preparedness program assists community organizations in developing formal disaster preparedness plans and participates as the Emergency Support Function (ESF) 8 lead agency in the Escambia County Emergency Operations Center. During disasters, staff work to ensure adequate shelter for vulnerable populations and monitor the safety of the food and water supply. Working to Respond Faster The Florida Department of Health uses the Everbridge Mass Notification System to provide quick communications to employees, volunteers, and partner organizations. This system also supports a variety of personnel who may be called to action during disasters, all-hazards response efforts, and other public health activities. Quarterly drills are executed to measure how efficiently we can respond within one hour.
U-Count Event Providing Vaccinations for the Homeless On January 23, 2020, FDOHEscambia participated in the 2020 U-Count Homeless Resource Day event sponsored by Opening Doors Northwest Florida, our Homeless Coalition. U-Count is a single-day, “one stop shop” event that provides care and services for individuals experiencing homelessness. Over 300 participants received services at the event. FDOH-Escambia offered Hepatitis A and Influenza vaccinations. Student nurses from the University of West Florida and Pensacola State College volunteered to help vaccinate participants.
78 67 51
PARTICIPANTS REGISTERED FOR VACCINATIONS RECEIVED THE HEPATITIS A VACCINE
RECEIVED THE INFLUENZA VACCINE
2020 Year in Review
Everbridge Drill Response
29
Q3 Jan – Mar 2020
88.0%
Q4 Apr – Jun 2020*
N/A
Q1 Jul – Sep 2020
96.2%
Q2 Oct – Dec 2020
94.6%
*Everbridge Drill was not conducted as staff were dedicated to COVID-19 test site.
PICTURED ABOVE: U-Count Homeless Resource Day event on January 23, 2020.
Record-Breaking Hurricane Season The 2020 Atlantic Hurricane season was historically active. There were 30 named storms with 13 producing hurricanes and 6 of those becoming Major hurricanes. Twelve (12) storms made landfall in the United States. FDOH-Escambia’s ESF-8 team was on stand-by for each storm, and were officially activated for three in Escambia.
Hurricane Laura
Hurricane Zeta
Activated 09/16/2020 for 240 hours (last day 09/25/2020)
Activated 09/28/2020 for 24 hours
Activated 10/24/2020 for 24 hours
2020 Year in Review
Hurricane Sally
PICTURED ABOVE: Christie Gillenwater, DOH-Escambia Environmental Specialist, at the Community Outreach Resource Fair on September 26, 2020.
30
Highlight
Hurricane Sally
2020 Year in Review
Hurricane Sally made landfall as a Category 2 hurricane on September 16, 2020 near Gulf Shores, Alabama leading to significant damage and flooding as it moved through the Florida Panhandle. The storm substantially impacted Escambia County, causing 90% of residents to lose power. During this public health emergency, FDOHEscambia responded to meet the needs of the community.
31
Activation of the County Emergency Operations Center (EOC) prompted FDOHEscambia’s responsibility as the lead coordinating agency for Emergency Support Function (ESF) 8. FDOH-Escambia staff provided leadership in coordinating and integrating overall County efforts to provide health and medical assistance to affected areas and populations. In anticipation of Hurricane Sally’s potential impacts, Escambia opened shelters on September 14. Disaster Team 7 was activated to staff the special needs shelter, which was co-located with the general population shelter at the Pensacola Bay Center. Staff completed 35 written requests from LTCs/ALFs, hospitals, physician’s offices and clinics, and funeral homes. Additionally, an Environmental Health Strike Team was utilized and conducted over 320 environmental assessments within the community. FDOH-Escambia provided appropriate, coordinated, and
timely information to the public. Marie Mott, FDOH-Escambia Administrator and Health Officer participated in several EOC press conferences. FDOH-Escambia’s Public Information Office ensured that the public was well informed on relevant health advisories via various communications channels including press releases and social media platforms.
Community Outreach Resource Fair for Renters Impacted by Hurricane Sally In response to the devastating impact of Hurricane Sally to Escambia County, team members from divisions across FDOH-Escambia volunteered to participate in a 3-day community outreach event. The event was held from September 25 through September 27, 2020 and was tailored for renters impacted by Hurricane Sally. DOH-Escambia team members from CHEN, EH and WIC were able to provide resources on flooding, drain and cover, healthy eating, available services, etc. to event attendees.
2020 Year in Review
PICTURED: FDOH-Escambia Staff responding to Hurricane Sally.
32
COMMUNICATIONS The communications team develops content and distributes health messages to the public and media outlets through a wide variety of methods, including print and web advertisements, news interviews and press releases, social media, e-newsletters, videos, community presentations, and other shareable resources for businesses and faithbased organizations. Public Information Office The Public Information Officers (PIOs) interface with local and regional media outlets to provide accurate, timely, and relevant health information to the public. Information is shared through news media, social media, digital and print publications, and EscambiaHealth.com. PIOs also coordinate public health-related communications during disaster response and work closely with partner organizations as well as the Department’s Central Office of Communications in Tallahassee.
108 170
MEDIA RELEASES ISSUED. 70 WERE COVID-19 RELATED RESPONSES TO MEDIA REQUEST, 146 WERE COVID-19 RELATED
Campaigns
• 5-2-1-0 • Breast Cancer Awareness • COVID-19 Testing • Ciclovía • Diabetes Prevention • Drain & Cover is Mosquito Prevention • Flu Prevention • Hand-washing • Hepatitis A Prevention • HIV/AIDS Prevention • Rabies Prevention • Stay Home (COVID-19 Prevention) • Sun’s Up, Cover Up • Touch Supervision is Drowning Prevention • WIC
2020 Year in Review
COVID-19 Response
33
Our media partners play a vital role in our public health system; FDOHEscambia collaborates with media professionals to inform, educate, and empower people about health issues by providing accurate, timely information. Since the onset of the Corona virus outbreak, FDOH-Escambia has continuously worked with community partners and local governments to combat the spread of COVID-19. FDOH-Escambia has participated in several press conferences in an effort to encourage prevention efforts, such as social distancing, 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.
2020 Year in Review
PICTURED LEFT: September 23, 2020: Marie Mott participated in a Hurricane Sally press conference at the EOC.
34
ACCREDITATION During 2020, FDOH-Escambia began the Re-Accreditation process. Selected as a ‘PHAB 15 County’, the performance management team was required to write and submit 89 documents that correspond to the Ten Public Health Services framework and provided evidence that we, as a county health department, have been meeting national public health accreditation standards. Public health accreditation also requires the implementation of a performance management system and the creation and use of the strategic plan, quality improvement plan, and workforce development plan.
2020 Year in Review
Promoting a Culture of Quality The Performance Management System develops and implements a comprehensive approach to monitoring, assessing, and improving the quality of FDOH-Escambia’s work. It encompasses all aspects of organizational development and quality improvement, including state and local measuring and reporting, national accreditation, and strategic planning. Through quarterly tracking of our Strategic Plan objectives, corrective actions are taken if targets are not being met.
35
Strategic Planning FDOH-Escambia initiated a new strategic planning process in June of 2020. The strategic plan sets the direction for action for FDOHEscambia for a 3-year cycle. As part of the Performance Management (PM) system, it identifies the priority focus areas for the department, and aligns with state and national priorities. The plan will position FDOH-Escambia to operate as a sustainable integrated public health system and provide FDOH-Escambia customers with quality public health services. It is a living document that FDOH-Escambia
will evaluate and update annually to address new challenges posed by the changing public health environment. FDOH-Escambia published the 20212023 Strategic Plan January 1, 2021. Quality Improvement and Workforce Development The Performance Management and Quality Improvement (PMQI) Plan summarizes FDOH-Escambia’s comprehensive approach to improving outcomes through evidence-based decision-making, continuous organizational learning and performance improvement. Additionally, the purpose of the Work Force Development Plan is to ensure that the DOH workforce has the knowledge, skills, abilities, and competencies needed to carry out the Department’s mission and achieve its strategic objectives. In addition, the Plan is linked to and supports the PMQI Plan to help ensure that staff have access to the training needed to support ongoing PMQI activities.
PICTURED ABOVE: Kimberly Pace finalizing strategic plan training day presentation on October 22, 2020.
ACCOUNTING Striving Toward Operational Excellence The Accounting Office provides budgeting and accounting services to all programs within FDOH-Escambia. The categories of responsibility include accounts payable, accounts receivable, asset management, banking, billing, budget, contracts, procurement, purchasing card management, and provider credentialing.
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 Benefits 77%
NOTE: Financial reporting for this report is by fiscal year, July 1, 2019 through June 30, 2020; therefore, the full amount of COVID-19 funding and expenditures for 2020 is not reported in this Annual Report. Expenditures for COVID-19 activities totaled $458,000 through June 30, 2020. Some programs did not spend their total program funding allocation since employees were redirected to COVID-19 response.
2020 Year in Review
Contracted Services 9.2%
36
FACILITIES AND IT Facilities and Maintenance The Facilities and Maintenance program ensures a clean, safe, and well-maintained working environment. Staff inspect buildings and structures to detect malfunctions and perform routine maintenance at three different locations. Facilities supports the day-to-day needs of the department by performing office moves, minor repairs and any other needs through the Help Desk system.
2,000
FACILITIES HELP DESK TICKETS COMPLETED 2020 Special Projects All Sites: X Hurricane Sally Recovery
Information Technology Our Information Technology (IT) program supports FDOHEscambia’s technological needs and infrastructure. The IT Help Desk serves as the primary contact for all issues related to computer, network, and telecommunications systems, allowing IT staff to provide the highest level of support and work quickly to resolve reported technology issues. operate as a sustainable integrated public health system and provide FDOH-Escambia customers with quality public health services. It is a living document that FDOH-Escambia
2,879
IT HELP DESK TICKETS COMPLETED
X COVID-19 Logistic Support Fairfield: X Irrigation Pump Replacement X Renovated 23 Clinic Rooms after Community Health of Northwest Florida Pediatrics Vacated Downtown Center X Irrigation Pump Replacement
2020 Year in Review
X Exterior Painting on Second Floor
37
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.
2020 Year in Review
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-Escambia employs a wide variety of public health professionals, including nurses, physicians, dietitians, epidemiologists, geologists, and planners as well as support professionals, such as accountants, IT professionals, customer service representatives, training and personnel staff, and communications professionals. FDOH-Escambia also provides a wide variety of internship opportunities in various fields. 22 Interns Trained in Key Areas X Clinical Nursing X Communicable Diseases X Environmental Health
Participating Schools X CDC’s Public Health Associate Program X Florida State University X Pensacola State College
X Epidemiology
X Southern Methodist University
X Health Education
X University of Florida
X Infectious Disease
X University of South Alabama
X Nutrition
X University of South Florida
X Pediatric Medicine
X University of West Florida
X Pharmacy X Phlebotomy
X Wellness Workdays Dietetic Internship, Inc.
X Public Health Preparedness
X West Florida Pharmacy School
Note: The Internship Program was temporarily inactive from August until December of 2020 during the transition from Dr. Lanza to Marie Mott.
2020 Year in Review
100%
39
192
EMPLOYEES
OF EMPLOYEES COMPLETED ANNUAL MANDATORY TRAINING
96% Full Time
79% Women
Employee Wellness One of the many ways our employees live the department mission to protect, promote, and improve health is by participating in employee wellness activities. A well-designed employee wellness program can have many benefits, such as increased productivity and morale, and decreased absenteeism. FDOH-Escambia offers quarterly wellness challenges to encourage employees to engage in healthy behaviors, like eating healthy during the holidays or meeting physical activity goals.
2020 Employee Wellness Highlights 30-Day Water Challenge
X 20 employees wore green to raise awareness for mental health.
X Employees were given water recipes to encourage staying hydrated.
X Employees were encouraged to take post it notes from the bulletin boards with positive mental health messaging.
X 25 employees kept track and logged their water intake for the 30 days.
Race to the North Pole Walking Challenge
X 54 gallons were consumed during the 30-day period.
Dental Health Awareness Month
X Employees in each division were challenged to walk to the North Pole.
X The bulletin board educated employees about some key facts related to dental hygiene.
X Divisions competed against each other each week to see who turned in the most steps to help Santa save Christmas.
X Employees completed crossword puzzles related to the information on the boards.
X 25 employees turned in their steps every other week for the 3- month reporting period. X All divisions combined walked over 15,000,000 steps!
X Word searches were also provided to employees.
2020 Year in Review
Wear Green for Mental Health Awareness Month
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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 Breastfeeding Support and Education 3 Community Health Northwest Florida Dental and Pediatric Clinics 3 Community Health Planning and Statistics 3 Epidemiology 3 Family Health Clinic
3 Immunizations Clinic 3 Improved Pregnancy Outcome Program (IPOP) 3 Medical Records 3 Public Health Preparedness 3 Public Information 3 Nutrition Services
3 Family Planning Clinic
3 STD, TB, HIV/AIDS Screening and Treatment
3 Florida Breast and Cervical Cancer Early Detection Program
3 Tobacco Free Florida-Escambia
3 Health Education 3 Healthy Start
3 Vital Statistics 3 We Care Referral Program 3 Women, Infants and Children (WIC)
WIC Clinic: Northside Services Center
2020 Year in Review
8390 North Palafox Street Pensacola, FL 32534
41
850-484-5121 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 Biomedical Waste 3 Body Piercing and Tattoo Parlors 3 Fiscal 3 Food Hygiene 3 Mobile Home Parks 3 Onsite Sewage Treatment and Disposal Systems
3 Public Pools and Spas 3 Public and Private Schools 3 Rabies Surveillance 3 School Health 3 Storage Tank Compliance and Petroleum Cleanup 3 Tanning Salons 3 Water Quality Research
WIC Clinic: Naval Hospital Pensacola 6000 Highway 98 Pensacola, FL 32512 850-595-6670 Hours of Operation Wednesday thru Friday Appointments Only
2020 Year in Review
Programs and Services
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1295 West Fairfield Drive | Pensacola, Florida 32501 | 850-595-6500 www.EscambiaHealth.com
2020 Year in Review
@HealthyEscambia
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