Transcription
Florida Department of Health in Broward CountyCOMMUNITY HEALTH IMPROVEMENT PLANANNUAL PROGRESS REPORT2021Ron DeSantisGovernorJoseph A. Ladapo, MD, PhDState Surgeon GeneralApril 11, 2022Template revised 12/3/2020
Produced by:Florida Department of HealthBroward CountyTemplate revised 12/3/2020
Table of ContentsIntroduction . 1Overview of CHIP and Annual Review Meeting . 2Methodology . 2Issue Synthesis and Prioritization . 32021 Progress and 2022 RevisionsObjective 1.a.1 . 3Objective 4.a.1 . 4Objective 4.a.2 . 5Objective 2.a.1 . 6Objective 2.a.2 . 7Objective 2.a.3 . 8Objective 2.a.4 . 9Objective 2.a.5 . 10Objective 2.a.6 . 11Objective 3.a.1 . 12Objective 3.b.1 . 13Objective 3.d.1 . 14Objective 3.d.2 . 15Objective 3.d.3 . 16Objective 3.e.1 . 17Objective 3.c.1 . 18Objective 4.b.1 . 19Objective 4.b.2 . 20Objective 4.b.3 . 21Objective 4.b.4 . 22Objective 4.c.1 . 23Trend and Status Descriptions . 24New Objectives . 25Accomplishments . 26Conclusion . 27Appendices . 28Appendix A: Annual CHIP Review Meeting Agenda . 29Appendix B: Annual CHIP Review Meeting Minutes . 30Appendix C: Annual CHIP Review Meeting Sign-in Sheet . 31Appendix D: Comprehensive List of Community Key Partner Agencies . 32Appendix E: COVID-19 Accomplishments . 35Template revised 12/3/2020
IntroductionThis is the annual review report for the 2021 Broward County Community Health ImprovementPlan (CHIP). The activities and collaborative efforts of the Florida Department of Health inBroward County (DOH-Broward) and community partners will be reflected within the report. Thisdocument will serve as a progress review of the strategies that were developed and the activitiesthat have been implemented. While the CHIP is a community driven and collectively ownedhealth improvement plan, DOH-Broward is charged with providing administrative support,tracking, and collecting data, and preparing the annual review report.Overview of CHIP and Annual ReviewMeetingThe Mission of DOH-Broward is “to protect, promote and improve the health of all people inFlorida through integrated state, county and community efforts”. In accordance with this mission,DOH-Broward engaged the Broward County community in the Mobilizing for Action throughPlanning and Partnerships (MAPP) process in 2012, 2016 and 2019. MAPP is a communitydriven strategic planning tool developed by the National Association of County & City HealthOfficials (NACCHO) for improving community health. This tool provides guidance forcommunities in each of the six MAPP phases: Organize for Success; Visioning; TheAssessments; Strategic Issues; Goals/Strategies; and Action Cycle. MAPP is a strategicapproach to community health improvement and assists communities to improve health andquality of life through community-wide strategic planning. MAPP includes four separateassessments: Community Health Status, Community Themes and Strengths, Local PublicHealth System, and the Forces of Change.Broward County has a long history of collaboratively planning across multiple state, county, andlocal entities from the public and private sectors to ensure the highest quality of care that alsoreduce redundancies and duplication within the system of care. DOH-Broward utilized thisexisting community-based planning structure to assist in the development of the CommunityHealth Assessment (CHA). The Broward Regional Health Planning Council met on May 23,2022, to approve the 2021 CHIP Annual Report.MethodologyThe Community Health Status Assessment was completed in November 2020. The healthstatus assessment outlines community health status through six broad health categories:Maternal and Child Health, Behavioral Health and Substance Use, Behavioral Risk FactorSurveillance Survey, Youth Risk Behavior Survey, School Health, Environmental Health,Leading Causes of Morbidity and Mortality and Communicable Disease. The report presents 10years of data when available and trends indicating better, worse or the same as the previousTemplate revised 12/19/20191
year. Data sources included Florida Charts, Behavioral Risk Factor Surveillance Survey,Florida Department of Health, United Way Commission on Behavioral Health and SubstanceAbuse, Broward County Environmental Protection and Growth Management Department, YouthRisk Behavior Survey and Broward County Public Schools.The Forces of Change Assessment focuses on identifying forces such as legislation,technology, and other impending changes that affect the context in which the community and itspublic health system operates. This answers the questions: "What is occurring or might occurthat affects the health of our community or the local public health system?" and "What specificthreats or opportunities are generated by these occurrences?" In Broward County, the surveywas completed by two community focus groups, two provider focus groups, communitymeetings, presentations, and key informant interviews.The Local Public Health System Assessment (LPHSA) was conducted in the fall of 2019using The National Public Health Performance Standards Program (NPHPSP). Theseassessments are intended to help users answer questions such as "What are the activities andcapacities of our public health system?" and "How well are we providing the Essential PublicHealth Services in our jurisdiction?" The dialogue that occurs while answering these questionshelps to identify strengths and opportunities for improvement. Forty-eight organizationscompleted the online performance rating survey. The Healthcare Access Committee memberscompleted the priority rating questionnaire and Florida Department of Health leadershipcompleted the agency contribution section.The Community Themes and Strengths Assessment utilized the 2019 Community HealthNeeds Assessment developed by Professional Research Consultants, Inc. The CommunityHealth Needs Assessment is a continuation of nine similar studies conducted since 1994 and isa systematic, data driven approach to determining the health status, behaviors and needs ofresidents in Broward County, Florida. The Assessment serves as a tool toward reaching threebasic goals: to improve resident’s health status, increase their life span, and elevate theiroverall quality of life; to reduce heath disparities; and, to increase access to preventive services.Template revised 12/3/20202
Issue Synthesis and PrioritizationAn analysis of the four MAPP assessments identified health related challenges in BrowardCounty that were identified and were validated in the Community Health Status Assessment.These challenges were then categorized into four broad categories each containing one or moreof the identified health challenges. The Community Health Assessment provided a peercomparison group selected based on the closeness of the match between select counties andsocio-demographic indicators for Broward County. Broward County's peer group is composed ofthe following Florida counties: Hillsborough, Miami-Dade, Orange and Palm Beach. Data foreach of the nine identified health challenges were then compared to the peer group average andthe state average value. In addition, the Healthy People 2030 goal and indicator were includedfor each identified challenge. Healthy People 2030 tracks approximately 1,200 objectivesorganized into 42 topic areas, each of which represents an important public health subject area.The Health Care Access Committee was established as a committee of the Coordinating Councilof Broward. The purpose of the committee is to improve access to health care for the residents ofBroward County, through the establishment of outcomes and indicators, which have been andwill continue to be implemented and measured throughout the next several years. The membersof the committee represent various facilities, agencies and/or departments within the county. Thecommittee continues to set goals for Broward County in many areas of health including but notlimited to maternal and child health, mental health, health care access, primary care and dentalcare. The Health Care Access Committee meets monthly and agreed to provide input andoversight to the Community Health Assessment and Community Health Improvement Plans.Strategic Issue Area1. Access to Care2. Communicable and Infectious DiseasesGoalIncrease health insurance for children ages0-18Reduce the Incidence of Communicable andInfectious DiseasePerinatal transmission of HIVSyphilis cases/incidence3. Maternal, Infant and Child HealthCervical CancerInfant Mortality (Blacks)Fetal deaths4. Preventative Care ActivitiesImmunizations for Children (2 y/o’s,Kindergarten, 7th graders)Unintentional injury and Drug Use: Preventand reduce unintentional injuries and deathsTemplate revised 12/3/20203
The Community Health Assessment provided a peer comparison group selected based on thecloseness of the match between select counties and socio-demographic indicators for BrowardCounty. Broward County’s peer group is composed of the following Florida counties:Hillsborough, Miami-Dade, Orange and Palm Beach. Data for each of the identified healthchallenges were then compared to the peer group average and the state average value. Inaddition, the Healthy People 2030 goals and indicators were included for each identifiedchallenge. Healthy People 2030 includes the Social Determinates of Health (SDOH) which arethe conditions in the environments where people are born, live, learn, work, play,worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes andrisks. Healthy People 2030 grouped SDOH into 5 domains that are considered in creating CHIPobjectives:Template revised 12/3/20204
2021 Progress and 2022 RevisionsStrategic Issue Area #1: Access to CareThe Access to Care strategic area focuses on efficient public health systems, and planning andassessing processes that maximize partnerships and expertise in a community. The specific focusareas are access to care, is being defined in the CHIP as increasing the number percentage of childrenaged 0-18.Goal 1.a: Increase access to immunizationsStrategy: Increase the number of Broward County residents who are fullyvaccinated for COVID-19Objective 1.a.1: Increase the percent of Broward County residents who are current with theirCOVID-19 vaccination schedule (fully vaccinated) from 0% (2019) to 80% by December 31,2025Key Partners: Health Care Access Committee, Healthy Start Coalition, 211, Broward Health Systems,Memorial Health Systems, Healthy Mothers, Healthy Babies, Urban League, CDTC, Premiere OBGYN, 8 delivery hospitals, Early Learning Coalition, Immunization Action Coalition, Healthy FamiliesAdvisory Council, Healthy Start. Nurse Family Partnership, Broward Regional Health Planning Council,Department of Health, Broward County Public Schools2021 PerformanceObjectiveNumberObjective1.a.1Increase the percentof Broward Countyresidents who arecurrent with theirCOVID-19vaccinationschedule (fullyvaccinated) from 0%(2019) to 80% byDecember 31, 2025Baseline0%(2019)Source: FLHealthCHARTS,FL SHOTSPerformancepercent 5 vaccinated84%TargetValue80%Target Date Trend1Status1On TrackDecember 31, 20252022 RevisionsN/ARationaleN/A2021 Progress: metric is on track to meet target by December 31, 2025.How Targets Were MonitoredThe target was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. Additionally, DOH-Broward has developed and implemented aTemplate revised 12/3/20203
comprehensive performance management system that continuously monitors organizationalperformance. Program activities at all levels in the organization down to the individual employee aremonitored using cascading Scorecards-Active Strategy. All program metrics including the CHIP arereviewed for their progress during the monthly Business Review meetings and corrective actions areimplemented for underperforming metrics.Strategic Issue Area #4: Enhance Preventative Care ActivitiesUndiagnosed and untreated health conditions can have serious health consequences. Prevention,diagnosis and treatment can have exponential benefits including health, quality of life and cost savings.thGoal 4.a: Immunizations for Children (2 y/o, Kindergarten, 7 graders)Strategy: Increase number of newborns and children less than 24 monthsenrolled in Shots by TwoObjective 4.a.1: Increase the percent of 2-year-olds fully immunized from 79.1% in 2019 to95.0% by December 2023Key Partners: Health Care Access Committee, Healthy Start Coalition, 211, Broward Health Systems,Memorial Health Systems, Healthy Mothers, Healthy Babies, Urban League, CDTC, Premiere OBGYN, 8 delivery hospitals, Early Learning Coalition, Immunization Action Coalition, Healthy FamiliesAdvisory Council, Healthy Start. Nurse Family Partnership, Broward Regional Health Planning Council,Department of Health, Broward County Public Schools2021 PerformanceObjectiveNumberObjective4.a.1Increase the percentof 2-year-olds fullyimmunized from79.1% in 2019 to95.0% by December2023Baseline79.1%(2019)Source: FLHealthCHARTS,FL SHOTSPerformance85.8%(2020)Source: FLHealthCHARTS, FLSHOTSTargetValue95.0%Target Date Trend1Status1On TrackDecember 31, 20232022 RevisionsN/ARationaleN/A2021 Progress: metric is on track to meet target by December 31, 2023.How Targets Were MonitoredThe target was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitorsorganizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theTemplate revised 12/3/20204
CHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for underperforming metrics.Strategic Issue Area #4: Enhance Preventative Care ActivitiesUndiagnosed and untreated health conditions can have serious health consequences. Prevention,diagnosis and treatment can have exponential benefits including health, quality of life and costsavings.thGoal 4.a: Immunizations for Children (2 y/o, Kindergarten, 7 graders)Strategy: Increase number of newborns and children less than 24 monthsenrolled in Shots by TwoObjective 4.a.2: Increase the percent of children fully immunized in kindergarten from 93.9% in2020 to 96.0% by December 2023Key Partners: Health Care Access Committee, Healthy Start Coalition, 211, Broward Health Systems,Memorial Health Systems, Healthy Mothers, Healthy Babies, Urban League, CDTC, Premiere OBGYN, 8 delivery hospitals, Early Learning Coalition, Immunization Action Coalition, Healthy FamiliesAdvisory Council, Healthy Start. Nurse Family Partnership, Broward Regional Health Planning Council,Department of Health, Broward County Public Schools2021 PerformanceObjectiveNumberObjective4.a.2Increase the percentof children fullyimmunized inkindergarten from93.9% in 2020 to96.0% byDecember 2023Baseline93.9%(2020)Source: FLHealthCHARTS,FL SHOTSPerformance93.60%(2020)Source: FLHealthCHARTS, FLSHOTSTargetValue96.0%Target Date Trend1Status1Not on TrackDecember 20232022 RevisionsN/ARationaleN/A2021 Progress: metric is not on track to meet target by December 31, 2025. Action planning to improvemetric attainment will be conducted.How Targets Were MonitoredThe target on the objective was monitored through CHIP quarterly reports. Specific activities andactions were developed and monitored. The program manager reported on the activities on a quarterlybasis to the Community Health Planner using the CHIP template. In addition, DOH-Broward hasdeveloped and implemented a comprehensive performance management system that continuouslymonitors the organizational performance. Program activities at all levels in the organization down to theindividual employee are monitored using cascading Scorecards-Active Strategy. All the programTemplate revised 12/3/20205
metrics including CHIP are reviewed for their progress during the monthly Business Review meetingsand corrective actions are implemented for the underperforming metricsStrategic Issue Area #2: Communicable and InfectiousDiseasesReporting of communicable and sexually transmitted diseases (STDs) is important in the planning andevaluation of disease prevention and control programs, in the assurance of appropriate medical therapy,and in the detection of common-source outbreaks.Goal 2.a: Reduce the incidence of communicable and infectiousdiseasesStrategy: Decrease the incidence of communicable diseases including STIs, HIV,and eliminate perinatal HIV transmissionObjective 2.a.1: Decrease the rate of new HIV Infection from 32.4 per 100,000 to 26.32 byDecember 2023Key Partners: Test and Treat Champions: Ryan White Part A Providers, Test and Treat Contacts:Registered Counseling and Testing Sites, CBOs, DOH, Healthcare Providers, BRTA businesses,Contracted providers, Black AIDS Institute2021 PerformanceObjectiveNumberObjective2.a.1Decrease the rate ofnew HIV Infectionfrom 32.4 per100,000 to 26.32 byDecember 2023Baseline32.4 per100,000Source: nce Value24.0 per26.32100,000per(2020)100,000Source: FLHealthCHARTS,HIVSurveillancereportTarget Date Trend1Status1On TrackDecember 20232022 RevisionsN/ARationaleN/A2021 Progress: metric is on track to meet target by December 31, 2023.How Targets Were MonitoredThe target objective was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitors theTemplate revised 12/3/20206
organizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theCHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for the underperforming metricsStrategic Issue Area #2: Communicable and InfectiousDiseasesReporting of communicable and sexually transmitted diseases (STDs) is important in the planningand evaluation of disease prevention and control programs, in the assurance of appropriatemedical therapy, and in the detection of common-source outbreaks.Goal 2.a: Reduce the incidence of communicable and infectiousdiseasesStrategy: Decrease the incidence of communicable diseases including STIs, HIV,and eliminate perinatal HIV transmissionObjective 2.a.2: Decrease the rate of early syphilis per 100,000 population from 60.6 in 2019 to55.6 by December 2023Key Partners: Test and Treat Champions: Ryan White Part A Providers, Test and Treat Contacts:Registered Counseling and Testing Sites, CBOs, DOH, Healthcare Providers, BRTA businesses,Contracted providers, Black AIDS Institute2021 PerformanceObjectiveNumberObjective2.a.2Decrease the rate ofearly syphilis per100,000 populationfrom 60.6 in 2019 to55.6 by December2023Baseline60.6 per100,000(2019)Source: nceValueTarget Date Trend1Status1Not on Track70.5 per55.6 per December 100,000100,000 2023(2020)Source: FLHealthCHARTS, HIVSurveillancereport2022 RevisionsN/ARationaleN/A2021 Progress: metric is on not track to meet target by December 31, 2023. Programmatic actionplanning will be conducted to improve metric.How Targets Were MonitoredTemplate revised 12/3/20207
The target was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitorsorganizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theCHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for underperforming metricsStrategic Issue Area #2: Communicable and InfectiousDiseasesReporting of communicable and sexually transmitted diseases (STDs) is important in theplanning and evaluation of disease prevention and control programs, in the assurance ofappropriate medical therapy, and in the detection of common-source outbreaks.Goal 2.a: Reduce the incidence of communicable and infectiousdiseasesStrategy: Decrease the incidence of communicable diseases including STIs, HIV,and eliminate perinatal HIV transmissionObjective 2.a.3: Decrease the rate of infectious syphilis cases among blacks from 25.6 per100,000 in 2019 to 19.4 by December 2023Key Partners: Test and Treat Champions: Ryan White Part A Providers, Test and Treat Contacts:Registered Counseling and Testing Sites, CBOs, DOH, Healthcare Providers, BRTA businesses,Contracted providers, Black AIDS Institute2021 PerformanceObjectiveNumberObjective2.a.3Decrease the rate ofinfectious syphiliscases among blacksfrom 25.6 per100,000 in 2019 to19.4 by December2023Baseline25.6 per100,000(2019)Source: nceValueTarget Date Trend1Status1On Track25.1 per19.4 per December 100,000100,000 2023(2020)Source: FLHealthCHARTS, HIVSurveillancereport2022 RevisionsN/ARationaleN/A2021 Progress: metric is on track to meet target by December 31, 2023.Template revised 12/3/20208
How Targets Were MonitoredThe target was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitorsorganizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theCHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for underperforming metrics.Strategic Issue Area #2: Communicable and InfectiousDiseasesReporting of communicable and sexually transmitted diseases (STDs) is important in theplanning and evaluation of disease prevention and control programs, in the assurance ofappropriate medical therapy, and in the detection of common-source outbreaks.Goal 2.a: Reduce the incidence of communicable and infectiousdiseasesStrategy: Decrease the incidence of communicable diseases including STIs, HIV,and eliminate perinatal HIV transmissionObjective 2.a.4: Increase the percent of people living with HIV retained in care on ART from74% in 2019 to 90% by December 2023Key Partners: Test and Treat Champions: Ryan White Part A Providers, Test and Treat Contacts:Registered Counseling and Testing Sites, CBOs, DOH, Healthcare Providers, BRTA businesses,Contracted providers, Black AIDS Institute2021 PerformanceObjectiveNumberObjective2.a.4Increase the percentof people living withHIV retained in careat ART from 74% in2019 to 90% byDecember 2023Baseline74%(2019)Source: nceValue73.3%90%(2020)Source: FLHealthCHARTS, HIVSurveillancereportTarget Date Trend1Status1Not on TrackDecember 20232022 RevisionsN/ARationaleN/ATemplate revised 12/3/20209
2021 Progress: metric is on track to meet target by December 31, 2023. Programmatic action planningwill be conducted to achieve metric target.How Targets Were MonitoredThe target objective was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitors theorganizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theCHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for the underperforming metrics.Strategic Issue Area #2: Communicable and InfectiousDiseasesReporting of communicable and sexually transmitted diseases (STDs) is important in theplanning and evaluation of disease prevention and control programs, in the assurance ofappropriate medical therapy, and in the detection of common-source outbreaks.Goal 2.a: Reduce the incidence of communicable and infectiousdiseasesStrategy: Decrease the incidence of communicable diseases including STIs, HIV,and eliminate perinatal HIV transmissionObjective 2.a.5: Increase the percent of people living with HIV retained in care on ART withsuppressed viral load from 70% in 2019 to 90% in December 2025Key Partners: Test and Treat Champions: Ryan White Part A Providers, Test and Treat Contacts:Registered Counseling and Testing Sites, CBOs, DOH, Healthcare Providers, BRTA businesses,Contracted providers, Black AIDS Institute2021 PerformanceObjectiveNumberObjective2.a.5Increase the percentof people living withHIV retained in careon ART withsuppressed viralload from 70% in2019 to 90% inDecember 2025Baseline70%(2019)Source: nceValue89% (2020) 90%Source: FLHealthCHARTS,HIVSurveillancereportTarget Date Trend1Status1On TrackDecember 20252022 RevisionsN/ARationaleN/ATemplate revised 12/3/202010
2021 Progress: metric is on track to meet target by December 31, 2025.How Targets Were MonitoredThe target objective was monitored through CHIP quarterly reports. Specific activities and actions weredeveloped and monitored. The program manager reported on the activities on a quarterly basis to theCommunity Health Planner using the CHIP template. In addition, DOH-Broward has developed andimplemented a comprehensive performance management system that continuously monitors theorganizational performance. Program activities at all levels in the organization down to the individualemployee are monitored using cascading Scorecards-Active Strategy. All program metrics including theCHIP are reviewed for their progress during the monthly Business Review meetings and correctiveactions are implemented for t
The Community Themes and Strengths Assessment utilized the 2019 Community Health Needs Assessment developed by Professional Research Consultants, Inc. The Community Health Needs Assessment is a continuation of nine similar studies conducted since 1994 and is a systematic, data driven approach to determining the health status, behaviors and needs of
