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2019–2021A N N U A LR E P O R TOUR VISION: TO BE THE HEALTHIEST STATE IN THE NATIONCOVID-19 ResponseConfronting the Global PandemicO U R VA L U E essExcellenceOUR MISSIONTo protect, promote,and improve thehealth of all peoplein Florida throughintegrated state,county, and communityefforts.FLORIDADEPARTMENT OF HEALTHIN HILLSBOROUGH COUNTY1105 E. Kennedy Blvd.Tampa, FL sborough
2 ANNUAL REPORTP R O D U C E D B Y T H E F LO R I DAD E PA RT M E N T O F H E A LT HI N H I L L S B O R O U G H CO U N T YThe mission of the FloridaDepartment of Health is toprotect, promote and improvethe health of all people inFlorida through integrated state,county, and community efforts.In Hillsborough County,the programs and servicesfall under six divisions:Administrative Services,Community Health, DiseaseControl, Environmental Health,Nutrition/WIC, and Public HealthPreparedness. Throughout 2019,divisions focused operations onits programs and services, butby 2020, the COVID-19 pandemicforced all to respond to thepublic health threat.MANAGING EDITORKevin WatlerSR. LEADER ADVISORCindy MorrisLAYOUT/DESIGNRyan L. TerryEDITINGRebecca WhisenhuntGOVERNORRon DeSantisMESSAGE FROM THEDIRECTORDr. Douglas A. HoltEach year, the Florida Departmentof Health in Hillsborough County(DOH-Hillsborough) produces an annual report to summarize accomplishments and activities that occurredduring the previous fiscal year.However, this annual report coversthe last two fiscal years, from July2019 to June 2021.These two years were very challenging. We responded to the COVID-19pandemic, a bad flu season, and theHepatitis-A public health emergency.According to the 2019 County HealthRankings and Roadmaps tool releasedby the University of Wisconsin andthe Robert Wood Johnson Foundation,Hillsborough County is moving in theright direction. In 2011, the countyranked 30th in the state for healthoutcomes.day and night to protect the public’shealth. They have risen to the challenge in the most amazing, heroic way.I am proud and blessed to work withthe team.“The DOHHillsboroughfamily has.risento the occasionin the mostremarkableways.”Last fiscal year we ranked 23rd in thestate. Now we are ranked 19th in thestate. DOH-Hillsborough is committedto being a model public health agency.By the end of the fiscal year, we finalized a community health assessmentand community health improvementplan, which is done every five years.The findings will create priority areas for the upcoming years. TheDOH-Hillsborough family has workedLT. GOVERNORJeanette NuñezDedicationSURGEON GENERALDr. Joseph Ladapo (2021)Dr. Scott Rivkees (2019–21)This annual report is dedicated to the life and publicservice of Brenda Hammers, who passed away on March23, 2021. Ms. Hammers worked in the Nutrition Divisionas a Health Support Specialist at the North HillsboroughWIC clinic.
3 FY 2019–202141820171412COVID-19 Pandemic Response04Environmental Health17Administrative Services10Nutrition/WIC18Public Health Preparedness20 rom the moment COVID-19 was detected in HillsboroughFCounty, our response began, and continues to this day inance & Accounting, General Services, PersonnelFServices, Information Technology, Performance &Quality Improvement, and Vital StatisticsCommunity Health12Disease Control14Epidemiology, Health Promotion & Education,and Office of Health EquityClinical HIV Research, HIV/AIDS Program Office &Surveillance, Immunization, Refugee Health, STDs,Specialty Care Center, and Tuberculosis ProgramCommunity Environmental Health, Safe Drinking Water,Onsite Treatment and Disposal SystemsBreastfeeding support, Food Accessibility,Clinical DieticiansEmergency Support, Special Needs Shelter Registry, RiskCommunications and Public Information, Cities ReadinessInitiative, and Medical Reserve CorpsFY 2019–2021
4 ANNUAL REPORTCOVID-19 RESPONSEConfronting the Global P a n d e m i cH e r e a t H o m e i n Ta m p a B a yfor a combined response. The CountyEmergency Operations Centerbecame the central hub to coordinatemanpower, operations, and resources.As cases began to be identified in lateFebruary 2020, the department took thelead role in establishing a communityplan for isolating and quarantiningresidents and visitors. Working withGeneral Services, a hotel was identifiedfor those individuals who could notsafely remain at home. Additionally,food and other basic necessities had tobe provided to these individuals.As reports of COVID-19 beganspreading outside of China inDecember 2019, Epidemiology beganclosely monitoring the spread of thedisease.workgroups of community partnerswere formed to address large-scaleisolation/quarantine, support services,vaccinations, and health care systemsurge.When cases were first identified inthe United States in early January,the department began communicatingsituational awareness to the localmedical system and other partners.On January 13, 2020, preparednessstaff met with Hillsborough CountyEmergency Management andemergency medical services agenciesto establish a formal response structureand identify gaps for a potentialpandemic. A broader-scope meetingwas held at the end of January with allcommunity partners identified as havinga role in the response.In mid-January, the Director begancommunicating with local leadersabout the disease and to ensureawareness of plans existed to respondto a highly infectious disease. TheHillsborough County PandemicInfluenza Plan served as the model forresponse.Actions and activities specific to theCOVID-19 disease were developed astactical, supporting plans; as well asEarly in March 2020, after the first casewas identified in the County, a UnifiedCommand was established between theDepartment of Health in HillsboroughCounty and Hillsborough CountyGovernmentRisk communications with the publicwas essential to keep the publicinformed and provide actions thatthey could take to reduce the risk ofcontracting the disease and reducingthe spread. A Joint Information Center(JIC) was established to addresscommunication with the public.The Public Information Officer (PIO)worked with the Hillsborough CountyCommunications Office to establishcall centers. Scripts were developedand updated daily to provide to thecontractor, who would screen thecalls, provide general information, andtransfer callers to the DOH-Hillsboroughfor specific technical questions.Testing was in extremely high demandbeginning in late February 2020. TheState of Florida Division of EmergencyManagement established a single siteclose to Raymond James Stadiumthat was open to the public. Thedepartment worked with the county,City of Tampa, and local healthcaresystems to establish public testingsites geographically spread and staffwere throughout the county to increaseaccess.With the demand for testing exceedingthe capacity, priority testing for highrisk persons identified by Epidemiologywas problematic. Disease Control
5 FY 2019–2021Epidemiology also identified manyindividuals who could safely isolate attheir residence but did need supportfor wrap-around services such as food,medical care, hygienic items, and otherservices was developed. School Healthnurses, assigned to PHP, implementeda case management system to identifyneeds.created a testing site for high-risk,medical staff, first responders, andindividuals at the Sulphur SpringsHealth Center and subsequently movedto the University Area Health Centerand opened to the public.By March 2020,media coverage ofthe pandemic wasnonstop, and theanxiety level of thepublic was extremelyhigh.The PIO worked with ManagementInformation Systems (MIS) to developa call tree directing COVID questionsfrom the public to a call center toaddress general questions andalleviate the extremely high volume ofcalls for Epidemiology.Staff from the Nutrition Division andSchool Health Program were assignedto Preparedness staff the center.Baycare Health worked with TampaInternational Airport (TIA) and theHealth Department to establish atesting point at the airport.This was a first in the country andmany other major airports acrossthe United States later followed themodel. During Epidemiology’s caseinvestigation, travelers were advisedthey must isolate if positive. If a travelerwas not cooperative, the departmentstaff would coordinate with the specificairline and Tampa Airport Operationsto prevent passengers from boarding.From October 2020 – April 2021, thissite identified 175 positive travelerswho could not travel.The Epidemiology Program played acrucial role in the COVID-19 response.The program added more than 120staff to assist the program in thecritical task of investigating COVID-19cases, identifying contacts, providingeducation, and linking cases andcontacts to community resources.The team connected people to testing,medical, and assisted living facilities(ALF) to ensure residents routinelytested for COVID-19, had accessto adequate supplies of personalprotective equipment like masksand gowns, were able to arrangevaccinations, and safety isolate andquarantine residents to preventCOVID-19 transmission in these highrisk settings.Preparedness provideditems masks, thermometers,pulse oximeters, and healthcare referrals and workedwith the County SocialService team to providefood, if needed, delivered theitems to their homes.Preparedness provided items such asmasks, thermometers, pulse oximeters,and health care referrals and workedwith the County Social Service teamto provide food if needed delivered theitems to their homes.The county was able to lease twohotels side-by-side, to accommodateisolation and quarantine individuals.Preparedness, working withEpidemiology, approved, tracked, andreleased individuals from the Hotels.The sites were staffed with security,food service, and transportationservices.Many individuals identified as COVIDpositive were in congregate caresettings or at hospitals pendingdischarge and had very specific needs.Preparedness staff provided casemanagement for 237 individuals toensure their medical and supportneeds were met.Another significant issue wasdischarging hospitalized long-termcare residents back to their facilitiesMany of these individuals did not meethospitalization criteria but required ahigher level of care than afforded at theisolation hotels, and the facility wouldnot accept the residents back.Working with the County, a contractwas established with an assisted livingfacilities (ALF) to place the patient backin their facility. The Department staffworked with hospital case managers toevaluate the appropriateness of placing135 individuals into the ALF until theyreturned to their originating facility.
6 ANNUAL REPORTeach patient and then coordinatereimbursement to the transportingorganization. Several of these moveswere immense scale involving morethan 40 patients from a single facility. Intotal, the Department moved and placed204 patients into hospitals.The health care system, comprisedof hospitals, nursing homes, assistedliving facilities, and EmergencyMedical Services, began experiencinga significant surge in cases amongpatients, residents, and staff.The Associate Director for USF’sDivision of Infectious Disease andInternational Medicine was able towork with the Morsani College ofMedicine and Tampa General Hospitalto establish Telemedicine as a pointof access to care for underservedindividuals within the community.USF and TGH created theCOVID-19 TransitionalCare Clinic to provideambulatory care forpatients who have testedpositive for COVID-19.The program offeredpatients the option ofhome management ofthe virus to preventhospitalization.The TGH providers use telehealth visitsto assess, monitor, and treat patientsfor COVID-19 based on the latestmedications approved, including themonoclonal antibody treatments forinfected patients or as prevention fortheir household contacts. The Directorwas able to link the telehealth team toour isolated patients, ensuring theirmedical needs were. Patients treated inthe multi-disciplinary, evidence-basedprogram have a much lower rate ofprogression to COVID long haulersyndrome, with only 5% reportinglingering symptoms versus 30-50% inthe rest of the nation.Many ALFs and nursing homesexperienced residents with significantillnesses and needed to transfer toarea hospitals. In some cases, localhospitals exceeded bed capacity,and DOH-Hillsborough worked withall hospital leadership to developa system to evenly distribute thepatients over through the hospitalsin Hillsborough, Pinellas, andPasco counties. Preparedness staffcoordinated directly with the facilitiesto obtain necessary patient medicalconditions and worked with receivinghospitals to facilitate the admission foreach patient.Staff would also arrange for theappropriate medical transport forThe long-term care facilities becamea priority for case identification andinvestigation as the residents arethe most vulnerable. Many facilitiescould not isolate cases nor quarantinethose who were exposed. As a result,this population recorded the highestpercentage of deaths associated withany group.Led by the Assistant Director, thehealth department created a Long-TermCare Task Force (LTCTF) composedof Nursing Director, Epidemiology,Preparedness, the Agency for HealthCare Administration (AHCA), other stateregulatory agencies to address issuesand concerns with these facilities.Teams of DOH-Hillsborough nursesand support staff visited facilities withknown outbreaks to coordinate masstesting, evaluate, and educate thefacility staff on safe practices to includeisolation/quarantine, infection controlmeasures, and donning/doffing ofPersonal Protective Equipment (PPE)for the employees. The LTCTF engagedwith a total of 319 facilities during thistimeframe.The Department staff also worked withthe cruise ship industry, U.S. CoastGuard, the CDC, and local hospitalsto airlift ill crewmembers from shipsoff the coast of Florida to receivinghospitals in Hillsborough County. Asystem of conference calls directlywith the ships was put in place to gain
7 FY 2019–2021situational awareness on the statusof ill and exposed crewmembers andidentify needs, as well as provideguidance to ships’ physicians. Themain issues that surfaced during thefirst eight months of the pandemicwere staffing and Personal ProtectiveEquipment (PPE) shortages.Preparedness staff coordinated withthe state to augment staffing withcontracted specialists in 17 differentfacilities. Environmental Health staffconducted a two times per week calldown to each facility to proactivelyengage the facilities to identify anyissues or concerns. Worldwide, PPEshortages were impacting all facilities.The Department staff worked with stateand local Emergency Management toacquire large caches of these criticalsupplies and provide them to facilitiesuntil manufacturing could meet thedemand.We were able to fill over 1,700 requestsfor N-95 respirators, surgical masks,gloves, gowns, and miscellaneouscleaning supplies for health carefacilities. An additional 2,242 requestswere approved for non-governmentalsupport agencies as well asjurisdictional government agencies.As the number of new cases beganto drop, the Governor started toease restrictions and began openingbusinesses as well as special events.Hillsborough County Governmentrequired all events involving massgatherings to have a COVID SafetyPlan as part of their permit application.Preparedness staff reviewed 68 plansfor various events being held aroundthe county and provided advice andguidance to vendors on how they couldsafely operate. The size and scope ofthe reviews ranged from very smallgatherings to the Florida State Fair andStrawberry Festival.The department also worked with theSchool District and two universities ontheir graduation ceremonies.In August 2020,Preparedness wasasked to be part of aworkgroup to developthe State COVIDVaccination Plan.Over the next three months, staffcreated priorities for vaccinationbased on vulnerability and occupationand vaccine distribution logisticsthroughout the state. These strategiesinclude distribution based onavailability (scarce, limited, widelyavailable) and projected populationneed.Anticipating receiving the Pfizervaccine, Preparedness beganworking with Immunizations toidentify and acquire specializedcold storage for vaccines capable ofmaintaining temperatures of -80ºC.Until the equipment was received,Immunizations worked with the StateLab on USF to create a temporaryLogistics Center at the State Labuntil a permanent location could beprepared at the MOSI.Immunizations created a systemof receipt, handling, issuance, andaccountability of vaccines, breakingdown bulk supplies and repackagingthem to support specific. Stafffrom Administrative Service andEnvironmental Health were reassignedto this team for two months until staffcould be hired.This team provided support for anaverage of 16 missions weekly andtotalling over 700,000 vaccines in thefirst five months.As the only county on the west coastof Florida capable of handling ultracold storage, the Logistics Team wasdesignated a regional responsibility ofproviding vaccines to other counties,federal and state contractors, as wellas private physician offices andretail pharmacies. The Departmentstaff recruited local providers tobecome COVID Vaccine Providers andprocessed hundreds of requests forvaccine. In total, the Logistics teamprovided 402,161 vaccines and suppliesto the community.Within the county, the Departmentworked with local EmergencyManagement to establish drive-thrulocations based on geographic location,population density, and vulnerabilityto provide the most significant access.Vaccines were initially received inminimal quantities and focused solelyon persons 65 years old and above,hospitals and health care workers, aswell as LTCF residents and their staff.The long-term care residents werescheduled through state and federalcontractors. The county was allocateda limited amount of vaccines for thepublic, meeting the 65-year age limit.Four locations were opened in January2021 and managed by a contractorcapable of having a fully electronicmedical record that could interfacewith the Florida immunizations registryfor real-time tracking. A total of462,484 vaccines were administeredat these four sites from January toMay 2021. We were also able topartner with several large practicegroups specializing in care for theelderly and provide them with smallervaccine allocations. PHP initiatedMemorandums of Understanding andprocessed 386 orders before theybecame widely available.In February 2021, an agreement wasreached with TRANSCARE AmbulanceServices to provide vaccinations forpersons who are medically unableto use a public vaccination site.TRANSCARE paramedics were able tovaccinate 1,194 homebound persons.The Disease Control Division took thelead on creating Targeted Vaccine Area(TVA) vaccination teams to focus on
8 ANNUAL REPORTlow-income independent livingfacilities. The teams were supportedwith volunteers from every divisionwithin the health department. DOHHillsborough partnered with the countyto identify all low-income areas andcoordinate additional TVA missionsutilizing DOH-Hillsborough and othercontracted resources. The TVA conceptwas the first known of its kind andreceived significant media coverage.The TVA teams vaccinated a total of16,775 people.The Department also conductedmultiple events to provide vaccinationsto healthcare workers who were notaffiliated with a healthcare system,agricultural/migrant workers, andindividuals who are underserved.Again, volunteers from all departmentsalong with medical teams from theMedical Reserve Corps, conductedeight large-scale events. Thedepartment worked with the JamesA. Haley Veteran’s AdministrationHospital (JHVAH) to obtain a waiverof Federal law to allow the JHVAH toadminister COVID-19 vaccine to non-VAbeneficiaries.Working with multiple state and Federalofficials, the law was waived, andapproval was granted to the JHVAHwas able to establish a vaccination siteopen to the public.Hillsborough County governmentworked with the University of SouthFlorida and established a formalagreement to host the site campus.In all, the department provided over25,000 vaccines to support effort whichwas the only Veteran’s Administrationsite in the country able to partner witha local jurisdiction to provide vaccinesto non-VA beneficiaries.The Public Information Officerrecruited known, respected communityphysicians to communicate directlywith the public to dispel myths aboutthe disease and vaccinations. Workingwith different jurisdictions, he hostedand moderated several broadcastforums through social media platforms,including Facebook Live events, ZoomVideo Presentations, and Instagramquestion and answer chats. Thisallowed the public to interact directlywith an expert as an alternative to a callcenter or media release. The sessionswere well attended and influenced someof the more hesitant residents.
9 FY 2019–2021
10 ANNUAL REPORTVITAL STATISTICSIn March 2020, closed both VitalStatistics offices’ lobbies (MainUniv-ersity location and Satellitewithin St. Joseph’s Women’sHospital), as well as all 6 of theHillsborough County Tax Collectoroffices that help issue birth recordson our behalf. During these lobbyclosures, we modified our businesspractices to continue processingcustomers’ orders by mail, fax, andonline.By June 30, 2020, all closed lobbieswere reopened. We supported andaudited 5 of 6 Hillsborough CountyTax Collector offices that had reopened their lobbies to the public,and were offering appointments forbirth recordservice.2019-2020 Fiscal Year - Recorded19,300 new births and 12,346deaths in Hillsborough County.Vital Statistics office continuedits partnership with HillsboroughCounty Tax Collector’s Office,issuing more than 106,000combined birth and deathcertificates over the past year.Birth Certificates: 44,072Death Certificates: 62,6732020-2021 Fiscal Year - Recorded18,782 new births and 14,713deaths in Hillsborough County.Vital Statistics Office continuedits partnership with HillsboroughCounty Tax Collector’s Office,issuing more than 123,000combined birth and deathcertificates over the past year.Birth Certificates 46,186Death Certificates 74,258ADMINISTRATIVESERVICESOur purpose is to provide quality support servicesthat help program staff achieve our missionAdministrative ServicesDuring the 2019/2020 fiscal year,Finance and Accounting managed a 41.7M budget, with over 35 fundingsources, including local, state, andfederal dollars. Posted revenues anddisbursements, including 13 standardcontracts, totaling approximately 4.7M. We maintained more than 415positions, hired 74 staff, and had 11retirements.During the 2020/2021 fiscal year,Finance and Accounting managed a 46.2M budget, with over 35 fundingsources, including local, state,federal, and COVID-only dollars.Posted revenues and disbursements,including 16 standard contracts,totaling approximately 4.8M. Wemaintained more than 415 positions,hired 56 new staff, and had eightretirements.General Services createdadditional space for staff and madeimprovements to workspaces.Personnel Services processedmore than 200 new employeesduring the 2020/2021 fiscal year.They maintained more than 415positions, hired 74 staff, and had 11retirements the year before. TheManagement Information Systems teamserviced and set up new computersfor the additional staff and expandedinformation technology services. QualityImprovement team made improvementsto the onboarding process to betterprepare new staff for their first fewweeks at work.Personnel ServicesPersonnel Services provided expertisein all aspects of Personnel Services,from recruitment to retirement, to helpthem achieve a competent workforcewith good morale and productive habits.We maintained more than 415 positions,hired 74 staff and had 11 retirements.Performance and QualityPerformance & Quality Improvementsoversaw the clinical managementsystem (HMS) workforce development,quality improvement and performancemanagement. Our purpose is toidentify, recognize, and cultivate qualitypeople and processes to build a cultureof continuous quality improvement.
11 FY 2019–2021
12 ANNUAL REPORTCOMMUNITY HEALTHThe Community Health Division encompasses three main programs: Epidemiology,Health Promotion and Education, and Office of Health EquityThe Community Health Divisionencompasses three main programswhich address prevention,management, and reduction ofcommunicable and chronic diseases inour community. The programs includeEpidemiology, Health Promotion, andEducation, and Office of Health Equity.These programs work in coordinationwith other divisions and communitypartners to ensure the provisionof programs and services in ourcommunity. Along with the Nutrition/WIC Division, Community Healthmanages the Healthiest Weight Floridaprogram, supporting communityeducation and programming to helpadults and children achieve andmaintain a healthy weight.Despite all the challenges of theCOVID-19 response, the EpidemiologyProgram also continued its otherresponsibilities investigating andall other reportable diseases andoutbreaks.Epidemiology ProgramEpidemiology staff conducte dailyand weekly surveillance reports ofemergency department and urgentcare data, performed influenzasurveillance, conducted mosquitoborne disease surveillance, andinvestigated foodborne illnessreports. Epidemiology provided virtualpresentations and education sessionsto community membersHealth Promotion and EducationProgramThe Health Promotion and EducationProgram continued to serve the publicthrough education and health screeningsto help reduce the risk of chronicdisease, lead poisoning, and cancer. Ourstaff made health screenings availableto all children in Kindergarten, 1st, 3rdand 6th grade in Hillsborough CountyPublic Schools. School nurses are alsoavailable to assist with medicationadministration and basic health servicesfor those students needing them.The Office of Health EquityThe Office of Health Equity released itsinaugural Health Equity Profile in thesummer of 2020. Local partners usedthis information to advance health equitywork in our community. For example,the information included in the profilewas used by a grassroots organization toprovide education for a local resolutiondeclaring racism as a public healthissue.Florida Healthy Babies ProgramIn the Florida Healthy Babies Program, asafe sleep shopping list was developedto educate new parents to help preventinfant mortality. In addition, the familyplanning and dental programs expandedtelehealth service offerings for clients tocontinue offering education to clients.Lead Poisoning Prevention ProgramOur Lead Poisoning Prevention Programcontinued to work with local medicalproviders to encourage lead testing forat-risk children under six.Our lead program specialist alsoworked with the Head Start Programin Hillsborough County to provide leadscreenings for those children enrolled inthe Head Start Program.Breast and Cervical Cancer EarlyDetection ProgramThe Breast and Cervical Cancer EarlyDetection Program assisted in makingbreast and cervical cancer screeningsavailable for over 1,200 uninsuredwomen through partnerships with localmedical and imaging providers.Chronic Disease ProgrammingChronic Disease Programmingwas moved to a virtual platformin COVID-19 to provide diabetesprevention and education, high bloodpressure, and weight managementeducation. In July 2021, we receivedthe NACCHO Innovative PracticesAward for virtual health educationprogramming.National Diabetes Prevention ProgramWe have maintained our NationalDiabetes Prevention Programrecognition for in-person programsand have also been awarded pendingrecognition for our new virtual options.NACCHO Innovative Practice AwardRecipientDuring the COVID-19 pandemic,NACCHO created the InnovativePractice Award to recognize and honorlocal public health practices thatwere developed in response to thepandemic. Our health department wona silver award!
13 FY 2019–2021The estate of the late, great Wilford Brimley gaveDOH Hillsborough permission to use the iconicactor’s image and likeness to promote Diabetes prevention and management.
14 ANNUAL REPORTDISEASE CONTROLPromotes, protects, and improves the health of our community through education,screening, immunizations and/or treatment options for preventable diseasesunity, which results in more than14,400 visits to the health departmentfor services. Included in these numbersare more than 350 newly diagnosedpeople with the disease or thosewho had been lost to care and werereadmitted into care. A significantportion of those who received servicesachieved viral load suppression. This isa level needed to become uninfectious.Additionally, our dental program,uniquely qualified to serve thoseliving with HIV, has more than 2,400encounters, serving 700 patients.The Disease Control Division promotes,protects, and improves the health ofour community through education,screening, immunizations, and/ortreatment options for preventableinfectious diseases. By using acombined, efficient, and financiallymaintainable model, this divisionfocuses on reducing the impact ofdisease within our community. Our onestop shop offers an on-site laboratory,pharmacy, case management, AIDSDrug Assistance Program, andresearch.The vision is to provide outstandingquality services by focusing on thepatient and being customer-friendly.We strive to accomplish this through acapable public health workforce, usingdata-driven, proven best practices,and through a culture of nonstopimprovement while being greatcustodians of funds assigned to us.During Fiscal Year 2020-2021, anddespite the challenges posed bythe COVID-19 pandemic, membersof the Division of Disease Controlprovided direct patient care servicesto over 16,700 residents and visitorsof Hillsborough County to make ourcommunity healthier. Services spannedvarious areas from vaccines forchildren, HIV, STI, to Refugee Healthan
Hillsborough County is moving in the right direction. In 2011, the county ranked 30th in the state for health outcomes. Last fiscal year we ranked 23rd in the state. Now we are ranked 19th in the . state. DOH-Hillsborough is committed . to being a model public health agency. By the end of the fiscal year, we final-ized a community health assessment
