2023 Year In Review: DOH Achieves Historic Public Health Successes
Sustainable Approaches to Addressing Substance Use Disorder
Breaking the Cycle of Addiction
In August, the Coordinated Opioid Recovery Network (CORE) celebrated its inaugural year of helping Floridians break the cycle of addiction and overdose by providing individuals with the tools necessary to do so. Floridians battling addiction can utilize CORE for stabilization, which includes medication-assisted treatment (MAT) and a network of specialized medical experts that guide them on a sustained path to healthy, lifelong recovery.
The most recent data from 2023 demonstrate that:
- Emergency medical services where the CORE Network is available transported 9,202 substance use disorder patients to a CORE emergency department or receiving clinic.
- 49% of opioid use patients served at a CORE receiving clinic have been placed on MAT, which reduces the risk of overdose and supports life-long recovery. The national average for patients that receive MAT is 16%.
- CORE receiving clinics provided a total of 527,106 services to substance use disorder patients. These services included primary and dental care, psychiatric evaluation and social support services to address underlying and additional symptoms of addiction.
Safeguarding the Health of our Children and Youth
Supporting Childhood Development
The Early Steps program provides early intervention services to infants and toddlers, age birth to 36 months, who have or are at-risk for developmental disabilities or delays. In Fiscal Year 2022-23, the Department’s statewide locations served nearly 61,000 children, a 3.6% increase from the previous year. Demonstrating successful outcomes, 98% of the children who completed Florida’s Early Steps program showed improved social-emotional skills, improved use of knowledge and cognitive ability, and improved ability to understand and use language.
Newborn Screening and Early Care
The Newborn Hearing Screening Program implemented targeted point of care screening at the birthing facility for congenital Cytomegalovirus to guarantee hearing testing for newborns upon referral or by 21 days of age. Since screening began in January 2023, 107 newborns were identified with congenital Cytomegalovirus, allowing earlier access to treatment options.
Enhancing Medical Foster Care
The Medical Foster Care Program enhanced outreach efforts to support a growing need of foster families for medically complex children. The program launched a recruitment portal where interested parents can complete a readiness profile to determine compatibility with the program, resulting in 153 parents signing up to begin their journey to become medical foster parents. Since July 2023, 48 new parents have received program training, and seven new families are currently providing nurturing homes.
Supporting Growing Families
To support the reduction of maternal morbidity and mortality, the Department enhanced the capabilities of a smartphone application, developed in partnership with UF Health Shands Hospital, to provide daily risk assessments for women up to six weeks postpartum. Assessments are conducted for women based on their identified risk factors including mood disorders, surgical wound infection, diabetes, hypertension, cardiovascular disease, substance use disorder and lactation. Responses are received in real-time by a medical team that determines if there are emerging or urgent needs and the treatment necessary to address the concerns.
Pediatric Behavioral Health
Aligned with First Lady DeSantis’ Hope for Healing, the Department launched the Florida Pediatric Behavioral Health Collaborative to provide Florida’s pediatric and family primary care providers with the necessary knowledge, skills and ability to improve their confidence in better identification and treatment of children and youth with common mental health needs such as ADHD, anxiety or depression. The initiative leveraged partnerships with universities or tertiary care systems to expand the number of Behavioral Health Hubs to nine regional pediatric mental health care teams. The hubs offer providers care coordination and access to telepsychiatry consultation services. In Fiscal Year 2021-22, hubs facilitated 88 skill-based behavioral health trainings, reaching nearly 400 providers and extended services to 1,293 clients.
Additionally, the Florida Behavioral Health Collaborative’s pediatric hotline provided 113 consultations. The hotline provides free access to board certified child and adolescent psychiatrists and care coordination to all pediatric providers caring for children and youth up to age 21.
Teen Drug Prevention
To continue the efforts of preventing substance abuse in our adolescent population, the Department partnered with the Department of Children and Families and the Department of Law Enforcement to host First Lady DeSantis’ The Facts. Your Future. Youth Drug Prevention Summit for parents. The summit provided parents, guardians and community partners with educational resources to understand the impacts and risks of drug use, in addition to effective communication tools for parents to have those tough conversations with teens. Attendees received firsthand information from the enforcement agencies that intercepted dangerous drugs entering our state and were provided tangible resources, including a parent toolkit, to guide parents on how to discuss the dangers of drugs with their children.
Tobacco Free Florida is making progress in addressing the use of electronic vaping products by Florida’s youth. Current use of electronic vaping products has decreased by more than 45% among ages 11-17 between 2019 and 2023. According to the Florida Youth Tobacco Survey, 9% of youth report current use of electronic vaping products in 2023 compared with 16.6% in 2019. During this same time, current use of inhaled nicotine products among youth has decreased by 42.9%, from 18.9% in 2019 to 10.8% in 2023.
Protecting Florida’s Public Health
Holding Public Health Accountable
The Public Health Integrity Committee, led by Florida State Surgeon General Dr. Joseph Ladapo, met on four occasions throughout 2023 to review, research, and evaluate public health policies and assess the impacts of federal public health recommendations. The committee meetings recommended that Florida’s public health policies and priorities remained tailored to the communities they protected. Topics that were addressed included:
- The developmental impacts of requiring facial masking in school-aged children, particularly following extended school holidays. Lack of randomized clinical trials regarding effectiveness of masks in disease transmission.
- The negative impacts associated with bivalent COVID-19 boosters in specific populations.
- Federal response to the pandemic and the adverse effects of misinformation, inconsistencies, and media influence on public perception.
- Lack of comprehensive testing for adverse reactions and efficacy during development of COVID-19 vaccines.
- What can be done to hold the U.S. Centers for Disease Control and Prevention accountable for pandemic response and options for Florida to have a rapid response with randomized clinical trial protocols in place when faced with another pandemic.
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Addressing the Federal Drug Administration's inconsistent drug approval and advertising protocols including the Prescription Drug User Fee Act allowing for the “Accelerated Approval” and “Fast Track” programs.
Ending Multiple Public Health Epidemics with Public-Private Collaboration
The Department expanded a public health initiative with the critical task of ending the syndemics of human immunodeficiency virus (HIV), hepatitis C virus (HCV), syphilis, and the opioid crisis – four conditions that oftentimes occur in tandem. The FOCUS initiative enables health care institutions to develop and share best practices in routine blood-borne virus screening, diagnosis, and linkage to care.
Last year, the program’s 28 partners conducted 189,512 HIV tests, with 88% of those testing positive linked to care. Additionally, 75,716 HCV tests were conducted, and 77% of those testing positive were linked to care. This statewide approach is transformative and a critical component to ending the HIV epidemic in the U.S.
Innovative Approaches to Beating Cancer
Cancer Connect Collaborative
In February, First Lady DeSantis announced the launch of the Cancer Connect Collaborative, expanding the scope of Florida Cancer Connect. The collaborative is a team of cutting-edge medical professionals gathered to rethink Florida’s approach to combatting cancer. By breaking down long-standing silos between researchers, cancer facilities and medical providers, the collaborative is working to transform Florida’s approach to cancer treatment and research.
Leading the Nation in Research
Working in partnership with the Department and the Agency for Health Care Administration in being the first state in the nation to collect cancer recurrence data, the collaborative released the State of Cancer 2023 Report to provide insight into trends from the most common cancers afflicting Floridians, highlight effective screening and prevention measures and detail the history of cancer research and care in the state. The report highlights the top five most frequently diagnosed cancers in Florida: breast, lung, prostate, colorectal and skin cancers. It also demonstrates that since 2017, these top five cancers have accounted for just over half of all cancer diagnoses (50.3%) in Florida.
Investing in Provider Workforce and Strengthening Resources
Florida Reimbursement Assistance for Medical Education
Due to the support of Governor DeSantis and the generous funding from the 2022 Legislative Session, the Florida Reimbursement Assistance for Medical Education (FRAME) program awarded $16 million in student debt relief to more than 1,000 health care professionals during its inaugural award cycle. FRAME provides student loan debt relief to health care professionals practicing in underserved areas of the state. The FRAME program offers annual awards to offset educational debts incurred by medical doctors, osteopathic doctors, registered nurses, licensed practical nurses, advanced practice registered nurses, autonomous advanced practice registered nurses and physician assistants.
Veteran Licensure Services
Governor DeSantis signed CS/CS/HB 139 in 2023 establishing the Office of Veteran Licensure Services enabling the Department to facilitate special assistance to veterans and their spouses as they navigate the health care licensure process. In partnership with Veterans Florida, the office will support a referral program to assist veterans and their spouses with obtaining training, education, and employment in Florida’s health care professions.
Streamlining Licensing
The Department continued to deliver timely service to health care applicants and practitioners to support the health care workforce. The volume of applications has steadily risen, with an average increase of 46% more initial licenses than 10 years ago. In Fiscal Year 2022-23, the Department licensed over 128,000 new health care practitioners with an average processing time of 0.09 days per license.
Empowering Volunteers
Due to the generosity of volunteers, the Department’s Volunteer Health Care Provider Program reported nearly 500,000 medical and dental services provided in 217 clinics across 49 Florida counties, with an estimated value of $345 million.
Legislative Accomplishments
In May, the Department’s agency bill CS/CS/SB 1387 was signed into law. Highlights from this bill include:
- Florida was the first state to prohibit gain-of-function research in Florida that may produce an enhanced potential pandemic pathogen (ePPP) – which are artificially modified pathogens to increase transmissibility and virulence. The bill also requires that researchers applying for state or local funding disclose in the funding application whether the research involves, or could involve, ePPPs.
Additionally, the Department’s 2022-23 Legislative Budget included:
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Nearly $38 million for the Casey DeSantis Cancer Research Program to improve data timeliness and collection of data elements pertaining to patient outcomes such as cancer type, mortality, survival rates and cancer recurrence. This funding also supports a long-range comprehensive plan designed to expand the program to include a broader pool of Florida-based cancer centers, research institutions and medical schools that focuses on quality of care, efficacy of treatment and patient outcomes.
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$5.4 million to establish a telehealth minority maternal care pilot program in Duval and Orange counties to expand the capacity for positive maternal health outcomes in targeted underserved communities. In 2023, more than 2,500 women were served and received interventions that reduced instances of emergency room visits and provided remotely monitored devices that assisted in maintaining optimal blood sugar levels and effectively managing gestational diabetes.
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