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PACE-EH (Protocol for Assessing Community Excellence in Environmental Health) NOTE: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. For more information on this project, contact Julianne Price, Statewide PACE EH Coordinator,

The Division of Environmental Health has adopted the National Association of City and County Health Officials' (NACCHO) Protocol for Assessing Community Excellence in Environmental Health - PACE EH . The department's efforts were recognized in June 2004 in a letter from NACCHO Executive Director Patrick Libbey to former Department of Health Secretary Dr. John Agwunobi(pdf <1MB).

For several years, the Division of Environmental Health has supported county health departments to work with their communities and address environmental health concerns. Collectively, the county health departments across Florida who have implemented PACE EH in communities have become a national model and provided evidence that communities identify built environment and urban planning issues as environmental health issues.

The division has provided over $800,000 in grants during 2003-08 to establish the PACE EH process in 33 Florida counties.  The participating counties are listed below with links to individual grant detail pages.  You may also view a map of Florida showing the participating counties.

While some of the projects do not follow the PACE EH methodology exactly, all projects are designed to open the lines of communication between the department's county health departments and their affected communities.

NEW Projects!

• Sumter County - TWe were awarded our PACE grant on May 12th. This month we kicked off our PACE Project with a meeting on June 2nd. Key staff who will be participating in the project met to develop a strategy and further define the goals and objectives. On June 10th, the Sumter CHD PACE Team met to work on tasks 1, 2 and 3. We discussed and identified community capacity for the assessment, determined available and needed resources, further defined and characterized the community, and came up with a list of 20 people to invite to participate in our Environmental Health Assessment Team. Participants include community partners from city/county government, private businesses, faith based organizations, and community leaders. Before adjourning, we discussed what our next steps should be including a routine meeting schedule. For more information about this project, contact Keith Hunter.
   

• Duval County - As part of Jacksonville’s urban core, East Jacksonville has experienced decay in past years. For example, Aerostar Environmental Services confirmed that of the 2,034 properties evaluated in East Jacksonville, 551 (27%) were found to have potential contamination risks. In recent years, ambitious urban renewal such as widening of streets, beautification projects, construction of a sports complex and concert hall has taken place in proximate areas. However, such projects have not occurred within East Jacksonville. East Jacksonville is a community comprising approximately nine square miles. It is bounded by the St. Johns River, Iona Street, the Arlington Expressway and 20th Street. These boundaries are in close alignment with the boundaries of Duval County’s census tracts three and four. According to the US Census, 5,260 people reside in these census tracts of which 2,030 people live below the poverty level. Residents of East Jacksonville have organized into a community group called the Eastside Environmental Council. Using PACE protocol, the Eastside Environmental Council identified several environmental health issues. One of the key identified issues is the lack of redevelopment efforts that promote economic revitalization and a healthy community.
  
  The proposed project will address this issue by creating incentives that will catalyze private redevelopment efforts. The Eastside Environmental Council recognizes that one obstacle to economic revitalization is the trepidation of would be business property investors due to the fear of contamination related liability. Through collaboration with the DCHD, the Eastside Environmental Council has expressed keen interest in developing an information repository of East Jacksonville Brownfield site information and groundwater data linked to a geographic system (GIS). PACE EH will help facilitate the inclusion of several historically relevant sites, located within East Jacksonville, into the National Register of Historical Places. Inclusion of these sites would provide local and national recognition to East Jacksonville. Moreover, East Jacksonville would then be eligible to receive consideration in the planning for Federal projects, Federal tax benefits and Federal assistance for historic preservation. Graduate history students at the University of North Florida will perform the needed research and application procedures. For more information, contact the Duval County Environmental Health Director, Dr. Aaron Hilliard.
   

• Osceola County - PACE-EH will be utilized in a very low income area of Osceola County. This area is a high drug area of homes that have been neglected and forgotten by much of the community. Our intent is to establish community partnerships and through surveys and visit's determine the community’s priorities. The ultimate goal of the project is to restore pride in the community and restore a healthy and safe environment. Many of the homes are serviced by failing septic systems and the homes are infested with vermin and are unsafe for use. It is our goal through partnerships to clean up and improve the conditions for residents in the community.” For more information, please contact the Osceola CHD Environmental Manager, Brett Smith.

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  Recently, we have been contacting residents to work out a time for our second PACE meeting at the beginning of September, where we'll explain the specific steps of PACE and get feedback for items to include on our community survey. I am enjoying the opportunity to get to know community members on a personal basis. Our challenge, however, is that we have had only a very few residents of the 25 that signed up initially commit to any meeting dates outside of the monthly community meetings. The most common concern from residents I have heard is that they are very busy in their lives and who is not.
  
  As I have hosted community programs in previous jobs, I was not terribly surprised by this. This is a significant challenge and we may find that utilizing the monthly community meetings more may be beneficial in our recruitment efforts. We have to be clear and upfront about team member expectations and time commitments, so that community participants can be honest about what they are able to contribute. (August Report) (September Report ) (October Report ) (November Report) (February 2008 Report)

  In November we submitted the top issues and survey results to the community for discussion at their monthly association meeting. In our representation at the Community Enhancement Area CEA group meeting, we also discussed the survey results. There, were able to encourage enhanced awareness and communication with the community to the stakeholders who attended. PACE EH in Southside Umatilla (pdf<1mb) PACE Flyer Example (pdf<1mb) Interviewer Survey Template(pdf<1mb)

  
  Overall, it was a strong start to our project and I'm looking forward to garnering continued enthusiasm from the community.
  
  
   

Active Projects

• DeSoto County - The aftermath of the 2004 hurricane season presented DeSoto county residents with environmental issues previously considered lightly such as mosquito control, indoor air quality, adequate migrant housing, minimum housing standards and much more. A positive has been the building of strong partnerships between the CHD and other community programs. This is certainly a timely opportunity to employ the PACE-EH tool to identify environmental health issues as determined by the community. Possible areas for focus include the Horse Creek community where annual flooding impacts septic systems and improperly constructed drinking water wells; the economically blighted areas in the City of Arcadia; rebuilding issues related to hurricane damage and the south county where new developments are being established. The DeSoto County Health Department is leading a MAPP (Mobilizing for Action through Planning and Partnerships) process which will dovetail nicely with PACE-EH. (Read more.)

• Escambia County - As part of our proposal we will perform research on the completed projects of PACE EH recipients within DOH. Through this process of review we will then select the proposals that achieved the objectives and that produced the most benefit for the community. This list will then be shared with our PACE EH team so that it can be used during their meetings. The list will be a result of evidenced based research and will reveal how this process can lead to successful results if the team, our community partners and the community that is selected are committed to a successful outcome. The projected time that is detailed in our Work Plan to train the ECHD personnel, to complete the evidence based research and perform the community assessment will require that the ECHD PACE EH project extend for sixteen months. (Read more.)

• Hardee County -  Limestone, a community that straddles the Hardee DeSoto County line, has been selected to conduct PACE-EH. Hardee and DeSoto County Health Departments are collaborating on the project. A meeting was held on Friday, June 27, 2007 at Hardee County Health Department. Kedesch Altidor, PACE coordinator and Keith Keene, DeSoto Environmental Manager introduced the PACE EH process. In attendance were Marsha Rau, Hardee CHD Adminstrator and Junior Archer, EH manager. Hardee County Commissioner Gordon Norris was also in attendance. Jim Griffin, Hardee business manager and Glenda Harn rounded out the meeting. They are excited about the PACE-EH process and believe PACE-EH can make a big difference the Limestone community.  Several well attended meetings have been held in the community and a core work group identified to carry out the PACE process. Partners include the Hardee County Commission, DeSoto and Hardee County Health Departments, and the Saint Paul Missionary Baptist Church and the Limestone Baptist Church. Problems identified are the lack of a community playground, safety concerns, noise levels, lack of storm drainage, air quality and street lighting.  At last Tuesdays meeting, the group began developing a survey to seek input from community residents. Results of the survey will shape the direction of the project. (more to follow)
   

• Are you interested in other Florida Department of Health community assessment efforts?  Visit the department?s COMPASS & MAPP websites.

• Indian River County - Utilizing the PACE methodology as a tool to improve the quality of life in West Wabasso, FL, we have been very successful in developing many projects to improve the infrastructure of this community. Using the seed money from the PACE grant which was utilized from January 2004 to December 2004, the goals to empower the community, establish effective lines of communication between residents and county officials, and to improve the quality of life for the residents have been accomplished. It is our desire and intent to continue to aid the community in the future; however, due to lack of funding and the effect that two hurricanes have had on operations, it is necessary for us to request further funding so that we may ensure our continued partnership with West Wabasso. Projects such as supplying access to county water, creating sidewalks, administering a septic grant, improving park facilities, and improving housing are ongoing projects and require the involvement of our facilitation to ensure that they are carried out successfully. The coordinator of this project is Julianne Price. The Environmental Health Director is Cheryl Dunn.  (Read more.)

• Lake County - The area of South Umatilla has reached a critical juncture in its development.  Anecdotally named by its residents as the South Side, it is approximately a two-square-mile area in between the community of Donna Vista and the city limits of Umatilla.  Qualitative data of the area based on field observations, interviews of local citizens, and discussions with public health leaders identify possible environmental health concerns including dilapidated buildings, drainage and septic issues, roaming animals, and illegal dumping.  Monday, August 13th was our introduction to the monthly neighborhood association meeting at Southside. About 40 community members and interested parties attended. We did a brief intro rally on the PACE project and, at the end of the meeting, we have over 25 residents sign up to participate in our PACE Community Assessment CA Team  I also attended an Enhancement Area meeting hosted by Lake County Community Services to get a feel for other similar projects in the county and some of the resources available currently to communities. I was pleasantly surprised at the number of similar projects with overlapping goals in our county. And, I was proud to see how well our project fits in to those projects, while still being unique to the issues of Environmental Health.
   

• Madison County - Madison County has seen influx of new residents for the last three years. Developers have seven proposed subdivisions before the Planning and Zoning Board at this time.  In spite of this growth and development outside the city limits, little attention has been given to the neighborhoods located within the city limits, especially those to the south of Base Street, which includes the Fraleigh/Smith Subdivision, the Mickel Subdivision, the Session Hill Subdivision, and the Moseley Addition.  The community has identified several issues, including: a lack of adequate lighting, lace of sidewalks, abandoned and run down property, and drug trafficking in the local children's park.  March Report

• Marion County - The funds secured by the Environmental Health Division of the Marion County Health Department will be used to facilitate a community-driven initiative. This project - West Ocala Neighborhood PACE-EH Project - seeks to collaboratively conduct an assessment, strategically plan and set priorities to address environmental health concerns. The goal of the project is to impact and improve the quality of life of the West Side community of the city of Ocala. This project is the winner of the 2005 Ocala/Marion County Chamber of Commerce Walter Driggers Environmentalist of the Year Award!  (Read more.)

• Miami-Dade County - MDCHD has an established Community Hygiene Program which is funded by the Miami-Dade County Community Development Block Grant. The main focus of this program is to conduct Environmental Health Assessments within low and moderate income communities within unincorporated Miami Dade County. This program seeks to effect behavior changes in the residents of those communities. The program has an excellent working relationship with all other governmental agencies and community base organizations. The residents of the PACE EH program will be informed through direct contact and through educational brochures on how to recognize and control environmental hazards that may be in their communities. We will use the model developed by PACE EH to craft a task-specific action plan to address environmental issues in the Little Haiti community. (Read more.)

  Read NACCHO's report on Florida's PACE EH Project

• Orange County - This funding will be used to address county findings that revealed higher childhood asthma related to poor indoor air quality problems in certain neighborhoods.  Project focus will include a media campaign addressing poor indoor air quality as well as childhood lead poisoning prevention. (Read more.)

• Palm Beach - Palm Beach CHD seeks to complete an environmental health assessment in the Watergate Estates neighborhood, identified by their county as a community revitalization area. Using the PACE EH protocol, the health department will work to establish a collaborative group of community members and address local environmental health concerns. (Read more.)

• Polk County - Polk County seeks to complete a disease prevention and health assessment intervention in the Combee Settlement area of Polk County, originally started with a grant from NACCHO.  Additionally, the grant will jumpstart educational outreach in an impoverished community in Wahneta, Florida, where many migrant farm workers, Spanish-speaking families live without access to basic community or health services. (Read more.)

  Read "The Built Environment and Health," from The Prevention Institute (750K pdf)

• Sarasota County - The Sarasota PACE EH project evolved out of EH participation in several community meetings where much of the focus was on the health impacts of Red Tide, sewage spills, mercury levels in fish, and our healthy beaches program. The project will conduct a comprehensive environmental health assessment of our coastal communities. We hope to determine the environmental health concerns our community identifies as being linked to our coastal environment as well as the environmental health educational needs of our community. Visit our website! (Read more.)

Past Projects

• Baker County - The Baker CHD will partner with the Northeast Florida Consortium Epidemic Intelligence Service to support the PACE EH process in the Sanderson community. The process will allow more focus on a community with identified environmental issues and support opportunities for residents to utilize the resources of the heath department. (Read more.)

• Broward County  - The focus of this project is on the Collier City subdivision of Pompano Beach, Broward County. This area has a number of environmental risk factors of public health significance to the community residents. Some of the issues identified by residents include vacant lots, drugs, and lack of street lights. The Environmental Health Director for Broward County is Howard Rosen.
   (Read more.)

• Duval County - The Duval County Health Department received a grant to conduct specialized Environmental Medicine training and education for physicians in Hillsborough and Miami-Dade counties by providing an overview of their role in preventing disease and safeguarding public health. Training topics included pediatric environmental medicine, hazardous waste sites, West Nile virus, bioterrorism, and water - and foodborne outbreaks. This was to support a PACE EH grant from NACCHO that Duval County had previously obtained to conduct a community needs assessment. The CHAC identified a critical need to educate physicians on environmental hazards. During this time, the Duval CHD has partnered with area hospitals and academic institutions to communicate the need for local physicians to be educated on the vital roles that environmental health professionals play in preventing disease. For more information, contact the Duval County Environmental Health Director, Dr. Aaron Hilliard. (Read more.)

• Gadsden County - Gadsden County is using PACE EH funding to further address the existing Gadsden Community Health Council's objectives of coordinating health care resources, initiating a strategic planning process with community needs assessments, and addressing barriers caused by isolation , language, literacy, cultural and racial disparities. PACE EH will help the community understand environmental health issues in regards to laws, regulations, and roles in the community. Results so far have indicated animal nuisance and drinking water quality as two community issues.  A draft animal nuisance ordinance has been completed and presented to the Board of County Commissioners.  An article addressing drinking water quality in the county has been created for the local newspaper.  Creating an Environmental Health section in the local newspaper has been proposed.  The EH Director is Addie Brooks. (Read more.)

• Highlands County - The goal of the Highlands County Health Department?s PACE EH project is to create a coalition of Highway Park residents trained in the PACE methodology in order to identify, prioritize and address environmental health needs within their community. Highlands County is a rural county with approximately 90,000 residents spread over 1,000 square miles and has three main population centers along U.S. Highway 27 in central Florida. Highlands County, when compared to similar counties in Florida, is socio-economically disadvantaged. Highway Park is a close knit, geographically distinct community in unincorporated Highlands County. Highway Park?s socio-economic status is below average in Highlands County. It is a predominantly African American community consisting of 2,500 residents with many environmental health issues. (Read more.)

• Hillsborough County - This project focused on the needs of the Palm River Community. The process sought to strengthen the ability of a current network of community partners to address widespread environmental health issues and identify the critical needs of their highly populated county. The community is buffeted by urban boundaries, a landfill, a battery dump, and possibly brownfields. The community is also fragmented across a large area. The coordinator worked with existing community resources and created a partnership with the Weed and Seed office. Survey issues included traditional environmental health issues, as well as topics such as crime and traffic. The Environmental Health Director is Cindy Morris. (Read more.)

• Lafayette and Suwannee counties - The funding for these two counties, jointly administered, was used to support further collaboration between the two counties, their health officials and the communities that share economic and demographic similarities. Much effort was put into the survey of residents, with a focus on the Wellborn Community. Survey results will be used to identify community environmental health issues. Mary Taylor is the project coordinator. Larry Williams is the Environmental Health Director.  (Read more.)

• Madison and Jefferson counties - The project was proposed to administer a minimum of five of the thirteen tasks in the PACE EH Process, and to coordinate with the MAPP process. The project contracted with the FSU College of Medicine, and through a series of community meetings the top issues identified were obesity (Jefferson) and traffic fatalities (Madison). The project has included both city and county commission support and discussion of smart growth concepts. Several committees have been established to address the identified issues: a YMCA committee, a School Health Advisory committee, and a Racial Disparities committee. The project has contracted to prepare a grant application for the Active Living by Design program and has interest in establishing a process to review development in the counties that look at green space, recreational facilities, etc. Kim Barnhill is the joint Administrator for Jefferson and Madison County Health Departments. (Read more.)

• Manatee County - Funding will be used to expand a new environmental health education program.  The primary focus will center on general education and technical assistance on water quality issues.  Target outreach will be provided to residents as well as owners and operators of mater metered drinking water distribution systems.  Most residents served by these systems are unaware that public utility companies do not test or care for them until a water main breaks behind a master meter. (Read more.)

• Martin County - Martin County Health Department will be working closely with a community in Hobe Sound. The grant will be used to conduct a community-based environmental health assessment of this neighborhood so that the community can set priorities for action. This grant will allow us to be more involved with the community and to be the catalyst for positive change. (Read more.)

• Okaloosa County - The Okaloosa County Health Department seeks to develop a survey aimed at tourist and local residents to identify their top public health and environmental  issues of concern.  Mortality data related to those issues will later be gathered to determine if local priorities should be altered.  The information will be used to better understand and increase awareness about the perceptions among these two groups. (Read more.)

• Putnam County - Environmental health issues have taken center stage in the Putnam County Health Department Quality Improvement strategic planning process as a result of major hurricanes that impacted Florida in August and September 2004.  Torrential rains from Charley, Frances, and Jean caused major flooding in Putnam County that has lead to contamination of wells, sewage runoff, and an explosion in mosquito populations.  (Read more.)

• Santa Rosa County - We will utilize the PACE-EH protocol to enable community members to identify and address local environmental health concerns. Funds from the grant will be used to hire an OPS environmental health specialist or health educator/community organizer who will build on existing community relationships to establish a collaborative group of community members. We would also like to utilize students in the new MPH program at the University of West Florida. The collaborative group will follow the steps of PACE-EH to produce an action plan based on priorities developed from the assessment of local environmental health status, health outcome indicators, and community issues and values. Community outreach and educational activities in the neighborhood will inform residents of the impact of environmental health and the neighborhood environment on health outcomes and quality of life issues, and will strengthen the community's capacity to address problems as they are identified. (Read more.)

• Seminole County - This grant will fund the development of a community-survey to assess issues related to water quality safety, hazardous waste sites, indoor air quality and childhood lead poisoning.  These issues are more prominent due to rapid development, pollution hazards and drought conditions that have occurred in central Florida over the past several years. (Read more.)

• Taylor County - This funding will be used to assess and address community drinking water system issues in the community of Steinhatchee. (Read more.)

• Walton County - The Walton County Health Department will conduct a community health assessment as part of their countywide "Walton County 2020" visioning process.  This process will support efforts to integrate environmental health issues into county's overall priorities and implement a public awareness campaign. (Read more.)

• Washington County - The Washington CHD will partner with a student intern from Florida State University to undertake the PACE EH process. The CHD has a strong interest in better understanding and evaluating the community's environmental health needs and concerns. The health department will facilitate community gatherings to study the connection between health and the environment, collect data, and set priorities for action to address environmental heath issues. (Read more.)

PACE EH Links

• NACCHO's PACE EH project homepage
• PACE EH FAQ
• The PACE EH Guidebook (English and Spanish versions available) and PACE in Practice
• PACE EH Online Module
• Community Based Health Assessments in the States, August 2005 (from ASTHO) (pdf <1mb)
• The PACE EH Demonstration Site Project: Communities in Action (pdf <1mb)
• PowerPoint presentation on PACE EH by NACCHO
• Island County Washington's PACE EH Website
• Delaware (OH) General Health District PACE EH Website
• Multnomah County (OR) PACE EH Website
• Burlington (NJ) PACE EH Website
• PACE EH in Peru

PACE EH Contacts

For more information on the department's PACE EH initiative, contact Julianne Price at the Indian River County Health Department, or Daniel Parker or Eric Grimm in the Division of Environmental Health, 850-245-4250.  For specific information on each pilot county's efforts, contact the county Environmental Health Director.