Population Characteristics

 

In Tennessee, there are approximately 1.3 million women of reproductive age (15-44), comprising 20% of the state’s total population in 2020. In 2020, there were 78,685 births to Tennessee residents, translating to a general fertility rate (GFR) of 58.5 per 1000 women aged 15-44. There are an estimated 334,628 Tennessee children aged 0-17 with special health care needs, approximately 22% of the population. Through efforts to advance emergency preparedness, Tennessee used AMCHP’s “Public Health Emergency Preparedness and Response Checklist for Maternal and Infant Health” to calculate estimates of the number of pregnant people (S2-A2), as well as infants and children <5 years statewide, by region, and by county. Using the Centers for Disease Control and Prevention’s “Estimating the Number of Pregnant Women in a Geographic Area: A Reproductive Health Tool,” there are an estimated 62,532 pregnant people in Tennessee at a given point in time, with county ranges between 31 – 10,288. There are 81,188 infants in Tennessee, with county ranges between 47 – 12,674. There are 407,366 children under 5 years in Tennessee, with county ranges between 218 – 64,464. A map of population estimates by county for pregnant people, children > 1 year, and children > 5 years can be found in the Supporting Documents section.

 

COVID-19 Data Collection and Analyses

 

Surveillance of Emerging Threats to Mothers and Babies

Tennessee continued to receive CDC’s Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) and partner with the MCH/Title V Program to inform data to action efforts. SET-NET data dashboards and infographics are published to the Pregnancy and Infant Care COVID-19 Website, quarterly. Data are regularly presented to the Perinatal Advisory Committee and the Health Disparities Task Force. Due to community feedback and engagement, public service announcements were launched to promote vaccine uptake by pregnant populations disproportionately impacted by COVID-19 through the Our Voices campaign. From June 2021 – October 2021, ads ran with nearly 8,000 commercials in Memphis, Jackson, Nashville, Chattanooga, and Knoxville.

 

Pediatric COVID-19, Multisystem Inflammatory Syndrome, and COVID-19 Vaccines

Pediatric COVID-19 cases as well as MIS-C cases are publicly available as data dashboards on the Special Populations Website, weekly. To support the equitable rollout of the pediatric COVID-19 vaccine, maps of pediatric vaccine (5-11) uptake rates by county were published monthly and shared with community partners. Strategies to engage providers on becoming a COVID-19 pediatric provider were based on these data.

 

Pregnancy Risk Assessment Monitoring System COVID-19 Supplement

Initial PRAMS COVID-19 supplement data were analyzed that asked about experiences

during the COVID-19 pandemic. Among Tennessee mothers who delivered June – December 2020, key findings included:

• 82% reported in-person only prenatal care and 16% reported both in-person and virtual PNC. Of those not attending virtual PNC, 86%, preferred in-person visits. Lack of virtual appointments from the provider was another reason for not having virtual appointments (30%)
• 46% of new mothers who had a mix of in-person and virtual PNC appointments reported cancellation or delay in PNC. A top reason for delays in PNC was due to lack of childcare/family care during the pandemic
• 85% of pregnant people reported always wearing a mask in public and 14% reported sometimes wearing a mask in public
• Almost half of new mothers reported they couldn’t stay home during the pandemic while they were pregnant due to their job
• 11.4% of new mothers reported having COVID-19 during pregnancy and 11% reported someone in their household had COVID-19
• 4% of new mothers reported postponed baby immunizations and delay of visits due to COVID-19
• More than half of new mothers reported an increase in anxiety and one in four an increase in depression. Economic impacts were also common. One in four new mothers had problems paying bills due to COVID-19 and one in five reported food insecurity

 

New Data Collection Efforts

 

Gold Sneaker Program

• Implemented additional data element on Gold Sneaker Certification application to capture small business status and minority or female owned business status. Data are collected on an ongoing basis and are yet to be analyzed.

 

Family Planning Telehealth Patient Satisfaction Survey

• Implemented a patient satisfaction survey for the Family Planning Telehealth Program. Data are collected on an ongoing basis and are yet to be analyzed.

 

Emergency Preparedness

• Implemented three focus groups among youth and families with experience having a child with technological dependence to understand barriers and facilitators to emergency preparedness training at pediatric hospital discharge.

 

• Analyzed PRAMS data to understand preparedness among women with a recent live birth. Key findings included:
  • 83% of women with a recent live birth had at least one preparedness item implemented
  • 63% had emergency supplies at home (water, food, meds) to last 3 days
  • 49% had an evacuation plan for their child/children
  • Less than one-third (29%) had copies of important documents in a safe place outside the home

 

National Survey of Children’s Health Oversample

Through collaboration with the Division of Health Disparities Elimination, FHW applied for an oversample of Black and Hispanic respondents for the National Survey of Children’s Health starting in 2022 for an initial period of two years.

 

Tennessee Department of Health Roadshows

The roadshow is an annual event that takes place between January-March of each year. Several Central Office based offices/divisions met with metro health department health promotion staff, as well as select local and regional staff. Due to the COVID-19 pandemic, the last roadshow concluded in February 2020. Some of the key workforce themes included:

• Increased salaries needed to be competitive and retain staff
• Increased resources for mental health
• Streamlined onboarding training for local and regional staff
• Increased need for translation of materials

 

FHW External Customer Satisfaction

Standardized questions have been developed for inclusion in all satisfaction surveys. Customers are asked to respond (Never, Rarely, Sometimes, Frequently, Always) to questions related to their interaction with FHW:

• Exemplifies courteous, respectful and professional behavior
• Creates a culture of collaboration by incorporating the ideas of others
• Provides materials and resources to enhance program effectiveness
• Demonstrates a commitment to quality work
• Consistently responds to inquiries in a timely manner
• Communicates clearly and effectively

 

Advisory Councils

 

There are specific advisory councils required by state law:

• Traumatic Brain Injury Advisory Council continues to meet quarterly and has nine members.
• Genetic Advisory Committee meets three times a year and has 18 members. Membership includes the directors of the genetics and hemoglobinopathies centers, subspecialists, and a consumer representative.
• Perinatal Advisory Committee meets three times a year and has 21 members. Membership includes co-directors of the five regional perinatal centers, other neonatal and obstetric providers, and a consumer representative.

 

Other work groups or task forces also support MCH/Title V work to engage with a multidisciplinary team of partners. Examples of these groups include:

• Maternal Health Task Force
• Lead Advisory Committee
• Hearing Advisory Committee
• Suicide Task Force
• Injury Prevention Coalition
• Health Disparities Task Force

 

Changes in Health Status and Needs of the State’s MCH Population

 

National Outcome and Performance Measures

There are 10 Outcome and Performance Measures with significant improvement in Tennessee since baseline from data reported in the 2022 Federally Available Document:

• Severe maternal morbidity decreased from 90.8 per 10,000 delivery hospitalizations in 2015 Q1-3 to 73.1 per 10,000 in 2019 (NOM-2)
• Low birth weight decreased from 9.2% in 2015 to 8.9% in 2020 (NOM-4)
• Neonatal abstinence syndrome decreased from 16.9 per 1,000 birth hospitalizations in 2015 Q1-3 to 10.9 in 2019 (NOM-11)
• HPV vaccination increased from 48.7% among adolescents 13-17 in 2015 to 71.7% in 2020 (NOM 22.3)
• Tdap vaccination increased from 79.7% among adolescents 13-17 in 2015 to 88.8% in 2020 (NOM 22.4)
• Teen births decreased from 30.6 per 1,000 15-19 year olds in 2015 to 23.3 per 1,000 in 2020 (NOM-23)
• Low-risk cesarean delivery decreased from 27.6% in 2015 to 25.9% in 2020 (NPM-2)
• Bullying victimization among adolescents 12-17 decreased from 29.3% in 2015 to 26.2% in 2019 (NPM-9)
• Transition among non-CYSHCN aged 12-17 increased from 12.1% in 2016 to 24.8% in 2019-2020 (NPM-12)
• Smoking in pregnancy decreased from 14.3% in 2015 to 10.9% in 2020 (NPM-14.1)

 

There are 10 Title V Outcome and Performance Measures with significant worsening since baseline:

• Early prenatal care decreased from 74.2% in 2015 to 73.7% in 2020 (NOM-1)
• Early term birth increased from 26.6% in 2015 to 28.4% in 2020 (NOM-6)
• Preterm-related mortality increased from 189.8 per 100,000 live births in 2015 to 264.8 in 2019 (NOM-9.4)
• Adolescent mortality among 10-19 year olds increased from 39.8 per 100,000 in 2015 to 48 in 2020 (NOM-16.1)
• Child vaccination (completion of combined 7-vaccine series by 24 months) decreased from 73.9 in 2015 to 63 in 2017 (NOM-22.1)
• Flu vaccination among children 6 months to 17 years decreased from 61.8% in 2015/16 to 55.9% in 2020/2021 (NOM-22.2)
• Child injury hospitalization among children 0 through 9 years increased from 109.3 per 100,000 in 2015 Q1-3 to 129.2 in 2019 (NPM-7.1)
• Adolescent injury hospitalization among children 10 through 19 years increased from 191.2 per 100,000 in 2015 Q1-3 to 222.2 in 2019 (NPM-7.2)
• Adolescent physical activity among children 12 through 17 years decreased from 22.4% in 2016 to 13.4% in 2019/2020 (NPM-8.2)
• Preventive dental visit in pregnancy decreased from 42.3% in 2015 to 33.9% in 2020 (NPM-13.1)

 

Overall

The 2022 Vanderbilt Child Health poll aimed to gather insights from Tennessee parents regarding their children. A representative sample of 1,026 parents in the state was surveyed in Fall 2021. The top five concerns parents had for kids were: 1) education and school quality, 2) bullying, including cyber bullying, 3) child mental health and suicide, 4) getting sick from COVID, and 5) disruptions to schooling. More than 4 in 5 parents reported excellent or very good overall health.

 

Emerging Issues

 

COVID-19

• Masks and COVID-19 School Policies: nearly half of children’s schools don’t have a mask mandate in place. Over two-thirds of parents sent their kids to school wearing one and over half of parents agreed that children are safer in schools if personnel are masked. Parents were split on whether schools should require COVID-19 vaccine for teachers and staff.
• COVID-19 vaccines: 46% of parents report their child 12+ was vaccinated for and 43% of parents reported some level of likelihood they would get the vaccine for their child under 12; this compares to 62% of parents who report a likelihood to get the flu vaccine for their child.
• Learning loss due to COVID-19: Approximately 40% of kids missed at least one school week for reasons related to COVID-19 so far in the school year; on average, Tennessee kids missed 8 days of school. A majority of parents, 71%, reported wanting a remote learning option for their child.

 

Food Insecurity

Nearly 1 in 3 Tennessee families experienced food insecurity in 2021 according to the Vanderbilt Child Health Poll. In Fall 2021, 44% of families received support from a food program in the last week leading up to the poll. Most parents (90%) support free school meals for children.

 

Infant Formula Shortage

In May 2022, Tennessee ranked #1 for formula shortages, with over half of top-selling products sold out due to the Sturgis plant closure. There were many news stories on this issue across the state detailing the frustration and panic among parents.

 

ESSENCE

An analysis of Tennessee syndromic surveillance data in ESSENCE showed since February 2022, there have been 357 emergency department (ED) visits statewide that mentioned formula recall in chief complaint, discharge diagnosis or triage notes. Since the recall, there were a total of 131 ED diagnoses related to water intoxication, which can occur as a result of diluting formula, and 67% (88) were admitted.

 

Child Homicide Deaths

In 2020, 67 Tennessee children died of homicide, a rate of 4.4 deaths per 100,000 children; the highest number and rate over the past five years. Tennessee consistently is above the national rate of 2.2 per 100,000 from 2019. Firearms were used in 75% of homicide deaths among children. Additionally, child homicide deaths persist in disproportionately impacting Black children.

 

Mental Health

Since the COVID-19 pandemic, mental health continues to be strong issue in Tennessee. According to the Vanderbilt Child Health poll, ~1 in 7 parents reported their child was diagnosed with anxiety in 2021, an increase from 1 in 10 in 2019. More than 1 in 10 parents say their child has been cyberbullied and 72% of parents with kids aged 6-17 worry about cyberbullying. In 2020, 38 children under 18 died by suicide.

 

Pregnancy-Associated Mortality

In 2020, 98 women in Tennessee died during pregnancy or within the year after pregnancy. There were 46 pregnancy-related deaths, which translates to a pregnancy-related mortality ratio of 58.5 deaths per 100,000 live births, a 51% increase from 2017 – 2019. In 2020, more than 3 out of 4 deaths were deemed to be preventable, and discrimination contributed to 1 in 3 pregnancy-related deaths.

 

 

Changes in Title V Program Capacity or MCH Systems of Care

 

Postpartum Medicaid Extension

In April 2022, Tennessee announced extension of TennCare, which lengthens postpartum coverage from 60 days to one year. TennCare has also included added dental benefits for pregnant and postpartum women.

 

FindHelpNowTN

TDH led the development of a real-time treatment locator to help those with substance use disorders, www.findhelpnowtn.org. A formal launch is expected in September 2022. This site allows people to search for treatment providers based on location and insurance payor. Additionally, an option to select pregnancy/postpartum specific treatment resources was built into the platform.

 

Women’s Reproductive Health Services

n Tennessee, the Title X Grant was reduced by $1.2 million per year. As a result, $1 million was cut from the budget including: reduction of funds to metro contracts which will limit expansion of services for serving additional clients; decreased travel which will affect professional development opportunities; reduction in office supplies, postage and contraceptives; and the elimination of a provider position to expand telehealth services. This still left a deficit of $200,000 which will be made up with state funds. Tennessee will continue to promote and offer state-available women’s reproductive health services.

 

New Grants to Promote MCH in Tennessee

 

Advancing Surveillance for the Tennessee Birth Defects Surveillance System

In 2021, Tennessee received the CDC’s 5-year grant to strengthen the capacity of the birth defects surveillance program to respond to emerging threats to mothers and babies, identify and address mechanisms contributing to health disparities, and improve health outcomes of affected populations. This grant supports the staff (director, nurse consultant, and epidemiologist).

 

Tennessee Pediatric Mental Health Care Access Program

Children's behavioral health needs continue to grow, further exacerbated by COVID-19, and the number of mental health providers is insufficient to meet the needs. In 2021, Tennessee received this grant to promote behavioral health integration into pediatric primary care by supporting pediatric mental health care telehealth access programs.

 

State, Local, Territorial, and Tribal Partnership Programs to Reduce Maternal Deaths Due to Violence

In 2021, Tennessee received this 5-year grant to develop and implement interventions to reduce maternal deaths due to violence, specifically homicide and suicide, based on data specific to their geographic area.

 

Emerging Issues in Maternal and Child Health

In 2021, Tennessee received this 1-year grant to enhance data and informational systems through adding the birth statistical system (BSS) data into the statewide Integrated Data System (IDS). The ability to link these data systems have enabled Tennessee to explore emerging non-fatal issues in pregnancy and the postpartum period to identify upstream opportunities for prevention and intervention and will be sustained through State Systems Development Initiative (SSDI) coordination.

 

Improving State-level Preparedness through Measuring Improvements to the System of Care

In 2022, TDH’s partner, Tennessee Chapter of Family Voices, received this small project grant to improve the state system of care for preparedness by centering the needs of families, including youth, on emergency preparedness communication, education, and resource needs, with specific focus on those with technological dependence. In February 2022, TDH identified funding for a one-year program manager position to lead MCH emergency preparedness efforts, with sustainability efforts to continue funding for this position ongoing.

 

Neonatal Abstinence Syndrome (NAS) Standardized Surveillance Case Definition Implementation Project

In 2021, Tennessee was awarded short-term funding through the Council of State and Territorial Epidemiologists (CSTE) to implement a new standardized case definition for NAS. The implementation of a new standardized case definition will result in a better understanding of NAS and allow for more reliable comparisons between states. Detailed information about the CSTE standardized case definition can be found here. Infants will be classified as confirmed, probable, or suspect cases. To meet the requirements of the case definition, new questions were added to the REDCap survey.

 

Workforce Development

CDC provided Tennessee funds through the Cooperative Agreement for Emergency Response:  Public Health Crisis Response to establish, expand, and sustain a public health workforce.  Part of the funds have been used to provide software training (SAS, ArcPro, and Tableau).  FHW epidemiologists have participated in these trainings.

 

STRETCH Grant

TDH is one of ten state public health agencies selected to participate in the national STRETCH ("Strategies to Restore Equity and Transform Community Health”) Initiative lead by ASTHO, Michigan Public Health Institute and CDC Foundation. The goal of the initiative is to design meaningful, lasting systems of change and create inclusive public health systems by embedding equity into priorities, programs, policies, and practices. TDH is leveraging this opportunity to develop a department-wide Health Equity Plan that provides a strong foundation for creating an integrated, action-oriented approach toward economic prosperity, strengthening program infrastructure, eliminating health disparities, and assuring health equity for Tennesseans.

 

State Title V Partnerships and Collaborations

 

Tennessee’s MCH/Title V program continues to partner with numerous entities at the federal, state, and local level to serve the legislatively defined MCH populations and to expand the capacity and reach of the state MCH/Title V and CYSHCN programs. Existing partnerships are highlighted within the annual report.

 

The MCH/Title V CYSHSN program has a staff member responsible for Family/Youth Engagement and Involvement whose primary responsibility is to work with Family Voices to ensure opportunities for family and youth training on patient centered medical homes, transition, and policy/advocacy. In addition, several programs continue to expand their own advisory and family groups to better inform programs and services, including recruitment of regular parent participants in the Perinatal Advisory Committee and Genetics Advisory Committee. Likewise, the Community Health Access and Navigation in Tennessee (CHANT) program has incorporated family engagement to assure that the needs of children and families are being met appropriately.

 

Efforts to Operationalize Needs Assessment Process and Findings

 

Organizational Structure for Title V Priorities

Each priority has a priority lead and an epidemiology lead. The priority lead is a Section Chief within FHW with subject matter expertise in the designated priority. The epidemiology lead is an epidemiologist within FHW who works closely with programmatic data to inform the activities around the priority. There are also supporting internal staff with expertise in each subject area.

 

This past year, each team worked closely with the new FHW Physician Liaison for Health Equity to develop a health equity specific strategy in the action plan to decrease disparities identified in each priority area.

 

Partners Meetings

Internal partner meetings were held in April 2022 to review health equity action plans for each of the Title V Priorities. Feedback to identify opportunities for collaboration and align efforts to address gaps were addressed. These included representation from:

• Deputy Commissioner for Population Health
• Office of Strategic Initiatives
• Office of Primary Prevention
• Division of Health Disparities Elimination
• Division of Population Health Assessment
• Communicable and Environmental Disease and Emergency Preparedness

 

Internal partner meetings also provided an opportunity for teams across FHW to share best practices and strategies for shared challenges, such as community engagement.

 

After internal partner meetings, external partner meetings were held for each priority. Again, the focus was on the presentation of the health equity action plan and to receive feedback. Action plans were edited after both the internal and external meetings to better meet the needs of partners. Further, several priority topics presented their health equity data and action plans to the Health Disparities Task Force in an effort to solicit feedback and increase engagement and dissemination of priorities.

 

FHW Staff Capacity Building for Health Equity Implementation

Overall, FHW Program Managers meetings prioritized training for leadership as well as implementation of health equity initiatives.  This included trainings on implementation science methods, community engagement strategies, and structural and upstream changes to strengthen equitable program delivery. These trainings were directly applicable to the development of health equity action plans across MCH/Title V priorities.

 

Implementation of the Adaptome Framework

The Adaptome Model was designed to review and adapt programs to ensure that cultural sensitivity, mode of delivery, and service setting can improve, while not changing program core concepts. FHW applied the model to the Checkpoints Parent Teen Driving Agreement. Developed by Dr. Bruce Simons-Morton and tested largely with white, suburban groups, the Checkpoints Parent-Teen Driving Agreement is designed to reduce teen crashes. Most Tennessee schools that currently implement the program in large, less diverse suburban schools. Maury County Schools, Montgomery County Traffic Court, and Shelby County Officials, who represent diverse populations in Tennessee, helped review the Checkpoints Program using the model. This review was showcased during a FHW Program Managers meeting so all program managers could experience review process.  Checkpoints materials were reviewed for diversity, consistency with population beliefs, technological format, health literacy, and other measures.  The reviewers were given the opportunity to provide input on each measure and make suggestions to improve the program for their respective populations.

 

The Adaptome Model proved to be a useful tool to help communities feel empowered to make suggestions to improve evidence-based programs to meet the needs of their community. Based on the success of using the framework to review Checkpoints, other programs will be encouraged to implement the Adaptome with the guidance of the Physician Liaison for Health Equity.

 

Tennessee Health Disparities Task Force

The Health Disparities Task Force was formed in April 2020 to engage leaders from non-profit and faith-based organizations, academia, health care and local and state government agencies. Members meet weekly and collaboratively generate responsive solutions and policies to reduce disparities and to ensure equitable access to health care, resources and services. Nearly 1,300 interagency and community partners actively participate in meetings and special events, such as the Health Equity Book Series which has featured prominent individuals from Henrietta Lacks’ family as well as Professor Sir Michael Marmot. To learn more information about the Task Force and the Division of Health Disparities Elimination, go to www.HealthDisparitiesTN.com.

 

Changes in Organizational Structure and Leadership

 

UNC Workforce Development Center

In 2021, Tennessee applied to work with the University of North Carolina’s Workforce Development Center to address challenges in adapting onboarding and trainings in a virtual environment. FHW implemented the Staff Engagement Survey and presented results at a FHW Division meeting in 2022. Results reflected decreased staff engagement and satisfaction in almost all areas. Areas of concern included:

• Decreased value of employee opinion at work (91% in 2021 to 76% in 2022)
• Decreased feelings that supervisor, or someone at work, seems to care about me as a person (98% in 2021 to 85% in 2022)
• Decreased opportunities at work to learn and grow (89% in 2021 to 77% in 2022)
• Qualitative responses indicated increased satisfaction of working from home; however, responses noted management practices have not adapted and increased feelings of disconnection.

 

The FHW Workforce Development Workgroup operationalized action items of communications, onboarding, and employee recognition as priorities for improvement. Due to efforts of this workgroup, there is added capacity in communications and onboarding through new and reclassified state positions.

 

FHW transitions over the past year have filled key roles as well as presented new gaps to fill to address key emerging issues.

FHW

• Title V Program: Ashley Moore, MPH, has been in block grant coordinator role since May 2022. Ashley brings a wealth of TDH institutional knowledge as she has previously worked in Injury, Tobacco, and Perinatal Services within FHW.

• MCH Emergency Preparedness: Yolanda Vaughn, MS, PMP was started in March 2022 and is responsible for efforts aimed at prioritizing systems of care gaps for emergency preparedness. Currently, CDC Foundation supports this position.
• Emerging Issues in MCH and SSDI: Hanna Santuro stated in September 2021, and she is currently directing the HRSA MCHB Emerging Issues in Maternal and Child Health Grant. She also adds capacity to the SSDI grant and other TDH data modernization efforts.
• Chronic Disease and Health Promotion: Kimothy Warren transitioned into the Section Chief position, and now oversees MCH/Title V Priorities: Decrease Overweight and Obesity Among Children and Decrease Tobacco and E-cigarette Use Among Adolescents
• Maternal Mortality: Tina Evans, a program director, and Osa Ikhile, an epidemiologist, have joined as contractors to support the maternal deaths due to violence program. Linda Hampton joined the program as a nurse abstractor.
• Pediatric Mental Health Access: Angela Okonji recently joined as a contracted program director to support the pediatric mental health access grant. The epidemiologist position is open.
• NAS: Janelle Wenstrup joined the NAS Program as an epidemiologist, a new state position; and Candace Smith joined as a contract public health nurse to support the NAS work.
• CDC/CSTE Applied Epidemiology Fellowship: Emily Lumley, MPH started their fellowship in August 2021 and has contributed to health equity MCH/Title V alignment, emergency preparedness, and pediatric COVID-19 vaccination.
• Technical Training: Amira Wooten provides coordination for SAS, Tableau, and ArcPro courses available to TDH employees.
• Health Equity: Dr. Sophia Kostelanetz served as the physician liaison for health equity until her departure in May 2022. FHW is excited to onboard someone with prior experience in health equity to provide similar support to FHW. ­­
• Fellows and Interns: FHW seeks to strengthen the MCH pipeline through connecting with interns and fellows early in their careers.
  • Graduate Student Epidemiology Program Intern: During Summer 2022, this intern will add capacity to the Birth Defects Program and analyze PRAMS data to inform data-to-action strategies.
  • TDH Public Health Executive Fellows: FHW matched with two fellows starting in June 2022 to increase communications capacity and support MCH/Title V implementation efforts.
  • Title V Interns: TDH matched with 2 Title V interns to support health equity efforts in Title V priorities and emerging issues.

 

Tennessee Department of Health

• Commissioner: Lisa Piercey stepped down as Commissioner in May 2022. Governor Lee appointed Morgan McDonald, former Tennessee MCH/Title V Director, to the interim position starting in June 2022.
• Chief Data Officer: Stephen Espy was appointed to a new TDH position, Chief Data Officer, over the Office of Informatics and Analytics.
• Vaccine Medical Director: After a one-year vacancy, the position of Medical Director for Vaccine Preventable Diseases and Immunization Program was filled by Dr. Caitlin Newhouse.
• Interim Director of Vital Statistics: Alyson Holland is the current interim director of Vital Statistics and brings many years of experience within the Office of Vital Statistics.
• Interns: TDH initiating paid internships (starting at $15/hour) in Summer of 2022.