Board of Selectmen Special Budget Meeting (linked)

DEPT/AGENCY:
TOWN OF WATERFORD
GENERAL FUND
2024 - 2025 PROPOSED BUDGET
10120 SOCIAL SERVICE GRANTS/MISC
52590 WATERFORD SHELLFISH COMMISSION 1721 4,134 4,134 1,290 1,290 (2,844) 68.80%
52633 WATERFORD/EAST LYME SHELLFISH 2,500 i Q 1 i Q 0.00%
52634 SECT CT COUNCIL OF GOVERNMENTS (SCCOG) 10,764 10,764 10,764 10,764) 10,764 0 0.00%
52635 HISTORIC PROPERTIES COMMISSION 392 400 3 400 400. 0 0.00%
52636 T.V.CCA. 
5,500 6,050 6,050 6,244 6,244 194 3.21%
52638 DISABLED AMERICAN VETERANS 250 250 is) 250 250 Q 0.00%
52639 V.F.W. POST 6573, 9975 & AL 161 1,939 1,940 0 2,000 2,000 60 3.08%
52643 SAFE FUTURES 6,500 6,500 6,500 6,500 6,500 9 0.00%,
52644 SEAT 36,965 39,477 39,479 ALAS1 42,695 1,974 5.00%
52645 EASTERN CT CONSERVATION DISTRICT INC 1,500 1,500 9 1,500 1,500 Q 0.00%
TOWN HISTORIAN
1D! CIE
58340 WTED HISTORICAL SOCIETY 2,000 2,200 2,200 3,000 3,000 800 36.36%
58440 UNITED COMMUNITY & FAMILY SERVICES 8,000 8,000 8,000 8,000 8,000 0 0.00%
$8450 THE ARC OF EASTERN CONNECTICUT 1,800 1,800 0 1,800) 1,800) 9 0.00%:
58595 Ni HOMELESS HOSPITALITY CENTER 7,500 7,500 Q 15,000 15,000 7,500 100.00%.
SACCEC

DEPT/AGENCY:
TOWN OF WATERFORD
GENERAL FUND
2024 - 2025 PROPOSED BUDGET
PUBLIC HEALTH NURSING SERVICE
[SNTIEAGTED OUTSIDE AGENCIES
58010 PUBLIC HEALTH NURSING 8,279 25,911 4,841 26,297 . : _ 386 : 1.49%
SUBTOTAL 8,279] 25,911 o} 4,841| 26,297 0 o} 386 1.49%
|DEPARTMENT TOTAL 8,279 25,911 Oo} 4,841] . 26,297} oO} 0] 386 1.49%

Assets
Current assets.
Cash and cash equivalents
Shortterm investments
Patient receivables
Other assets
Total current assets
Assets umited as to use
Long-term investments
Other assets
Right of use assets
Property, plant, and equipment, net
Goodwilt
Total assets
LAWRENCE MEMORIAL CORPORATION AND SUBSIDIARIES
Consoidating Balance Sheet
September 30, 2023
(in thousands)
VNA of
Lawrence Lawrence Southeastern
Memorial femonal Lam Connecticut, Westerly: Westerly LaM
Hospital Corporation Systems tac, Hospital Foundation Homecare Eliminations Total
42,570 ~ _ 148 1.462 377 5,704 _ 23.764
6.431 AP 182 = Aad 530 5,432 — _ 68.420
68,605 = - VAR 16,679 _ _ _ 85,461
96.215 Bt = 942 12,208 304 198 (84.917) 44,699
182,821 47 245 = 10,742 30,371 8910 6.898 (84.917) 222.044
8,367 19.281 _ FSS $382 - ~ (19.241) 31.250
20.739 158 _ _ 4.540 2 _ _ 25.769
13,455 — = _ _~ 132 _ (14,147) 2,440
5.518 _ _ - 325 _ _ - 5,843
197,173 §.323 _ 2588 47,590 _ _ _ (252,674
= 42,182 = = = = = = 42,162
428.073 84.170 = 30.837 88.478 §.074 6.898 (95.245) 552.179

LAWRENCE MEMORIAL CORPORATION AND SUBSIDIARIES
Consolidang Balance Sheet
September 30, 2023
in mousards)
VNA of
Lawrence Lawrence Southeastern
Memonat Memorial Lam Connecticut, Westerly Westerly
Liabitities and Net Assets __ Hospital _ Corporation Systems. toc. __ Hospital Foundation
Current habilies
Accounts payable and accrued expenses & 3 2¢ 1,643 79.754 1.926
Current portion of long-term debt ~_ _ _ _ -
‘Operating lease hadility - snort term - - _ ~
Other hapilities _ _ _ = _
Total current liabilities a 2s 1613 1.920
Long-term debt, net of current portion and deferred
financing costs _ _ — — —
Acctued pension and postretrement benefit obfigations — ~ _ = —
Cperating lease lapthty — ong term _ _ 106 _ 447
Otner irabitties = = 486. 13.608 . _ (11147 13.862
Total sabiitwes 8 2g 2.099 93.719 128 (76.064)
Net assets ideficiency:.
Net assets without donor resinctions 245,114 84,162 (ae 28.596 (15,421) 6.225 8,772 (39,281) 338.138
Net assels with conor resinctons 35.924 =. = 136 10,780 923 = = 47.460
Tatal Lawrence Memorial Comoration &
Subsidianes net assets (deficiency: 281,035 $4,162 (29) 28.732 (5,244) F148 6,772 (19,284)
Total habilites and net assets. S____- 428,073 84,470 — 30.831 88.475 S074 6.898 (95.345)
See accompanying notes to consoticated financiat statements,

Net assets without donor sestrctions
Patient service revenue
Other revenue
Total operanng revenue
Operating expenses
Salaries and benefics
Supplies and otner
Depreciation and amor:
Insurance
Interest
Total operating expenses
income floss} from operations
Nonoperating gains (losses i, net.
income from investments, donabons and other. net
Pension cost other than service cost. net
Total nonepersung gains, nec
Excess (deficiency) of revenue over expenses:
Other changes in net assets winout donor restrictions:
Other
Net assets released from restnctens for purchases of
property, plant and equipment
Pension and postetrement related changes other than
net periodic benefit cost
Changes in net assets without donor restrictions
LAWRENCE MEMORIA CORPORATION AND SUBSIDIARIES.
Consolaating Statement of Operzvens and —nanges in Net Assets.
Year ened September 30. 202
(in thousanas:
VNA of
Lawrence Lawrence Southeastern
Memorial Memorial LaM Connecucut, westerly Westerly Lam
_ Hospital = _ Corporation Sysiems inc, Hospital __ Foundation Homecare = _ Eliminanions _ Total
7” > 8.096 124,259 - _ ~
3 ~ 4203, 1.449 - = 2.100)
. 3 = 12,299 125,708 =
212.293 - = 12.704 63,166 188 7 _ 229,320
237 945 - _ 1.424 76,799 163 96 (2.100) 314,327
10,387 - _ 163 4,608 — _ _ 15.150
$ 900 - _ 213 1,436 _ _ _ 7549
24ut _ -~ = = ~ _ = 2434
465.954 = = 48,501 146,004 318 96 (2,100) 828,730
3.136 3 = _,__ (3.202) (20,283) 312) (96) = (20,770)
1.645 2,871 _ 2.156 273 1.015 730 _ 8.691
23 = a = = = - 223
_. 1869 2,874 = 2.156 273 1.015 730 = 8,974
6.005 2,874 _ 41,046) (20,020) 697 634 _ 117,856)
7 _ _ - 104 _ - _ 101
301 _ - _ - 610 _ ~ ait
1,738 — = — = ~ = _ 4,738
7,041 2.874 = £1,045) (19,916) 1.307 534 = 19,106)

Net assets with conor restrichens
Income trom investments
Net realized and unrealized losses on investments
Bequests anc contbutons
Net assets released irom restnctions for purchases
property. plant and equipment
Net assels released from restnctions for operavons
Net assets reieased from restictions for clinical programs
Other
‘Change in net assets vain donor restncuens.
Increase (cecrease} in nel assets
Net assets (deficiency) at beginning of year
Net assets (deficency) at end of year
See accompanying notes to consolidated financial statements.
LAWRENCE MEMORIAL CORPORATION AND SUBSIDIARIES
3 Changes in Net Assets
Consolidating Statement of Operations ar
Year endec Sentemoe:
{ln thousands)
VNA of
Lawrence Lawrence Southeastern
Memorial Memoriat Lan Connecticut, Westerly Westerly LaM
__._ Hospital Corporation Systems. . lac. Hospital Foundation Homecare Eliminations: Total
ATS — _ 1 cz) = _ = 854
2.087 _ ~ 2 ta) ~ _ cod 2.085
3,405 _ _ 25 203 200 _ _ 3.833
(309) _ _ _ _ (610) _ - (911)
£1,492) > - Q) (92) 7 > - (6.586)
{739} _ - _ (2234 _ - _ {362}
328 = = = 396 18 = = 733
4367 = ae 26 31 (205: = ~ 4,349
14,408 2874 _ {1,020} (19, S65) 12 634 _ (4,757)
259,627 81,288 (29) 29,752 14,324 6236 PRE (29.281) 388,055
281,035 84.162 (29) 28.732 {5.2413 7448 6,772 383,208

in providing visits to residents.
The budget for VNASC service is divided in two programs: clinic services and health promotion/indigent care. The hourly
charge is $87.15. This is an increase of $4.15 per clinic hour (5%). The home health skilled visit charge is $175 per nursing
visit. We had to increase our rates as we are bound to collective bargaining agreements for our RN staff. Salaries and benefits
have increased and are projected to increase again in the coming year. Salary and benefit increases were necessary due to the
serious nursing shortage healthcare is experiencing at this time.
The VNA of Southeastern Connecticut is committed to providing healthcare services to the town at an appropriate level.
Any reduction of the budget below the current level will result in fewer services to the residents. A reduction in services
would be a decision made by Waterford's governing body.
The agency is a state-licensed, Medicare-certified, home care organization. VNASC is governed by a community board
of directors and is an affiliate of L+-M Healthcare and Yale New Haven Health. Our Board Chairperson is Shanna Reels.
‘ndigent Care/Health Promotion
VNASC has been holding blood pressure clinics at the Waterford AHEPA and the Community Center to promote wellness in
the Waterford Community. We have also been holding foot clinics.
Home visits to residents at risk for handicapping conditions or hospitalizations are made under consultation with
the family physician. A plan is established to assist the resident to remain safely at home,
Home healthcare services including nursing, therapies, home health aide and social workers are provided under a plan of care
when the resident is uninsured or underinsured and meets the financial criteria for free or subsidized care.
There is a continued need for assistance with care for those who are struggling to stay independent at home. The need for free
care has reduced in the past few years due to the greater use of CT expanded Medicaid. At this time it is unknown whether the
expansion will continue.
Visiting Nurse Association of Southeastern Connecticut
Proposed Service for the Town of Waterford
July 1, 2024 - June 30, 2025

every other
month
Homecare for the | As needed not $175/Visit Skilled Home $16,100.00
indigent to exceed Health Visits
budget
Total Request $ 26,296.55

Description
i
i
|
i
\
1
|
i
Actua!
Budget Projected Actual Proposed Budget | Proposed Budget |
iPublic Health Nursing | $ 22,655.00 $ 26,000.00 | $ 22,922.00
$
25,911.00 | $ 26,296.55 |

TOWN OF WATERFORD
GENERAL FUND
2024 - 2025 PROPOSED BUDGET
DEPT/AGENCY: 10132 CONSERVATION OF HEALTH
148,407| 148,407

Hi Kim and Rob —
Hope you are both doing well and enjoyed the holidays.
| wanted to alert you that we received a communication from DPH/OPM on Friday directing us to use the 2021
population estimates due to errors in the 2022 calculations. This means that the FY25 contribution will be exactly the
same as the FY24 contribution of $148,407, which is $380 lower than the number | originally provided.
Please let me know what you would like me to send you in terms of a formal communication. | can send a revised
version of the letter | originally sent or | can send an addendum to that letter noting this change. Whichever works
easiest for you and where you are in the process.
Best,
Jen
Jennifer Muggeo, MPH (she/her/hers)
Director of Health
main phone. 860.448.4882 ext. 1300
direct dial. 860.910.0386 (no text)
cell phone. 860.912.1429 (ok to text)
fax. 860.448.4885
jmuggeo@llhd.org
www.llhd.org
Your work day/hours may not be the same as mine. Please don’t feel obligated to respond outside of your normal working hours
Promoting healthy communities
LLHD
Ledge Light Health District
From: Kimberly Allen <kallen@waterfordct.org>
Sent: Wednesday, December 27, 2023 10:22 AM
To: Jennifer Muggeo <jmuggeo@llhd.org>
Cc: Rob Brule <rbrule@waterfordct.org>
Subject: RE: FY2025 Budget Requests

860.440.0579 (fax)
Tou of
Waterford
CONNECTICUT
PRIVILEGED AND CONFIDENTIAL: This communication, including attachments, is for the exclusive use of addressee and
may contain proprietary, confidential or privileged information. If you are not the intended recipient, any use, copying,
disclosure, dissemination or distribution is strictly prohibited. If you're not the intended recipient, please notify the
sender immediately by return email and delete this communication and destroy all copies.
From: Jennifer Muggeo <jmuggeo@Ilhd.org>
Sent: Tuesday, December 12, 2023 11:05 AM
To: Kimberly Allen <kallen@waterfordct.org>
Cc: Robert Brule <rbrule@waterfordct.org>
Subject: RE: FY2025 Budget Requests
Good morning Kimberly,
lam so sorry for the delay, | am just waiting for the team to confirm a few numbers on the activity report that we always
include. I’m attaching the letter and budget document for your reference and will get you the complete packet later
today.
Please let me know if you have any questions and please let me know when | need to be there for the budget hearings!
All the best.
Jen
Jennifer Muggeo, MPH (she/her/hers)
Director of Health
main phone. 860.448.4882 ext. 1300
direct dial. 860.910.0386 (no text)
cell phone. 860.912.1429 (ok to text)
fax. 860.448.4885
jmuggeo@llhd.org

Sent: Monday, December 11, 2023 9:18 AM
To: Helen Adap <hadap@llhd.org>; Jennifer Muggeo <jmuggeo@llhd.org>; Desantis, Karen
<Karen.Desantis@YNHH.ORG>; Elizabeth Ritter <betsyritter24@gmail.com>; Jennifer Kohl <jek.koh|@gmail.com>
Subject: FY2025 Budget Requests
All,
FY2025 budget requests were due to the finance office on Friday, 12/8/23. To date, | have not received any request for
the FY2025 budget. Please submit your entities, commission or board’s budget request as soon as possible so that it can
be included in the annual FY2025 budget request. If nothing is received, your entity may not have any funds available
for next fiscal year.
Regards,
Kimberly Allen
Director of Finance
Town of Waterford
15 Rope Ferry Road
Waterford, CT 06385
kallen@waterfordct.org
860.444.5842
860.440.0579 (fax)
Tou of
Waterford
CONNECTICUT
PRIVILEGED AND CONFIDENTIAL: This communication, including attachments, is for the exclusive use of addressee and
may contain proprietary, confidential or privileged information. If you are not the intended recipient, any use, copying,
disclosure, dissemination or distribution is strictly prohibited. If you're not the intended recipient, please notify the
sender immediately by return email and delete this communication and destroy all copies.

December 1, 2023
Town of Waterford
First Selectman Robert Brule
15 Rope Ferry Rd
Waterford, CT 06385
First Selectman Brule:
At their November meeting, the Board of Directors of Ledge Light Health District approved my proposal
to keep the FY25 member contributions at the current per capita rate of $7.59. Based on the population
reported to us by the Department of Public Health, the Town of Waterford FY25 contribution to Ledge
Light Health District will be $148,787.
A detailed draft budget for FY25 is attached for your review. We have also included a report on our
activities and the services offered to Waterford, the first two editions of our new LLHD Highlights
Newsletter, and our FY23 audited financial statements (FY24 audit is underway).
As you are aware from previous years, the FY25 budget will not be formally approved until March 2023,
following a public hearing.
Please let me know if you have any questions regarding this; | look forward to attending the budget
hearings in 2024.
Best regards,
Jennifer Muggeo, MPH
Director of Health

Groton
Ledyard
Lyme
New London
North Stonington
Old Lyme
Stonington
Waterford
Total Population:
State Per Capita
Environmental Health Fees
Food Service
Cosmetology
Pools
Septic/Well
Other
37,743
15,456
2,401
27,980
5,174
7,684
18,480
19,603
153,309
Training/Consulting/Other Services
Interest
Grants
Block Grant
Gasp-SPF
Gasp-LPC
Immunization
LPC-DFC
LPC-LPC
PHEP R4
Workforce
ELC
OHS-HIC
OD2A
CAP
$42,905
- $125,000
$7,000
$100,000
$125,000
$3,907
$342,650
$250,000
$500,000
$200,000
$75,000
$200,000
$286,469
$117,311
$18,224
$212,368
$39,271
$58,322
$140,263
$148,787
$225,000
$17,700
$7,800
$145,000
$2,500
$398,603
$398,000
$10,000
$12,000
$2,221,462

Personnel Services
Employee Salary-Core
Benefits/Payroll Taxes-Core
Employee Salary-Grants
Benefits/Payroll Taxes-Grants
Non-Personnel Operating Expenses
Facilities, Utilities and Vehicles
Utilities
Maintenance
Security
Telephone & telecommunications
Data Connection
Vehicle Repair/Fees
Vehicle Fuel
Auto/Mileage Reimbursement
Auto Insurance
Supplies and Equipment
Office Supplies
IT Supplies
Program Supplies
Postage, shipping, delivery
Equip rental & maintenance
Professional Services
Accounting fees
Legal fees
IT Consulting Fees
Medical Consulting Fees
Other Professional Service Fees
Insurance Agency Fee
Other Administrative Costs
Membership dues - organization
Staff development
Community Outreach and Engagement
General Liability Insurance
$10,000
$48,800
$600
$11,000
$7,500
$3,000
$4,000
$10,000
$7,200
$8,000
$50,000
$7,500
$5,000
$3,500
$13,500
$3,500
$20,000
$3,000
$2,500
$20,000
$2,500
$12,000
$2,500
$13,000
$3,272,479
$1,280,442
$486,993
$1,114,848
$390,197
$102,100
$74,000
$62,500
$60,700


Ledge Light Health District (LLHD) serves as the local health department for the municipalities of Waterford,
East Lyme, Groton, Ledyard, New London, North Stonington, Old Lyme, and Stonington. The LLHD team,
comprised of experts in administration and finance, environmental health, communicable disease prevention,
and health education and community outreach, work cooperatively to promote healthy communities and ensure
that healthy opportunities are available to everyone.
Environmental Health
Regulated Establishments
LLUD inspects food service establishments to ensure they are compliant with the Connecticut Public Health
Code (PHC) and are following good food safety practices. These establishments are inspected based on the risk
associated with their level of food preparation activities. We work with these local businesses to implement
comprehensive food safety practices and provide cost-effective food service education programs. This year, the
State of Connecticut Department of Public Health implemented the legislation passed several years ago to
update the PHC to be in alignment with the FDA Food Code. This has required extensive education for both our
sam and the establishments we inspect. In Waterford there are 99 licensed food service establishments.
We also inspect public pools (5 in Waterford), cosmetology (20 in Waterford), day care (7 in Waterford) and
body art establishments (1 in Waterford) to ensure these entities are taking measures to protect public health.
We also respond to complaint about lodging establishments (6 in Waterford) and visit other residential and
commercial properties in response to complaints or concerns raised by the public (38 in Waterford last fiscal
year). Our online complaint reporting system provides residents the opportunity to submit their concerns
electronically. During the swimming season, LLHD conducts weekly water sampling at bathing beaches (3 in
Waterford) and informs the public regarding bathing water quality that does not meet EPA/State standards.
Land Use
Our environmental land use staff of Sanitarians and Environmental Technicians conduct soil testing and plan
reviews for new building lots served by onsite septic systems and/or wells. On existing properties served by
septic systems we review residential and commercial building additions, lot line changes, the addition of
accessory structures (sheds, decks, pools, and detached garages), and changes in use (residential to commercial,
or an increase in the number of bedrooms). All reviews are conducted to ensure compliance with State of CT
regulations 19-13-B100a and 19-13-B103 (there were 9 B100a reviews in Waterford last fiscal year). Septic
installation plans for new septic systems (10 in Waterford during FY23) or repairs (10 in Waterford in FY23)
are reviewed under 19-13-B103 and permitted and inspected by LLHD personnel. Requested exceptions to the
CT Public Health Code are reviewed and referred to CT DPH when required. LLHD also conducts the site
location review, permit approval, site inspection and water test review for private and public drinking water
wells, irrigation wells and geothermal wells. Certain septic systems and water supply permitting involve DPH
t DEEP — our sanitarians work closely with both agencies to ensure compliance with all code requirements.
216 Broad Street * New London, CT 06320 * phone. 860.448.4882 ° fax. 860.448.4885 * www.llhd.org

who are un- or under-insured. We provide education to the public and organizations about infection prevention
and control practices and investigate reports of communicable and/or infectious diseases such as tuberculosis or
food borne illnesses. These investigations may include conducting partner follow-up, delivering direct observed
therapy (to ensure patients are taking their medications as required), implementing control measures, and
providing general support to the affected individual and their families.
LLUD provides support to schools and long-term care facilities during reported outbreaks to help prevent the
spread of illness. We also provide yearly educational opportunities for infection control personnel in long term
care facilities and schools. We meet with Infection Preventionists from area Long Term Care facilities to
provide education and guidance.
Preparedness Activities
LLHD works closely with municipal and regional partners to prepare for and respond to emergency situations.
These activities include participation in Drive-Thru Clinics and Millstone exercises, working with local partners
to develop Continuity of Operations and COVID plans. Lately, we have been working on Monkeypox Plans and
updating the Ebola Plan.
LLHD is the regional lead for emergency preparedness and manages the contract from the Department of Public
Health for all health districts within DMHS Region 4. This regional effort provides opportunity to align plans
and share resources.
Health Education & Community Outreach
LLHD engages and supports the communities we serve in health education, health promotion, and health policy
development activities in a variety of ways. These efforts draw on scientific, evidence-based best practices to
ensure that the programmatic processes involved make efficient use of available funding, while achieving
measurable and desired changes in our population’s overall health and resilience. LLHD works diligently to
secure external funding to support these activities and supplement our municipal members’
contributions. LLHD continues to support public health projects initiated by other agencies by serving on a
variety of coalitions, providing community outreach, educational presentations and materials to schools,
healthcare providers, businesses and the community-at-large.
Regional Asthma Management Program — Breathe Well-Respira Bien
Asthma is the most common chronic disease of childhood and a leading cause of preventable hospital
admissions for both children and adults. Asthma rates in CT are among the highest in the nation; there are
approximately 50 deaths from asthma each year in our state. LLHD has a long history of participating
in programs to help reduce the burden of asthma. Although asthma cannot be cured, it can be managed.
Understanding medications and their use can prevent emergency situations. Breathe Well is a free program co-
sponsored by Lawrence and Memorial Hospital, designed to help children and adults with asthma to manage
their asthma better. A trained asthma educator and public health environmental specialist review medications
and provide an in-home environmental assessment of asthma triggers.
216 Broad Street * New London, CT 06320 ¢ phone. 860.448.4882 ® fax. 860.448.4885 © www.llhd.org

participate in the Preventive Health Services Block Grant program. The Block Grant which ran through August
of 2024 was used to implement diabetes management programming. The new Block Grant, expected to begin
this February, will support LLHD’s Community Health Worker Program. Community Health Workers are
public health team members who support people experiencing barriers to health in accessing healthcare,
insurance, social services, transportation, housing, food and other resources. They draw from their lived
experiences and trust relationships with community members as well as their knowledge of systems of care to
help community members achieve their individual health goals.
Immunization Action Program (IAP), COVID Immunization Action Program and Immunization Promotion
Programs
The Connecticut Department of Public Health provides several funding streams to promote immunization
across the lifespan and reduce preventable and sometimes fatal diseases. LLHD provides public education,
vaccination clinics and professional development for healthcare providers, conducting site visits to ensure
proper vaccine storage and handling and promote quality improvement strategies among providers. LLHD
reaches out to parents of children who have missed vaccine doses or need a vaccine provider, conducts
ommunity outreach and awareness campaigns, and enrolls families into CTWiZ. A SECT Immunization
cartnership meets twice annually to guide program activities and assist in the promotion of childhood
immunizations.
Overdose Action Team
The Overdose Action Team continues its coordinated efforts to address the overdose crisis by increasing no
barrier access to care and services, saturating the community with naloxone and reducing stigma and
discrimination against people living with substance use disorder. The team continues to adapt and innovate in
response to new information and changing conditions and to expand partnerships in order to more fully support
people’s needs and improve community conditions that contribute to overdose. We are grateful for the support
of our municipal partners in sharing the science-based information and messaging about overdose prevention
and look to continue that partnership.
Community Health Assessment (CHA) and Improvement Plan (CHIP)
LLHD continues — in partnership with numerous partner agencies and community members, to monitor the
health of our communities and take collective action to address prioritized health concerns through the Health
Improvement Collaborative of Southeastern CT. The Health Improvement Collaborative is currently completing
an update to our Community Health Assessment and Community Health Improvement Plan. While we examine
the data to identify any new or emerging public health priorities, we continue work on this identified in the 2019
Community Health Improvement Plan: Food Justice; Access to Care; Black Health Across the Lifespan;
Hispanic Health; the Overdose Crisis; and Racism as a Public Health Issue.
216 Broad Street * New London, CT 06320 * phone. 860.448.4882 * fax. 860.448.4885 * www.llhd.org

It's hard to believe summer is over and schools are back in swing, but thank goodness we still have a
few weeks of lovely weather. Hopefully that weather is not impacted by a busy hurricane season but
it's always good to be prepared! September is National Preparedness Month—look for tips and
resources about getting ready for hurricanes and other emergencies on our website.
As we leave summer and head into fall we are finalizing our 2023-2028 Strategic Plan, which
includes goals and objectives related to equity, workforce development, communications and
community building. We are grateful for the time and insights of the community partners and
community members who participated in the focus groups, interviews or surveys that helped shape
our plan. Look for it to be launched on our website next month.
Jennifer Muggeo
Director of Health
As always, there are a TON of activities happening at your health department—we've highlighted just a
few things in this newsletter but hope you will stay up to date with us by following us on social media, visiting our website, or just
giving us a call when you have a question. We are committed to working in partnership with all of you to promote a healthy
community for everyone!
On behalf of the team,
aa
Jennifer Muggeo, jmuggeo@llhd. org
COVID is Still Here — and So are We! INSIDE THIS ISSUE
. yo e Academic Detailing on Opioid Safety
LLHD continues to support our community with the COVID-19 response.
Throughout the summer, we distributed COVID-19 test kits, isolation and
exposure guidance, and hand sanitizing wipes while promoting COVID e Beach Water Program
vaccination to community partners and residents. Since July, we have e Follow Us on Social Media
observed an increase in COVID cases and outbreaks. If you are sick, please
stay home and get tested. If you need help finding a test kit, masks, or
COVID vaccinations or treatment—or just have a question, please call us!
Look out for more information on updated COVID-19 vaccines in the coming e Group Therapy
weeks! Mary Day, mday@llhd.org e Immunization Awareness Month
e Mujeres Entre Culturas
e Anniversaries
e Grant Management
e Groton Community Center Project
e Overdose Awareness Day
e Public Health Nursing in the Community
| c Ae D e Summer Means Temp Events
Ledge Light Health District 216 Broad Street New London , CT 06320 - 860.448.4882 : www.LLHD.org

some of our local faith leaders, businesses, and local
political figures that have been assisting and supporting the
work being done to help save a life by learning how to
administer Narcan (Naloxone).
: a : Other team members participated in the Community Speaks
Our day in community began at the Mashantucket Pequot Out event at Ocean Beach while a third group supported
Reservation where the NLC CARES team was able to table Chatham Health District's efforts to get the message out in
at one of the employee cafeterias and have conversations their community about overdose and how to save a life with
about what this day meant, what we do locally, and the naloxone. All of the towns were provided resource
support offered at the Mashantucket Pequot reservation information about the NLC CARES program, Peer
with a new Peer Navigator now there. We spoke with the Navigators, locations of emergency naloxone boxes and
EMT's, Human Resources Training Department, casino how to contact the team for support.
employees, and new hires who were a very receptive Margaret Lancaster, mlancaster@llhd.org
audience, and we were given the opportunity to do
additional training for staff in the future. Then to Williams
Park in New London where the memorial tent was set up to
remember those we have lost, speakers from the NLC
CARES team gave comments, a naloxone training was
provided, and a mother who lost a child to an overdose
reflected on their life, their smile, their caring heart and how
they loved. This was a moment of tears, smiles and
laughter for many that were there.
The evening sent the NLC CARES team in separate
directions. In Stonington team members joined the First
Selectman, State Senator Somers, the Stonington Borough
Fire Department, Stonington Public Schools, the Stonington FOLLOW US ON FACEBOOK AND INSTAGRAM
Police Department and community members to mark @oat_sect
Overdose Awareness Day and have unveil the first 24/7
naloxone distribution box in Stonington.

pediatricians and other providers on the topic of respiratory
syncytial virus (RSV) and the new vaccines and monoclonal
antibody products to prevent it among adults, pregnant women and
infants. To learn more, watch this short clip - Preventing RSV in
Babies: A Scientific Milestone; certainly, RSV is a disease you will
be hearing more about. Education materials were provided at New
London food pantry sites and in collaboration with local farmers
markets in Niantic, Ledyard, Groton and New London, LLHD
provided community outreach, speaking to hundreds of residents
about the vaccines across all ages and distribute COVID test kits.
Cindy Barry, cbarry@llhd.org
Public Health Nursing in the Community
In addition to leading the COVID response, the public health nursing team has been busy with other disease
surveillance and response, including Mpox, Vibrio, Tuberculosis, and foodborne illnesses. We continue to host ongoing
blood pressure screening events at various locations, and are putting plans in place for respiratory disease season. We
will be offering free flu and COVID-19 vaccines for ages 6+, prioritizing outreach to underserved populations through
small mobile clinics and events organized with community partners. Mary Day, mday@llhd.org
Beach Water Program
Labor Day Weekend marked the close of Ledge Light's
2023 beach water sampling season. We had five samplers
on the ground every week for the last 15 weeks sampling
45 beaches throughout East Lyme, Groton, Waterford, New
London, Stonington, Ledyard and Old Lyme.
Of those 45 areas, there are just three bodies of fresh
water — the rest are marine bathing areas. There are
different thresholds of bacteria that establish acceptable
water quality standards for fresh water versus marine
water, and different bacteria for which the water is being
tested. Fresh water is tested for E. Coli while marine water
is tested for enterococcal bacteria. Any results above the
respective thresholds are considered to be at a
concentration that could adversely affect human health and
would trigger a swimming advisory and/or beach closure
issued by LLHD.
Vibrio hit the headlines this year due to at least three
confirmed cases of the infection in our state. Vibrio can
cause infection via consumption of contaminated, raw, or
undercooked shellfish, or by sustaining an injury while
exposed to marine water. It can also enter the bloodstream
through an open wound that was not properly covered
before entering the water. While LLHD does not test marine
water for the vibrio bacteria, the State of CT Bureau of
Aquaculture, a division of the State’s Department of
Agriculture, does test various shellfish beds throughout the
state. Connecticut shellfish have never been linked to any
vibrio vulnificus infections. The bacteria itself is naturally
occurring and lives in coastal and brackish water. Infections
are extremely rare, and people who are at the greatest risk
are those with weakened immune systems and the elderly.
Next year, LLHD plans to revamp our beach page on our
website, returning with our interactive map of sample
locations, as well as adding an FAQ section to address our
most common inquiries (including vibrio!).
Danielle Holmes, dholmes@llhd.org

The Black Health Collective—an action team of the Health
Improvement Collaborative of SECT, has been very busy
implementing elements of our mental health campaign this
summer. The centerpiece of this effort has been our
collaboration with artist Frank Colmenares, whose album
“Beautiful Trauma” explores themes related to domestic
violence, mental health and healing. Through a unique
performance experience we call “Group Therapy” Mr.
Colmenares shares his music and then participates in
therapy in real-time and with audience interaction. The goal
of this effort is to normalize discussions about mental health
and breakdown misperceptions about therapy. We are
grateful to Mr. Colmenares, the band, and therapist Jewell
Jones for sharing their gifts at performances at The Garde
Arts Center, Sailfest and The Telegraph this summer and
are looking for opportunities to continue and expand the
reach of this project. Stephanye Clarke, sclarke@llhd.org
FOLLOW US ON FACEBOOK
@BlackHealthCollectiveNLC
interested in obtaining at the Community Center. LLHD
Health Program Coordinator Karl Jennings, Groton
Community Ambassador Neelam Talati, along with
LLHD Community Health Workers Lizbeth Polo-Smith
and Amparo Bustamante have successfully connected
with community members at several sponsored survey
events held in Groton. Over 200 surveys were
completed by community members via digital and paper
applications.
In addition to community feedback surveys, our
partnership offered nutrition education sessions at
Thrive 55+. LLHD Health Program Coordinator Veronica
Mallqui held six interactive 1-hour workshops throughout
the summer. Those who attended the sessions were
highly motivated and eager to learn about food and
nutrition. The workshops allowed community members
to learn how to read nutrition facts labels; how to shop
on a budget; and how to choose foods lowest in salt,
sugar, and saturated fats. Some of the feedback
received from these workshops included, “Il am now
reading the Nutrition Label when | go shopping” and “|
now compare the foods to select the best option”.
Karl Jennings, kKjennings@llhd.org. and
Veronica Mallqui Reyes, vmallqui@lihd.org
Academic Detailing on Opioid Safety (ADOPS)
Our Academic Detailing on Opioid Safety program is focused on reaching prescribers and pharmacists in Eastern CT.
We are offering brief, focused modules with an emphasis on increased knowledge and behavior change. Available
modules include prescription monitoring, naloxone, medications for opioid use disorder, pain management and having
difficult conversations. We are seeking interested providers to participate in the program. Our program assistant,
UCONN School of Pharmacy student Tiffany Vicente, has been with us helping us conduct provider outreach.
Continuing education credits and incentives (depending on employer policy) are available. Referrals are welcome!
Carolyn Wilson, cwilson@llhd.org

helped them collect all their
documentation, address
changes, obtain their
passports, and proof of
their residency in
Connecticut. A total of 30
immigrants applied for the
license; unfortunately only
one could give take the
exam because we found many obstacles regarding the
proof of residency. We have made new appointments for
each of the applicants and sought how to obtain more
proof of residency. We are helping immigrants to have
their passports and identifications from their countries of
origin so it facilitates the procedures they must do here,
(DMV, healthcare, schools, obtain savings accounts in
banks, changes of address, registration in the Libraries to
access the different programs for children, recreation
department, etc.). To help more community members
navigate these systems we have created a "map" where
we indicate each step to follow to start their new life in
this country.
In recent months we have seen an increase in cases of
domestic violence, which in most cases are not treated as
quickly as we would like and this causes anxiety and fear
in women. The biggest obstacle in these cases is the lack
of knowledge of the laws and their rights regardless of a
For the month of July, August and September, we have
the events of raising the flags of the different countries, for
which we work together with the organized groups of each
country and the city towns. We are also getting ready for
Hispanic Heritage Month, which will include the women
serving lunch at the Community Meal Center as well as a
number of community celebrations. We will have a
"multicultural event" where women who have participated
inthe crafts workshops will offer everything they have
done and learned, there will also be a walk of typical
costumes where they will show their clothes and tell us
about what each costume means. For this event we have
sponsors who can have an information table and will
donate some gifts to be raffled that day.
We continue to follow up on families twice a week, for this
we make appointments with them and visit them in their
homes and talk about how the processes they are doing
are going and we see what their most urgent needs are
and if necessary we make medical appointments or in
organizations with which they have services.
Lizbeth Polo-Smith, lpolosmith@llhd.org and Amparo
Bustamante, abustamante@llhd.org
FOLLOW US ON FACEBOOK AND INSTAGRAM
@mujeresentreculturas

Markets. LLHD team members work to make sure all
vendors have appropriate food safety plans and
practices in order to reduce the chance of food borne
illness from these fun events,
Tyler Do-Taylor, tdotaylor@Ilhd.org
Grant Management
During the past fiscal year, July 2022 through June
2023, LLHD received and managed twenty-seven
grants awarded from the federal and state government
and foundations totaling $3.35 million. Utilizing these
funds, we administered and managed thirty-three sub-
contracts to local health departments and community
partners totaling $1.02 million. We also managed
memorandums of agreement and donations to LLHD
totaling $630 thousand acquired from LLHD Member
Municipalities, staff speaking stipends, community
organizations and individual contributions received over
the past two years.
Catherine Dragoo, cdragoo@llhd.org
A yearly flu vaccine is the first
tea
g
y
partners to promote healthy communities.
June
George Calkins, 15 years
July
Kris Magnussen, 15 years
August
Mike Bibens, 12 years
Kim Hamley, 5 years
September
Helen Adap, 2 years
Katie Baldwin, 15 years
Melissa Edmonson, 2 years
FOLLOW US ON
SOCIAL MEDIA
@ledgelighthd
HOON
Join our
Community Email List
Get our newsletter and important updates sent
directly to your inbox, Email us at eharrison@llhd.org.
and most important step in
protecting against flu viruses.
Please visit www.LLHD.org
for our schedule of
upcoming vaccination clinics.cm? €
LLHD
Ledge Light Health District
Newsletter Designer & Editor: Estelle Harrison
Editor: Jennifer Muggeo

frost and consistently cooler temperatures. It's a good time to do a health check on your heating equipment and
ensure proper ventilation and other safety measures are working. If you need assistance paying for heat this winter
please contact our friends at TVCCA to enroll in the energy assistance program—call them at 860.425.6681 or go
online to tvcca.org/energy-assistance.
It's also a good time to remember that although it's cooler now it's not consistently cold, which means we should still
be on the lookout for ticks! Ticks may be active any time the temperature is above 40°F, so while you're enjoying the
changing leaves use tick protection strategies to stay safe. You can find them on our website at IIhd.org or pick up a Jennifer Muggeo
pamphlet at our office. Director of Health
Finally, many of us have holiday meal planning on our minds! We hope that everyone enjoys a safe, healthy and happy holiday season and
avoids foodborne illness by following good practices when defrosting, preparing, cooling and storing all the delicious food your family traditions
call for, We'll be sharing easy to follow guidelines on our website and social media the week of Thanksgiving so check them out before you get
cooking!
On behalf of the team,
Gea
¢
Jennifer Muggeo, jmuggeo@llhd.org
INSIDE THIS ISSUE
e Anniversaries
e Follow Us on Social Media
e Groton Alliance for Substance use Prevention
e Lead Poisoning Prevention
e Ledyard Prevention Coalition
e Medical Reserve Corps
4
e Mujeres Entre Culturas
e Public Health Nursing in the Community We're so grateful for our community partnerships! “Cross-sector
e Radon Awareness Month collaboration” sounds jargony but it's what we call the simple and
. . oa —: common sense approach of different organizations bringing resources
Did you miss Issue 1 of LLHD Highlights? Find it and expertise together in service of our community. In October, we met
on our website at https://tiny.lIhd.org/Issue4 our colleagues from Uncas Health District at Backus Hospital to receive a
donation of flu vaccines and EpiPens. The hospital resources of vaccines
combined with the health district resources of mobile health services
means that more people in our region will be protected against the flu
this season! Thank you Backus Hospital!
Jennifer Muggeo, jmuggeo@llhd.org
Ledge Light Health District 216 Broad Street New London , CT 06320 - 860.448.4882 - www.LLHD.org

a prick to the finger or heel in the pediatrician s office and results are usually presented
BS immediately. If a child has a capillary screening result of 3.5 g/dL or greater, the
pediatrician will require the child to have a lead venous (in the arm) draw at a laboratory.
i If you reside in a home that was built before 1978 and have children under the age of 6,
call your pediatrician today to discuss having your child tested for lead!
Ledge Light Health District has a robust staff of environmental health professionals who
are committed to preventing lead poisoning among children in Connecticut, If you have
concerns about your home and lead paint, LLHD inspectors are certified to assess risks
of lead in homes and can assist you in identifying potential lead hazards. An inspector
will conduct a site visit and perform a visual and environmental assessment of your
space. The inspector will provide education on lead hazards and prevention, If you are
interested in a home risk assessment, please contact us at 860-448-4882 to schedule an
in-home lead risk assessment. Katie Baldwin, kbaldwin@llhd.org
In this picture Katie Baldwin, Supervisor of Regulated Facilities and Housing, is collecting a dust wipe of a floor in a home. She places the wipe in a clean tube
which is then sent to the lab to be analyzed for lead content in the floor dust. The result should be less than 10 pig/ft2.
Radon Awareness Month
January is National Radon Awareness Month! Radon is a naturally occurring odorless, tasteless and radioactive gas released
into homes from rock, soil and water from the
breakdown of uranium. Since you cannot see or
taste the gas, the only way to know if itis present | HOW
in your home is to test! On January 2, 2024, RADON GAS
Ledge Light Health District will commence our 7 | ENTERS AHOUSE
year participating in the State of Connecticut
Annual Radon Partnership Program. We are
anticipating receiving 50 radon test kits which will
be available to residents free of charge on a first
come, first served basis. The test kit includes the
short test kit, instructions on testing and a pre-
paid envelope to mail the test kit directly to the
laboratory. Please contact Tyler Do-Taylor at 860-
448-4882 ext. 1346 to obtain a free test kit. For
technical and basic radon questions, please
contact Supervisor of Regulated Facilities and
Housing, Katie Baldwin at 860-448-4882 ext.
1319. Katie Baldwin, kbaldwin@llhd.org
BEDROCK

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y
qf
to underserved populations. Our goal is to minimize or eliminate
barriers to vaccine access such as cost, health insurance
status, proximity, and convenience. So far this season, we have
done vaccination events with New London Adult Education,
Alliance for Living, Church of the City, Waterford Farmer's
Market, New London Community Meal Center, New London
Homeless Hospitality Center, New London Senior Center,
Hispanic Alliance of SECT, Waterford Farmer's Market, Alliance
for Living, and Old Lyme VNA, and we will continue to schedule
events into the winter. We are also assisting the Naval
Submarine Base with a four-day mass vaccination event in
November.
LLHD has purchased a small amount of COVID-19 vaccine to
administer to our homebound residents. We've also received
a small amount of free COVID vaccine through the State of
Connecticut Childhood Vaccine Program and the Center for
860.448.4882 for more information or assistance.
These immunization activities would not be possible without the
help and support of our Medical Reserve Corps volunteers,
Thank you to the LLHD MRC Unit for your service!
Mary Day, mday@llhd.org
Boost your safety this holiday season! Vaccines are available to protect us
from illnesses including, pneumococcal disease, respiratory syncytial virus
(RSV), flu and COVID, Contact us for more information and help finding a
vaccine!
Medical Reserve Corps
Our Medical Reserve Corps volunteers can be found doing blood pressure checks, helping at the New London Food Pantry and
vaccinating folks against flu and COVID. If you came to
any of our many vaccine clinics over the past few years,
one of our volunteers gave you your shot. We have 147
volunteers, who are medical and non-medical, but we
have a core group of about 30 that always sign up to
work. Last year our volunteers contributed 2,387 hours
providing services to our communities.
Recently, on a very rainy and windy Saturday, 21 of our
volunteers assisted the Old Lyme VNA in giving 200 flu
shots in a drive-thru clinic. MRC volunteers assisted with
traffic monitoring, greeting, and vaccinating.
In November, some of our physicians, nurses, and
pharmacists will be at the submarine base vaccinating
4,000 sailors and staff against flu. The base clinic does
not have the manpower to vaccinate so many. Even though we have to be on the base at 0530, that hasn’t kept our volunteers
from signing up.
Anyone interested in joining our MRC unit, please sign up via https://ctresponds.ct.gov/
Kris Magnussen, kmagnussen@llhd.org
FOLLOW US ON FACEBOOK @LLHDMRC

Take it To the Box Radio Campaign on WBMW and WJJF. The
Campaign ran for the month of October and concluded with
National Prescription Drug Take Back Day on October 28!" at the
Ledyard Police Department. Thank you to Chief Rich, Principal
Amanda Fagan, Mayor Allyn, Parks and Recreation Director,
Scott Johnson and Ledyard Town Council Member, Gary Paul for
participating in the campaign.
Our 2023 Ledyard Youth Survey Report has been completed.
This survey is a tool to measure practices and attitudes related to
substance use among the town's young people. Results are used
to develop appropriate prevention and intervention strategies for
youth and for general comparisons with regional and national
statistics. Youth in grades 6 through 12 participated in the survey.
FOLLOW US ON SOCIAL MEDIA @ledyardprevents
An abbreviated version of the report will be distributed to the
community in November. Overall, we are seeing positive results
such as: increased rate of harm of using substances, increased
difficulty in obtaining substances, and increased disapproval rate
of using substances by friends.
The LPC continues to collaborate with Ledyard Youth and Social
Services to facilitate the Ledyard Juvenile Review Board. This
year the Juvenile Review Board has seen 9 cases between
October 1, 2022 through September 30, 2023.
Other highlights include:
e Implemented a parent education campaign, “Talk They Hear
You’ this campaign was created by SAMHSA.
e Participated in several events including National Night Out,
Farmer's Markets, and Mashantucket Pequot Tribal Nation's
Suicide Prevention Event.
e Recruited 30 Ledyard Middle School students and provided
a leadership program at Waterford Country School's Ropes
Course and Nature Farm.
e Provided substance prevention education classes at the
Ledyard Parks and Recreation Department as part of their
summer program.
Kerensa Mansfield, kmansfield@llhd.org and Karl Jennings,
kjennings@llhd.org.
Groton Alliance For Substance use Prevention (GASP)
Groton Alliance For Substance use Prevention (GASP) is funded largely by the CT DMHAS part B grant
focused on underage drinking prevention. The two risk factors we are addressing are family norms and retail
availability. With our partners, this summer we focused on surveillance and enforcem