Representative Town Meeting Annual Budget Meeting Materials - Day 2 (linked)

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Ledge Light
December 14, 2020
Town of Waterford
First Selectman Robert Brule
15 Rope Ferry Road
Waterford, CT 06385
First Selectman Brule:
At their December meeting, the Board of Directors of Ledge Light Health District
approved my proposal to increase the FY22 member contributions from the current per
capita rate of $7.37 to $7.59, Based on the population reported to us by the Department of
Public Health, the Town of Waterford’s FY22 contribution to the District will be
$142,282.
As you are aware, the District has been able to maintain a flat per capita rate of $7.37
since 2018, while the budgetary and operational burden placed on our organization
continues to increase. This 3% increase will help to assure that our continued response to
the pandemic, and all of our public health responsibilities, continue to be met.
A detailed draft budget document for FY22 is.attached for your review. We have also
included a report on our activities and the services offered to Waterford residents,
As you are aware from previous years, the FY22 budget will not be formally approved
until April, 2021, following a public hearing.
Sincerely,
fa Wd
Stephen Mansfield, MPH, REHS
Director of Health
: 216 Broad Strael = New Londen, CT 06320 © phone. 860.448.4882 ° fox. B60,448,4885 ¢ www.lihd.org

; Projected Expenses
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 RepairdFees
Vehicle Fuet
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
Books, subscriptions, reference
Staff development
Community Outreach and Engagement
General Liability Insurance
Property Insurance
Public Officials Insurance
Employment Practices Insurance
Umbrella Insurance
Travel
Conference, convention,meeting
Other expenses
CHIP Implementation/Accreditation Prep
Program development
Capital Assets
Grant Non-Personnal
$18,000
$48,000
$500
$10,000
$6,500
$3,000
$4,000
$10,000
$7,171
$9,000
$34,000
$7,500
$6,500
$900
$143,500
$3,500
$25,200
$3,000
$2,500
$48,500
$2,500
$750
$2,500
$2,500
$8,000
$2,000
$1,700
$3,200
$3,500
$3,530,317
$1,251,580
$488,103 $2,667,588
$687,337
$240,568
$107,174
$57,900
$66,200
$26,650
$604,808

Ledge Light , District
Ledge Light Health District
Ledge Light Health District (LLHD) serves as the local health department for the municipalities of Ledyard, -
East Lyme, Lyme, Groton, Waterford, Old Lyme, Stonington, North Stonington, and New London. The LLHD
team, comprised of experts in administration and finance, environmental health, communicable disease
prevention, and health education & community outreach, work cooperatively to promote healthy communities
and ensure that healthy opportunities are available to everyone.
Environmental Health
Regulated Establishments
LLHD 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; Class III establishments (those with extensive hot
holding, cooling, preparation, etc.) are required to be inspected three times each year, while Class I
establishments only require inspections annually. We work with these local businesses to implement
comprehensive food safety practices and provide cost-effective foodservice education programs. Our Café
program provides our establishments and volunteers with food safety instruction that fulfills the “designated
alternate’ requirement of the PHC. Café classes are scheduled on an as needed basis for volunteer groups,
temporary event staff, and persons who do not normally engage in food preparation. Our ServSafe Certified
Food Protection Manager (CFPM) classes are geared toward foodservice managers and employees who desire
more comprehensive instruction that fulfills the PHC requirement for a CFPM to be onsite at Class II, III and IV
establishments.
LLHD also inspects temporary events where food is served to assure proper food safety practices are being
followed and inspects public pools, cosmetology, day care and lodging establishments to ensure these entities
are taking measures to protect the public health. We also visit residential and commercial properties in response
to complaints or concerns raised by the public. Our online complaint reporting system provides residents the
opportunity to submit their concerns electronically. LLHD is also responsible for assuring that our coastal and
inland waterways are safe for recreational activities. We work with our local shellfish commissions and the
Connecticut Department of Aquaculture to assure that our waters are safe for shell fishing and conduct weekly
inspections and water sampling at all our bathing beaches.
Land Use
Our environmental land use staff of five sanitarians conducts soil testing, plan reviews, groundwater monitoring
and construction inspection activities for building lots served by onsite septic systems and/or wells. In addition
to new lot reviews, we oversee the review of lot line changes, residential and commercial additions, accessory
structures (sheds, decks, pools, and detached garages), and changes in use (residential to commercial or an
increase in the number of bedrooms), 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.
216 Broad Street * New London, CT 06320 * phone. 860.448.4882 © fax. 860.448.4885 © www.lihd.org

vedge Light 1
District
Communicable Disease Prevention
LLID holds annual free flu vaccination clinics for all age and provides free vaccinations for new parents,
grandparents, and caregivers of infants to protect against Pertussis (whooping cough). 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.
LLHD 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 monthly with Infection Preventionists from area Long Term Care facilities
to provide education and guidance.
In October, LLHD held its 9 annual Drive-Thru to Beat the Flu exercise in Waterford, where we provided free
flu shots to 197 residents in a drive-thru scenario. Throughout the District, we strive to provide flu vaccinations
to individuals who may otherwise “fall through the cracks”. We visit homeless shelters, soup kitchens, schools,
adult education centers, community meal settings and other areas where underserved populations may gather.
feparedness Activities
LLHD works closely with municipal and regional partners to prepare for and respond to emergency situations.
These activities include participation in the Millstone exercises, working with local partners to develop ‘
Continuity of Operations and Closed Point of Dispensing plans, and recruiting and training volunteer members
of the Medical Reserve Corps. Because of the COVID pandemic, our participation in weekly preparedness
activities has increased dramatically.
LLHD is a regional leader in emergency preparedness; Director Stephen Mansfield currently represents the
public health sector on the Regional Emergency Preparedness Planning Team (REPT) and is the chair of the
DEMHS Region 4 ESE-8 Group. In addition, he is the preparedness lead and a board member of the
Connecticut Association of Directors of Health and represents local health on the Sector Rules DECD/DPH
COVID Subcommittee.
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 taxpayer dollars, 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.
216 Broad Street » New London, CT 06320 ° phone. 860.448.4882 ¢ fax. 860.448.4885 ¢ www.llhd.org

Ledge Light t District
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.
Health Services Block Grant
The Connecticut Department of Public Health offers Local Health Departments/Districts the opportunity to
participate in the Preventive Health Services Block Grant program. The grant is awarded for a three-year period.
Funding levels are determined and adjusted annually using a per-capita formula. Each contract year, DPH
outlines the programmatic options to advance the Healthy People 2020 objective. LLHD is currently using these
funds to:
e Implement a Live Well with Diabetes Self-Management Program (by phone during the COVID
pandemic) for adults living with diabetes, pre-diabetes and/or their support person(s),
e Pilot the Cook Well with Diabetes Program ~ a four-week cooking program for adults with diabetes.
LLHD works collaboratively with local senior centers and parks and recreation departments to offer these
programs in addition to Senior Resources Area Agency on Aging.
Immunization Action Program
New to LLHD in 2020 is a CT Department of Public Health funded program aimed at reducing preventable and
sometimes fatal diseases by increasing childhood immunization rates for the sixteen vaccines currently
recommended by the Centers for Disease Control and Prevention (CDC). Over the next five years LLHD will
provide professional development for healthcare providers, work to ensure that vaccine is provided by health
care providers, reach out to children who have missed vaccine doses or need a vaccine provider, conduct
community outreach and awareness campaigns, and enroll families into the statewide immunization registry,
called CTWiZ. A SECT Immunization Partnership has been established to guide future activities of the program
and assist in the promotion of childhood immunizations.
Overdose Action Team
The Overdose Action Team continues to advance the shared goals of increasing access to effective treatment for
opioid use disorder, saturating the community with naloxone and reducing stigma. Through our work engaging
with people in community settings and responding to calls to the phone line, our Recovery Navigators continue
support their individual health goals. They have been distributing naloxone kits funded by a grant from the
Community Foundation. Stigma reduction work is primarily carried out through work to increase community
understanding of substance use disorder and change the language used to discuss this chronic disease. The
Overdose Action Team’s work continues to serve as a model for other communities in Connecticut to take
collective action to address this public health epidemic.
216 Broad Street * New London, CT 06320 ¢ phone. 860.448.4882 ° fax. 860.448.4885 * www.llhd.org

Ledge Light . : District
Community Health Assessment (CHA) and Improvement Plan (CHIP)
LLHD continues to work with the many community partners on the Health Improvement Collaborative of
Southeastern Connecticut to monitor the health of our communities and take collective action to address
prioritized health concerns. In 2019, the Health Improvement Collaborative produced an updated Community
Health Assessment and Community Health Improvement Plan, which are available on our website at
https://lhd. org/healthy-communities/health-improvement-collaborative-of-sect/community-health-needs-
health concerns which are: Access to Care; Black Health Across the Lifespan; Latinx Mental Health; Opioid
Use Disorder and Overdose and Racism as a Public Health Issue. In addition, the Health Improvement
Collaborative of Southeastern Connecticut continues to participate in the State Office of Health Strategy State
Innovation Model Health Enhancement Communities work. The idea of Health Enhancement Communities is
that communities would take collective action on “upstream” things that impact health — housing, food security,
etc., and that action would result in documented savings in healthcare expenditures, a portion of which would be
retumed to the communities to continue the prevention work.
COVID-19
Schools
UHD continues to help assure that all our school systems are prepared to respond to cases of COVID among
weir students and faculty. We have met with numerous school officials to discuss scenarios and procedures
associated with safely keeping students in school and developed and distributed a decision tree and guidance
documents to help respond to cases or clusters of COVID. We have shared this information with the
Connecticut Department of Public Health, who asked us to present our work to other health departments and
emergency preparedness directors. Although we cannot predict what impact COVID will have on our schools as
the pandemic progresses, we are confident that we have provided our school systems with the most up-to-date,
comprehensive guidance available.
Sector Guidance
Director Mansfield has been participating ina DPH/DECD subcommittee whose purpose is to provide a public
health perspective on the proposed and amended Sector Rules developed by the DECD. This group of six health
directors meets multiple times each week, usually after hours, to consider the implications of certain re-opening
strategies, and how these decisions may affect the health of our communities. Getting a seat at this table was a
hard-fought battle, as the initial re-opening committee did not contain any representatives from local public
health departments. The Connecticut Department of Public Health has been working closely with our group to
help align the economic, public health and social implications of the Sector Rules. Our environmental and
adininistrative teams have played a key role in the interpretation and enforcement of the Sector Rules; we have
developed comprehensive policies and procedures to follow up on complaints of violations in restaurants,
cosmetology establishments, etc.
216 Broad Street * New London, CT 06320 ® phone. 860.448.4882 ° fax. 860.448.4885 © wwwllhd.org

Ledge Light | District
Contact Tracing
Mary Day continues to lead our contact tracing activities. We have utilized the Connecticut Department of
Public Health’s contact tracing system and have been working in close partnership with DPH representatives to
assure that our contact tracing efforts are the best they can be. Although the transition to the state system was
difficult in the beginning, it is now working well, and we are confident that we will continue to be successful in
our contact tracing efforts as we move into the winter. As we move closer to a mass dispensing scenario, it is
likely that our contact tracing policies and procedure will be modified to allow for adequate mass dispensing
vaccine preparation and delivery.
Mass Dispensing
LLHD continues to prepare for COVID mass dispensing activities. Although the vaccine distribution plan is
very fluid, we will utilize our mass dispensing plans for a portion of the planned vaccine distribution, and wiil
likely be responsible for vaccinating frontline workers including fire, police, EMS, etc. Private care providers,
pharmacies and hospitals will play a role as well.
COVID Funding
In cooperation with the Connecticut Association of Directors of Health, and with the support of our municipal
and legislative partners, LLHD has been advocating for increased funding for local health departments, both in
response to the COVID pandemic and due to the lack of adequate funding for core public health activities and
responsibilities. In late August, we were informed by the Connecticut Department of Public Health that a
significant amount of funding had been earmarked for local health departments. This funding was distributed to
local health departments based on their population and the level of poverty in their communities. Over the next
30 months, LLHD will receive approximately $860,000 to support our response efforts. We are currently in the
process of assessing our needs to best respond to the pandemic in the future. We have utilized this funding to
hire a vaccine logistics coordinator, and two contact tracers. Additional hires are in the works.
COVID and the Social Determinants of Health
COVID has certainly emphasized the need for our work to include action and advocacy to address barriers to
health in systems such as employment and income, education, transportation, and food access. In conjunction
with our partners on the Health Improvement Collaborative, we have participated in numerous activities
focused on the “social determinants of health” including leading both the planning and implementation of food
distributions; working with SEAT to design and implement COVID safety protocols to help assure the
continuation of crucial public transportation systems; exploring options for public internet access to assure
everyone can access telehealth, distance learning and electronic benefit enrollments; identifying and addressing
individual needs of people reached through contact tracing; and advocating for rent relief to prevent widespread
evictions resulting from thousands losing access to regular sources of income. This work is enriched by the
ongoing efforts of the Health Improvement Collaborative to broaden and deepen capacity in our region to
address Racism as a Public Health Issue. The Collaborative is offering regular education to its members and
recently 25 member organizations completed an Equity Pre-Test, which was an opportunity for them to look at
internal policies and practices and identify areas where action could be taken to address systemic racisin.
216 Broad Street » New London, CT 06320 © phone. 860.448.4882 ¢ fox. 860.448.4885 * www. lhd.org