Board of Selectmen - 69 (02/02/2022)

DEPT/AGENCY:
TOWN OF WATERFORD
GENERAL FUND
2022-2023 PROPOSED BUDGET
142,882
142,282

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Ledge Light Health District 
communities
November 15, 2021
Town of Waterford
First Selectman Robert Brule
15 Rope Ferry Road
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 FY23 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 FY23
contribution to the District will be $148,126. A detailed draft budget document for FY23 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 FY23 budget will not be formally approved until April,
2022, following a public hearing.
On behalf of our staff and board, | would like to express our gratitude for supporting the District
through the appropriation of a percentage of your Corona Virus Relief (CRF) and American Rescue
Plan (ARP) funds. These contributions are crucial to the success of our COVID response and
contributed to our ability to keep our budget flat for FY23.
Sincerely,
Frid 
by
Stephen Mansfield MPH, REHS
Director of Health
216 Broad Street 
* New London, CT 06320 * phone. 860.448.4882 © fax. 860.448.4885 * www.lihd.org

Projected Revenue
Per Capita Rate
Municipality
East Lyme
Groton
Ledyard
Lyme
New London
North Stonington
Old Lyme
Stonington
Waterford
Total Population:
State Per Capita
Environmental Health Fees
Food Service
Cosmetology
Lodging and Pools
Septic/Well
Other
$7.59
Population
18,645
38,445
15,420
2,352
27,376
§,152
7,615
18,288
19,516
152,809
Training/Consulting/Other Services
Interest
Grants
Block Grant
Gasp-SPF°
Gasp-LPC
immunization
LPC-DFC
LPC-LPC
PHEP R4
Yale-JCOIN
ELC
OHS-HIC.
New SUD grant
CAP
Other
G&A
Other
R1
R4
$42,905
$125,000
$7,000
$100,000
$125,000
$3,907
$342,650
$50,000
$500,000
$200,000
$75,000
$200,000
$75,000
$12,000
$54,000
$34,260
Ledge Light Health District
Budget FY2023
FY2023
Contribution
$141,516
$291,798
$117,038
$17,852
$207,784
$39,104
$57,798
$138,806
$148,126
$225,000
$17,700
$16,100
$130,000
$2,500
$3,910,145
$1,159,820
$397,303
$391,300
310,000
$5,000
$1,846 462
$100,260

Projected Expenses
Personnel Services
Employee Salary-Core
Benefits/Payroll Taxes-Core
Employee Salary-Grants
Benefits/Payroll Taxes-Grants
Non-Personne!l Operating Expenses
Facilities, Utilities and Vehicles
Utilities
Maintenance
Security
Telephone & telecommuni:
Data Connection
Vehicle Repair/Fees
Vehicle Fuel
Auto/Mileage Reimbursem
Auto Insurance
Supplies and Equipment
Office Supplies
(T Supplies
Program Supplies
Postage, shipping, delivery
Equip rental & maintenance
Professional Services
Accounting fees
Legal fees
IT Consulting Fees
Medical Consulting Fees
Other Professional Service
Insurance Agency Fee
Other Administrative Costs
Membership dues - organi:
Staff development
Community Outreach and
General Liability Insurance
Property Insurance
Public Officials Insurance
Employment Practices Ins:
Umbrella Insurance
Square fees
Meeting expenses
CHIP implementation
Grant Non-Personnel
$10,000
$48,800
$600
$11,000
$7,500
$3,000
$4,000
$10,000
$7,200
$8,000
$50,000
$7,500
35,000
$3,500
$13,500
$3,500
$20,000
$3,000
$2,500
$20,000
$2,500
$12,000
$2,500
$13,000
$2,400
$1,700
$3,200
$1,600
$10,000
$4,300
$7,500
$3,910,145
$1,252,156
$512,228 
$3,088,331
$980,702
$343,246
$102,100
$74,000
$62,500
360,700
$522,574

Ledge Light Health District 
communities
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 III and IV
establishments. When the FDA Food Code is implemented, which is likely to be in the coming year, the CFPM
requirement will also apply to Class II establishments. LLHD inspects temporary events where food is served to
assure proper food safety practices are being followed. We also inspect public pools, cosmetology, day care and
lodging establishments to ensure these entities are taking measures to protect the public health. We 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 bathing beaches.
Land Use
Our environmental land use staff 
of five sanitarians conduct 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. llhd.org

Ledge Light 
Health 
District 
communities
Communicable Disease Prevention
LLHD holds annual free flu vaccination clinics for all ages. 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 with Infection Preventionists from area Long Term Care facilities to
provide education and guidance.
In October, LLHD held its 10"" annual Drive-Thru to Beat the Flu exercise in Groton, where we provided free
flu shots to more than 150 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 locations where underserved
populations may gather.
Preparedness 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 ESF-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 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 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.

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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 for adults living with diabetes, pre-
( 
diabetes and/or their support person(s).
e 
Provide a Train-the-Trainer Cook Well with Diabetes Program — a four-week cooking program for
adults with diabetes for senior and recreation centers interested in implementing the program.
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 (IAP)
The [AP is a Connecticut Department of Public Health funded program aimed at reducing preventable and
sometimes fatal diseases by increasing childhood immunization rates for the vaccines currently recommended
by the Centers for Disease Control and Prevention (CDC). Over the next four 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 CT WiZ.
A SECT Immunization Partnership meets twice annually to guide program activities 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. 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.lihd.arg

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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. The Health Improvement Collaborative produced an updated Community Health
Assessment and Community Health Improvement Plan, which are available on our website at
hitps://Ithd.org/healthy-communities/health-improvement-collaborative-of-sect/community-health-needs-
assessment-cha’, The Community Health Improvement Plan includes goals and objectives around the prioritized
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
returned to the communities to continue the prevention work.
COVID-19
Schools
LLHD continues to help assure that all our school systems are prepared to respond to cases of COVID among
their 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. Although recommended policies and procedures
have changed significantly as the pandemic has progressed, we are confident that we have provided our school
systems with the most up-to-date, comprehensive guidance available.
Sector Guidance
Director Mansfield has participated in a DPH/DECD subcommittee whose purpose was to provide a public
health perspective on the proposed and amended Sector Rules developed by the DECD. [his group of six health
directors met 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. The Connecticut Department of Public Health worked closely with our group to help align the economic,
public health and social implications of the Sector Rules. Our environmental and administrative 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. In recent months, the sector “rules” have been replaced by “guidance”, which has lessened the
administrative burden associated with enforcement.
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. Recently, the DPH contact tracing program has
been reduced dramatically, leaving the majority of contact tracing activities to local health departments and

Ledge light 
FHealth District 
-ommunities
their community partners. We are confident that we will continue to be successful in our contact tracing efforts
as we move into the winter, and are hopeful that the availability of vaccine for expanded populations will lessen
the need for extensive contact tracing activities.
COVID Vaccinations
LLHD dedicated extensive resources to providing vaccinations to our residents during the initial stages of the
vaccination campaign. As the demand for the vaccine lessened, we moved our efforts toward focusing on those
populations with lower vaccination rates. Although the number of individuals that we vaccinated at each clinic
was reduced dramatically, the logistics of this operation was complicated and labor intensive. LLHD continues
to prepare for COVID mass dispensing activities associated with the COVID booster. We will continue to work
with our many community partners to assure that everyone has equal access to the COVID vaccine.
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. Last year, we were notified that the per capita contributions from the state to local health
districts and departments had been increased significantly. We owe a debt of gratitude to all of our legislators,
\. 
municipal leaders and other supporters for helping to push this initiative forward.
LLHD also received a significant amount of COVID related funding from our nine municipalities. In
Connecticut, a large portion of federal funding associated with the pandemic was directed to municipalities. At
LLHD, we are fortunate to have a group of municipalities that values our organization and the work we do. This
funding was associated with the American Rescue Plan and Corona Virus Relief funding, and provided us with
a significant income stream that allowed us to purchase much needed supplies, hire additional contact tracers,
community health workers and other staff to assist with our 
COVID response.
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 food distributions, connecting people with rent/housing
relief, reducing barriers to COVID testing and vaccinations, and helping community members access food and
other resources while under isolation/quarantine. 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 works with community partners to
advocate for action to address systemic racism.
216 Broad Street * New 
London, CT 06320 © phone. 860.448.4882 © fax. 860.448.4885 * www.ilhd.org