Connecticut River Area Health District Annual Report 2012-2013
The Connecticut River Area Health District (CRAHD) is a
three town health district providing core public health services to the towns
of Clinton, Old Saybrook and Deep River.
The district is responsible for implementing programs that improve the
health of its residents. The district
provides a strong environmental health component, targeted public health
nursing services, health education and promotion venues, disease tracking and
prevention activities and public health preparedness planning. Currently, the district employs 5 full time professional
staff, as well as 3 part time contractual program professionals. The district is dedicated to carrying out its
mission to maximize the highest quality public health services possible given
its current resource level. This report
covers the period from July 1, 2012 through June 30, 2013.
This fiscal year, the district elevated one of its 3
Sanitarian positions to Chief Sanitarian and promoted from within. The Chief Sanitarian supervises the
district’s 2 full time Licensed Sanitarians and 2 part time certified
inspectors to run its environmental health section. Programs include state mandated inspections
for compliance with the Connecticut Public Health Code, as well as education
related to program specific topics.
Inspections are conducted in the following areas:
Food service establishments: restaurants, food stores, school cafeterias, nursing
homes, churches, vendors
Cosmetology establishments including Nail and
Beauty Salons and Barber Shops
Child Day Care Centers and Group Day Care Homes
Public Swimming Pools
Public Bathing Beaches
Response to general nuisance complaints
landlord-tenant issues related to minimum housing standards
Private water supplies permitting, testing and
On-site sewage disposal site evaluations, plan
reviews, installations, alterations and repairs.
Inspection activity (not all inclusive) during the 2012-2013 fiscal
year (July 1 to June 30) included:
Food establishment inspections
55 Cosmetology inspections
9 Day care inspections
15 Public pool inspections
148 Beach/bathing water samples taken and tested
19 New well permits were issued
13 Permits were issued for new septic
41 Engineer designed septic system plans
were reviewed and approved
306 Permits were issued to repair an
existing septic system
236 Properties were tested for
suitability for a septic system
63 Complaints: including
general nuisances, animals, housing, sewage, etc.
302 Applications were reviewed for health code compliance for
proposed building activities including building expansions, additions to homes,
in-ground and above ground pools, accessory apartments, garages, decks, etc.
In June of 2013, the board of directors for CRAHD adopted a local ordinance requiring the registration and inspection of all overnight stay facilities within the district. Overnight stay facilities include but are not limited to: hotels, motels, inns, and bed and breakfast establishments. The district will be seeking compliance of these facilities in minimum sanitation standards for common areas as well as individual rooms. This new program will become effective July 1, 2013 and will be carried out in the next fiscal year and annually thereafter.
responsible for Tuberculosis case medication management and has utilized local
VNA’s to conduct follow up visits to ensure treatment compliance.
Our Public Health
Nurse, under the guidance of the Director of Health, conducts active
surveillance of all mandatory reportable diseases identified by the CT
Department of Public Health. In
addition, the Public Health Nurse conducts follow up investigations of selected
illnesses reported to control the spread of these diseases in the community.
The Public Health
Nurse works closely with all three school districts to conduct surveillance for
flu like illness, to assist in the control of illness in the school settings,
and to support health education activities.
course of the year, the role of the Public Health Nurse has been further defined
as a key person in the planning and execution of public health preparedness,
and is the district’s preparedness coordinator.
Health Education and
CRAHD has assisted
with in-school flu clinics offered at Morgan High School in Clinton. In coordination with the VNA of Southeastern
CT, CRAHD has also assisted with clinics in Old Saybrook at the three schools,
the town hall, the firehouse for emergency personnel and at the CRAHD office. The benefits of this concept have been
presented to the three district towns.
continued to be involved in the promotion of good oral health for the un/under-
insured through the Old Saybrook Dental Initiative Group.
Health Nurse attended Science Day at the Goodwin Elementary School Program and
the Old Saybrook Middle School Health Day to educate on the importance of good hand washing
and personal hygiene using Mr. Glow Germ Kits.
She also mentored two different groups of Junior and Senior High School
groups to assist with this education to the schools. Student assistants were Honors Biology
Students interested in the Medical Field.
attended an English as a Second Language Adult Education Class at Clinton High
School and educated about the Seasonal Flu and the importance of vaccination
and hand washing in the prevention of getting and spreading the Flu.
of Health and Pubic Health Nurse were core participants in the development of
the Middlesex County Coalition on Community Wellness, an outgrowth of the
county’s CDC Community Transformation Grant, by collecting data for a county
wide wellness assessment, including Change Tool completion, Key Informant
interviews, and further data collection
toward the submission of a proposal to the CDC requesting funding for implementation
of programs geared toward creating positive change in the areas of physical
activity, healthy eating and management of chronic disease.
Preventative Health Block Grant, CRAHD created and presented an educational
program to at risk town employees and others in the prevention of Skin Cancer. Municipal and park and recreation staff, as
well as elderly, were educated on the dangers of sun exposure, provided
pamphlets and literature on prevention of sun exposure, including Tanning
Beds. At the end of each education
session, each participant received his or her own sunscreen lotion.
CRAHD is the
lead health department in Mass Dispensing Area #39, which includes the 3 health
district towns as well as Westbrook, Chester, Essex and Killingworth. We continued work to improve operationalizing
our mass dispensing plan and pandemic influenza plan. These plans direct how medication will be
dispensed to large segments of the
population in a very short time period, and public health actions needed in a mass
dispensing scenario. Working in
cooperation withthe Department of Public Health, local Emergency Management
Directors, Health Directors, and town leaders in all 7 towns, we have placed an
emphasis on volunteer recruitment and training, and creation of more closed
PODs or points of dispensing. We also worked
with our colleagues in public health preparedness Region 2 to complete a
regional Technical Assistance Review (TAR) and Project Public Health Ready; two
assessment tools designed to identify areas to improve our capacity to prepare
for and respond to public health emergencies.
Our Public Health Emergency Staff and Volunteers attended an Incident
Command ICS 100 class to better prepare them as volunteers to work under a
command structure in an emergency situation. CRAHD has been meeting with each
town from MDA #39 to review the mass dispensing plan and to encourage them to
include the plan in their respective all hazards plan for their town.
has been working on a Quality Improvement (QI) project to improve its Health
Alert Network (HAN) capacity and usefulness.
Our Public Health Nurse was an active participant in a statewide work
group for the revision and vetting of a new Head of Household Form which would
be used in a mass dispensing scenario. The
form is developed from a medical model and is more user-friendly.
River Area Health District continues to be an integral part of its constituent
towns Water Pollution Control Agency planning and/or plan implementation. In Old Saybrook,CRAHD plays an integral part
in the Water Pollution Control Authority’s Waste Water Management District
(WWMD) program. The Health District
Staff works closely with the Water Pollution Control Authority (WPCA) to ensure
implementation of its upgrade ordinance.
CRAHD is responsible for ensuring that all on-site conventional sewage
disposal system upgrades meet the requirements of the CT Public Health Code and
the Ordinance’s Upgrade Standards.
Approximately 120 out of 1900 on-site septic systems have been upgraded
under the program.
In addition, the
health district has been assisting the Clinton Water Pollution Control
Commission in its planning for its own waste water management plan.
Disease Tracking and
The Health District’s
Director of Health and Public Health Nurse perform active surveillance and
provide control follow up for diseases and health conditions that are
reportable to the local director of health by law. Follow up was provided for illnesses that had
the potential of being spread person to person or through a medium such as food
or water. Outreach and education is
continuously provided for diseases of importance such as Hepatitis A, B and C,
elevated childhood lead levels, Lyme Disease and other vector borne diseases.The
district also manages the mosquito control activities in the towns that
participate in control and monitors for mosquito borne diseases.