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Health
District Planning Meeting Minutes for New Canaan/Norwalk
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PUBLIC HEALTH & WELFARE COMMITTEE
PUBLIC HEARING TO CONSIDER THE FORMATION OF
A HEALTH DISTRICT
COMMON COUNCIL CHAMBERS
MAY 26, 2005
ATTENDANCE: Rev. Jeannette Olmstead-Sawyer, Chair; Peter Wien; William
Krummel; Richard McQuaid; Leona Williams, Douglas Sutton.
STAFF: Tim Callahan, Director of Health, City of Norwalk
OTHERS: Tom Hamilton, Finance Director, City of Norwalk; Tom
Berstone, Facilitator for State of Connecticut, UConn.;
Ken Lalime, Member of the Norwalk Board of Health;
Laura Epstein, Senior Service Council; Ed Tracey;
Betty Karkut, Director, Honey Hill Care Center; Diane
Lauricella, League of Women Voters & Independent
Environmental Health Consultant, Bill Gerrish, State of
Connecticut Department of Public Health, Hartford;
Jacqueline M. Lubell, Norwalk NAACP; Shirley Mosby,
Norwalk NAACP, James Cole, New Canaan Health Task
Force, Ed Musante, Norwalk Chamber of Commerce, Dr.
David Reed, Health Director, Town of New Canaan,
David Kennedy, C.E.O, United Way
CALL TO ORDER AND OPENING OF PUBLIC HEARING
The public hearing was called to order at 7:40 p.m. by the chair. The public was invited to sign up at the podium if they wished to speak.
OVERVIEW OF PROPOSED HEALTH DISTRICT
Mr. Tim Callahan, the Director of Health for the City of Norwalk,
opened the meeting with a slide presentation that reviewed the proposal for
the Norwalk- New Canaan Health District. He stated that the State of Connecticut
is comprised of 169 towns. The current population of the state is almost 3
and a half million people. Nearly 90% of the population of the State are served
by full time Health Departments. Out of those 169 towns, 31 have full time
municipal Health Departments. There are currently 19 Health Districts in Connecticut.
There are still 46 part time Health Departments in the State. These serve
between 10, almost 11% of the population. The majority of the people of the
State are served by Health Departments that are full time and offer a broad
category
of services.
The Health Districts are governed by Connecticut State Statute 19a-241, which has very specific guidelines for communities to follow. These include: a public hearing and legislative body vote; the district becoming an extension of the municipalities; governed by a Board of Directors with a Health Director and must adopt reasonable rules and regulations.
The statutes are very specific about full time employees who
move from the City to the District are guaranteed their jobs. Also by statute,
those employees have the right to remain with the pension plan at the town
or State where they were working. If a town withdraws from a district or the
district is dissolved, those employees have the right to go back to the city
from which they came. No district has ever shut down. There have been a couple
instances where towns have moved from one district to another geographically.
At the time, they decided to join the District, there was only one and subsequently
additional Districts were formed and it made more sense for them to
join one of the newly formed Districts.
The other very important item that is outlined in the statute is the state of reimbursement. Health Departments receive some funding from the State at set rates per capita. The State reimburses full-time Health Departments .94¢ per capita. New Canaan currently is reimbursed at .49¢ per capita. A District, however, receives $1.66 per capita. That is the incentive the State can offer us. For Norwalk and New Canaan, if we form a Health District that means additional $84,000 per year.
Emergencies and disasters do not stop at town borders. Towns need to be prepared. The State has pushed us in that direction because they have said, “Norwalk and New Canaan, you are the regional area for the smallpox response.”
In addition, efficiency is greatly increased. Obviously, there
are emerging health problems. We know that a big study in Norwalk last year
found that an alarming number of children in our school system who are considered
obese or becoming obese.
We need to develop interventions or plans. If we went to New Canaan with that
same study, we would discover that childhood obesity doesn’t understand town
borders.
In developing intervention, it takes alot of resources. With a District, we
could develop an intervention that would go across a broad based population.
Savings would be around 9% for the first year of operation. After talking with other directors of Health Districts, they have all found that once they got going, the savings were much bigger than they ever thought they would be.
Senate Bill 978 will require that all part time Health Districts become full time Health Departments. There is a possibility that this will not be implemented before the legislative session is over. In the event that it doesn’t happen this year, it will happen within the next few years.
How will this affect Norwalk and New Canaan. A Task Force was appointed, 6 representatives from Norwalk and 5 from New Canaan for a total of 11. We took a very thorough look at the laws, at service levels and statute requirements and the budgets. We met with other Health District leaders to hear their experiences and had input from the State Department of Health.
What the Task Force found was that Norwalk meets the statutory required levels of services. However, New Canaan was not able to meet these requirements and must improve their levels of service. It was also discovered that regard to emergency response that both Norwalk and New Canaan are already working together, as a result of the smallpox response mandate. By working together, Norwalk and New Canaan can maximize services to the area. The Task Force determined that current staffing levels are sufficient and that the costs would be reduced for both the City of Norwalk and the Town of New Canaan.
The Task Force concluded that forming a District would improve services in both communities and reduce the local public health care costs. Also, implementing a Health District would make us the fourth largest District in the State and give us potential to influence legislation. We would also be unique in that Norwalk and New Canaan would be the first to form a District composed of a city and a town. The combined population of the two towns would allow the District to apply for grants and funding for which we have not previously been eligible The CDC is already talking about requiring accreditation, so by forming now, we would determine our own course of action and strategically position ourselves.
The Task Force therefore recommended that City and Town Leaders and Administrators move the project forward, start working with the collective bargaining unions and review the budget forecasts.
Mr. Callahan then reviewed the Finances, and reiterated the savings of 9% overall. He also indicated there would be a consistent rate fee schedule and that New Canaan would pick up the services that are not currently available to them.
Mr. Callahan then reviewed four memos: a Memorandum of Understanding Employees, a Memorandum of Understanding Offices - which assured the residents that their records would remain in their towns, a Memorandum of Understanding Costs and a Memorandum of Understanding Compliance.
Mr. Callahan concluded his report with the recommendation for approval of a Norwalk-New Canaan Health District.
Chairwoman Olmstead-Sawyer thanked Mr. Callahan for his presentation.
PUBLIC COMMENTS
Chairwoman Olmstead Sawyer opened up the meeting to public comments at 8:04
p.m.
Mr. Thomas Hamilton, Finance Director for the City of Norwalk
125 East Avenue, Norwalk, CT.
Mr. Hamilton apologized to the Committee and the public for the delay of the hearing as the Finance Department had not completed their evaluation and review.
Mr. Hamilton then distributed a three page Financial Benefits to Norwalk of the Proposed Norwalk-New Canaan Health District report.
He indicated that a Norwalk-New Canaan Health District would be eligible for additional State grant revenues estimated at $83,660 per year which would be received beginning June, 2005.
Also a Norwalk-New Canaan Health District would be in a better position to secure more State, Federal and or Private Foundation grants than either town alone.
The creation of a Health District would open up new opportunities for the District to generate greater revenues from fees for services.
The City has performed its due diligence to identify outstanding financial and other issues associated with the creation of a District.
The creation of a Health District will save Norwalk taxpayers money starting this year and increase in the future.
Mr. Hamilton concluded his report with the recommendation for approval of a Norwalk-New Canaan Health District.
Mr. Thomas Berstone, Consultant for the State of Connecticut
- UConn
95 Rimsfield Drive, South Windsor, CT 06074
Mr. Berstone stated that he was a facilitator for the State of Connecticut and the University of Connecticut.
He reviewed the process that was utilized with the committee in viewing the entire project. It was a two phased project. First, a meeting was held initially with Dr. Reed in New Canaan and did a general fact finding overview and put together a business plan for viability. Based on that, it was felt that the project was worthwhile and significant savings would be realized. The second phase was a series of meetings with the committee in which facilitated guidance decision making was needed. The committee members discussed it and put forward a proposal that was felt to be workable for each of the services. This was done with each of the aspect of the project: staffing, structure of district, etc. In the latter three meetings there were alot of aspects, looking at what the current budgets were, and projecting budgets for 2006 so that the committee could see what it would look like individually and what it would look like combined. This information was analyzed and resulted in the conclusion that the committee recommends that this project go forward. It is notable that the State thought highly enough of this project to bring in assistance for both