Department of Public Health

 

 

 

 

 

At a Glance

 

J. ROBERT GALVIN, M.D., M.P.H., Commissioner

Norma D. Gyle, R.N., Ph.D., Deputy Commissioner

Established – 1878

Statutory authority - CGS Chap. 368a, Sections 19a-1a et seq.

Central office - 410-450 Capitol Avenue,

      Hartford, CT  06106

Number of employees 862

Recurring operating expenses -

                Federal:  $124,884,704

                State:  $80,813,241

                Additional Funds:  $1,602,523

Organizational structure -

  • Administration Branch
  • Affirmative Action Office
  • Communications Office
  • Government Relations Office
  • Health Care Systems Branch

·         Laboratory/Mobile and Surge Hospital Liaison

  • Local Health Administration Branch
  • Multicultural Health/Comprehensive Cancer Office
  • Operations Branch
  • Oral Public Health Office
  • Planning Branch
  • Public Health Initiatives Branch
  • Public Health Laboratory
  • Regulatory Services Branch
  • Research and Development Office

 

Mission

To protect and improve the health and safety of the people of Connecticut.

 

Statutory Responsibility

     The Department of Public Health (DPH) is the state’s leader in public health policy and advocacy.  The agency is the center of a comprehensive network of public health services, and is a partner to local health departments for which it provides advocacy, training and certification, technical assistance and consultation, and specialty services such as risk assessment that are not available at the local level.  The agency is a source of accurate, up-to-date health information to the Governor, the Legislature, the federal government and local communities.  This information is used to monitor the health status of Connecticut’s residents, set health priorities and evaluate the effectiveness of health initiatives.  The agency is a regulator focused on health outcomes, maintaining a balance between assuring quality and administrative burden on the personnel, facilities and programs regulated.  The agency is a leader on the national scene through direct input to federal agencies and the United States Congress. 

 

Public Service

Administration Branch

    The Administration Branch assures that department-wide administrative activities are coordinated and accomplished in an effective and efficient manner.  The branch provides the following services across the agency:

 

Contracts and Grants Management

  • Provides oversight and administration of approximately 650 contracts with total funding of approximately $125 million. 
  • Provides support services to the department in the following contracting areas: training/education, fiscal oversight, compliance with state and federal regulations, contract budget planning, and liaisons with the Office of Policy Management, Office of the Attorney General, and the Department of Administrative Services. 
  • Administers the Public Health Foundation of Connecticut, Inc. 

 

Fiscal Services

·         Administers budget planning and preparation, monitoring of state and federal grant expenditures, revenue accounting, accounts payable/receivable, and purchasing, including emphasis for procurement activities from small and minority-owned vendors

·         Provides mail services and inventory control

 

Contract Monitoring and Audit Section

     Provides agency grantees and their auditors a single point of contact for accounting and audit issues related to grants and contracts. The unit also provides technical assistance to contracting units within the Department of Public Health and monitors the final financial settlement of agency grants and contracts.

 

Human Resources

     Provides comprehensive personnel management to the department, including labor relations for seven bargaining units and managerial/confidential employees, recruitment, merit system administration, performance appraisal review, statistical personnel status reports, payroll, fringe benefit administration, classification work for appropriate job titles, and Performance Assessment and Recognition System for managers.

 

Public Health Hearing Office

     The Public Health Hearing Office presides over hearings and renders decisions concerning:

·         Individual healthcare providers who do not have licensing boards

·         Appeals of orders issued by local health directors

·         The Women, Infants and Children’s (WIC) Program

·         Need for new or expanded service hearings concerning emergency medical service providers

·         Disciplinary actions against day care and youth camp licensees, and facility licensees (e.g., long-term care facilities)

·         Voluntary and involuntary transfers of water companies/Appeals of orders issued to water companies

·         Involuntary discharges from long-term care facilities

·         The office also investigates all Commission on Human Rights and Opportunities claims, provides support for 15 professional licensing boards, responds to ethics questions, and ensures compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

 

Affirmative Action

     DPH is strongly committed to the principles, policies and practices of affirmative action and equal employment opportunity in all agency programs and services.  The Affirmative Action Office ensures that the agency is in compliance with all applicable state and federal laws.  The office provides quality services, develops applicable policies and also implements other programs, such as contract compliance, small business set-aside, employee assistance, and Americans with Disabilities Act compliance.

 

Communications

    The Office of Communications provides comprehensive communications management to the department, including public information and freedom of information oversight, media and community relations, public education, website management, and risk communication responsibilities. 

 

Government Relations

    The Office of Government Relations is responsible for the full range of legislative and regulatory activities, including:

  • Managing and developing the department’s legislative and regulatory programs and implementing strategies to achieve the goals of the department’s legislative agenda
  • Coordinating the development of the department’s regulations
  • Acting as the commissioner’s liaison to the General Assembly, congressional delegation, community-based organizations, private sector organizations and other public interest groups
  • Coordinating the maintenance of the Public Health Code

 

Health Care Systems Branch

    The Health Care Systems Branch regulates access to the health care professions and provides regulatory oversight of health care facilities and services.  The branch protects public health by ensuring competent and capable health care service providers.  The branch consists of three major program components, which have responsibility for implementing state licensure and federal certification programs.  The branch has the authority to investigate and take disciplinary action against providers, who are in violation of the law or otherwise pose a risk to public health and safety. 

 

 

    The branch consists of the following sections and programs:

 

Facility Licensing & Investigations

·      Licensing, certification and investigations of healthcare institutions, including:

·      Ambulatory care services

·      Clinical laboratories

·      Dialysis facilities

·      Home care and hospice services

·      Hospitals

·      Intermediate care facilities for the mentally retarded

·      Nursing homes

·      Substance abuse and mental health treatment facilities

                                                                                                                            

Practitioner Licensing and Investigations

·      Applications and examinations of health care professionals for licensure

·      Investigations of licensed and certified practitioners

·      Nurse aide registry

·      Physician profiles

 

Legal Office

·      Criminal background checks program

·      Prosecution of regulated entities

·      Legislative and regulatory support

 

Laboratory/Mobile and Surge Hospital Liaison

    The Laboratory/Mobile Field Hospital Liaison is the Commissioner's liaison for agency bond projects.  Current projects assigned to the liaison include:  the design and construction of a new state-of-the-art Public Health Laboratory; the purchase and operational development of a Mobile Field Hospital (Ottilie W. Lundgren Memorial Field Hospital); and an initiative to improve isolation care capacity in acute care hospitals statewide.

 

Local Health Administration Branch

     The Local Health Administration Branch is the primary interface and liaison between the department and Connecticut’s local health departments (LHDs).  Responsibilities include:

 

  • Advising the commissioner on the approval of appointments of local director of health and acting directors of health.
  • Coordinating and providing an orientation for new directors of health.
  • Providing technical assistance and consultation to Department of Public Health programs, local health directors, local officials and residents on local public health issues and health promotion activities.
  • Administering per capita grants-in-aid for LHDs.
  • Planning and coordinating the commissioner’s semi-annual meeting for directors of health
  • Maintaining a current local health department / district database
  • Collecting annual reports from local health departments and analyzing data to monitor activities to assure compliance with Connecticut Statutes.
  • Working with local health departments to integrate and promote integration of the National Public Health Performance Standards.
  • Maintaining and developing Connecticut’s Health Alert Network (HAN) and assisting local health departments with the development of local HANs.
  • Strengthening Connecticut’s public health infrastructure by collaborating with other Department of Public Health programs, state and federal agencies and professional organizations.
  • Providing guidance and financial assistance to part-time health departments to become full-time health departments or to form and/or join other health districts.

 

Multicultural Health/Comprehensive Cancer

     The Multicultural Health section is responsible for improving the health of all state residents by eliminating differences in disease, disability, and death rates among ethnic, racial and cultural populations.  The office may provide grants for culturally appropriate health education demonstration projects and apply for, accept, and spend public and private funds for these projects.  It also may recommend policies, procedures, activities and resource allocations to improve health among the state's racial, ethnic, and cultural populations.

 

     The Comprehensive Cancer section integrates the Comprehensive Cancer, Breast and Cervical Cancer Early Detection, and Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN). 

  • The Comprehensive Cancer Program in collaboration with the Connecticut Cancer Partnership, a broad and diverse group devoted to cancer prevention and control, is implementing the Connecticut Comprehensive Cancer Control Plan, which is a blueprint for addressing the cancer prevention and control needs in Connecticut. 
  • The Breast and Cervical Cancer Early Detection Program provides comprehensive breast and cervical cancer screening, diagnostic services, and treatment referral services to medically underserved and uninsured women in Connecticut. 
  • The WISEWOMAN Program provides cardiovascular disease screening to women enrolled in the Breast and Cervical Cancer Early Detection Program to reduce the burden of cardiovascular disease by reducing the prevalence of cardiovascular disease risk factors.

 

Operations Branch

Emergency Medical Services

     The Office of Emergency Medical Services administers and enforces emergency medical services statutes, regulations, programs and policies.  Responsibilities include:

·         Developing the Emergency Medical Services Plan and training curriculum

·         Approving and overseeing the five Regional Emergency Medical Services Council work plans and contracts

·         Regulatory oversight of licensing and certifying emergency response personnel and licensing and certifying provider organizations, facilities and approving sponsor hospital designations

·         Conducting complaint investigations

·         Coordinating Emergency Planning with the Department of Emergency Management and Homeland Security (DEMHS)

·         Integrating statewide electronic EMS data collection

 

Informatics

·         Direct plans and information technology functions of the agency.  Responsibilities include strategic planning, maintaining critical agency infrastructure and providing help desk services to agency employees along with outside organizations with interfaces to agency systems.

·         Work with the Department of Information Technology to provide service level support for application development and infrastructure to support programs.

·         Oversight and maintenance of over 100 application support agency programs.

 

Public Health Preparedness

     The Office of Public Health Preparedness is responsible for the design, development and implementation of the department’s public health emergency plans and initiatives.  The office ensures compliance with state and federal mandates with respect to public health preparedness, and is responsible for identifying and securing grants in support of the state’s public health preparedness efforts.  Within the department’s incident command structure, the office provides operational management.  This office also coordinates the CDC Public Health Emergency Preparedness and HRSA Hospital Bioterrorism grant submissions.

 

Oral Health

    The Office of Oral Public Health strives to promote health and reduce disease and health disparities in Connecticut through enhanced oral health and oral health care access.  The office works to build the public health infrastructure for oral health within the Department of Public Health and throughout Connecticut in order to reduce the prevalence and impact of oral diseases and conditions and to enhance oral health care access.  Goals of the office also include implementing effective, culturally appropriate oral health promotion and disease prevention programs that adopt, adapt and enhance best practices.  The office also works to centralize, coordinate, enhance and integrate oral health data, information and monitoring systems to detect disease, inform policy, and evaluate programs.

 

Planning Branch

     The Planning Branch is responsible for the promotion, enhancement, and protection of: health data collection, monitoring, analysis, and reporting; public health planning and policy development; and training and professional development activities.  The branch provides information and support for collaborative health policy decisions, integrated state health planning activities, and coordinated training programs. 

 

     The branch consists of four sections:

 

CT Tumor Registry and Epidemiological Research

  • Maintains the Connecticut Tumor Registry, a population-based resource for examining cancer patterns in Connecticut.  The registry’s electronic database of over 814,000 cancers includes all reported tumors diagnosed in Connecticut residents from 1935 through 2004, as well as treatment, follow-up and survival data. All hospitals and private pathology laboratories in Connecticut are required by law to report cancer cases to the registry. State confidentiality laws restrict access to the identities of all patients reported to the registry.  The registry is also one of only ten statewide, federally funded Surveillance, Epidemiology and End Results (SEER) sites in the country, selected by the National Cancer Institute for their ability to manage a cancer reporting system.  SEER data are believed to be generally representative of cancer rates for the entire United States.
  • Provides epidemiologic consultation to programs within the department and other agencies doing public health research
  • Oversees review and approval of research applications from researchers who want to use department data

 

Health Information Systems and Reporting

  • Maintains the statewide registry for births, deaths, marriages and civil unions
  • Maintains the state paternity registry and collaborates with the Department of Social Services and obstetric hospitals to encourage unwed couples to establish paternity 
  • Processes all adoptions for Connecticut-born children, foreign-born children adopted by Connecticut residents, and adoptions finalized in Connecticut
  • Proposes legislation, develops appropriate procedures and systems to support the implementation of the Federal Intelligence Reform Act and the Real ID Act of 2005
  • Analyzes and reports on vital statistics, hospital discharge, and hospital quality of care data.  Collects medical and demographic data for morbidity and mortality research, public health planning, and the annual registration report
  • Manages all federal and state reporting for the Preventive Health and Health Services block grant
  • Administers the national Behavioral Risk Factor Surveillance Survey
  • Administers the CT School Health Survey
  • Oversees the Health Professional Shortage Area and National Interest Waiver processes
  • Manages the Biomedical Research Program
  • Calculates, certifies, and publishes the annual population estimates of 169 Connecticut municipalities for years between the decennial U.S. census enumerations
  • Surveillance of cardiovascular diseases and diabetes
  • Improving the infrastructure for data and surveillance related to health disparities

 

State Health Planning

  • Provides support and technical assistance to the department, other state agencies and policymakers in assessing public health resource needs and setting public health priorities
  • Develops and manages workgroups to assure comprehensive and coordinated planning processes within the department
  • Develops and maintains the State’s Health Plan and Public Health Emergency Response Plan
  • Conducts hospital and managed care surveys as part of the Community Benefits Reporting Program
  • Assesses health status and health services of Connecticut residents as part of the Healthy Connecticut 2000 and 2010 projects
  • Manages and administers the department’s Virtual Office of Genomics

 

Workforce and Professional Development

  • Enhances public health worker competencies through the creation of a DPH Training Center
  • Supports and promotes preparedness and response training opportunities
  • Enhances distance learning technology and promote online learning opportunities
  • Evaluates training and education provided to the public health workforce
  • Monitors public health and health care workforce issues

 

Public Health Initiatives Branch

    The Public Health Initiatives Branch improves and protects the health of Connecticut's residents using a variety of methods:  a) through the promotion of primary and preventive health care at every stage of life and through the identification of risk factors that contribute to chronic and infectious diseases; b) through the collection of data to assess and improve individual and population health; c) through disease surveillance and linked intervention activities such as patient counseling, public education, provision of vaccines or medicines, organization of special clinics; and d) through planning and development of a flexible emergency-response capability to address emerging disease problems such as West Nile virus and possible bioterrorism events such as anthrax or smallpox.

 

     The branch consists of the following sections:

 

AIDS and Chronic Diseases

  • HIV/AIDS Prevention Program
  • HIV/AIDS Surveillance and Viral Hepatitis Program
  • Cardiovascular Health Program
  • Data Management and Administrative Support
  • Health Care and Social Services

 

Family Health

  • Children and Youth with Special Health Care Needs
  • Adolescent Health
  • School-based Health Centers
  • Newborn Screening (metabolic and hearing)
  • Case Management for Pregnant Women
  • Family Planning
  • Community Health Centers

 

Health Education, Management and Surveillance

  • Women, Infant and Children (WIC) Supplement Food Program
  • Nutrition Education Program
  • Obesity Prevention Program
  • Asthma Prevention Program
  • Tobacco Use Prevention and Control Program
  • State Loan Repayment Program

 

Infectious Diseases

     Encompasses programs for:

  • Surveillance for emerging infections and more than 50 acute communicable diseases including conditions potentially associated with bioterrorism, outbreak detection, and investigation
  • Prevention of perinatal infectious diseases, vaccine-preventable diseases, sexually transmitted diseases and tuberculosis
  • Public health intervention response planning for bioterrorism and public health infectious disease emergencies
  • Epidemiology Program
  • Immunization Program
  • Sexually Transmitted Diseases Program
  • Tuberculosis Diseases Program

 

Public Health Laboratory

    The Public Health Laboratory supports the needs of all communities in the state by the analysis of human clinical specimens and environmental samples submitted by federal and state agencies, local health departments, the health care community, utilities and environmental engineering firms.  Analytical data are used to monitor for agents harmful to the public, identify the cause of outbreaks, and assure that control measures (i.e. vaccines, antibiotics, insect spraying) are effective.  The laboratory is comprised of the following testing units:

 

Biological Sciences – tests for infectious agents in humans, animals, food and water, provides reference testing in support of epidemiological investigations, serves as the state’s response laboratory for the identification of biothreat agents, tests all Connecticut newborns for the presence of 42 inherited disorders that cause severe mental and/or physical illnesses.

 

Environmental Chemistry – tests for over 100 toxic chemical agents in drinking water; in rivers, lakes and streams; in wastewater, landfills, spills, soils and air; in consumer products and other materials where there is human exposure.  This unit also provides monitoring of the nuclear power industry and is part of the state’s nuclear response team.

 

Biomonitoring – tests for the presence of toxic chemicals in human clinical specimens.  Serves as the state’s response laboratory in an event where the public is exposed to a Weapons of Mass Destruction (WMD) or other toxic chemicals.  Supports the Connecticut Poison Control Center and the department biomonitoring studies.  Tests approximately 55,000 children each year for the presence of elevated lead from exposure to old paint, folk medicines or other environmental sources. 

 

Regulatory Services Branch

    The Regulatory Services Branch has regulatory oversight of the state’s drinking water systems, child day care facilities, youth camps and environmental services.  Programs include licensure, investigation, and enforcement action against suppliers/providers that are in violation of the law or otherwise pose a risk to public health and safety.  The branch also operates prevention programs focusing on health education.  Technical assistance to licensed providers is a priority.

 

    The branch consists of:

 

Community Based Regulation Section

    Licensing, technical assistance, and investigations of facilities, including:

  • Child Day Care centers
  • Group Day Care homes
  • Family Day Care homes
  • Youth camps

 

Environmental Health Section

  • Asbestos Program
  • Environmental Engineering Program (On-Site Subsurface Sewage Systems, Mausoleums, Crematories, Private Burial Grounds)
  • Environmental Laboratory Certification Program
  • Environmental and Occupational Health Assessment Program
  • Environmental Practitioner Licensure Unit
  • Food Protection Program
  • Lead Poisoning Prevention and Control Program
  • Private Wells Program
  • Radon Program

·         Recreation Program

 

Drinking Water Section

    The Drinking Water Section (DWS) maintains oversight of public water systems for water quality monitoring and reporting, approval of treatment, infrastructure upgrades, new sources, source water protection, and completion of sanitary surveys.  The section is comprised of five functioning units, which include:

 

Certification

  • Treatment Plant and Small Water System Operators
  • Oversight of Operator Certification Program for Distribution System Operators
  • Oversight of Backflow Prevention Device Testers and Cross Connection Survey
  • Inspectors

 

Compliance

  • Monitoring, Reporting & Enforcement
  • Implementation & Response
  • Capacity Review & Standards
  • Technical Review

 

Programs

·   Data Management

·   Drinking Water State Revolving Fund (DWSRF)

·   Grant/Contract Development

·   Public Outreach

·   Report Development

·   Security & Emergency Response

 

Source Water Protection

·         Liaison and Source Water Protection Planning

·         Site Assessment and Review

·         Permitting, Education and Training

 

Water Utility Coordinating Committee

  • Discussion among water utility representatives and local officials regarding long-range water supply issues.

 

Research and Development

    The Office of Research and Development (ORD) oversees the management of cross branch initiatives to drive strategic priorities of the Department of Public Health (DPH).  The ORD addresses the horizontal integration of DPH assets and manages the research, development and implementation of new agency-wide initiatives.  Programs are conceptualized, resourced and put into operation by bringing together internal and external subject matter experts under the direction of the ORD.  Effectiveness is measured by the timeliness of program start up and the sustainability of programs and initiatives with the agency, and compliance with statutory mandates.  The current programmatic areas of focus and responsibility include:

 

  • Genomics and Public Health
  • Embryonic and Human Adult Stem Cell Research
  • Stroke Prevention and Cardiovascular Health
  • Umbilical Cord Blood Bank Feasibility Study

 

Improvements/Achievements 2005-06

Government Efficiency and Performance

  • DPH has embarked on a project to design and build a new state-of-the-art Public Health Laboratory.  A bonding authorization of $50 million is in place to fund this project.  An Environmental Impact Evaluation (EIE) has been completed and a Record of Decision has been submitted to the Office of Policy and Management.  Bond funds have been allocated for design, and pre-design work is in progress.
  • DPH has purchased and equipped a Mobile Field Hospital, the Ottilie W. Lundgren Memorial Field Hospital.  The field hospital will enhance surge capacity and isolation care in the event of an infectious disease outbreak or other public health emergency.  This facility is currently being used for training, exercises, and drills for Disaster Medical Assistance Team and for the department’s public health, health care, and emergency response partners.  An Advisory Board of Directors has been convened, and policies and procedures for deployment and operation of the hospital are being developed.
  • The Public Health Laboratory is conducting a project to replace its Laboratory Information Management System (LIMS), which is now almost 30 years old.  A Request for Proposals has been issued, and an evaluation team is presently evaluating these proposals and developing a recommendation for procurement.
  • During the past year the Local Health Administration Branch has been working to build Connecticut’s public health infrastructure to provide full-time health services to the residents of Connecticut.   Currently Connecticut has 82 health departments, 49 that are full-time health departments/districts and 33 that are part-time.  As a result of these efforts, the following part-time health departments have joined a health district; Roxbury, Bridgewater, East Lyme, Bozrah, Sprague, Bethany, and Newington.  In addition a new Health District was formed called the Connecticut River Area Health District which includes the Towns of Clinton, Deep River and Old Saybrook.  Connecticut now has full-time health services serving 92 percent of the population (3,214,770 people).
  • The department produced the report Hospital Performance Comparisons: A Report on Quality of Care in Connecticut Hospitals in an ongoing effort to provide standardized, useful, and valid information to the public about hospital quality of care and to promote quality improvement efforts within hospitals.  Included in the report are comparisons among acute-care hospitals in Connecticut about how often they provide the recommended care to patients who have been diagnosed with a heart attack, heart failure, or pneumonia. 
  • The department completed the second round of review of Biomedical Research proposals.  Five researchers were funded for a total of $1,359,095.
  • A formal graduate public health field experience program was established with the University of Connecticut and Southern Connecticut State University.  The program allows students to integrate knowledge and classroom skills with practice in a real public health setting.  A student intern handbook was developed to streamline the process for selecting students and projects, and students attend one of two student orientation sessions per year where department programmatic staff describes essential responsibilities of a state public health agency.
  • Implemented a supervisory/management training program, Putting the Pieces Together, and a Leadership training program, Leading the Way.  These are skill development certificate programs open to both state and local public health employees.  The programs were developed based on the results of a training needs assessment.
  • Published the Education and Training Course Catalogs for state and local public health workers and preparedness partners.  The Course Catalog is published three times per year and includes over 70 course offerings including instructor led courses, web-based self study programs, and information on public health and business certificate programs available to the workforce.

·         TRAINConnecticut, the web-based learning management system for public health and health care professionals, has doubled in size during the past year to over 7,800 learner accounts.  State and local public health workers and preparedness partners use the system to find and register for education and training programs.  System functions have improved significantly with the addition of assessment and evaluation tools, community training calendar, and batch registration utilities.

  • The Virtual Children’s Health Bureau at DPH created an internal Children’s Health Cabinet to promote better collaboration among child health programs within DPH.
  • Assembled a planning workgroup with occupational health stakeholders in our state representing academia, private sector employers, employee unions, labor lawyers, the insurance industry, and worker safety and health advocacy groups to help advise DPH on an occupational health and safety program agenda for the coming years.
  • Served on a National Academy of Science panel to review the status of human biomonitoring programs and debriefed United States Environmental Protection Agency, Centers for Disease Control and Congress on ways to improve biomonitoring efforts in this country.
  • A statewide radon initiative was made with implementation of the Radon Measurement in Schools Protocol. The initiative included training for school staff and the radon measurement workforce on the new protocols, outreach to school districts and the Connecticut Schools and Building Grounds Association. Over 80% of the 1200 public schools in Connecticut have yet to complete radon testing by 2008.

·         Conducted several Soils Training Workshops for local health officials, engineers, subsurface sewage disposal system installers, and other interested parties. The course offers a complete overview of practices related to design and construction of small subsurface sewage disposal systems with a focus on soils.  The training includes topics on identifying soil texture, color and horizons, landscape position, site hydraulics, geographical formations, using soil maps and identifying restrictive layers for sewage disposal systems.  Properly characterizing the soil is the first step in siting a system and ensures a viable long-term solution to wastewater disposal.

·         Developed an electronic data interchange program to accept water quality data electronically from water testing laboratories and public water systems to more efficiently receive, process and evaluate regulatory compliance data.

·         Developed tools to optimize web architecture for navigability and to assist public drinking water systems to obtain current water quality testing schedules, regulatory information and forms. Public drinking water system personnel have the ability to register on-line for operator training courses, view newsletters, regulatory information essential to more efficiently operate and ensure safe drinking water to the public.

  • Conducted five public drinking water system training seminars to increase the knowledge and capability of the states 1,300 certified drinking water system operators and certified 83 new operators in the past year.
  • Facilitated strategic water supply planning meetings at several municipalities, such as Brookfield, to foster the consolidation of municipally owned public water systems in an effort to resolve the public health concerns at non-compliant systems.
  • Assisted the University of Connecticut with the refinement of operational measures to increase efficiency and performance of the University’s drinking water system.
  • Sponsored three regional forums to promote interconnections between large community water systems and the consolidation of small non-viable water systems.  Forty-one (41) small public water systems were also consolidated across the State in the past fiscal year.
  • Participated with EPA national headquarters in developing a brochure related to capacity development of small public water systems. Two (2) of the six (6) case studies appearing in the nationally distributed brochure highlight success stories from CT.
  • Migrated agency to MS Outlook State Enterprise email system, providing improved internal controls and establishing secure outside web access to email.
  • Developed a new “Inventory Control Management System” for the agency’s Bio-terrorism/Strategic National Stockpile (BT/SNS) drills.

·         Developed a new in-house task tracking system to manage, measure, monitor and support all IT activities thus improving processes for defining IT priorities and milestones.

·         Implemented electronic data interface between DPH and DCF for timely identification of Daycare employee applicants on the DCF child abuse registry.

  • In conjunction with the Department of Information Technology:
    • installed and tested the Connecticut Electronic Disease Surveillance System to improve time to detection of reportable disease events,
    • automated the ability of laboratories to send test results electronically to improve timeliness of reporting
    • migrated immunization registry and tracking system to a web-based application
    • migrated the Health Alert Network to an EWTA compliant platform.
  • Established Public Health Information Network (PHIN) workgroup to identify and manage migration of multiple agency systems to PHIN compliant architectural guidelines established by the CDC to ensure compatibility of data across systems.

 

Public Health Preparedness

  • DPH sponsors the federally recognized CT-1 Disaster Medical Assistance Team (DMAT).  The DMAT team has been expanded to 140 Members and had four local and eight federal deployments.
  • DPH received $8.5 million in bonding money and purchased a 100-bed Mobile Field Hospital (MFH).  The MFH will enhance surge capacity and isolation care in the event of an infectious disease outbreak or other public health emergency.  This facility will also be used for training, exercises, and drills for Disaster Medical Assistance Team and for the department’s public health and health care partners.
  • DPH planned and participated in a week long Strategic National Stockpile, full-scale exercise. Approximately 300 governmental and non-governmental agencies and departments participated in and supported the exercise at venues statewide.  This was the first exercise to use the state’s plans and procedures to receive, distribute and dispense SNS supplies in response to a statewide bio-terrorism incident; the first major full scale public health exercise in the state; and the first to adopt the federal Homeland Security Exercise and Evaluation Program recommendations. The DPH command center was activated to coordinate the receipt, storage and delivery of emergency supplies to local points of dispensing (PODs) and hospitals. PODs and hospitals successfully activated and conducted emergency dispensing operations of SNS.
  • DPH maintained its capabilities for early detection of, and response to, possible terrorist events and outbreaks, including the special daily hospital admissions surveillance, rash illness surveillance to assure the early detection of smallpox, gram positive rod surveillance for the early detection of human anthrax, and a network of 18 emergency departments which send chief complaint data on a daily basis to provide information which can be readily used to determine whether outbreaks are occurring and monitor the course of a large-scale public health event.  In SFY 2006, these systems identified and followed-up on 392 possible anthrax cases and 99 possible smallpox cases, and were used to monitor the impact of the influenza season on the health care system. In addition, 11 food-related outbreaks were investigated.

·         Working with our local health partners, maintained a statewide database that lists more than 9,000 persons who would be called up to assist in mass vaccination or antibiotic distribution by local health departments should it be needed.  

·         Provided over 100 public health preparedness courses and training sessions with approximately 3,800 attendees.  Programs covered key preparedness content areas and core skills such as incident command systems, risk communications, basic epidemiology and surveillance, mass dispensing and emergency response protocols, worker safety, biological and chemical agents, and information technology.

  • Refined the DPH Pandemic Influenza Preparedness Plan in February 2006 and released it for public comment.
  • Initiated a vulnerability assessment that evaluates the state's major users of toxic chemicals and hazardous materials in terms of potential risks to the public should there be an accidental or terrorist release.  This effort has involved a planning committee that includes the Dept. of Homeland Security and other law enforcement and regulatory agencies.
  • Implemented a Drinking Water Emergencies Assessment and Response team trained in Incident Command and emergency response procedures related to drinking water systems.
  • Conducted quarterly meetings of the Drinking Water Emergency and Security Advisory Committee comprised of representatives of the drinking water industry, FBI, U.S. Dept. of Justice, local health, Dept. of Emergency Management and Homeland Security, DEP, EPA, and Infragard.

 

Health Promotion and Disease Prevention

·         Conducted a statewide media, outreach and communications campaign for National Radon Action Month (January 2006). The campaign was conducted in collaboration with the American Lung Association, the U.S. Environmental Protection Agency, and several local health departments throughout the state.   Components of the campaign included a gubernatorial proclamation (January as Radon Action Month), media coverage (newspaper, radio and television), advertising slicks, payroll stuffers to all (17,000+) state employees, local health departments’ distribution of educational materials and radon test devices to local citizens, a ½-day conference, and the development and posting of large banners in two prominent locations in the city of Hartford.

·         Developed a six-page educational brochure for restaurant owners, managers, and employees to educate them on how to avoid the most common work-related injuries occurring in restaurants, including burns, lacerations, sprain/strain injuries, and slip/trip/fall-related injuries.

·         Developed a pamphlet and sign for the supermarket fish counter that guides consumers to the best fish to eat and those to avoid because of contaminants such as mercury and PCBs.  DPH is focus group testing these materials and plans to work with the food retailing industry in getting this information to the public.

·         Created a new school indoor air-teaching module called Tools for TECHS in collaboration with the State Department of Education, University of CT Division of Environmental and Occupational Medicine, and AFT Teachers Union.  This module was created specifically for technical high schools and was designed to closely resemble the US EPA’s Tools for Schools program for traditional schools.

·         Have trained 580 schools in 93 school districts in the implementation of EPA’s Tools for Schools IAQ program. Over 2,900 school staff, parents and students have been trained. According to EPA, Connecticut leads the nation in the number of documented schools utilizing the Tools for Schools program.

·         Continued a very successful community outreach effort for residents in the Newhall Neighborhood in Hamden whose homes were built on hazardous landfill waste.  During home visits, residents were provided fact sheets about exposure and risk and were given the opportunity to discuss their soil testing results. The effort also included an evaluation component to assess how effective the outreach program has been in communicating exposure and risk information.

·         In collaboration with the Danbury, Hartford, and Meriden Health Departments, the Lead Action for Medicaid Primary Prevention Project, and community partners implemented a multifaceted public health initiative to address childhood lead poisoning within high-risk urban neighborhoods in Danbury, Hartford, and Meriden.  The initiative focused on primary prevention, screening, community education and outreach, case management, hazard identification and remediation, and public health surveillance.  ConnectiCare provided funding through the Public Health Foundation of Connecticut, Inc for the project.  The initiative was designed to provide preventative environmental health services to targeted geographic areas that have demonstrated increased risk for lead exposure and lead poisoning.  By August 2006 over 800 children had blood lead screening tests through this initiative.

·         In collaboration with the University of Connecticut, developed a video that provides property owners and do-it-yourselfers with information about potential sources of lead exposure and lead hazards that may be encountered during renovation and repainting projects in older residential properties.  The video provides guidance on work techniques that will reduce the potential for lead exposure to children, occupants, and workers by using five steps to lead safety.  The video is available in English and Spanish. Norm Abram, Master Carpenter of PBS’s This Old House and host of PBS’s New Yankee Workshop introduces the video.

·         Collaborated with Groton Utilities and surrounding municipalities in the development of a Drinking Water Quality Management Plan for the protection of public drinking water sources in southeast Connecticut

·         Connecticut currently has 92 health professional shortage areas (HPSA) designations representing all or part(s) of 36 towns in each of the state's eight counties.

·         Connecticut currently has 39 Medically Underserved Area (MUA) designations representing all or part(s) of 31 towns in each of Connecticut's eight counties.

·         Completed a technical strategic plan to create the HIP-Kids data warehouse, and secured federal funds to begin implementation.  Data from existing child health databases maintained within DPH will be linked to create a single comprehensive child health profile, a composite of linked child health information, which will be available on an on-going basis for health surveillance and monitoring. 

·         Released results from the Connecticut School Health Survey (CSHS) in the spring of 2006.  The CSHS is a joint effort with the Connecticut State Department of Education and provides information on health risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States.  The CSHS asks questions of Connecticut high school students in grades nine-12 in the following topic areas: tobacco use, dietary behaviors, physical activity, alcohol and other drug use, sexual behaviors, behaviors that contribute to unintentional injuries and violence.  Middle school students are asked questions about tobacco use and attitudes toward tobacco.  Results of the CSHS can be viewed at http://www.dph.state.ct.us/PB/HISR/CSHS.htm

·         Posted the following reports on the DPH website:  Mortality and Its Risk Factors in Connecticut, 1989-1998, Connecticut Resident Mortality Summary Tables by Gender, Race, & Hispanic. Ethnicity, 1999-2001, “Diabetes Preventive Care Practices,” “Facts About Stroke in Connecticut,” and the Connecticut Hospital Stroke Care Survey report.

·         Launched the Connecticut Health Disparities Project with funding support from the Connecticut Health Foundation.  The project will improve the statewide infrastructure for documenting, reporting and addressing health disparities among racial and ethnic minority residents of Connecticut.

·         Implemented the Genomics Action Plan, and created the Expert Genomics Advisory Panel that is developing implementation strategies for various components of the plan.  Distinguished genomic scholars and practitioners within Connecticut and nationally were recruited for membership.

·         The DPH Virtual Office of Genomics was successful in applying for another three-year cycle of HRSA funding through the New England Consortium for Genomics Education.  Priorities of the Virtual Office include informing medical practitioners about the Family Health History Project sponsored by the US Department of Health and Human Services and the production of an educational guide for the general public.

·         The department’s Connecticut Tumor Registry participated in a National Cancer Institute (NCI) funded Patterns of Care Study across SEER registries. Tumor Registry data were supplemented by contacting physicians regarding treatment for Connecticut residents diagnosed with cancers of the head and neck, kidney, and breast. These data will be analyzed by NCI to examine treatment patterns and trends as well as changes in survival of cancer patients.

·         The DPH Immunizations Program received an award at the National Immunization Conference for achieving an 88 % immunization coverage rate for two-year-old children. This is the 6th time in the last 10 years, and the 3rd consecutive year, that Connecticut has been recognized for having one of the nation’s highest immunization rates.  

·         During 2005, the rate of gonorrhea decreased another 4 percent, achieving an all-time low in Connecticut.  

·         During 2005, a total of 95 TB cases were reported.  This case count continues a recent downward trend and is the lowest ever reported in Connecticut.  At the same time, approximately 3,000 individuals with latent TB infection were placed on preventive treatment using state-supplied antibiotics.

·         Beginning January 2006, a new surveillance system was established to monitor the extent to which a new highly toxigenic strain of Clostridium difficile has spread from hospitals to the community.  C. difficile causes severe intestinal disease, usually as a complication of taking antibiotics in persons who are already asymptomatic carriers.

·         A new vaccine against Hepatitis A was added to the list of vaccines routinely supplied by the state for Medicaid-eligible and uninsured children. The vaccine protects children 12-23 months of age. A new vaccine for Tetanus, diphtheria, and acellular pertussis was added for all adolescents regardless of their insurance status. The vaccine protects adolescents 11-18 years of age. 

·         DPH maintained and enhanced two recently begun new disease surveillance projects: HIV incidence, intended to provide estimates of the number of new HIV infections in Connecticut by the end of 2006; and behavioral surveillance, intended to provide information about trends in behavior that place Connecticut residents at high risk for HIV infection.  This information will be useful in the future to assist in evaluating and targeting HIV prevention initiatives.

·         The DPH’s Early Childhood Partners Project (HRSA grant) created an outcome-driven strategic and implementation plan to assure children are healthy and ready for school by age five.  ECP achievements in 2005-2006 included participation on the Connecticut Early Childhood Education Cabinet, training of child care health consultants through the CT Nurses Association, advocacy training of parents and providers through the Commission on Children and Parent Leadership Training Institute, collaboration with the Children’s Trust fund to conduct Ages and Stages workshops held in Hartford and New Haven, and the creation of the ECP website: www.ecpartners.org   

·         Implemented an expanded viral hepatitis surveillance program that includes hepatitis A, B, and C registries with follow-up to obtain information about possible sources of infection, and to provide recommendations to providers about prevention.  Information from this system can be found on the DPH website. The Public Health Laboratory conducted a pilot project to provide hepatitis C testing to medically underserved persons.

·         Expanded implementation of ConnectiFIT, a workplace wellness program to Department of Administrative Services employees.

·     The Obesity Program was one of thirteen states awarded a National Governors Association Grant to improve the health and well being of Connecticut's largest workforce.

·         Developed, in collaboration with the School of Allied Health at UCONN, three undergraduate dietetics supervised practice courses to enhance student achievement and competence in knowledge and skills germane to public health nutrition. Curriculum included linkages between public health agencies, community-based initiatives, and academia—with the focus on the elements of service, teaching and research.

·         DPH funded eight of the ten asthma-planning regions in the state to conduct community-level asthma activities.  Funding of these regions will help ensure that the recommendations made in the Statewide Asthma Plan are implemented at the community level. The Asthma Program held a statewide asthma conference attended by a diverse audience of medical providers, public health professionals, and nurses that provided updates for treatment guidelines and programs within CT from both state and national asthma experts.

·     Published Asthma in CT 2005, Surveillance Report. This report identified a higher incidence of asthma in women, Hispanic and black populations and those in lower socioeconomic levels.  The report will assist the program in targeting its efforts to improve asthma diagnosis and management of those most in need.

·         The Injury Prevention Program facilitated the Interagency Suicide Prevention Network, which completed the Comprehensive Suicide Prevention Plan.  The program has received a core injury program grant from the Centers for Disease Control and Prevention.  Major grant activities include development of an injury surveillance system and a state injury prevention plan that addresses unintentional and intentional injuries across the life span. 

·         DPH completed the required Maternal and Child Health Five-Year Needs Assessment identifying nine priority needs among the three population groups:  pregnant women and infants; children and adolescents; and child and youth with special health care needs.  These nine priority needs will be addressed in the next five years through planned activities and strategies to improve the health and well being among these population groups.

·         DPH received a one-year grant to implement a statewide multi-media, multi-lingual perinatal depression screening awareness campaign.  The campaign included community based provider trainings on screening for perinatal depression, hospital grand rounds and a series of radio, television and print (billboards, newspaper, bus panels and movie trailer) advertisements throughout the state.

 

 

Health Care Quality and Regulatory Standards

·         DPH has reevaluated its entire internal process for investigating and disciplining physicians and other licensed health care providers and has implemented additional measures to promote regulatory fairness, efficiency and effectiveness. 

·         The department instituted a number of reforms, including adding investigative staff and physician consultants to enhance the timeliness and quality of the review and investigation of complaints concerning quality of care.  DPH also established an internal quality assurance review committee comprised of non-physician health care professionals, as well as lay staff, which reviews pending cases to determine if proposed remedies are appropriate to protect the public. 

·         DPH continues to expand information available on its website concerning regulatory programs, including healthcare practitioner boards and online filing of complaints against licensed practitioners or entities. 

·         Connecticut has been selected as a pilot state for the federal Centers for Medicaid and Medicare Services (CMS) Quality Improvement Survey Demonstration Project.  DPH currently has two survey teams performing Quality Improvement Survey (QIS) and plans on expanding this model of the survey process.

·         DPH has initiated quarterly meetings with multiple provider groups to discuss mutual issues of interest and concern.

·         DPH has revised several provider regulatory requirements to reflect current standards.

·         DPH continues to participate in the enhancement of healthcare through the Quality of Healthcare Committee.  In 2006, an educational program was initiated for citizens to carry wallet sized medication cards, which reflect current medications and allergies.

·         The Legal Office received for fiscal year 2005-2006:  509 cases for prosecution and disposed of 495 cases, either by settlement, Memorandum of Decision, Voluntary Surrender of License or dismissal.  In addition, the background check program processed for fiscal year 2005-2006:  25,936 federal and state applicant fingerprint cards and DCF authorizations.

·         DPH created and distributed brochures and wallet cards for parents to help them assess the quality of child day care programs

·         Analyzed occupational illness and injury data as well as the distribution of the Connecticut workforce among industry sectors for the previous 30 years to identify any significant changes in the health of the Connecticut workforce that have occurred during that time period.

·         Assisted DEP in updating their 1996 Soil and Groundwater Cleanup Criteria by providing them with revised targets that reflect current toxicity values and that take into account the extra exposure and risk possible in young children.

·         Provided input to the Connecticut Siting Council on health issues related to power lines and electric/magnetic fields (EMF) to assist them in developing Best Management Practices that will govern the siting of future transmission lines.

·         Trained sanitarians, housing code enforcement officials, and public health nurses about specific housing problems and the associated health impacts, how to characterize risk using epidemiological principles, identification of higher risk populations for housing-related disease and injury, housing systems contributing to a comfortable living space, and types of codes that can be used to enforce remediation of housing-based health threats.

·         Developed guidelines for the cleanup of methamphetamine labs and an on-scene safety fact sheet for first responders and others who encounter methamphetamine labs.  Provided training to first responders and child welfare workers.  Participated in a statewide methamphetamine task force created to address the problem of methamphetamine use in Connecticut.  Assisted several local health departments in addressing clean up of methamphetamine labs in their towns.

·         In collaboration with the DEP, published the Reasonable Confidence Protocols – a series of environmental laboratory methods with specific Quality Control/Quality Assurance criteria. This will help to standardize the quality of environmental laboratory data used to make critical environmental decisions statewide.

·         Developed and implemented guidance to obtain DPH approval to conduct asbestos abatement while school is in session within public and non-public, elementary and secondary schools.  The guidance was developed in response to an informal opinion rendered by the Office of the Attorney General and more effectively prevents unintended exposure to asbestos for students and other children occupying school buildings.