Health System Profile



I. General State Information

A. Selected Sociodemographic Indicators

                                         State     United States

Population (1988) 3,233,000 245,803,000 Population Density (1988) 663.6 69.4 (per/sq.mi.) Number of Counties 8 3,139 Median Age (1987) 33.9 31.7 Percent Below Poverty Level (1985) 7.6 14.0 (persons) Percent of Population Rural (1980) 21.0 26.0 Percent of Population White (1980) 90.1 83.1 Percent of Population Non-white (1980) 9.9 16.9 Median Years of Education (1980) 12.6 12.5 (25 years of age and over)

B. County Government Structure

Connecticut has no functioning county governments. Counties are used for geographic designation only.

II. State Health Agency (SHA

A. General

    Free-standing, Independent Agency
The Connecticut Department of Health Services (CDHS), the SHA, is a free-standing, independent agency. The mission of CDHS is to become the best state health department in the nation. In doing so, the CDHS will promote and enhance the public's health by employing the most efficient and practical means to prevent and suppress disease.
The following are some areas of responsibility for the SHA:

  State Public Health Authority
  Lead Environmental Agency in the State
  State Agency for Children with Special Health Care Needs
  State Health Planning and Development Agency
  State Professions Licensing Agency
  Institutional Licensing Agency
  Institutional Certifying Authority for Federal Reimbursement

The Department encourages the development and expansion of full-time local health services by subsidizing the cost of such services to local communities. Grants-in-aid are made to all departments and districts with full-time health officers. To be eligible for funding, the local health departments must comply with funding regulations in the public health code.

B. Head of State Health Agency

    No M.D. Requirement, Cabinet-level Appointment
As the chief executive officer of the CDHS, the Commissioner is appointed by the Governor for a term of office concurrent with the gubernatorial term and required to have M.D./M.P.H or M.P.H. degrees. It is the duty of the Commissioner of CDHS to use the most efficient and practical means for prevention and suppression of disease, and administer the health laws and the public health code. The Commissioner is also responsible for the overall operation and administration of CDHS.

C. State Board of Health/Council

    No State Board of Health
Although Connecticut has no State Board or Council of Health, it does have a statewide advisory committee on public health. The advisory committee is composed of 25 members who are health care professionals, providers, and consumers.

D. Regional/District Health Offices

CDHS has two regional offices located in Norwich and Bridgeport which are extensions of the central office and have only managerial functions. The offices do not have specific geographic areas of service.

E. State-local Liaison

    Decentralized Organizational Control, Formal Liaison Function
The Office of Local Health Administration has responsibility for state-local liaison. This function began in the fall of 1989 when CDHS began a major local health initiative to focus on the needs of local health officers, their departments, and districts in the state by establishing an Office of Local Health Administration. An objective of this office is to enhance communication between the Department and other state agencies with local health officers through periodic forums, resource materials, advisory groups, and other mechanisms. The interaction between state and local public health agencies in Connecticut may be characterized as decentralized organizational control. Under this arrangement local governments directly operate health departments with or without local boards of health.

F. Budget

Total FY 1988 Connecticut SHA expenditures were $72,983,000. Total FY 1988 United States SHA expenditures were $8,312,928,000.
 Source of Funds
       Federal Grants and Contracts          $35,225,000
       State Funds                           $37,758,000
       Local Funds                                     0
       Fees and Reimbursements                         0
       Other                                           0

III. Local Public Health Agencies (LPHAs)

Connecticut has 49 local health departments, consisting of full and part-time local health departments and district health departments. The districts consist of towns, cities, and boroughs which have voted to combine their health services into a district health department. Currently there are 13 districts, 28 full-time, and 8 part-time health departments. The designation of full- or part-time depends on the presence or absence of a full-time health officer. There are 70 other jurisdictions in Connecticut which have health services but do not have at least one full-time position.

B. Services Provided

The following information on services provided by local health departments in Connecticut is derived from a survey conducted by NACHO during 1989. Seventy of the local health jurisdictions in Connecticut responded to the survey. These respondents include several service units known as part-time health departments, which do not meet our definition of a local health department. Services provided by at least 70 percent of health departments in the state responding to the survey are underlined.
                                            Number and Percent
Services Provided by LPHAs                  of LPHAs Reporting

I. Assessment Activities A. Data Collection/Analysis 1. Behavioral Risk Assessment 14 ( 20.0%) 2. Morbidity Data 24 ( 34.3%) 3. Reportable Diseases 63 ( 90.0%) 4. Vital Records and Statistics 18 ( 25.7%) B. Epidemiology/Surveillance 1. Chronic Diseases 22 ( 31.4%) 2. Communicable Diseases 61 ( 87.1%) II. Policy Development A. Health Code Dev. and Enforcement 58 ( 82.9%) B. Health Planning 35 ( 50.0% C. Priority Setting 30 ( 42.9%) III. Assurance Activities A. Inspection 1. Food and Milk Control 58 ( 82.9% 2. Health Facility Safety/Quality 32 ( 45.7%) 3. Rec. Facility Safety/Quality 46 ( 65.7%) 4. Other Facility Safety/Quality 32 ( 45.7%) B. Licensing 1. Health Facilities 17 ( 24.3% 2. Other Facilities 61 ( 87.1%) C. Health Education 43 ( 61.4%) D. Environmental 1. Air Quality 26 ( 37.1%) 2. Hazardous Waste Management 43 ( 61.4%) 3. Individual Water Supply Safety 57 ( 81.4%) 4. Noise Pollution 25 ( 35.7%) 5. Occupational Health and Safety 23 ( 32.9%) 6. Public Water Supply Safety 34 ( 48.6%) 7. Radiation Control 20 ( 28.6%) 8. Sewage Disposal Systems 66 ( 94.3%) 9. Solid Waste Management 31 ( 44.3%) 10. Vector and Animal Control 42 ( 60.0%) 11. Water Pollution 61 ( 87.1%) E. Personal Health Services 1. AIDS Testing and Counseling 18 ( 25.7%) 2. Alcohol Abuse 8 ( 11.4%) 3. Child Health 34 ( 48.6%) 4. Chronic Diseases 22 ( 31.4%) 5. Dental Health 15 ( 21.4%) 6. Drug Abuse 11 ( 15.7%) 7. Emergency Medical Service 16 ( 22.9%) 8. Family Planning 8 ( 11.4%) 9. Handicapped Children 8 ( 11.4%) 10. Home Health Care 15 ( 21.4%) 11. Hospitals - 12. Immunizations 53 ( 75.7%) 13. Laboratory Services 11 ( 15.7%) 14. Long-term Care Facilities 5 ( 7.1%) 15. Mental Health 11 ( 15.7%) 16. Obstetrical Care 4 ( 5.7%) 17. Prenatal Care 8 ( 11.4%) 18. Primary Care 5 ( 7.1%) 19. Sexually Transmitted Diseases 33 ( 47.1%) 20. Tuberculosis 32 ( 45.7%) 21. WIC 18 ( 25.7%)

C. Local Health Officer

    No M.D. Requirement, Local Governing Body Appointment
Local health officers are hired by the municipality or health district and approved by the Commissioner of CDHS. Local health officers are not required to be physicians. They are, however, required to have a graduate degree in public health as a result of at least 1 year's training that has included at least 60 hours in local health administration. The health officers are responsible for all duties assigned by the local board of health as well as those required by statutes and the public health code.

D. Local Board of Health

District boards of health represent districts that are formed when a group of local jurisdictions (towns, cities, and boroughs) vote to form district departments of health. Each town, city, and borough which voted to become part of the district may appoint one member to the board. Jurisdictions with populations of more than 10,000 are entitled to an additional representative for each 10,000 population, with a limit of five representatives. The members are appointed by the governing bodies of the respective jurisdictions to terms of 3 years. The terms are staggered so that approximately one-third of the terms expire each year. The board is responsible for managing the affairs of the district health department. Some towns and municipalities have boards of health that function in an advisory capacity to the local governing body. The board members are appointed by the local governing body. The number of members vary greatly for these boards.

E. Staff

The staffs of the local health departments are employed and supervised by the local jurisdiction. The number of staff employed by local health departments ranges from 1 to 140.

F. Budget

Total FY 1988 LPHA expenditures were $29,957,000*. Total FY 1988 United States LPHA expenditures were $3,978,948,000.
    Source of Funds
      Federal Grants and Contracts      $2,696,000
      State Funds                       $5,748,000
      Local Funds                      $21,513,000*
      Fees and Reimbursements                    0
      Other Sources                              0
      Source Unknown                             0

* The SHA reported that these figures were estimated.
Data for this state were updated February 1991.