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PRESENT:    Donna McCarthy Culbert - Director of Health, Dr. Robert Grossman, Chairman; Board Members:  Joan Crick, Audrey Grasso, Bernard Meehan, Herb Rosenthal, Ann Marie Lindblom; Dr. Draper, Medical Advisor

PUBLIC PARTICIPATION:   Robert Silvaggi, First Selectman Town of Brookfield


Bernie Meehan made a motion to accept the meeting minutes from June 25, 2008.  Audrey Grasso seconded.  Motion approved.    


Brookfield’s Acceptance into the Newtown Health District

Ms. Culbert opened this discussion reminding the BOH members of Brookfield’s interest in joining the Newtown Health District (NHD).  Ms. Culbert informed the Board members that Brookfield has formed a task force to look at its public health needs and has been meeting regularly.  Ms. Culbert noted that the Task Force consists of members of the community interested in public health issues in the community such as the school nurses, Land Use Department, Parks and Recreation Department, senior center, to name a few and that this is an on-going process by the Task Force committee members.  Ms. Culbert added that she has attended every meeting except one.  

Ms. Culbert reiterated to the Board that she remains the Acting Director for the Brookfield Health Department during this decision making process.  At this point, Ms. Culbert turned the discussion over to Brookfield First Selectman, Mr. Robert Silvaggi.

Mr. Silvaggi addressed the Board members by stating that the Town of Brookfield has been performing due diligence by  trying to put together the statistics necessary to show that the town is moving in the right direction for creating a viable Health Department.  Mr. Silvaggi shared that to his surprise, statistics show that the Town of Brookfield would have to expend more money than they realized to move in the proper direction.  Mr. Silvaggi added that he thought it would benefit Brookfield to be part of the Newtown Health District and to additionally support his position he noted that Brookfield is also part of the Emergency Preparedness Mass Dispensing area for the Newtown Health District.    

Ms. Culbert shared that during her tenure as Acting Director she has assisted the Town of Brookfield in hiring a Senior Sanitarian, Paul Avery.  Ms. Culbert stated that there has been a complete turnover in staffing at the Health Department.  Ms. Culbert added that an Assistant Sanitarian was recently hired and that she has some field work experience and appears to be a qualified, capable addition to the staff.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 2

Dr. Grossman asked the Board members if they had any questions for Mr. Silvaggi.  

Mr. Rosenthal asked Mr. Silvaggi what the population of Brookfield was.  Mr. Silvaggi replied 16,400.  

Mr. Rosenthal, doing a quick calculation, estimated that should Brookfield be added to the NHD, it would bring the total number of residents in the District to about 48,000.   Mr. Rosenthal asked if there were additional funding to be had with a number of 50,000.  Ms. Culbert stated that it would fall under the same per capita rate and the state looks at 50,000 as a target number for services provided to residents; a number for planning purposes.  Ms. Culbert said the figure of 50,000 is used when calculating mass dispensing plans for clinic setting purposes.

Mr. Rosenthal asked Mr. Silvaggi if the Brookfield Board of Selectmen was in agreement about having the Health Department join the NHD.  Mr. Silvaggi replied yes, but that it would have to go to referendum before they could officially join.  

Dr. Grossman asked about additional funding.  Ms. Culbert stated the Town of Brookfield would receive the per capita rate of $2.08 per person.  Right now they receive $0 .49 per person as a part-time Health Department.  Ms. Culbert noted that this is the same rate that we receive for Newtown - $2.08 for this fiscal year and  $2.43 per person for towns with less than 5,000 residents.  Ms. Culbert noted that the smaller the town, the more money  the State gives you as an incentive to join a Health District

Ms. Crick asked Mr. Silvaggi why he was looking at Newtown and if Brookfield has contacted any other Districts for consideration.  Mr. Silvaggi answered that because Newtown is contiguous with Brookfield it seemed like the appropriate partner and secondly the numbers were good.  Mr. Silvaggi shared that Brookfield did meet with New Fairfield and Sherman to consider organizing a new Health District but it did not quite work out, it was not a good fit and the numbers were small.  Mr. Silvaggi noted that New Milford was not interested in forming a Health District.  

Ms. Crick shared with the Board members her concern regarding the acceptance of Brookfield into the NHD, specifically the potential for increased costs for employees as well as taking on existing problems already in place that the NHD does not deal with now.  Ms. Crick stressed the importance of giving this decision the utmost consideration.  

Mr. Meehan asked Mr. Silvaggi to explain his earlier comment that Brookfield had a lot of work to do.  Mr. Silvaggi replied that Brookfield needs to identify how many employees they would need to hire and what the most cost efficient solution would be to bring their Health Department up to standard.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 3

Ms. Crick asked Mr. Silvaggi what problems Brookfield is experiencing now.  Mr. Silvaggi explained that there is a water line project in the Silvermine Road area that is the site of condominiums; this project is currently out to bid.  Mr. Silvaggi noted that uranium was detected in the water supply and it is anticipated that the problem would be remedied by Spring 2009 with federal funding received to help facilitate the project.  

Dr. Draper asked where the water would be coming from to remedy the situation.  Mr. Silvaggi replied Brookfield Water Company.  Mr. Silvaggi shared with the BOH members that United Water had a large well that DPH made them move because it was too close to the river.  United Water moved the well close to a site near a DOT salt pile that was open for years, was rained upon, and the end result was that salt leached into the site of the well and contaminated the water supply.  Additionally, Mr. Silvaggi shared that the DEP, in an effort to protect the well, allowed United Water to install a filter that would act as a barrier and noted that  it seems to be working.  Mr. Silvaggi noted that because it does not have any track record, the condos could not be served by it until further testing has been done.  Mr. Silvaggi added that if United Water can establish that this filter has long term success, the well can be utilized.  

Mr. Meehan asked if there was a contingency plan for Candlewood Shores’ sanitary sewer systems and water supply.  Mr. Silvaggi stated that they do not have a contingency plan, but that septic systems are checked yearly in that area.  Mr. Silvaggi added that should the Sanitarian identify a failing septic system, the homeowner is responsible for a code complying repair.  Dr. Draper asked Mr. Silvaggi if they have a public water supply system in that area.  Mr. Silvaggi answered that he thought the homes were served by private water supplies.  Dr. Draper asked if there were uranium problems with the water supply in that area.  Mr. Silvaggi replied that he was not aware of any.

Herb Rosenthal questioned the fiscal responsibility of adding Brookfield to the NHD.  Mr. Rosenthal stated that assuming the District budget stays the same, the Brookfield addition based on its population would add an additional $170,000.  Ms. Culbert stated that her calculations based on a population of 16,400 and the applied the rate of $15.00 would figure out to be more than $240,000.  Mr. Rosenthal stated he was also considering fee and state per capita revenue.  

Mr. Rosenthal asked if that was enough to cover them.  Ms. Culbert answered that there are some unknowns.  Ms. Culbert stated that to take on a town like Brookfield, they would not be brought in with a “break even” approach similar to the acquisition of Bridgewater and Roxbury into the District.  Ms. Culbert noted that Roxbury and Bridgewater spent approximately the same amount of money for their employee and his benefits as what they are paying to be in the Health District.  Ms. Culbert added that in addition they have the benefit of a full-time Health District, full-time health director and both towns experience more coverage and opportunity.  Additionally, Ms. Culbert reflected that Bridgewater and Roxbury are very small towns and for the most part they do not have many issues.  Ms. Culbert shared that she does not have to visit those towns to alleviate issues and problems but rather visits for health education and typical public health code enforcement, i.e., septics, wells, food service, temporary events.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 4

Ms. Culbert noted that this is more of a proactive approach to public health rather than a reactionary mode and offers the District more opportunities for grant funds.   They are getting greater services for the same amount of money they had been paying.  

Ms. Culbert compared Brookfield to this line of thinking and offered the following:  The incorporation of Brookfield would require the addition of two full-time employees, they are there now, and the addition of administrative staff.  Also required would be the benefits for those positions as well as vehicles, office equipment and supplies.  What isn’t taken into account is the effort that would be required to address the unknown and the funds needed to recoup that effort.  

Ms. Culbert noted that in addition to the office staff, the community of Brookfield is larger than that of Bridgewater and Roxbury and has a large commercial base.  Typically commercial areas are served by public water and sewer, but in Brookfield, in the commercial area, that is not always the case.  When you apply the per capita figure of $15.32 or $15.48, it may not be enough funding necessary to ensure proper Health District coverage.

Mr. Meehan asked Ms. Culbert to clarify whether or not it would cost the District more money to absorb Brookfield or should they consider Brookfield on a pay as you go term.  Mr. Meehan shared with the Board members his concern that it has been almost a year and Brookfield does not have a definitive report and asked whether they were up to date with their reporting and schedule for the Newtown Health District’s consideration.   Dr. Grossman suggested that the NHD receive that information in black and white.  

Ms. Culbert shared with the Board members that during her tenure as Acting Director for almost a year, Brookfield has been operating without  a full-time director, but that existing staff are qualified to do their assigned tasks.  Ms. Culbert stated that she is serving as Acting Director on an as-needed basis without any compensation to herself or the Health District.

Ms. Culbert stated that the Town of Brookfield needed a full-time Health Director that will give Brookfield their full effort.  Ms. Culbert stated that if Brookfield were to join the NHD, she would be spending the majority of her time in Brookfield.    

Ms. Culbert noted that the Town of Brookfield needs to turn its attention to its public health needs and infrastructure.  Ms. Culbert stated that that is where the unknown liabilities exist.  Presently the Brookfield Health Department is under the Land Use umbrella and the employee most familiar with the administration of the Health Department has since left and there is no plan to replace her.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 5

Herb Rosenthal stated that if the overall region’s health improved and the cost for the existing
District members would not increase as a result of bringing Brookfield in, then he would be in favor of acquiring Brookfield.  Mr. Rosenthal then offered the suggestion of hiring a Deputy Director of Health to fill the void that would be left by Ms. Culbert’s attention to Brookfield and the running of its Health District operation there.  Brookfield would certainly demand more of her time and effort and he would not be against it as long as there was still coverage.

Dr. Grossman inquired about Pamela Kilbey-Fox’s opinion.

Ms. Culbert stated that Ms. Kilbey-Fox’s position has always been to build Health Districts throughout the State, but that sometimes details regarding the specific communities are left out of the formulation scenarios.  Ms. Culbert refuted Ms. Kilbey-Fox’s statement that as long as there was adequate staff it should not present problems.  Ms. Culbert explained that Brookfield is unique because given its size, it has been a part-time health department for too long, its population has grown and the town has developed without the added benefit of full-time public health and its collaboration with Land Use.  

Mr. Silvaggi shared with the Board that when he took office it was obvious to him that Brookfield had a Health Director in name only and that it was an unacceptable situation.  Mr. Silvaggi noted that this is what got the ball rolling and his initial discussion with Ms. Kilbey-Fox.  

Mr. Meehan informed the members that he agreed with Mr. Rosenthal’s previous statements and endorsed his suggestion of a Deputy Director of Health should Brookfield be absorbed into the District.  Mr. Meehan asked at what point would the suggestion of a Deputy Director make sense, for instance a population of 50,000?  Ms. Culbert replied that she did not know.  Mr. Meehan added that his point was that it would have to be mutually beneficial and it really would make no sense for Brookfield to join the District if the costs were exactly the same for them to form their own health department.  Mr. Meehan noted that additionally it could not be a burden to the existing three member district to acquire Brookfield.  Mr. Meehan stated that he did not want to lose Ms. Culbert to Brookfield, but felt that should the acquisition of Brookfield require her services at their offices, the Newtown office could be staffed by a Deputy Director.  Mr. Meehan stated that he did not think there was a lot of due diligence performed and expressed his desire to see it in writing by presenting a report identifying issues and problems in Brookfield.

Ms. Crick asked where the funding for a Deputy Director of Health would come from.  Mr. Meehan replied Brookfield.  Ms. Crick noted that this would be a bad time for Mr. Silvaggi to include this in his budget.  Mr. Silvaggi agreed.  Mr. Meehan added that Brookfield would be incurring additional monies either way.    

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 6

Ms. Crick asked Mr. Silvaggi if there were other towns or districts that Brookfield looked at.  Mr. Silvaggi replied that they had, but none of them made sense.  Ms. Culbert stated the Newtown Health District is the only District in the area.  Ms. Culbert stated that New Milford looked at the Districting concept a while ago because they provide contract services to Washington, but they prefer to keep it the way they are.  Ms. Culbert explained that Sherman and New Fairfield also have that same arrangement.  Ms. Culbert noted that there is a full time health director in New Fairfield and he covers Sherman part-time.  Mr. Silvaggi added that he looked at the option of a New Fairfield, Sherman, Brookfield District, with Candlewood Lake linking all three towns but it could not be realized because the numbers were too small.  Ms. Culbert added that the only other town in the area was Danbury and they are their own entity.

Mr. Meehan suggested contracting services to Brookfield for a period of a year or two.  Mr. Meehan felt Brookfield would benefit from our expertise and the NHD would acquire a better handle on the public health system in place there, enabling the NHD to make an informed decision.  Ms. Grasso asked if the District would have to hire someone for that position and who would pay for it.  Mr. Meehan replied Brookfield would pay for the additional staff person

Ms. Culbert made the suggestion that Brookfield hire a full time director and let them know that they are under a contract for three years, re-examine their needs and issues at that time and then they could consider their addition to a District or forming a new District at that time.    

Mr. Meehan asked what funding would go to Brookfield from the State to join the NHD.  Ms. Culbert replied that it would be $2.08 per capita and that their revenue fees would come to the NHD.  Mr. Meehan noted that it would not cover but would help offset the cost of hiring an employee.

Mr. Rosenthal shared with the Board members that the NHD really needed to look at all of the numbers before a final decision could be made.  Mr. Meehan asked where the grant monies went to investigate Brookfield’s addition to the NHD.  Mr. Silvaggi stated that Maureen Farrell, a Brookfield resident, is heading up this effort by chairing a Task Force that meets regularly to review public health issues, concerns and needs in the Brookfield community.

At this point, the Board members thanked Mr. Silvaggi for attending the meeting and he departed.  

Joan Crick voiced her concerns about the addition of Brookfield to the NHD.  Dr. Grossman agreed with Mr. Rosenthal that they need to get their facts and figures together.  Ms. Grasso added that Brookfield does not have their own act together enough to be part of another group.  Ms. Culbert stated that Brookfield has been trying locally by the formation of the Public Health Task Force, but that is more focused on its infrastructure than putting together a presentation to come before the Board of Health.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 7

Ms. Culbert stated that it was necessary for the town of Brookfield to go through the data collection process so that facts and figures could be presented to the public before they can ask for the formation of a full-time Health Department.

The discussion among the Board members turned to the fact that Ms. Culbert has been Brookfield’s Acting Director of Health since February on a voluntary basis without funding.  The
Board members expressed their concern that they did not realize that and Ms. Culbert should be compensated.

Dr. Draper shared with the Board members that when Roxbury and Bridgewater joined the District it was a natural fit because we are there in a preventative mode and they are able to take advantage of the experience we have had in the past 30 years.  Dr. Draper noted that Brookfield is very much in an interventionist mode; they are going to require major intervention, major public education, and the demands of that unique population upon the Health Director will be enormous.  

Dr. Draper agreed with Ms. Culbert that Brookfield should really have their own Director and center and maybe after a while petition to increase services.  Dr. Draper noted that the expectation once the Town realizes they are paying for services could be tremendous,  and Brookfield saying Newtown is telling them what to do as their Health Director is a potential major source for conflict right from the beginning.     

Ms. Culbert shared her concerns about the potential of serving in the capacity of Director of Health and spending the majority of her time in Brookfield.  Ms. Culbert stated she would feel responsible for the smooth operation of that office and that would require the majority of her time to bring it up to speed.  Mr. Meehan added that in the end that might make the District stronger.  The members asked him how.  Mr. Meehan replied there was strength in numbers.  Dr. Draper stated that they should have courted Bethel then.  Mr. Meehan asked why not both.  Ms. Culbert stated that there are already two Health Directors.   

Dr. Draper brought up the issue that Ms. Culbert was not being compensated for her time and effort.  Ms. Culbert stated that Ms. Kilbey-Fox was going to bring that up at the next Task Force Meeting and inform them Brookfield should be paying.   

Dr. Draper added that Brookfield is getting some of their water from New Milford, their sewers from Danbury and that is the direction they should be going in.  Ms. Culbert offered the suggestion that the NHD could ask for a more organized presentation of the data that has been collected.  Ms. Culbert restated that she thought the best course of action for Brookfield was to hire a full-time health director for a period of time, look at their situation after a certain period of time and then decide if they want to remain their own full time health department, join an existing district or form their own district.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 8

Ms. Culbert stated that this kind of work is best done within their own town infrastructure first to strengthen themselves and that they could potentially make a much better partner in the future.  Finally, Ms. Culbert noted that if the NHD tries to do all that work and education in Brookfield it would be a lot more difficult as an outside agency coming in rather that Brookfield doing it themselves.

Dr. Draper shared that 30 years ago when Brookfield was developing their own sanitary code they had no interest in joining our District, but wanted us to share our experience regarding the kinds of people and qualifications necessary when hiring employees and often chose the route requiring the least possible effort.  Ms. Grasso stated that Route 7 scared her.  Dr. Draper agreed saying it would be overwhelming.  

Ms. Culbert noted that it might be easier for the Town of Brookfield to present to its community the need for a full-time health director versus trying to explain the per capita income and the fees going to one office.  

Mr. Meehan suggested that Ms. Culbert prepare a position paper stating that Brookfield should hire a full-time Health Director, bolster their own operation, get them up to speed and then apply to a district or form their own district.  The paper would be prepared and presented to Brookfield as a recommendation from the Newtown Board of Health and its Acting Director of Health.  The Board members were in agreement with this line of thinking and endorsed Mr. Meehan’s suggestion.  

Mr. Meehan addressed Ms. Culbert and stated that she needed to end her Acting Directorship.  Dr. Grossman added that since she has been the Acting Director for several months, he thought it would be appropriate for her to receive compensation.  

Ms. Culbert agreed and stated she would submit a position paper for their approval next week.


Ms. Culbert distributed the budget to the Board members.  Ms. Culbert explained that the front page is a calculation of what it will cost to run the District and an anticipation of what our revenues will be.  Ms. Culbert noted that more importantly the very last page compares, using the major line items, what the current fiscal year is, what the proposed is, what the differences are and what the proposed changes are (whether they are increases or decreases).  

Ms. Culbert explained to the Board members that the biggest items in the budget are salaries and health insurance.  Ms. Culbert stated that the salaries are an increase based on the employee’s contract and there is no flexibility there.  Ms. Culbert offered that health insurance looks like a decrease but is actually a number showing the District as a separate contract under the umbrella of the towns insurance contract; the number was given to her from the Human Resources  Department.  Ms. Culbert  was told to anticipate a nine percent increase in health insurance.  Ms. Culbert stated that she also subtracted what comes out of the employees as co-pay so that this is the number that the town is providing the District as “in-kind” services.

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 9

Ms. Culbert stated that the Contractual Line Item is a significant decrease and reflects the Town offices leaving the Kendro building.  Ms. Culbert noted that the Health District presently pays rent because the Town leases this building.  Ms. Culbert states she was informed by the Financial Director that he anticipates the town offices to be out of 31 Pecks Lane before December 2009,  but that she has included a half a year’s rent in the budget to be conservative.  This is a number that is included in the “in-kind” services provided by Newtown that is subtracted from their costs.  

Ms. Culbert shared with the Board that the budget is prepared based on how much money we need from each town.  Ms. Culbert stated that she accounts for the services they provide, then the actual funding the District needs to pay salaries and pay for its operation.  

Ms. Culbert noted that the front page is the District’s requests for the upcoming budget.  Ms. Culbert noted that for the current year, Newtown looks higher percentage wise because there are two line items that are significantly different, number 8 and number 9.

Ms. Culbert explained that the first item is CIRMA insurance which used to be provided under the umbrella of the town of Newtown.  In this current year, that has been broken out and we have to pay that separately.  That is no longer a service provided by the town of Newtown.  Ms. Culbert noted that this was not anticipated during the preparation of the current year’s budget and may need to be addressed later in the year.  

Ms. Culbert stated that the other item is Pension.  Ms. Culbert noted that this had been paid for by the Town of Newtown and has not been accounted for in the budget historically and that we need to account for that.  

Ms. Culbert informed the Board members that the current year’s budget is $610,935.80, and that what she is proposing for next year is $620,352.58.  Ms. Culbert stated that the District’s per capita rate in this current fiscal year is $15.32 and in the next fiscal year it is $15.48.  Ms. Culbert explained that the difference in the cash flow looks a little bit different because of the CIRMA and pension; the town used to provide for that but the District will now pay for that separately.  

Dr. Grossman asked Ms. Culbert if this is the budget that will be presented to the Board of Selectmen next month.  Ms. Culbert replied yes.  Ms. Culbert stated that she looked at different areas of the budget that could accommodate some savings.  Ms. Culbert stated she was able to  collaborate with the VNAs and reduce some of the costs associated with medical services such as flu vaccine and Hepatitis B shots.  Ms. Culbert noted that the past year required the services of the Town Attorney and there were some costs associated with this.

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 10

As a note of interest, Ms. Culbert informed the Board that the numbers from the State population last year for the borough was 2,317 and this year 1,835.  That is a 500 person difference and they are census numbers.    

Herb Rosenthal made a motion to approve the budget as presented.  Dr. Grossman seconded.  Motion approved.

At this point, Audrey Grasso departed the meeting to attend another meeting.   

New Business

Deer Ad-Hoc Committee

Ms. Culbert informed the Board members that a Deer Ad-Hoc Committee has recently been formed at the direction of the Board of Selectmen.     

At this point, Herb Rosenthal departed the meeting to attend another meeting.  

Ms. Culbert explained that Rob Sibley, Conservation Official and she have been fielding a lot of phone calls and e-mails from residents concerning deer and tick borne diseases.  Ms. Culbert added that both she and Mr. Sibley have been offering guidance to Joe Borst, First Selectman, regarding the Task Force’s composition and direction.    

Ms. Culbert stated that right now Dr. Licht is interested in joining the committee from a public health perspective.  Ms. Culbert noted that other interested parties are Kirk Blanchard, Dr. Marge Cramer and Ann Wilson and their names will be presented to the Board of Selectmen for their approval.  

Ms. Culbert noted that the committee will be looking at issues such as deer population, traffic accidents and tick-borne diseases.  Ms. Culbert stated that she hopes the committee would grow no larger than eight members from the community.  

Ms. Culbert added that both she and Rob Sibley prepared a memo to go before First Selectman, Joe Borst and then let the committee determine how they are going to operate using the experts and scientists that are available from the state,

Mr. Meehan offered that he recently learned that the DEP did a study on deer management and that it appears that coastal Connecticut and land trust areas that do not allow hunting are presenting big problems for the surrounding communities.  Mr. Meehan added that bow hunting has become a consideration in trying to offset the deer population.  

Ms. Culbert explained that both she and Mr. Sibley are willing to be resources to this committee but that they will not direct or be a leader on the committee.  

Newtown District Department of Health Board Meeting Minutes
December 9, 2008
Page 11

Ms. Lindblom shared that the Sunny Valley Preserve in Bridgewater did deer kills for 10 days in the fall.  Ms. Lindblom thought they might be a good source of information for this committee.  Dr. Draper suggested that Dr. Scholl do a presentation to the BOH members.  

Mr. Meehan  offered that Roxbury has 13,000 acres with 4500 tied up in the land trust and that hunting is not allowed.  .  

Ms. Culbert stated that she believed that if open space is bought with grant funds, hunting is not allowed but she was unsure if open land that was set aside as part of a subdivision could be hunted on.  

Ms. Culbert stated that it was important to the educational process in trying to understand the issues of deer and tick borne diseases.  There was some discussion among the BOH members regarding options for culling the deer population, birth control, etc.

Senior Depression Screening

Newtown Health District is teaming up with the Pomperaug Health District and Neal Lustig,  their Director of Health,  who initiated a grant application through the Office of Rural Health for senior depression screening and education.  Mr. Lustig will be the lead on this but the Newtown Health District will be working with him to do senior depression screening in Woodbury, Oxford, Bridgewater and Roxbury.  Lessons learned from this experience can be applied to Newtown in the future.    

Mr. Meehan asked what happens when a senior is identified with depression.  Ms. Culbert responded they would be given a referral to a health care provider.  Ms. Culbert stated that the majority of the screening will be performed at senior centers, but there is a component to reach out to people in their homes.  Ms. Culbert noted that Roxbury has a pretty organized senior center and Bridgewater has a new senior center that just opened.  

Ms. Culbert stated there would be a kick off meeting for that grant next week.  Ms. Culbert stated she will share with the Board the results from this effort.  There was some discussion from the board members concerning the need for on-going education in this area.  Dr. Grossman also voiced his concern about the senior population and the common incidence of falling and the subsequent injuries.  Ms. Culbert agreed with Dr. Grossman and stated this topic came up at the last Newtown VNA meeting.  

With no further comments, Dr. Grossman made a motion to adjourn the meeting.  Seconded by Joan Crick.  Meeting adjourned.

Submitted by:

Maureen C. Schaedler
Administrative Assistant