Should Maine experience an infectious disease outbreak today that requires a coordinated state response, it’s far from certain that Maine would be capable of responding adequately.
That’s because the LePage administration has been steadily chipping away at Maine’s public health infrastructure.
For nearly a century, public health nurses have been the “boots on the ground,” contributing to emergency preparedness; monitoring treatment for those infected with tuberculosis; training health-care providers in TB treatment protocols; visiting expectant and new mothers in their homes; carrying out immunization clinics; and much more.
But over the course of the LePage administration, the state’s staff of public health nurses has been cut in half. Today, there are 25 who are regularly out in the field and in a position to stage an effective response the next time there’s a public health crisis. The LePage administration has undermined the public health nursing program in other ways, too, from barring its director from emailing staff without approval from staffers in Maine Department of Health and Human Services Commissioner Mary Mayhew’s office to closing many of the program’s regional offices and forcing nurses to complete paperwork in their cars.
Public health nurses have long been part of local efforts across the state aimed at preventing and containing health problems before they become full-blown crises and helping local communities respond to emergencies. These local efforts have involved the Healthy Maine Partnerships, 27 coalitions located across the state that held state contracts to work on a range of community health issues, from preventing tobacco use to promoting physical activity.
But the LePage administration is no longer funding the Healthy Maine Partnerships, which effectively made up for Maine’s lack of county health departments, a public health structure that is common throughout the nation.
The state’s ability to fulfill other key public health functions also is in doubt.
Research has shown home visits from nurses or trained parent educators can reduce the likelihood of pregnancy complications, infant deaths, family violence and child maltreatment. They also contribute to improved parenting and school readiness.
But as a series of BDN articles in recent weeks have demonstrated, the LePage administration never expanded home visiting services, even with the help of a $5.7 million federal expansion grant. Indeed, the administration recently outsourced management of the state’s largest home visiting program to a nonprofit organization without putting the work out to a competitive bid. And the administration, with its favoritism of one home visiting program at the expense of others, failed at efforts it pledged to undertake to inspire collaboration among home visiting providers, not competition, and expand the reach of their services.
These are damning failures for a state government that’s charged with ensuring the public’s health — a function that should involve, first and foremost, ensuring that the state’s youngest residents have a healthy start in life.
Maine’s challenges are many when it comes to improving the public’s health and the well-being of children, in particular. Extreme child poverty is on the rise, Maine’s national ranking for child well-being has slipped and more Maine infants are dying. But in Augusta, the administration in office has proven unwilling to pursue policies that respond to the state’s real problems.
The LePage administration has more than two years left. The minute Gov. Paul LePage leaves the Blaine House, his successor will have to start digging out from the damage he and his administration leave behind.
In the two years before that change in power happens, Maine needs a shadow government of people with the state’s best interests — and its future — in mind. Lawmakers, public health and child development experts, business people and others with the right expertise should come together now to take stock of the damage done and develop plans that are ready to launch on the first day of a new administration.
Maine will be recovering from LePage-induced damage for years to come. It might as well start now.