November 23, 2017
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Bill that restores public health nursing program earns initial approval

By Matthew Stone, BDN Staff
Contributed photo | BDN
Contributed photo | BDN
State Sen. Brownie Carson, D-Harpswell.

A bill to restore Maine’s corps of public health nurses earned initial approval in a legislative committee’s party-line vote Thursday afternoon.

Members of the Legislature’s Health and Human Services Committee voted 6-4 in favor of the measure, with Democrats supporting it and Republicans opposed. The committee’s three senators, two Republicans and one Democrat, have yet to cast their votes on the measure.

The legislation, LD 1108, follows a BDN Maine Focus story last summer that detailed the major, unannounced contraction of Maine’s public health nursing program in recent years as the LePage administration refused to fill nursing vacancies even though the Legislature appropriated funds to pay for the positions.

When Gov. Paul LePage took office in 2011, Maine employed about 50 nurses spread across the state whose job was to respond to disease outbreaks and other public health emergencies; visit postpartum mothers and their babies at home, a strategy that can prevent infant deaths; and provide school nurse services in rural schools that couldn’t manage to hire nurses of their own.

Today, Maine has a staff of about 20 nurses in the field visiting clients. At a public hearing last month on LD 1108, medical providers said they could no longer refer new moms and babies with medical needs to public health nurses because no nurses were available. If they referred patients, they had no idea whether they ultimately received a nurse’s services.

And with diminished nurse staffing, the state’s public health nursing program in recent months has had to call on nurses based in Aroostook County to travel to Portland and Lewiston to staff clinics at which the nurses ensure people with latent tuberculosis — which becomes contagious, active TB in about 5 to 10 percent of those infected — take their medications.

LD 1108 would restore public health nurse staffing to 2011 levels by requiring that the Maine Center for Disease Control and Prevention hire nurses to fill the positions by March 1, 2018. The Legislature’s nonpartisan Office of Fiscal and Program Review estimated the cost at $800,000 next year.

“If we have an outbreak of a new strain of influenza or drug-resistant TB, we would have real difficulty stopping it right now,” Democratic state Sen. Brownie Carson of Harpswell, the bill’s sponsor, told committee members Thursday.

Republicans on the Health and Human Services Committee expressed skepticism that the state could hire enough nurses to fill the positions if the legislation passed and suggested the state hire a private firm to determine the state’s public health needs and even deliver many of the services.

Rep. Deborah Sanderson, R-Chelsea, said she had confidence in changes the Maine CDC is making to the state’s public health infrastructure.

Maine CDC leaders had seldom spoken publicly about shrinking the public health nursing program until Carson proposed LD 1108 earlier this year. They’ve spoken in general terms about shifting more public health and emergency preparedness responsibilities to private organizations, instead of relying on state-employed nurses.

In preparing the legislation this year, Carson’s requests for data on public health nursing from the Maine CDC went mostly unanswered. However, on Thursday at 1 p.m., the scheduled start time for the committee’s work session and vote on LD 1108, the CDC released a nine-page description summarizing some of the agency’s public health nursing-related initiatives.

While Carson had requested a year’s worth of data on the number of drug-affected babies medical providers had referred to public health nursing and the number of referrals accepted and rejected, the CDC on Thursday provided data from the last two weeks.

Once the Health and Human Services Committee’s three senators cast their votes, the bill moves to the full Senate.

 


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