If the state of Maine has a plan to prevent more Mainers from using tobacco, becoming addicted to drugs and alcohol and contracting chronic diseases, it’s largely keeping it a secret.
In recent months, the LePage administration has quietly dissolved the Healthy Maine Partnerships — 27 small, regional coalitions that have been responsible for promoting public health in local areas for the past decade and a half.
Going forward, the Maine Department of Health and Human Services will instead work with just five organizations that will each have statewide responsibility for coordinating a specific public health effort, such as obesity or substance use prevention.
But the LePage administration has not clearly explained why it’s making the switch. Given LePage’s history of trying to divert the partnerships’ funding for other purposes, Maine residents would be forgiven for assuming the worst.
The Maine Department of Health and Human Services has been tight lipped on precisely how it plans to deliver public health services without the Healthy Maine Partnerships. In a March news release the department said the new system will help facilitate program evaluation and data collection. It did not say how.
It’s a curious situation, given the years of statewide discussion and planning that went into forming the partnerships. Before them, the state lacked any structure that ensured every region of the state could take proactive steps to improve public health and help with the response to a public health emergency.
The Healthy Maine Partnerships in their current form came out of years of planning by a 40-member work group that met from 2005 to 2007. The group proposed the partnerships arrangement, and the Legislature incorporated its recommendations into law in 2008.
The partnerships were funded not with tax dollars but with money the state receives each year through its participation in the Tobacco Master Settlement Agreement with the nation’s largest tobacco companies.
Sept. 30 marked the last day for these regional coalitions.
But as of Oct. 17, the state had signed only one of these five contracts. Let’s Go! a program of the Barbara Bush Children’s Hospital at Maine Medical Center, will tackle obesity prevention.
Contracts for the other four public health domains — substance use prevention, tobacco use and exposure, youth engagement and empowerment and health communications — have yet to be finalized, according to people close to the negotiations.
Specific questions that remain unanswered include the following: How will the new system be more effective than the Healthy Maine Partnerships? Why has the signing of four of the five new public health contracts been delayed well beyond Oct. 1?
And, crucially, why does Maine need this change now?
With one Mainer each day dying from a drug overdose, the possibility of marijuana being legalized in the November election and the state having the highest rates of obesity and smoking in New England, is now really the time to dismantle the state’s public health infrastructure?
If Gov. Paul LePage and DHHS Commissioner Mary Mayhew have good reasons to change how the state delivers crucial public health services, they should share them with the public, now.