State public health officials have been trying to construct an alternate reality recently to explain what’s become of Maine’s public health nursing program.

When Gov. Paul LePage took office, the state employed about 50 nurses whose jobs included responding to disease outbreaks, visiting mothers and their new babies at home in order to promote their health and well-being and providing school nurse services in rural schools that couldn’t hire their own nurses.

Today, however, the program is a shell of its former self. About 20 state-employed nurses (fewer than half of the traditional 50) are dispatched to visit clients — helping new mothers address problems with breastfeeding, tending to the health of substance-exposed infants once home from the hospital and containing the spread of tuberculosis. The nurses are dispatched out of their homes because their program no longer has offices. There’s one nursing supervisor left, and she doubles as the program’s director.

The remaining nurses have been assigned to spend more of their time with adult clients at a time when 1,000 babies born in Maine each year are exposed to drugs in utero and need medical follow-up. They have struggled to keep up with a backlog of patients with latent tuberculosis, which has a 5 to 10 percent chance of developing into highly contagious, active tuberculosis. And at a time when Maine is the only state to see a higher infant mortality rate in this decade than it did in the last, there are fewer nurses to visit newborns at home — an intervention that research has shown is successful in preventing infant deaths.

To hear it from leaders at the Maine Center for Disease Control and Prevention, though, things are actually getting better with public health nursing.

“The Department of Health and Human Services continues to improve our Public Health Nursing team to promote accountability and productivity, and to prioritize specific populations who require more assistance from the program,” Maine CDC chief operating officer Sheryl Peavey said last week in a written statement released to the BDN.

And nursing services, in the minds of CDC leaders, are actually growing in Maine when the number of public health nurses has fallen from about 50 to 20 in recent years.

“By taking it apart, we were actually able to build a bigger system out of it,” Dr. Christopher Pezzullo, the state health officer, told the Legislature’s Health and Human Services Committee on March 16.

And, to Pezzullo, a program that twice earned a voluntary national accreditation — and was the only statewide public health nursing program in the country to earn the distinction — “was really broken.”

Now, Peavey and Pezzullo are discussing a host of improvements — electronic health records to simplify documentation, remote monitoring of patients with latent tuberculosis, and the formation of a “maternal and child health network” consisting of nurses with whom the Maine CDC already contracts. The public health nurses, they say, will even regain their office space.

Improvements that fundamentally change the way nurses do their work aren’t imminent. And in the meantime, Maine has a woefully understaffed public health program that can’t live up to its responsibility to protect the public’s health.

“My biggest fear is, it isn’t ‘if,’ it’s ‘when’ we get a SARS [or severe acute respiratory syndrome] or something like that that’s going to come across the pond in some plane, land in Boston, and people are going to bring it up here, and now we have absolutely zero infrastructure,” Dr. Eric Brown of the Eastern Maine Medical Center family medicine residency said in a BDN story published last week.

After all, public health nurses specialize in responding to and containing disease outbreaks.

But while Maine CDC leaders claim to be reworking a program that has served Maine well for nearly a century, they’ve allowed the state’s public health infrastructure to founder — with no clear endgame.

On Thursday, lawmakers will hear testimony on legislation that would restore Maine’s staff of public health nurses to their pre-LePage levels. Most of the money for the nurses is already there: The current budget funds 43 nurses, but the LePage administration has simply refused to fill vacancies as they come up.

Meanwhile, the deficiencies in Maine’s public health system are clear. Restoring the state’s public health nursing program is simply common sense.

The BDN Editorial Board

The Bangor Daily News editorial board members are Publisher Richard J. Warren, Editorial Page Editor Susan Young, Assistant Editorial Page Editor Matt Junker and BDN President Todd Benoit. Young has worked...