This is what happens when a state neglects public health

Lawmakers can no longer ignore the dangerous state of Maine’s public health system.

Since taking office, Gov. Paul LePage and his Department of Health and Human Services commissioner, Mary Mayhew, have systematically devastated the part of state government that’s supposed to help keep Maine people healthy.

Since 2011, despite having adequate funding from the Legislature, the LePage administration has allowed the number of public health nurses to drop by more than half, while needless bureaucratic hurdles have been put in place to hamstring the efforts of those who are left.

LePage’s current budget proposes further cuts to the number of public health nurse positions, leaving most of the state without adequate coverage or care.

The results have been catastrophic for at-risk babies, and they put each and every one of us at risk. Infant mortality rates are increasing. We’re the only state in the country that can lay claim to that terrible superlative. Rural Maine, where access to health care is particularly frayed, is bearing the brunt of the toll.

And our state has been left woefully unprepared to respond to a fast-moving public health emergency, like the one we faced in 2009 with the H1N1 flu pandemic. Public health nurses are on the frontlines of the government’s response to a crisis.

We are leaving ourselves unprotected from disease and disaster.

We’re turning a blind eye to a creeping catastrophe.

We are letting lives slip away.

Finally, a bipartisan group of legislators is taking on the fight to fix it, led by state Sens. Brownie Carson, Paul Davis and Roger Katz.

Last week, the Legislature held a public hearing on LD 1108, which would begin the hard work of resurrecting the state’s public health nurses program, which has been allowed to wither under LePage’s stewardship.

Nearly 60 people — doctors, nurses, advocates for children and the elderly — provided testimony on the bill, bringing enormous attention to an issue first uncovered by the Bangor Daily News’ investigative team last summer.

If you want a better understanding of what public health nurses do and how they contribute to the well-being of a community, Rebecca Boulos of the Maine Public Health Association provided an excellent primer during her testimony.

In short, public health nurses specialize in improving health by focusing on prevention and intervention.

Currently, Maine has about 20 public health nurses, down from about 50 in 2011. According to Boulos, a rural state like Maine should have 263 public health nurses to meet demand.

The proposed legislation would take us back to the 2011 level, short of the ideal but back to a more reasonable number.

Oftentimes when it comes to public policy debates, the outcomes are hard to predict and subject to political gamesmanship.

But that’s just not the case here.

We can see the results of the LePage administration’s blind eye to public health.

A young mother, her baby seriously ill, doesn’t have access to a public health nurse because she lives in Millinocket.

Every year during the last decade, an average of 85 babies have died before their first birthday, up about one baby a month from a decade earlier.

As I wrote last year on this same topic, Maine ranks second in the country for the rate of babies born addicted to opioids, the number of uninsured children in the state has risen from 11,000 in 2010 to 16,000 in 2014, and more children are going hungry. And infant mortality is on the rise.

That is the price of our indifference. We all need to raise our voices and be heard.

A work session on the legislation is scheduled for April 26 in front of the Legislature’s Health and Human Services Committee. The bill will need a strong vote of support from the committee and two-thirds support from both the House and Senate to overcome a potential veto from the governor.

Protecting the public health is one of the core functions of government. We can no longer ignore that obligation and allow larger gaps to develop in our public health system.

We have allowed public health to fade into the shadows, undermined to the point of limited effectiveness. It’s time we shine a light on this critical area and restore the ranks of public health nurses.

Lives are depending on it.

David Farmer

About David Farmer

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist. You can reach him at