Doctors, nurses, public health experts line up to support Sen. Carson’s public health nursing bill

Posted: April 13, 2017 | Senator Carson

AUGUSTA — Doctors, nurses, hospital officials, public health experts and patients lined up on Thursday to support a bill by Sen. Brownie Carson, D-Harpswell, that would restore Maine’s public health nursing program, which the current administration has cut to dangerously low levels.

The bill — LD 1108, “An Act to Restore Public Health Nursing Services” — was the subject of a public hearing Thursday in the Legislature’s Health and Human Services Committee.

“Public health nurses are the first line of defense guarding the well-being of Maine communities,” said Sen. Carson. “But for six years, with no public debate, the programs has been hollowed out. When public health markers like infant mortality are moving in the wrong direction, we shouldn’t be slashing funding for the men and women who can get us back on track. We should be supporting them.”

Unlike other health care providers who treat individuals, public health nurses promote and protect the health of entire populations, with a goal of preventing disease and disability.  In Maine, PHNs conduct home visits with young families and pregnant women, providing education and assessment to help new moms and dads raise healthy children. They also play a critical role in helping families with substance-affected babies. But their work goes beyond the household. PHNs provide critical crisis response services, such as in 2009 when they established 238 clinics in Maine to provide H1N1 vaccines.

But since 2011, positions in the public health nursing program have been left vacant or eliminated. Today, the program is a shadow of its former self, with just one-third the staff on hand to respond to emergencies and promote wellbeing in Maine.

In 2011, 59 public health nurses worked throughout the state from offices ranging from Sanford to Calais to Fort Kent. Today’s shortage leaves the state unprepared to meet the public health needs of Mainers in the best of times, let alone in an emergency. In the meantime, Maine has bucked national trends to become the only state where infant mortality rates are rising, and a drug epidemic is ravaging communities throughout the state.

Last year, 1,000 drug-affected babies were born in Maine. At the same time, referrals for homes visits by public health nurses are going unfulfilled because of a lack of staffing in the program.

Sen. Carson’s bill restores the PHN corps to 2011 levels, ensuring professional public health nurses will stand at the ready to safeguard Maine’s well-being against health emergencies, chronic disease and epidemic.

“Public Health Nursing plays an indispensable role in meeting the stated mission of the Maine CDC,” said Rep. Anne Perry, D-Calais, a cosponsor of LD 1108 and member of the Committee. “However, more than half of the authorized public health nurse positions remain vacant or have been discontinued. It is time to do something to restore public health in Maine and this bill begins to rebuild the tools needed to meet Maine CDCs mission.”

The Maine Public Health Association, Maine Medical Association, AARP Maine and the Primary Care Association all testified in favor of the bill. Health care professionals including doctors, nurses and public health experts from Eastern Maine Health, Central Maine Health and several rural, critical-access hospitals also testified in favor of the bill.

The committee will make a recommendation on LD 1108 in the coming weeks. The bill then faces votes in the House and Senate.

Excerpts from public hearing:

“We have a public health system for the same reason we have police, and firemen, and the military. These groups all serve to protect us from threats,” said Dr. Dervilla McCann, chief of population health at Central Maine Medical Center. McCann described the 1918 flu pandemic that rocked Maine and killed more people globally in 24 years than AIDS killed in 24 years. “At a time when the state is struggling with an opioid epidemic impacting newborns, it seems extraordinarily ill timed to dismantle the single best tool we have to safeguard at risk children. Similarly, it is foolhardy to leave the citizens of our state in the same state of unreadiness that lead to such tragic loss of life 100 years ago.”

Peter Michaud, J.D., R.N. from the Maine Medical Association, pushed back against the idea that other health care providers can perform the tasks of public health nurses: “Primary care physicians, nurse practitioners, and the nurses who work with them have their hands full with what they do now, and with the opioid crisis they are being asked to do even more. It makes no sense to add the entire menu of public health nursing to their plates. They don’t have the capacity to handle the additional duties, and they certainly don’t have the capacity to respond to a new outbreak of infectious disease.”

Cokie Giles, R.N., co-president of the Maine State Nurses Association: “We expect elected officials to do the right thing and move this bill forward because the health and safety of Maine residents hangs in the balance.”