Dear MPHA members,
Below please find TWO policy action alerts from the MPHA Policy Committee.  The first is a message from our friends at the American Lung Association of Maine regarding the Federal stimulus package and the lack of public health funding.  Action is requested on this TODAY.

The second (please scroll down) is in regard to the State public health infrastructure legislation (it has not been assigned an LD number yet).  The policy committee and Board would like to solicit MPHA member input so we can have a better understanding of our members' thoughts about this legislation.  Please read the legislation text and e-mail info@mainepublichealth.org with your input by this FRIDAY, February 13th. 

Our next Policy Committee meeting will be February 23rd at 3pm.  If you would like to participate more fully in the policy advocacy decisions of MPHA, please contact Shawn Yardley, Policy cmte Chair at shawn.yardley@bangormaine.gov  

Message from Ed Miller, Senior Vice-President for Public Policy, American Lung Association of New England
Seldom do we in Maine get an opportunity like this to affect nationwide public health policy.  Senator Susan Collins is at the center of attention in the proposed stimulus package negotiations and WE HAVE A SERIOUS PROBLEM WITH HER POSITION ON PUBLIC HEALTH FUNDING.
 
Senator Susan Collins stripped out the nearly $6 billion in the proposed Senate stimulus package for public health initiatives which included funding for among other things, tobacco prevention and treatment, pandemic flu prevention and healthy community initiatives that would provide nationwide support for efforts like we have in Maine.  She has stated that she will NOT support a final Senate bill that restores those funds.
 
Since the House and Senate are going to pass different bills, a Conference Committee will likely be established to work out the final compromise language.  The House version of the stimulus package that was passed contains $3 billion for the public health initiatives cited above.
 
Please contact Senator Collins' office and urge her NOT to support stripping out the $3 billion in public health funding in the final compromise bill.
 
Just a few key points:
 
*Congress just passed a 61 cent increase in the federal tobacco tax.  This is great news. But we know from experience here in Maine that this will cause millions of smokers nationwide to want to quit.  We need the public health funding to provide quality tobacco treatment to these smokers.  It is not only good for public health but it saves health care dollars and employs counselors to provide the assistance.
 
*Senator Specter said on the floor that the $10 billion in proposed National Institutes for Health funding would produce 70,000 jobs.   That's about $142,000 per job or about 7 jobs per million.   Tobacco Quitline funding gets to people BEFORE they get sick and produces up to 20 jobs per million -- About $50K per job produced
 
*In an economic downturn it is especially wise to invest in prevention efforts.  With millions out of work and many of them now without health insurance, there couldn't be a better time to fund evidence-based efforts to prevent illness.
 
*Public health jobs are real jobs too!!! With all due respect to the construction trades, they are not the only sector of the economy that has seen job loss.
 
Please call Senator Collins' office in DC at 202-224-2523   Their phone is very busy and their voice mailbox is often full so you may also want to leave a message with her Bangor office staff at 945-0417, or to one of the offices listed below.  If you can't get through, PLEASE KEEP TRYING.
 
Thanks in advance for your actions. 
 
DC Office:
Main: (202) 224-2523

Caribou State Office:
Main: (207) 493-7873

Bangor State Office:
Main: (207) 945-0417

Augusta State Office:
Main: (207) 622-8414

Lewiston State Office:
Main: (207) 784-6969

Biddeford State Office:
Main: (207) 283-1101

Portland State Office:
Main: (207) 780-3575

As a reminder, for the state legislation below, please send all feedback to info@mainepublichealth.org by FRIDAY, FEB 13th so we may better represent our members.

An Act to Establish and Promote Statewide Collaboration and Coordination in Public Health Activities and to Enact a Universal Wellness Initiative

Sec. 1. 22 MRSA chapter 152 is enacted to read:
Chapter 152: Public Health Infrastructure

§ 402. Definitions

1. Accreditation. “Accreditation” means a national federally-recognized credentialing process resulting in the approval of a public health system by a national federally-recognized review board, certifying that a public health system has met specific performance requirements and standards. Accreditation provides quality assurance, credibility, and accountability to the public, to government officials and to public health fund sources.

2. Comprehensive Community Health Coalition. “Comprehensive Health Coalition” is a multi-sector coalition serving a defined local geographic area; comprised of designated organizational representatives and interested community members who share a commitment to improving their communities’ health and quality of life; defines health broadly and includes public health in its core mission.

3. Department. “Department” means the Maine Department of Health and Human Services.

4. District Coordinating Councils for Public Health. “District Coordinating Council for Public Health” means a representative district-wide body of local public health stakeholders working toward collaborative public health planning and coordination to assure effectiveness and efficiencies in the public health system.

5. District Public Health Units. “District Public Health Unit” means a unit of public health staff set up whenever possible in each district in department offices. These staff shall include when possible public health nurses, field epidemiologists, drinking water engineers, health inspectors, and district public health liaisons.

6. Districts: “Districts” mean the eight districts of the department. They include: Aroostook District, comprised of Aroostook County; Penquis District, comprised of Penobscot and Piscataquis Counties; Downeast District, comprised of Washington and Hancock Counties; Midcoast District, comprised of Waldo, Lincoln, Knox, and Sagadahoc Counties; Central District, comprised of Kennebec and Somerset Counties; Western District, comprised of Androscoggin, Franklin, and Oxford Counties; Cumberland District, comprised of Cumberland County; and York District, comprised of York County.

7. Essential Public Health Services. “Essential Public Health Services” mean core public health functions as defined from time to time by the United States Centers for Disease Control and Prevention, and is a phrase that provides a working definition of public health and the guiding framework for the work and accreditation of public health systems.

8. Health Risk Assessment. “Health Risk Assessment” means a customized process by which individuals confidentially respond to questions and receive a feedback report to help them understand their personal risks of developing preventable health problems, know what preventive actions they can take, and learn what local and state resources are available to help them take these actions.

9. Healthy Maine Partnerships. “Healthy Maine Partnerships” mean a statewide system of comprehensive community health coalitions that meet the standards for department funding.

10. Local Health Officers: “Local Health Officers” mean municipal-based employees who have knowledge of their community and meet educational, training, and experience standards as set by the department in rule to comply with section 451.

11. Statewide Coordinating Council for Public Health. “Statewide Coordinating Council for Public Health” means a representative statewide body of public health stakeholders for collaborative public health planning and coordination to assure effectiveness and efficiencies in the public health system.


§403. Purpose

The purpose of this chapter is to establish improvements in the effectiveness and efficiencies of the public health system in this State through streamlining and coordination of existing resources to help Maine reach its goal of becoming the healthiest state in the nation, to ready and maintain the state public health system for national federally-recognized public health accreditation, and to assure the effective, efficient, and evidence-based delivery of the essential public health services.

It is further the purpose of this chapter to establish a Universal Wellness Initiative spearheaded by the public health infrastructure, with a goal of making Maine people the healthiest people in the nation.

§404. Coordination of Public Health Infrastructure Components

1. Local Health Officers.

The Local Health Officer system provides a link between the department’s Maine Center for Disease Control and Prevention and every municipality. Local Health Officers duties are set out in section 454-A.


2. Healthy Maine Partnerships.

Healthy Maine Partnership system provides appropriate Essential Public Health Services at the local level, including coordinated community-based public health promotion, active community engagement in local, district and state public health priorities, and standardized community-based health assessment that both inform and link to district-wide and statewide public health system activities.

Healthy Maine Partnerships shall include interested community members; leaders of formal and informal civic groups; leaders of youth, parent, and older adult groups; health system leaders such as hospitals, health centers, mental health and substance abuse providers; emergency responders; local government officials; leaders in early childhood development and education; school administrative units; colleges and universities; community, social service and other non-profit agency leaders; leaders of issue-specific networks, coalitions and associations; business leaders; leaders of faith-based groups; and law enforcement representatives.

The department and other appropriate state agencies will provide funds as available to coalitions in the Healthy Maine Partnership system that meet measureable criteria as set by the department for comprehensive community health coalitions.

3. District Public Health Units.

District Public Health Units help to improve the efficiency of the administration and coordination of state public health programs, policies and communications at the district and local levels and are responsible to ensure state policy reflects the different needs of each district.


4. District Coordinating Councils for Public Health

A. A District Coordinating Council for Public Health is a representative district-wide body of public health stakeholders for collaborative public health planning and coordination. The Councils shall:
1. participate as appropriate in district level activities to help assure the state public health system in each district is ready and maintained for national federally-recognized accreditation;
2. provide a mechanism for district-wide input to the state health plan;
3. assure that the goals and strategies of the state health plan are addressed in the district;
4. assure that the essential public health services and resources are provided for in each district in the most efficient, effective, and evidence-based manner possible.

The Maine Center for Disease Control and Prevention, in consultation with the Healthy Maine Partnerships, shall maintain a District Coordinating Council in each of eight department districts as resources permit.

B. The Maine Center for Disease Control and Prevention, in consultation with each Healthy Maine Partnership in each district, shall insure the invitation of persons to participate on the District Coordinating Council and shall strive to include persons who represent the Maine Center for Disease Control and Prevention, county governments, municipal governments, tribal governments, city health departments, local health officers, hospitals, health systems, emergency management agencies, emergency medical services, Healthy Maine Partnerships, school districts, institutions of higher education, physicians, other health care providers, clinics and community health centers, voluntary health organizations, family planning organizations, area agencies on aging, mental health services, substance abuse services, organizations that impact environmental health, and other community-based organizations.

Each District Coordinating Council, after consulting with the Maine Center for Disease Control and Prevention, shall develop membership and governance structures that shall be subject to approval by the Statewide Coordinating Council for Public Health.

5. Statewide Coordinating Council for Public Health
A. The Statewide Coordinating Council for Public Health is a representative statewide body of public health stakeholders for collaborative public health planning and coordination. The Council shall:
1. participate as appropriate to help assure the state public health system is ready and maintained for national federally-recognized accreditation;
2. provide a mechanism for the Advisory Council on Health Systems Development to obtain statewide input for the state health plan;
3. provide a mechanism for disseminating and implementing the state health plan; and
4. assist the Maine Center for Disease Control and Prevention in planning for the essential public health services and resources to be provided in each district and across the state in the most efficient, effective, and evidence-based manner possible.

The Maine Center for Disease Control and Prevention shall provide staff support to the Statewide Coordinating Council for Public Health as resources permit. Other agencies of State Government as necessary and appropriate shall provide additional staff support or assistance to the Council as resources permit.

B. Membership
1. The director of the Maine Center for Disease Control and Prevention, in collaboration with the Co-Chairs of the Statewide Coordinating Council for Public health, shall convene a membership committee.

After evaluation of the appointments to the Statewide Coordinating Council for Public Health, the membership committee shall appoint no more than 10 additional members and assure the total membership has at least one member who is a recognized content expert in each of the essential public health services, has representation from populations in Maine facing health disparities, and has at least two members from the Advisory Council on Health Systems Development. The membership committee shall also strive to assure diverse representation on the Statewide Coordinating Council for Public Health from the following: county governments, municipal governments, tribal governments, city health departments, local health officers, hospitals, health systems, emergency management agencies, emergency medical services, Healthy Maine Partnerships, school districts, institutions of higher education, physicians, other health care providers, clinics and community health centers, voluntary health organizations, family planning organizations, area agencies on aging, mental health services, substance abuse services, organizations that impact environmental health, and other community-based organizations.

2. Each District Coordinating Council for Public Health will appoint one member for the Statewide Coordinating Council for Public Health.

3. The President of the Senate, the Senate Minority Leader, the Speaker of the House, and the House Minority Leader shall each appoint a legislator member to the Statewide Coordinating Council for Public Health, for a total of four legislative members.

4. The Director of the Maine Center for Disease Control and Prevention or designee shall serve as a member.

5. The Commissioner of the Department of Health and Human Services shall appoint an expert from the department in behavioral health to serve as a member.

6. The Commissioner of the Department of Education shall appoint a health expert from the Department of Education to serve as a member.

7. The Commissioner of the Department of Environmental Protection shall appoint an environmental health expert from the Department of Environmental Protection to serve as a member.

C. Terms. The term of office of each member is 3 years, except that of the members first chosen by the membership committee, one-third shall be chosen for a term of 1 year, one-third shall be chosen for a term of 2 years, and one-third shall be chosen for a term of 3 years. All vacancies must be filled for the balance of the unexpired term in the same manner as the original appointment. Legislators serve during the term for which they were elected.

D. Chair and Co-chair. The membership shall annually elect a chair and co-chair. The chair is the presiding member of the committee.

E. Meetings. The Statewide Coordinating Council for Public Health shall meet at least quarterly, be staffed by the department as resources permit, and shall develop a governance structure, including determining criteria for what constitutes a member in good standing.

F. Reports. The Statewide Coordinating Council for Public Health shall report annually to the Advisory Council on Health Systems Development on progress made by the statewide public health system in addressing the designated public health goals, objectives, and strategies in the state health plan. In years when a new state health plan is being developed, The Council shall provide input from its own members and from the District Coordinating Councils stating goals, objectives, and strategies that should be addressed in the state health plan.

The Statewide Coordinating Council for Public Health shall report annually to the Joint Standing Committee on Health and Human Services of the Legislature and the Governor’s Office on progress made toward achieving and maintaining national federally-recognized accreditation of the state public health system and on district-wide and statewide streamlining and other strategies leading to improved efficiencies and effectiveness in the delivery of the essential public health services.


§405. Universal Wellness Initiative

The Maine Center for Disease Control and Prevention, the Statewide Coordinating Council for Public Health, the District Coordinating Councils for Public Health, and the Healthy Maine Partnerships shall seek to ensure that all people in Maine have access to resources and evidence-based interventions in order to know, understand and address health risks and to improve health and prevent disease. There will be a particular focus on the uninsured and others facing health disparities.

A. Resource Toolkit for the Uninsured. The Maine Center for Disease Control and Prevention and the Governor’s Office shall develop a toolkit with information on access to disease prevention, health care, and other methods for health improvement. The Healthy Maine Partnerships, District Coordinating Councils for Public Health, the Maine Center for Disease Control and Prevention, and the Statewide Coordinating Council for Public Health shall promote and distribute the toolkit materials, in particular through small businesses, schools, school-based health centers, and other health centers. Each Healthy Maine Partnership, District Coordinating Council for Public Health, and the Statewide Coordinating Council for Public Health shall report annually to the Maine Center for Disease Control and Prevention on strategies employed for promotion of the toolkit materials to the uninsured population and others facing health disparities.

B. Health Risk Assessment. The Healthy Maine Partnerships, District Coordinating Councils for Public Health, the Statewide Coordinating Council for Public Health, and the Maine Center for Disease Control and Prevention shall promote an evidence-based health risk assessment that is available to all Maine people, with a particular emphasis on outreach to the uninsured population and others facing health disparities. These health risk assessments and their promotion shall provide linkages to existing local disease prevention efforts, be collaborative with and not duplicative of existing efforts.

C. Report Card on Health. The Maine Center for Disease Control and Prevention, in consultation with the Statewide Coordinating Council for Public Health, shall develop, distribute, and publicize an annual brief report card on Maine’s health statewide and for each district by June of each year. The report card must include major diseases, evidence-based health risks and determinants that impact health.

The Maine Center for Disease Control and Prevention and the Governor’s Office of Health Policy and Finance shall provide staff support to implement the Universal Wellness Initiative as resources permit. Other agencies of State Government as necessary and appropriate shall provide additional staff support or assistance.

Sec. 2. 2 MRSA §103, as amended by PL 2005, c. 369, §§3-5, is further amended to read:
3. Requirements. The plan must:
A. Assess health care cost, quality and access in the State based on, but not limited to, demographic, health care service and health care cost data;
B. Develop benchmarks to measure cost, quality and access goals and report on progress toward meeting those goals;
C. Establish and set annual priorities among health care cost, quality and access goals;
D. Prioritize the capital investment needs of the health care system in the State within the capital investment fund, established under section 102;
E. Outline strategies to:
(1) Promote health systems change;
(2) Address the factors influencing health care cost increases; and
(3) Address the major threats to public health and safety in the State, including, but not limited to, lung disease, diabetes, cancer and heart disease;
F. Provide recommendations to help purchasers and providers make decisions that improve public health and build an affordable, high-quality health care system; and
G. Be consistent with the requirements of the certificate of need program described in Title 22, chapter 103-A; and
H. Include the report cards on health status by public health district issued by the Maine Center for Disease Control and the Statewide Coordinating Council for Public Health pursuant to 22 MRSA §405 to monitor progress in improving health. The Plan shall also use survey and other health tracking systems available in or to the Maine Center for Disease Control and Prevention to monitor rates of preventive risk factors and diseases among the uninsured.

SUMMARY

This bill recognizes and formally establishes the improvements in the efficiencies and effectiveness in the public health system in this State. These improvements in streamlining and coordination of existing resources are to help Maine reach its goal of becoming the healthiest state in the nation, to ready and maintain the state public health system for national federally-recognized public health accreditation, and to assure the effective, efficient, and evidence-based delivery of the essential public health services. The bill recognizes and formally establishes the existence of the Healthy Maine Partnerships, the District Coordinating Councils for Public Health, and a Statewide Coordinating Council for Public Health.

The bill also establishes a Universal Wellness Initiative using the existing resources of the public health infrastructure. The Initiative requires the development and distribution of a Resource Kit for the Uninsured and a Health Risk Assessment for all people in Maine with a focus on the uninsured and those facing disparities. It also requires the Maine Center for Disease Control and Prevention to issue an annual report card on health for each public health district in the State, and for the State Health Plan to publish the report.