Nurses oppose governor’s business decision to reduce public health services

Members of the Maine State Nurses Association/National Nurses United (MSNA/NNU) urged state lawmakers to pass a bill that would restore an important public health service that Maine’s governor has allowed to atrophy.

The bill LD 1108 would require the state’s Center for Disease Control and Prevention(CDCP) to hire more public health nurses.

CDCP acting on behalf of Gov. Paul LePage, who came to office in 2011 boasting that he would run state government like a business, has refused to fill vacant public health nurse positions.

As a result, the number of public health nurses has dropped from 50 to 23 leaving the nurses still on the job overwhelmed and putting the health of the public at risk.

Public health nurses in Maine play an important role in preventing disease and other health problems that if left unchecked could cause major public health problems.

LD 1108 would set a minimum staffing level for public health nurses at 50 and establish a deadline for the agency to meet the minimum staffing levels.

“Gov. LePage’s destruction of public health needs has caused suffering among patients in this state. Public health services need to be restored,” said Cokie Giles, president of MSNA/NNU on the eve of an April 13 legislative hearing on the bill. “LD 1108 is emergency legislation that must urgently be passed.”

Maine’s corps of public health nurses was created in the 1920s primarily to improve the health of expectant mothers and to reduce infant mortality.

Since then, their duties have been expanded to include overseeing vaccination programs, in-person monitoring of people with deadly infectious diseases such as tuberculosis, home visits to elderly people well enough to stay out of nursing homes but still medically fragile, and organizing responses to epidemics like the 2009 outbreak of the H1N1 flu virus.

Apparently the governor doesn’t think that it’s a good business decision to hire enough public health nurses to provide these vital public health services.

According to the Bangor Daily News, the LePage administration has “decimated” the state’s public health nurses’ program “by leaving more than half of its budgeted positions unfilled,”

Prior to LePage taking office, one of the most important services provided by public health nurses were their home visits to new mothers and their newborns.

According to the Daily News,

Decades of research have shown that sending a nurse into a new parent’s home, both prenatally and postpartum, is associated with a range of positive outcomes, from reduced likelihood of preterm births, infant deaths and child abuse, to improved language development and school readiness for the child and improved health for the mother.

But the LePage administration has greatly reduced public health nurse home visits to prenatal and postpartum women.

Much of this work has been farmed out to non-medical personnel who are not trained or licensed to deliver health services to new parents and their babies.

At the same time that public health nurses are paying fewer home visits to expecting and postpartum women, Maine is experiencing an alarming opioid abuse crisis, which affects the health of newborns.

According to the Daily News, “1000 babies born in Maine each year are exposed to drugs in utero and need medical follow-up.”

Disturbingly as the rise in opioid abuse has increased, so has Maine’s infant mortality rate.

In 1996, Maine had the lowest infant mortality rate in the US, but by 2014 it had dropped to 37th. While the infant mortality rate in other states has been improving, it is getting worse in Maine.

Despite Maine’s public health crisis of rising opioid abuse and increased infant mortality, Gov. LePage thinks that it makes good business sense to seek more cuts to public health nurse staffing.

His proposed budget for the next two years eliminates eight public health nurse positions and three management and support staff positions.

But some Maine lawmakers want to reverse Gov. LePage’s cuts and are supporting LD 1108.

State Senator Brownie Carson, a Democrat has sponsored LD 1108, and the bill has nine co-sponsors, seven of whom are Republicans.

“Six years ago, we had 59 public health nurses, including field nurses, managers and planners in 13 offices across the state who were looking after all of Maine’s people. Now, although the numbers are hard to get, we think we have between 20 and 23,” said Sen. Carson at a media conference.

In testimony during a senate committee hearing, Sen. Carson said that the state’s public health nurse program has been “hollowed out.”

“We must right this ship,” said Sen. Carson.

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