SEN. BROWNIE CARSON discusses his legislation to increase the number of public health nurses in Maine at a press conference in Augusta.

SEN. BROWNIE CARSON discusses his legislation to increase the number of public health nurses in Maine at a press conference in Augusta.

AUGUSTA

At a press conference on Thursday, Sen. Brownie Carson, D-Harpswell, introduced legislation to nearly triple the number of public health nurses in Maine.

“Six years ago, we had 59 public health nurses, including field nurses, managers and planners, and 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 Carson.

LD 1808, “An Act to Restore Public Health Nursing Services,” would require the state to increase the number of PHNs to the level they were at in January 2011 — the beginning of Gov. Paul LePage’s first term. Since 2011, the number of PHNs has dropped as the administration has left positions unfilled.

“Looking into it further, I found that yes indeed (the public health nursing program) is being dismantled,” said Carson. “Not only that, but it is being taken apart without any serious public conversation, no policy review, no engagement of people who really are experts in the field.”

That’s despite the fact that the state budget provides funding for 48 PHN positions added Carson, meaning half have been left vacant. The state website lists eight PHN staff for Cumberland County and another four for the Midcoast, although that information may not be up to date.

PHNs are part of the Maine Center for Disease Control, and have a number of functions. Primarily, they visit postpartum mothers in their homes and ensure healthy living, but they also provide nursing services in rural school districts and are an important part of preventing infectious disease outbreaks. With the growing number of drug-affected babies being born in Maine, said Carson, PHNs are more important than ever.

“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,” said Dr. Dervilla McCann, chief of population health at Central Maine Medical Center.

Following the press conference, the Health and Human Services Committee held a public hearing on the legislation. The Maine Public Health Association, Maine Medical Association, AARP Maine and the Primary Care Association all testified in favor of the bill, as did a number of individuals who are currently or were formerly affiliated with the public health nursing program.

“They are the largest segment of the professional health workforce,” said Ted Hensley, former head of the public health nursing program. “They are professional health care providers who respect your and my privacy so when they serve us nobody hears about it. Unless you’ve had experience with their help, most don’t know they exist, much less know what they do. That’s why they become low hanging fruit when it comes to budget cutting.”

Maggie Jansson, a pediatric nurse case manager affiliated with Midcoast- Parkview Health Systems, told the committee in written testimony that she’s seen the effect of the dropping number of public health nurses first-hand.

“Over the past few years I have watched as our infant referrals have changed in direct relation to the ongoing decrease in availability of state public health nurses,” said Jansson. “As their numbers have decreased, my referrals of 2-4 weeks old infants have increased. Without a public health nurse checking in on the most at risk new mothers and babies, many pediatricians are discovering underweight and developmentally delayed infants arriving for their first one month well check.”

In her testimony, Luanne Crinion, who was a PHN for more than 30 years, explained how the program can help prevent the spread of infectious disease. In 1989, she recalled, there was an outbreak of active tuberculosis cases diagnosed in the Bath/Brunswick area.

“There was several new cases of active infectious tuberculosis that was diagnosed. The local home health agency, which was not a state agency, had only one nurse that was assigned to provide the TB control services to the residents of that area of Bath/Brunswick,” said Crinion. “It became clear that one nurse from that agency was not able to provide all the needed services to help control the spread of this infectious disease.”

PHNs from across the state came to the southern Midcoast area to address the problem, providing tubercular skin tests and administering medication. Thanks to PHNs, said Crinion, a major crisis was averted.

“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,” said Cokie Gile, co-president of the Maine State Nurses Association.

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