Maine’s public health nursing workforce will more than double in the coming months and take on expanded duties – such as responding to the opioid crisis, according to the commissioner of Maine’s Department of Health and Human Services.

The public health nursing staff – front-line nurses who respond to infectious disease outbreaks and perform a number of health prevention duties – has been slashed by more than half under Gov. Paul LePage’s administration, declining from 59 in 2011 to about 25 positions in early 2017.

The staff increase for 2018 is being driven by a new law sponsored by Sen. Brownie Carson, D-Brunswick, that requires Maine to have at least 50 public health nurses on staff, a measure originally opposed by the LePage administration but now supported by DHHS.

It’s an about-face from last spring, when state health officials testified against the bill in April and LePage vetoed it. The Legislature overrode the veto last summer.

Ricker Hamilton, DHHS commissioner, told the Press Herald in an interview Wednesday that he has “always known the value of public health nursing” in his 41-year career with the department.

“Public health nurses have always been a high priority for me,” Hamilton said. “We’re re-committed and re-energized with this process. We want it to succeed and it will.”

Hamilton, a career DHHS employee, became acting commissioner in June after Mary Mayhew announced she would seek the 2018 Republican nomination for governor. Mayhew is a conservative who is closely aligned with LePage and worked on reforming public health and welfare programs during her tenure in his administration.

Hamilton was nominated and confirmed as permanent DHHS commissioner in October, after having served the department in a number of capacities under Democratic, Republican and independent administrations since the 1970s. He said he worked closely with public health nurses when he was the program director for adult protective services many years ago.

“They are true educators, and they’re very much connected to their communities,” Hamilton said. “They’re essential, a tremendous asset.”

Seven of the nursing positions have been filled so far, and the department has received more than 30 applications during a nursing shortage. The salary range is $40,000 to $55,000, depending on education and experience.

“We’re having a great response. What we’re finding is there’s a passion for this kind of work,” Hamilton said.

He said some previous criticism of the system was correct in that there was not enough documentation of what public health nurses were doing, which may have helped feed a perception that the positions could be cut back.

Dr. Dora Anne Mills, vice president of clinical affairs at the University of New England and former Maine Center for Disease Control director, said that Hamilton is well-positioned to restore the service because “he understands public health nursing in a way that many would not.”

“This is fantastic news, particularly for infants and their families,” Mills said, pointing out that one of the roles for public health nurses is to help at-risk new and expecting moms. About one out of every 12 babies born in Maine is drug-affected, according to the Maine CDC, and Mills said public health nurses could play a vital role in bringing those numbers down.

Mills said public health nurses “saved many lives” during the 1998 ice storm, going door-to-door in hard-hit areas without power, making sure families knew about the dangers of carbon monoxide poisoning from improperly vented alternative heating sources. She said the nurses also came through running vaccine clinics during the H1N1 flu epidemic in 2009.

Hamilton said details of how the nurses’ role might change will be forthcoming once the staff is at full strength, but he anticipates that in addition to their normal duties, the nurses will work on the opioid crisis, and issues such as elder abuse, child abuse and helping those with intellectual disabilities.

He said the nurses will keep tabs on “emerging health problems” and will respond when needed.

Carson, the bill’s sponsor, said it’s “hugely important” to have the administration on board with boosting the public health nursing workforce, and not doing the minimum to comply with the law.

“For them to recognize the value of public health nursing is extraordinary,” Carson said.

He said a key to raising awareness last year was getting Republican state lawmakers who represented rural areas on board. Once they recognized the value, mandating that the administration hire more was an easier sell.

“There’s a lot of isolated, frail elderly people in rural Maine who rely on public health nurses for well visits,” Carson said. “These positions had been set aside in the budget for seven years, but they weren’t being filled. The only way to get them filled was to pass legislation requiring it.”

Joe Lawlor can be contacted at 791-6376 or at:

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