Maine’s public health system will look different under a road map released Friday by Gov. Paul LePage’s administration, which aims to use tobacco settlement money in a more focused way to fight opiate abuse and smoking.
Advocates were still digesting a 75-page request for proposals released by the Maine Center for Disease Control and Prevention on Friday afternoon. But it’s clear that the role of Healthy Maine Partnerships — which the Republican governor proposed cuts to last year — will narrow.
Those 27 groups now do programming on public health issues including tobacco, drugs and obesity and work under state contracts expiring in July. They’re funded by roughly $5 million from the Fund for a Healthy Maine, consisting of money from a 1998 tobacco settlement.
The Maine CDC’s plan now calls for programming aimed at preventing use of opiates, alcohol and other drugs along with youth education and mass outreach on tobacco and substance abuse prevention, citing benchmarks for groups to meet.
That’s a nod to Maine’s opiate crisis: The state set a record in 2015 with 272 overdose deaths, driven by heroin and fentanyl use.
But the last RFP for the Healthy Maine Partnerships was broader, calling for programming and education around tobacco use, physical activity, nutrition and weight, substance abuse and chronic disease, including cancer.
It comes with another change: The Maine CDC said in a news release that it will transfer $1.45 million to District Coordinating Councils, a stakeholder group that coordinates public health planning. Spokesman John Martins didn’t respond to questions about the councils’ expanded role.
But Maine CDC Director Kenneth Albert said in a statement that the state will invest in “staffing support” to “strengthen their roles as the leaders of public health and their respective districts,” saying that “legislators, advocates and the current Healthy Maine Partnerships” have “improperly stated” that the partnerships “are the public health infrastructure.”
Advocates have feared changes to the program since fall, after LePage proposed moving smoking cessation efforts to the primary care setting, saying that while per-capita spending on those efforts was among the highest in the U.S., Maine’s drop in smoking only slightly exceeded the national average.
The Department of Health and Human Services said in a statement that it expects “bids to represent participation and input from all active and vibrant public health partners,” and Commissioner Mary Mayhew said it needs to “effectively address the use and abuse of addictive substances to avoid increased healthcare and societal costs associated with this behavior.”
But it’ll likely cause heartburn among advocates next week. Becky Smith, a lobbyist for the American Heart Association of Maine, said she hadn’t reviewed the RFP yet, but that it was “disappointing” that it doesn’t include obesity programming.