In April 2006, an Edward Little High School student was diagnosed with tuberculosis. It was a frightening discovery and the community demanded information from schools and city halls in Lewiston and Auburn. No public health departments existed to coordinate a response, so the cities and local doctors did the best they could.

That episode caused public officials and local health care providers to question whether L-A would benefit from a shared public health department that could coordinate responses in health care emergencies, direct public health programs throughout the Twin Cities and eliminate redundant overlapping of services.

Portland and Bangor are the only Maine cities with bureaus of health. The state’s Bureau of Health sets policy, makes recommendations and oversees many public health partnerships and programs, but does not operate at street level. The result is L-A and the rest of Maine make their own public health efforts, often in isolation.

For instance, Central Maine Medical Center, St. Mary’s Regional Medical Center, the B-Street Health Center and other providers offer fall flu clinics every year, but don’t share orders for flu vaccines, staff or locations, or check to ensure administration of vaccines is done cost effectively and in all neighborhoods throughout the community.

The mission of the shared department would be to “create public health partnerships that promote physical and mental health and prevent disease, injury and disability.” That includes planning for pandemic flu or other disaster, education to prevent injuries and promote healthy behaviors, guard against environmental hazards, and assure the quality and accessibility of health care services.

Sounds expensive. Initial conversation about this department, however, has two simple rules: No new department and no new staff.

“We don’t have the resources to waste,” Lewiston physician Edmund Claxton, program director for the Family Medicine Residency Program at Central Maine Medical Center, says, “so it would be good to work together to make the best of those resources.”

This is a “no new cost” venture, at least for now.

To think Lewiston-Auburn could gain efficiencies and improve public health without creating a department or adding staff sounds attractive. While it’s too early to fully endorse its creation until the public weighs in and logistics are considered, it’s a good time to listen to what the steering committee making this recommendation has to say.

CMMC and St. Mary’s are represented on the steering committee; both support a shared health department, of which they would become partners and work together. That’s pretty strong evidence this is worth examining.

L-A boasts top-notch health care providers and the cost of quality health care maintains its relentless climb. It makes sense to see what these providers, in partnership with government, can do to improve the situation.

A partnership has to be about more than flu vaccines, though. It has to be something that truly joins government, social service agencies, schools, police departments, hospitals and other providers to make the public’s health – in human and financial terms – a community priority.

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