AUGUSTA — The Republican-controlled Senate overwhelmingly gave its approval Wednesday to a proposal, opposed by Gov. Paul LePage’s administration, that would force him to more than double the size of its public health nursing division.

Sen. Roger Katz, R-Augusta, said that lawmakers “can sit by and idly watch the dismantling of our public health system” or they can take steps to restore a critically important piece of the state’s health care system.

The bill’s sponsor, Sen. Brownie Carson, D-Harpswell, said the state only has about 20 nurses left in the field, down from more than 50 when LePage took office.

Senators shrugged off arguments from Republican Eric Brakey of Auburn that the decline is part of a planned reform of an agency that was faltering. They voted 30-5 to back Carson’s bill, which heads next to the House.

Brakey, the Senate leader of the Health and Human Services Committee, said the measure “is not a serious solution” to a program that’s clearly deficient.

He said it’s not true that the public health nurses are being phased out. Instead, he said, the program “is undergoing restructuring and reform” so that highly trained nurses are used to their full potential.

“I don’t know how you restructure something by gutting it,” Katz said.

He said the Legislature approves budgets that fund the nursing positions but the administration simply leaves them unfilled.

Meanwhile, the supposed reform plan remains a mystery.

“We’ve been waiting for a plan and waiting for a plan and waiting for a plan,” Katz said. “And now it’s decision day and there’s still no plan.”

Sen. Shenna Bellows, D-Manchester, said effort to get answers from the department about why it’s seen the number of nurses decline from 50 to 20 in six years have gone nowhere. She called the effort to dismantle the program irresponsible.

Sen. Geoffrey Gratwick, D-Bangor, said the nurses “do their job very, very well.” He said they offer a different opinion than administrators who claim reforms are in the works.

Dr. Christopher Pezzullo, state health officer for the Maine Center for Disease Control and Prevention and MaineCare’s medical director, told lawmakers this spring that the 1920 model for the public health nursing program is obsolete.

He said that officials instead have a vision that sees using the nurses when it’s appropriate, but also bringing in “a network of other non-licensed supports, such as Maine Families Home Visiting and local community resources.”

Brakey said public health nurses in Maine are now seeing an average of less than two patients a day, well below the national average of five. He said they’re also often competing against the private sector for clients and providing services that people with less training could do more cheaply.

Supporters said, however, that national averages don’t mean much when nurses sometimes have to drive two hours each way to reach isolated rural patients, a problem aggravated by a decline in the number of nurses trying to cover the entire state.

Carson said he’s worried that if there’s an outbreak of a deadly disease, the dearth of nurses might endanger Mainers who have long since come to trust that they have a good public health system.

Katz said he fears the same thing. “Presently, we are simply unprepared,” he said.

“It is time to restore Maine’s public health nursing services,” Carson said.


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