An Act To Implement the Recommendations of the Commission To Study Public Health
Maine Legislature, Session 122, LD 0134
Committee: Health and Human Services

Legislative Document 
No. 134 
H.P.112 
House of Representatives, January 13,2005 
An Act To Implement the Recommendations of the Commission To 
Study Public Health 
Reported by Representative CRA VEN of Lewiston for the Commission to Study Public 
Health pursuant to Resolve 2003, chapter 95, sections 7 and 8. 
Reference to the Committee on Health and Human Services suggested and ordered printed 
under Joint Rule 218. 
Printed on recycled paper 
111~ 
'frJ·711~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA c. 260-B is enacted to read: 
CHAPTER 260-B 
PREVENTION OF OBESITY 
§15l5. 
Maine Obesity Prevention Fund 
1. 
Fund established. 
The Maine Obesity Prevention Fund, 
referred to in this chapter as "the fund," is established as an 
Other Special Revenue fund account wi thin the Department of 
Administrative and Financial Services for the purposes specified 
in this chapter. 
2. 
Sources of fund. 
The State Controller shall credit to 
the fund: 
A. 
All money allocated to the fund by the Legislature 
derived from sources determined by the Legislature to be 
contributing causes of obesity; 
B. 
Money from any other source, whether public or private, 
designated for deposit into or credited to the fund, other 
than the Fund for a Healthy Maine; and 
C. 
Interest earned or other investment income on balances 
in the fund. 
3. 
Unencumbered balances. 
Any 
unencumbered balance 
remaining at the end of any fiscal year lapses back to the fund 
and may not be made available for expenditure without specific 
legislative approval. 
4. 
Departmental indirect cost allocation plans. 
Any 
revenue transfer from a fund account to another account pursuant 
to 
an 
approved 
Department 
of 
Administrative 
and 
Financial 
Services indirect cost allocation plan is an authorized use of 
revenue credited to the fund. 
The State Budget Officer shall 
reduce allotment for the amount of any transfer made from a fund 
account for the purpose authorized in this subsection. 
5. 
Restrictions. 
This 
section does 
not 
require 
the 
prov~s~on of services for the purposes specified in subsection 
7. 
Allocations from the fund must be used to supplement. not 
supplant, appropriations from the General Fund or from the Fund 
for a Healthy Maine. 
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6. 
General Fund limitation. 
Notwithstanding any provision 
to 
the 
contrary in this 
section. 
funding 
for 
any 
program. 
expansion of a program. expenditure or transfer authorized by the 
Legislature using the fund may not be transferred to the General 
Fund without specific legislative approval. 
7. Obesity prevention puzposes. Allocations are limited to 
the following obesity prevention-related purposes: 
A. 
Coordinated school health programs: 
B. 
Annual assessments of body-mass index of students in 
schools: 
C. 
Increased availability of fresh fruits and vegetables in 
schools: and 
D. 
Media campaigns encouraging healthy diets and physical 
fitness. 
8. 
Report by Treasurer of State. 
The Treasurer of State 
shall report at least annually on or before the 2nd Friday in 
December to the joint standing committee of the Legislature 
having jurisdiction over appropriations and financial affairs and 
the 
joint 
standing 
committee 
of 
the 
Legislature 
having 
jurisdiction over health and human services matters. 
The report 
must summarize the activity in any funds or accounts directly 
related to this section. 
9. 
Annual appropriation. 
Beginning July I. 2006, the State 
Controller is authorized to provide an annual appropriation from 
the General Fund to the fund to provide money for the purposes 
described in subsection 7, 
in an amount determined by the 
Legislature to adequately support those purposes. 
10. 
Restricted 
accounts. 
The 
State 
Controller 
is 
authorized to establish separate accounts within the fund in 
order to segregate money received by the fund from any source, 
whether public or private, that requires as a condition of the 
contribution to the fund that the use of the money contributed be 
restricted to one or more of the purposes specified in subsection 
7. 
Money credited to a restricted account established under this 
subsection may be applied only to the purposes to which the 
account is restricted. 
Sec. 2. 
Commission extended. 
The Commission to Study Public 
Health, created pursuant to Resolve 2003, chapter 95, is extended 
through the Second Regular Session of the l22nd Legislature for 
the following purposes: 
to collect and evaluate evidence, to 
coordinate 
wellness 
initiatives, 
to 
seek 
grant 
funding 
and to evaluate existing health and wellness programs. 
The 
commission 
shall 
submit 
a 
report 
concerning its activities 
relating to these purposes and any accompanying legislation to 
the First Regular Session of t.he 123rd Legislature by November 3, 
2006. The commission is -authorized to submit legislation related 
to its 
report 
to 
the 
First 
Regular 
Session 
of 
the 
123rd 
Legislature. 
Sec. 3. Dirigo Health study and report; Department of Health and 
Human Services study and report. 
The Board of Directors of Dirigo 
Health, established pursuant to the Maine Revised Statutes, Title 
24-A, 
chapter 
87, 
shall consider the 
recommendations 
of the 
Commission to Study Public Health related to providing incentives 
to individuals using certain public benefit programs when it 
reviews the "Healthy ME Rewards" incentive program of the Dirigo 
Health plan. 
In response to the recommendations included in the 
final report of the Commission to Study Public Health, the Board 
of Directors of Dirigo Health shall conduct a study that includes 
the following: 
1. An analysis of the extent to which the "Heal thy ME 
Rewards" incentive program, 
or any quality assurance, disease 
prevention, 
disease 
management 
or 
cost-containment programs 
included as part of the Dirigo Health plan in accordance with the 
Maine 
Revised Statutes, Title 24-A, 
section 6910, 
contains 
incentives that encourage the purchase of healthy and nutritious 
food by individuals enrolled in the health plan and their 
dependents; 
2. An analysis of how food purchasing behavior information 
obtained via the electronic benefit transfer, EBT, card system 
about individuals 
rece1v1ng public benefits through the 
Food 
Stamp Program can be directly used by the Dirigo Health plan's 
"Healthy ME Rewards" incentive program to provide incentives to 
individuals enrolled in the health plan that participate in the 
Food Stamp Program; and 
3. An analysis of the extent to which the consumer education 
campaign developed and conducted by the Maine Quality Forum in 
accordance with the Maine Revised Statutes, Title 24-A, section 
6951, subsection 5 to help health care consumers make informed 
decisions and engage in healthy lifestyles includes information 
regarding the consumption of healthy and nutritious food by 
individuals enrolled in the Dirigo Health plan, 
as well 
as 
individuals who are receiving public benefits through the Food 
Stamp Program. 
The 
Board of Directors of 
report that includes findings 
Dirigo Health shall submit 
and 
recommendations 
from the 
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analyses of issues identified in this section as part of the 
annual report required by September 1, 2006 in accordance with 
the Maine Revised Statutes, Title 24-A, section 6908, subsection 
6. 
In addition, 
as part of the effort recommended by the 
Commission to Study Public Health to encourage the purchase of 
healthy and nutritious food by families using certain 
~lic 
benefit programs, the Department of Health and Human Services 
shall 
determine 
whether 
the 
EBT 
card 
system 
can 
obtain 
information regarding the fruit and vegetable purchasing behavior 
of individuals who are receiving public benefits through the Food 
Stamp Program, including the purchase of Maine-grown fruits and 
vegetables, and whether this information can be directly used by 
the Dirigo Health plan "Healthy ME Rewards" incentive program to 
provide incentives to individuals enrolled in the health plan 
that participate in the Food Stamp Program. 
The Commissioner of 
Health and Human Services shall submit a report that includes the 
information determined pursuant to this section by November 2, 
2005 to the joint standing committee of the Legislature having 
jurisdiction over insurance and financial services matters and 
the 
joint 
standing 
committee 
of 
the 
Legislature 
having 
jurisdiction over health and human services matters. 
Sec. 4. 
Comprehensive employee health program addressing 
obesity. 
The Department of Administrative and Financial Services, 
Bureau of Human Resources, 
Division of Employee Health and 
Benefits 
shall 
implement 
a 
comprehensive, 
population-based 
approach to addressing obesity-related risk factors and disease 
management, including nutrition counseling and physical activity 
and health risk identification and management. 
Implementation 
should include: 
1. Creating one or more full-time positions within State 
Government to support the development of a health improvement 
infrastructure; 
2. Requiring flex-time policies covering all state employees 
to encourage and support employee health; 
3. Conducting an inventory of the availability of fitness 
centers in locations of heavy concentrations of state employees; 
4. Creating performance management objectives through which 
supervisors and managers support and encourage healthy lifestyles 
among employees they supervise; and 
5. 
Dedicating at least 0.5% of annual health insurance 
premiums for all state employees to support employee health and 
wellness. 
Sec. 5. Expedited bid process. The Department of Administrative 
and Financial Services shall create an expedited process for 
consideration and approval of bids for pilot projects related to 
state employee health. 
Sec. 6. Healthy food and beverage options at state cafeterias, snack 
bars and vending machines. 
The Department of Labor, Bureau of 
Rehabilitation Services, 
Division of 
the 
Blind 
and Visually 
Impaired shall: 
1. Implement recommendations of food choice committees to 
include healthy food and beverage options at cafeterias, snack 
bars and vending machines under the division's purview. 
These 
food choice committees shall consider providing price incentives 
for purchase of healthy foods and beverages; 
2. 
Develop 
a 
system 
cafeterias and snack bars 
division's purview; 
for 
and 
tracking 
in vending 
food 
purchases 
machines under 
at 
the 
3. 
Perform nutritional analysis on all major-selling food 
items and post caloric and nutritional information at cafeterias 
and snack bars under the division's purview; and 
4. 
Include in the food choice committee for any executive 
department 
that 
uses 
a 
cafeteria 
or 
snack 
bar 
under 
the 
division's purview a wellness coordinator from that department. 
Sec. 7. 
Investigation of insurance cost savings. 
The State 
Employee Health Commission, 
established pursuant to the Maine 
Revised Statutes, Title 5, 
section 285-10., 
shall direct any 
insurance carrier providing health insurance coverage to state 
employees, retirees or MaineCare participants to investigate the 
cost savings of including the following services as part of that 
coverage, and if cost savings are shown, shall strongly recommend 
implementation of these services: 
body-mass index assessment; 
intensive 
counseling 
and 
behavioral 
interventions 
for 
any 
employee with a body-mass index of at least 30 kilograms per 
square meter; and evidence-based interventions for any employee 
with a body-mass index of at least 25 kilograms per square meter 
who is 45 years of age or older and has been diagnosed with 
prediabetes. 
Sec. 8. Encouragement of insurance incentives. The Department of 
Professional and Financial Regulation, Bureau of Insurance shall 
compose and distribute a letter to all carriers, as that term is 
defined in the Maine Revised Statutes, Title 24-10., 
section 
4301-10., 
subsection 
3, 
encouraging 
those 
carriers 
to 
provide 
incentives 
for 
their 
insureds 
to 
engage 
in 
the 
following 
services: 
body-mass index assessment; intensive counseling and 
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behavioral interventions for any covered person with a body-mass 
index 
of 
at 
least 
kilograms 
per 
square 
meter; 
and 
evidence-based interventions for any covered person with a 
body-mass index of at least 25 kilograms per. square meter who is 
years of age or older and has been diagnosed with prediabetes. 
This bill implements 
Study Public Health, which 
chapter 95. 
The bill: 
SUMMARY 
recommendations of the Commission to 
was created pursuant to Resolve 2003, 
1. 
Creates the Maine Obesity Prevention Fund, which is to 
be funded from sources determined by the Legislature to be 
contributing causes of obesity. 
This fund may not be funded by 
allocations from the Fund for a Healthy Maine, and allocations 
may not be made from it to the General Fund; 
2. 
Extends the Commission to Study Public Health through 
the Second Regular Session of the l22nd Legislature; 
3. 
Directs the Dirigo Health board and the Department of 
Health and Human Services to study and report on incentives 
provided to encourage purchases of healthy food and beverages; 
4. 
Directs the Department of Administrative and Financial 
Services, Bureau of Human Resources, Division of Employee Health 
and Benefits to implement a comprehensive employee health program 
addressing obesity; 
5. 
Directs the Department of Administrative and Financial 
Services to create an expedited bid process for pilot projects 
related to employee health; 
6. 
Directs 
the 
Department 
of 
Labor, 
Bureau 
of 
Rehabilitation Services, Division of the Blind and Visually 
Impaired to pursue reforms that will increase the availability of 
healthy foods and beverages in cafeterias, snack bars and vending 
machines under the division's purview; 
7. 
Directs the State Employee Health Commission to direct 
health insurance carriers who provide health coverage for state 
employees, retirees and MaineCare recipients to investigate, and 
possibly implement, potentially cost-saving services for obesity 
prevention among their insureds; and 
8. 
Directs the Department of Professional and Financial 
Regulation, Bureau of Insurance to encourage all health insurance 
carriers to provide incentives for their insureds to make use of 
potentially cost-saving services for obesity prevention. 
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