An Act To Establish and Promote Statewide Collaboration and Coordination in Public Health Activities and To Enact a Universal Wellness Initiative
Maine Legislature, Session 124, LD 1363
Committee: Health and Human Services
Sponsors: MILLER, ROSEN, JONES, CRA VEN
Amends: 2 MRSA §103, 22 MRSA §412

FIRST REGULAR SESSIOt~-2009 
Legislative Document 
No. 1363 
House of Representatives, Aplil 2, 2009 
An Act To Establish and Promote Statewide Collaboration and 
Coordination in Public Health Activities and To Enact a Universal 
Wellness Initiative 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
'I7/~d; 1h.1lliLc~{ 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative MILLER of Somerville. (GOVERNOR'S BILL) 
Cosponsored by Senator ROSEN of Hancock and 
Representatives: JONES of Mount Vernon, .STRANG BURGESS of Cumberland, Senator: 
CRA VEN of Androscoggin." 
Pl'intcJ llll I'Ci:ydcJ papL'1 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 2 MRSA §103, sub-§3, GjiF, as amended by PL 2005, c. 369, §4, is further 
amended to read: 
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4F. Provide recommendations to help purchasers and providers make decisions that 
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improve public health and build an affordable, high-quality health care system; aH6 
6-Sec. 2. 2 MRSA §103, sub-§3, ~G, as enacted by PL 2005, c. 369, §5, is 
amended to read: 
. G. 
Be consistent with the requirements of the certificate of need program described 
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in Title 22, chapter 103-A~; and 
Sec. 3 .. 2 MRSA §103, sub-§3, ~ 
is enacted to read: 
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H. Include the report cards on health status by district issued by the Department of 
Health and Human Services, Maine Center for Disease Control and Prevention and 
the Statewide Coordinating Council for Public Health pursuant to Title 22, section 
413, subsection 3 t6 monitor progress in improving health. The plan must also use 
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survey and other health tracking systems available in or to the Maine Center for 
Disease Conti·ol and Prevention to monitor rates of preventive risk factors and 
diseases among the uninsured. 
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Sec. 4. 5MRSA §12004-G, sub-§14-G is enacted to read: 
14-G. 
Health Care 
Statewide 
Not Authorized 
Coordinating 
Council for Public-
Health 
Sec. 5. 22 MRS A c. 152 is enacted to read: 
CHAPTER 152 
PUBLIC HEALTH INFRASTRUCTURE 
§411. Definitions 
MRSA §412 
As used in this chapter, unless the context otherwise indicates, the following terms 
have the following meanings. 
1. 
Accreditation. 
. "Accreditation" means a national federally recognized 
credentialing process resulting in the approval of a public health system by a national 
federally recognized review board certifying that a public health system has met specific 
performance requirements and standards. 
Accreditation· provides quality assurance, 
credibility and accountability to the public, to government officials and to public health 
fund sources. 
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2. 
Comprehensive community health coalition. 
"Comprehensive community 
health coalition" means a multisector coalition that serves a defined local geographic area 
and is composed of designated organizational representatives and interested community 
members who share a commitment to improving their communities' health and quality of 
life and that includes public health in its core mission. 
3. District coordinating council for public health. "District coordinating council 
for public health" means ,a representative districtwide body of local public health 
stakeholders working toward collaborative public health planning and coordination to 
ensure effectiveness and efficiencies in the public health system. 
4. District public health unit. "District public health unit" means a unit of public 
health staff set up whenever possible in a district in depaliment offices. A staff must 
include when possible public health nurses, field epidemiologists, drinking water 
engineers, health inspectors and district public health liaisons. 
5. Distdct. "District" means one of the 8 districts of the depaIiment, including 
Aroostook District, composed of Aroostook County: Penquis District, composed of 
Penobscot County and Piscataquis County; Downeast District, composed of Washington 
County and Hancock County; Midcoast District, composed of Waldo County, Lincoln 
County, KnoX: County and S'agadahoc County; Central District, composed of Kennebec 
County and Somerset' County; Western District, composed of Androscoggin County, 
.Franklin County and Oxford, County; Cumberland District, composed of Cumberland 
County; aild York District, composed of York County. 
6. Essential public health services. "Essential public health services" means core 
public health functions as defined from time to time by the United States Centers for 
Disease Control and Prevention that help provide the guiding framework for the work and 
. accreditation bf public health systems. 
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7. Health risk assessment. "Health risk assessment" means a customized process 
by which an individual confidentially responds to questions and receives a feedback 
repOli, to help that individual understand the individual's personal risks of developing 
preventable' health problems, know what preventive actions the individual can take and 
leani what local and state resources are available to help the individual take these actions. 
8., Healthy Maine Partnerships. "Healthy Maine PaIinerships" means a statewide 
system of comprehensive community health coalitions that meet the standards for 
depaliment funding that is established under section 412. 
9. Local health officer. "Local health officer" means a municipal employee who 
has knowledge of the employee's' community and meets educational, training and 
experience standards as set by the depaliment in rule to comply with section 451. 
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10. Statewide Coordinating Council for Public Health. "Statewide Coordinating 
Council for Public Health" means the council established under Title 5, section 12004-G, 
su bsection 14-G. 
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§412. Coordination of public health infrastructure components 
1. ' Local health officers. Local health officers shall provide a link between the 
Maine Center for Disease Control and Prevention and every municipality. Duties of local 
health officers are set out in section 454~A. 
2. 
Healthy Maine Partnerships. Healthy Maine Palinerships is established to 
provide appropriate essential I public health services. at the local level, including 
coordinated community-based public health promotion, active community engagement in 
loci:t\, district and state public health priorities and standardized community-based health 
assessment that inform and link to districtwide and statewide public health system 
activities. 
Healthy Maine Palinerships must include interested community members; leaders of 
formal andinforinal civic groups; leaders of youth, parent and older adult groups; leaders 
of hospitals, health centers, mental health and substance abuse providers; eme'rgency 
responders; local government officials; leaders in early childhood development and 
education; leaders of school administrative units and colleges and universities; 
community, social service and other nonprofit agency leaders; leaders of issue-specific 
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networks, coalitions and associations; business leaders; leaders of faith-based groups; and 
law enfoi'cement representatives. 
The department and other appropriate state agencies shall provide funds as available to 
coalitions in Healthy Maine Partnerships that meet measurable criteria as set by the 
. department for comprehensive community health coalitions. 
3. District public health units. District public health units shall help to improve the 
efficiency of the administration and coordination of state public health programs and 
policies and communications at the district and local levels and shall ensure that state 
policy reflects the different needs of each district. 
4. District coordinating councils for public health. The Mailie Center for Disease 
Control and Prevention, in consultation with Healthy Maine Partnerships, shall maintain a 
district coordinating council for public health in each of the 8 districts as resources 
permit. . 
A. A district coordinating council for public health shall: 
(1) Participate as appropriate in district-level activities to help ensure the state· 
public health system in each district is ready and maintained for accreditation; 
(2), PrOVide a mechanism for districtwide input to the state health plan under 
Title 2, section 103; 
(3) Ensure that the goals and strategies of the state health plan are addressed in 
the district; and 
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(4) Ensure that the essential public health services and resources are provided for 
in each district in the most efficient, effective and evidence-based manner 
possible. 
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B. 
The Maine Center for Disease Control and Preventiorl, in consultation with 
Healthy Maine Palinerships, shall ensure the invitation of persons to participate on a 
district coordinating council for public health and shall strive to include persons who 
represent the Maine Center for Disease Control and Prevention, comity governments, 
municipal governments, tribal governments, city health departments, local health 
,officers, hospitals, health systems, emergency management agencies, emergency 
medical services, Healthy Maine Palinerships, school districts, institutions of higher 
education, physicians and other health care providers, clinics and community health 
centers, voluntary health organizations, family phuming organizations, area agencies 
on aging, mental health'services, substance abuse services, organizations seeking to 
improve environmental health and other comrriunity-based organizations. 
A district coordinating council for publIC health, after consulting with the Maine Center 
for Disease Control and Prevention, shall develop membership and governance structures 
that are subject to approval by the Statewide Coordinating Council for Public Health. 
5. 
Statewide Coordinating Council. for Public Health. 
The Statewide 
Coordinating Council for Public Health, established under Title 5, section 12004-G, 
. subsection 14-G, is a representative statewide body of public health stakeholders for 
collaborative public health planning and coordination. 
A. The Statewide Coordinating Council for Public Health shall: 
(1) Participate as appropriate to help ensure the state public health system IS 
ready and maintained for accreditation; 
(2) 
Provide a mechanism for the Advisory Council on Health Systems 
Development under Title 2, section 104 to obtain statewide input for the state 
health plan under Title 2, section 103; 
(3). Provide a mechanism for disseminating and implementing the state health 
plan; and 
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(4) Assist the Maine Center for Disease Control and Prevention in planning for 
the essential public health services and resources to be provided in each district 
and across the State in the most efficient, effective and evidence-based manner 
possible. 
The Maine Center for Disease Control and Prevention. shall provide staff support to 
the Statewide Coordinating Council for Public Health' as resources permit. Other 
agencies of State Government as necessary and appropriate shall provide additional 
staff support 01' assistance to the Statewid,e Coordinating Council for Public Health as 
resources permit. 
B. Members of the Statewide Coordinating Council for Public Health are appointed 
as follows. 
(1) 
Each district coordinating council for public health shall appoint one 
member. 
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(2) The President of the Senate, the Senate Minority Leader, the Speaker of the 
House and the House Minority Leader shall each appoint a member who is a 
Legislator, for a total of 4 legislative members. 
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(3) The Director of the Maine Center for Disease Control and Prevention or the 
director's designee shall serve as a member. 
(4) . The commissioner shall appoint an expert in behavioral health from the 
department to serve as a member. 
(5) The Commissioner of Education shall appoint a health expert from the 
Department of Education to serve as a member. ' 
(6) 
The Commissioner of Environmental Protection shall appoint an 
environmental health expert from the Department of Environmental Protection to 
serve as a member. 
(7) The Director of the Maine Center for Disease Control and Prevention, in 
collaboration with the cochairs of the Statewide Coordinating Council for Public 
Health, shall convene a membership committee. . After evaluation of the 
appointments to the Statewide Coordinating Council for Public Health, the' 
membership committee shall appoint no more than 10 additional members and 
ensure that the total membership has at least one member who is a recognized 
content expert in each orthe essential public health services, has representation 
from populations in the State facing health disparities and has at least 2 members 
from the AdvisOlY Council on Health Systems Development under Title 2, 
section 104. 
The membership comniittee shall also strive to ensure diverse 
representation on the Statewide Coordinating Council for Public Health from 
county governments, municipal governments, tribal governments, city health 
departments, local health -officers, hospitals, health systems, emergency 
management agencies, emergency medical services, Healthy Maine Partnerships, . 
school districts, institutions of higher education, physicians and other.health care 
providers, cliniCs and community health centers, voluntary health organizations, 
family planning organizations, . area agencies on aging, mental health services, 
substance abuse services, organizations seeking to improve environmental health 
and other community-based organizations.' 
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·C. 
The term of office of each membet" is 3 years. All vacancies must be filled for the. 
balance of the unexpired term in the same manner as the original appointment. 
Legislators serve during the term for which they were elected. 
D. 
Members of the Statewide Coordinating Council for Public Health shall elect 
annually a chair and cochair. The chair is the presiding member of the Statewide 
Coordinating Council for Public Health. 
E. 
The Statewide Coordinating Council for Public Health shall meet at least 
quarterly, must be staffed by the department as j"esources permit and shall develop a 
governance structure, including determining criteria for ~hat constitutes a member in 
good standing. 
F. The Statewide Coordinating Council for Public Health shall repOli annilally to the 
Advisory Council on Health Systems Development under Title 2, section 104 on 
progress made by the statewide public health system in addressing the designated 
public health goals, objectives and strategies in the state health plan under Title 2, 
section 103. lri years when a new state health plan is being developed, the Statewide 
Coordinating Council for Public Health shall provide input from its own members 
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and from the district coordinating councils for public health stating goals, objectives 
and strategies that should be addressed in the state health plan. 
The Statewide Coordinating Council for Public Health shall report annually to the 
joint standing committee of the Legislature having jurisdictiori over health and human 
services matters arid the Governor's office on progress made toward achieving and 
maintaining accreditation of the state public health system and on districtwide and 
statewide streamlining and other strategies leading to improved efficiencies and 
effectivelless in the delivelY of essential public health services. 
§413. Universal well ness initiative 
The Maine Center for Disease Control and Prevention, the Statewide Coordinating 
Council for Public Health, the district coordinating councils for public health and Healthy 
Maine Pal1nerships shall undel1ake a universal wellness initiative to ensure that all people 
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of the State have access to resources and evidence-based interventions in order to know, 
understand and address health risks and to improve health and prevent disease. 
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pal1icular focus must be on the uninsured and others facing health disparities. 
1. Resource toolkit for the uninsured. The Maine Center for Disease Control and 
Prevention and the Governor's office shall develop a resource toolkit for the uninsured 
with information on access to disease prevention, health care and other methods for 
health improvement. Healthy Mail~e Partnerships, the district coordinating councils for 
public health, the Maine Center for Disease Control and Prevention and the Statewide 
Coordinating CounCil for Public Health shall promote and distribute the toolkit materials, 
in paJ1icular through small businesses, schools, school-based health centers and other 
health centers. Healthy Maine Partnerships, each district coordinating council for public 
health and the Statewide Coordinating Council for Public Health shall report annually to 
the Maine Center for Disease Control and Prevention on strategies employed for 
promotion of the toolkit materials. 
. 2. Health risk assessment. Healthy Maine Partnerships, the district coordinating 
councils for public health, the Statewide Coordinating Council for Public Health and the 
Maine Center for Disease Control and Prevention shall promote an evidence-based health 
risk assessment that is available to all people of the State, with apaJ1icular emphasis on 
outreach to the uninsured popUlation and others facing health disparities .. These health 
risk assessments and their promotion must provide linkages to existing local disease 
prevention eff0l1s and be collaborative with and not duplicative of existing efforts. 
3. Report card on health. The Maine Center for Disease Control and Prevention, in 
consultation with the Statewide Coordinating Council for Public Health, shall develop, 
distribute and publicize an annual brief report card on health status statewide and for each 
district by June 1 st of each year .. The rep0l1 card must include major diseases, evidence-
based health risks and detenninants that impact health. 
The Maine Center for Disease C0I1trol and Prevention and the Governor's Office of 
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Health Policy and Finance shall provide staff supp0\1 to implement the universal wellness 
initiative in this section as resources permit. Other agencies of State Government as 
necessary and appropriate shall provide additional staff support or assistance. 
3. 
Sec. 6. Staggered terms. Notwithstanding the Maine Revised Statutes, Title 22, 
section 412, subsection 5, .paragraph C,of the members first chosen by the membership 
committee of the Statewide Coordinating Council for Public Health, 113 must be chosen 
for a term of one year, IIJ must be chosen for the'term of 2 years and 113 must be chosen 
for a term of 3 years .. 
SUMMARY 
This bill coordinates and streamlines the public health system in this State. 
It 
prepares the state public health system for national federally recognized public health 
accreditation and ensures the effective, efficient and evidence-based delivery of essential 
public health services. 
The bill recognizes ~nd formally establishes Healthy Maine 
Partnerships, district coordinating councils for public health and the Statewide 
Coordinating Council for Public Health. 
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The bill also establishes a universal wellness initiative using the existing resources or" 
the public health infrastructure. The initiative requires the development and distribution 
of a resource toolkit for the uninsured and a health risk assessment for all people of the 
State with a focus on the uninsured and those facing health disparities. It. aho requires 
the Department of Health and Human Services, Maine Center for Disease Control and 
. Prevention to issue an annual repon: card on health for each public health district in the· 
State and for the state health plan to publish the report cards. 
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