An Act To Amend the Laws Regarding Public Health Infrastructure
Maine Legislature, Session 125, LD 0121
Committee: Health and Human Services
Sponsors: SOCTOMAH, RAYE, MAKER, MITCHELL, TILTON
Amends: 22 MRSA §411, 22 MRSA §412, 22 MRSA §413

Legislative Document 
No. 121 
H.P. 103 
House of Representatives, January 20, 2011 
An Act To Amend the Laws Regarding Public Health Infrastructure 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative SOCTOMAH of the Passamaquoddy Tribe. 
Cosponsored by President RAYE of Washington and 
Representatives: MAKER of Calais, McFADDEN of Dennysville, MITCHELL of the 
Penobscot Nation, TILTON of Harrington. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §411, as enacted by PL 2009, c. 355, §5, is amended to read: 
§411.  Definitions 
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 or a municipal 
health department by a national federally recognized review board certifying that a public 
health system or a municipal health department 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. 
For the purposes of this subsection, a health clinic or health department operated by an 
Indian tribe is deemed accredited. 
2.  Comprehensive community health coalition.  "Comprehensive community 
health coalition" means a multisector coalition that serves a defined local geographic area 
or an Indian tribe and is composed of designated organizational representatives, 
representatives of the Indian tribe 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 in each district working toward collaborative public health planning and 
coordination to ensure effectiveness and efficiencies in the public health system and in 
each health department or health clinic of an Indian tribe.   
4.  District public health unit.  "District public health unit" means a unit of public 
health staff set up whenever possible in a district in department offices or in the health 
department or health clinic or offices or facilities of an Indian tribe.  A staff must include 
when possible public health nurses, field epidemiologists, drinking water engineers, 
health inspectors and district public health liaisons.  
5.  District.  "District" means one of the 8 districts of the department, 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 Sagadahoc 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; and York District, composed of York County, or a district consisting of a health 
department or health clinic of an Indian tribe as determined by the Indian tribe. 
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 of public health systems or municipal health departments and the core 
public health functions as defined by a health department or health clinic of an Indian 
tribe. 
7.  Health risk assessment.  "Health risk assessment" means a customized process 
by which an individual confidentially responds to questions and receives a feedback 
report to help that individual understand the individual's personal risks of developing 
preventable health problems, know what preventive actions the individual can take and 
learn what local and state resources are available to help the individual take these actions. 
8.  Healthy Maine Partnerships.  "Healthy Maine Partnerships" means a statewide 
system of comprehensive community health coalitions that meet the standards for 
department funding that is established under section 412.  
8-A.  Indian tribe.  "Indian tribe" means a federally recognized Indian nation, tribe 
or band in the State. 
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 department in rule to comply with section 451 or an 
employee of a health department or health clinic of an Indian tribe. 
10.  Municipal health department.  "Municipal health department" means a health 
department or division that is established pursuant to municipal charter or ordinance in 
accordance with Title 30-A, chapter 141 and accredited by a national federally 
recognized credentialing process or a health department or health clinic of an Indian tribe. 
11.  Statewide Coordinating Council for Public Health.   "Statewide Coordinating 
Council for Public Health" means the council established under Title 5, section 12004-G, 
subsection 14-G. 
Sec. 2.  22 MRSA §412, as enacted by PL 2009, c. 355, §5, is amended to read: 
§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 and every 
health department or health clinic of an Indian tribe.  Duties of local health officers, 
except for the duties of a local health officer working in a health department or health 
clinic of an Indian tribe, are set out in section 454-A. 
2.  Healthy Maine Partnerships.  Healthy Maine Partnerships is established to 
provide appropriate essential public health services at the local level, including 
coordinated community-based public health promotion, active community engagement in 
local, 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 Partnerships must include interested community members; leaders of 
formal and informal civic groups; leaders of youth, parent and older adult groups; leaders 
of hospitals, health centers, mental health and substance abuse providers; emergency 
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 
networks, coalitions and associations; business leaders; leaders of faith-based groups; 
leaders and members of Indian tribes; representatives of health departments or health 
clinics of Indian tribes; and law enforcement 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 Maine 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 
(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. 
B.  The Maine Center for Disease Control and Prevention, in consultation with 
Healthy Maine Partnerships, 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, county governments, 
municipal governments, tribal the governments of Indian tribes and their health 
departments and health clinics, 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. 
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, 
except that approval of the Statewide Coordinating Council for Public Health is not 
required for the membership and governance structures of a district coordinating council 
for public health of an Indian tribe. 
5.  Municipal health departments.  Municipal health departments may enter into 
data-sharing agreements with the department for the exchange of public health data 
determined by the department to be necessary for protection of the public health.  A data-
sharing agreement under this subsection must protect the confidentiality and security of 
individually identifiable health information as required by state and federal law. A health 
department or health clinic of an Indian tribe may enter into data-sharing agreements with 
the department as provided in this subsection as determined by the health department or 
health clinic and the department. 
6.  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 
(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 or assistance to the Statewide 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. 
(2)  The Director of the Maine Center for Disease Control and Prevention or the 
director's designee shall serve as a member and shall appoint a health expert with 
experience in health issues of members of Indian tribes. 
(3)  The commissioner shall appoint an expert in behavioral health from the 
department to serve as a member. 
(4)  The Commissioner of Education shall appoint a health expert from the 
Department of Education to serve as a member. 
(5)  The Commissioner of Environmental Protection shall appoint an 
environmental health expert from the Department of Environmental Protection to 
serve as a member. 
(6)  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 of the essential public health services, has representation 
from populations in the State facing health disparities and has at least 2 members 
from the Advisory Council on Health Systems Development under Title 2, 
section 104.  The membership committee shall also strive to ensure diverse 
representation on the Statewide Coordinating Council for Public Health from 
county governments, municipal governments, tribal the governments of Indian 
tribes and their health departments and health clinics, 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. 
C.  The term of office of each member is 3 years.  All vacancies must be filled for the 
balance of the unexpired term in the same manner as the original appointment. 
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 resources permit and shall develop a 
governance structure, including determining criteria for what constitutes a member in 
good standing. 
F.  The Statewide Coordinating Council for Public Health shall report annually 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.  In years when a new state health plan is being developed, the Statewide 
Coordinating Council for Public Health shall provide input from its own members 
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 jurisdiction over health and human 
services matters and 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 
effectiveness in the delivery of essential public health services. 
Sec. 3.  22 MRSA §413, as enacted by PL 2009, c. 355, §5, is amended to read: 
§413.  Universal wellness 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 Partnerships shall undertake a universal wellness initiative to ensure that all people 
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.  A 
particular 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 Maine 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 particular through small businesses, schools, school-based health centers, health 
departments and health clinics of the Indian tribes 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 a particular emphasis on 
outreach to the uninsured population, members of Indian tribes and others facing health 
disparities.  These health risk assessments and their promotion must provide linkages to 
existing local disease prevention efforts 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 1st of each year.  The report card must include major diseases, evidence-
based health risks and determinants that impact health. 
The Maine Center for Disease Control and Prevention and the Governor's Office of 
Health Policy and Finance shall provide staff support 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. 
SUMMARY 
This bill extends to the federally recognized Indian nation, tribe and bands in the 
State and to their health departments and health clinics the laws on comprehensive 
community health coalitions, district coordinating councils for public health, district 
public health units, Healthy Maine Partnerships, the universal wellness initiative and 
health risk assessment.