Local health officers focus of meeting

DOVER-FOXCROFT – The Maine Center for Disease Control and Prevention, formerly the Bureau of Health, has gone from a small agency that collected and maintained vital records and tracked and controlled infectious diseases to an agency that also regulates drinking water, provides public health nursing and is responsible for inspections of restaurants, tattoo parlors and tanning facilities.

Dr. Dora Mills, CDC director, shared the developments of her department Tuesday with Piscataquis County commissioners. She said much has been done over the years to improve public health by coordinating efforts, streamlining contracts and working to get local health officers, or LHO, trained in the statutes.

Actually it was the local health officer issue that prompted her visit. Tom Iverson Jr., Piscataquis County’s Emergency Management Agency director, expressed his concern to commissioners last month that state law stipulated towns would have a health officer, but offered no provision for the Unorganized Territory. When he questioned state officials, Iverson said he was told the LHO in the closest community would be expected to respond to any health threat or public nuisance in the UT.

Piscataquis County commissioner Tom Lizotte told Mills that what makes Piscataquis County unique is the preponderance of UTs, which creates a “little wrinkle” with the local health officer situation.

“The local health officer requirement is toughest for the really small towns to deal with because most of them are 300 people or less,” Lizotte told Mills. He asked whether the state would be receptive to a regional health officer similar to the animal control officer who covers the county. He suggested there may be a resident with a public health background willing to do the job countywide for a stipend. It’s really difficult for small towns to find people to run for municipal office, let alone a health officer position, Lizotte noted.

Mills said the LHO does not need to be someone with a public health background, but they do have to be trained in the statutes. She said the law allows multiple towns to hire one local health officer. In some areas, the animal control officer or the code enforcement officer is the LHO, Mills said.

That news was hailed by Greenville Town Manager John Simko and Brownville Town Manager Sophia Wilson.

“I really, number one, do support the idea of a county-wide director simply because it’s not Brownville’s job to provide services in the UT, they are not providing resources to us,” Wilson said Tuesday.

Both Simko and Wilson said the communities should have a say in who is hired for the position and they also want to retain the right to hire their own LHO, if desired.

Dover-Foxcroft Selectman Brian Mullis, who previously served as health officer for Dover-Foxcroft, said that while he was on the job, he did not feel that he had a contact person to link him to the resources he needed.

Mills said that issue was addressed by the Public Health Work Group that was convened to develop a more effective and efficient public health system. The former fragmented system dealt with more than 500 contracts that went to a variety of agencies and organizations which made coordination difficult, she said. There also was the need to improve coordination, to work more collaboratively with social services and mental health systems, and to work on public health emergency preparedness and response, according to Mills.

Under the new revision, Mills said there is a statewide coordinating council to advise the CDC-Department of Health and Human Services on public health infrastructure, system assessment, performance and accreditation. Eight district coordination councils will plan and coordinate public health functions that can be more efficiently accomplished at the district level. Those districts are Aroostook; Penquis which represents Piscataquis and Penobscot counties; Downeast which represents Hancock and Washington counties; MidCoast which represents Knox, Waldo, Lincoln, Sagadahoc, Cumberland and York counties; Western representing Androscoggin, Oxford and Franklin counties; and Central representing Kennebec and Somerset counties.

In addition, Mills said there are Maine CDC-DHHS public health units in each district, which include public health nurses, field epidemiologists, health inspectors, drinking water engineers and district health liaisons. Those are followed by Healthy Maine Partnerships, a network of 28 comprehensive community health coalitions and the local health officers.

Lizotte said that maybe the county could make the local health officer position be an adjunct to the EMA office.

“If we had one person who was able to make that contact and build that relationship with your office for this region, I would think we would have a system that better served the common good all around than one health officer, say in Guilford, that may call your office every three years,” Mullis said.

It is expected that county officials will discuss the matter further with towns to gauge their interest in having one LHO for the county.

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