Keeping people healthy is better than treating them after they get sick. That’s why investment in public health is always worthwhile.

For the last 15 years, Healthy Maine Partnerships has been doing just that, using money from the landmark settlement with the tobacco industry to help people quit smoking, lose weight or avoid substance abuse.

That will end abruptly Friday, when the 27 regional agencies that have been delivering these services will see their contracts come to an end, and will be replaced by five statewide agencies.

In time, that may prove to be a better way to deliver these services, but recent history gives us reason to be concerned. The LePage administration has been cool to public health spending in general, and even hostile to Healthy Maine Partnerships, once trying to divert $10 million from the program for other uses before the proposal was overruled by the Legislature.

And characteristically, the administration is providing few answers to important questions on how the programs will work. Already there have been layoffs by public health agencies and concerns that there will be interruptions in service. Under Gov. Paul LePage and state Health and Human Services Commissioner Mary Mayhew, key public health jobs have remained unfilled, while preventable diseases are claiming lives.

The state’s plan is to award the funds distributed in these contracts to five statewide agencies that will fund programs in specific areas. For instance, MaineHealth has a $2.3 million contract for tobacco prevention, while the University of New England has a $2.5 million grant to fight substance abuse.

UNE, MaineHealth and the other agencies that have the new state contracts will subcontract with local programs: in some cases, the very programs that have been directly working with the state for years. Instead of simplifying the system, this change appears to be adding an intermediary layer of complexity between the funding source and the people being served.

Mayhew says the change is needed to facilitate data collection and program evaluation, which is a worthwhile goal. But she could make the transition much smoother if she would be more transparent about how the programs will work as the state shifts between systems.

Maine cannot afford to fall back in this area. The state is first in New England in obesity and smoking rates, the lifestyle factors that can lead to debilitating disease and premature death.

Community health education is a good investment that helps people live better lives and avoid expensive treatment. State officials should clearly explain how the new system will be better than the one that has been in place for the last 15 years.


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