Capitol Notebook: Maine DHHS a no-show for tobacco-fund hearings

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Lawmakers reviewing the Fund for a Healthy Maine have been frustrated that staffers from the Department of Health and Human Services have refused to appear before their committee.

Rep. Roberta Beavers, a South Berwick Democrat, was among those annoyed that DHHS staffers are not willing to discuss the fund with the Health and Human Services committee, which is holding hearings on the issue.

“The fact that DHHS is not at this meeting is unconscionable,” the three-term representative said at last week’s meeting, urging a stronger response from lawmakers.

The Fund for a Healthy Maine is a large account that holds the funds that the state receives in perpetuity from a 1998 settlement with the Philip Morris Co. Right now, that money is $56 million per year that was originally intended for tobacco cessation and other health-promotion efforts.

Committee members learned earlier this fall that providers who receive money from the fund have not produced required reports, as required by law. In a series of meetings to investigate the issue, the committee has been thwarted by possibly inaccurate information, and an inability to check this information and ask questions of DHHS staffers.

After the issue of fund reports was first raised, DHHS Commissioner Mary Mayhew took sharp exception to testifying before the committee.

“State government needs fewer studies and meetings and more action by lawmakers in eliminating wasteful spending and reprioritizing resources,” Mayhew wrote in a statement quoted in The Portland Press Herald.

At last week’s meeting, several providers cited flaws in the information provided by DHHS. Among them was Hilary Schneider, a lobbyist for the American Cancer Society.

“I share your frustration,” she told the committee. “In these three separate documents, some of these numbers should match and they don’t.” Schneider said her group had also run into problems getting information from the department, and had been required to file formal requests under the Freedom of Access Act.

But there was nobody from the department to sort out these questions for lawmakers.

Schneider said that her organization, and several other major health provider groups, including the Maine Medical Association and the Maine Osteopathic Association, withdrew from a process to write the state’s Health Improvement Plan after disagreements with DHHS.

“We are calling that plan into question,” said Schneider, adding that the final state plan did not rely on the evidence-based strategies that her group advocated.

For many years, going back to the administration of now-Sen. Angus King, the Fund for Healthy Maine has been raided to plug gaps in the state’s Medicaid, or MaineCare, budget. About half of the fund now goes towards MaineCare. The LePage administration argues that tobacco cessation efforts should take place in a primary-care setting, and seeks to use the funds to support reimbursement rates for doctors who serve MaineCare patients.

Some committee members want more of the funds to fight the state’s heroin epidemic. Rep. Richard Malaby said he would like to see the money go towards residential addiction treatment programs for pregnant women and women with children. In an interview after the meeting, Malaby said there is a huge need for residential treatment in Maine, since many addicts are sent out of state for treatment.

The Republican from Hancock also said that it was vital to measure the effectiveness of any new programs, which has not always been done successfully. About 5.5 percent of the fund now goes to substance abuse prevention.

Without information from the department on the programs that already get money from the fund, it has been difficult for lawmakers to judge their effectiveness.

Many questions were swirling at the close of last week’s meeting. Some had to do with how to establish a proper reporting mechanism for the fund and the proper role of the Legislature in its oversight. In their one remaining meeting, it’s not clear if they will approach the question of possibly using more of the fund for the desperate problem of addiction.

Portland resident Marian McCue is the former editor and publisher of The Forecaster.