Maine Public Health Association

MPHA Mission

The Maine Public Health Association is dedicated to improving and sustaining the health and well-being

of all Maine residents by advocating for polices and environments that promote public health and health

equity.

Our diverse membership has a commoninterest in protecting and advancing the health of

residents through advocacy, education, research and service.

MPHA is the Voice of Public Health in Maine

Maine Challenges

• 75% of healthcare costs are the result of chronic disease.

• Tobacco and Obesity are the leading causes of preventable death and disease in Maine.

• Tobacco related illness and associated lost productivity cost Maine $1.1 billion annually.

• Maine is the most obese state in New England with 65% of us obesity/overweight.

Maine Challenges

Maine spends approximately $8 billion on healthcare costs each year.

The Fund for a Healthy Maine, Maine’s only source of State funds for prevention, accounts for only .6% of Maine’s total health care expenditure.

Fund for a Healthy Maine:

Creating Opportunity for Greater Health and Lowering Costs for

Everyone

The ChallengeMaine’s Current Health Cost Investment Structure* Investing in Prevention Reduces Overall Health Costs

Greater investment in preventive medicine and education helps to dramatically reduce chronic Greater investment in preventive medicine and education helps to dramatically reduce chronic disease, thus decreasing long-term treatment costs to Maine and its residents.disease, thus decreasing long-term treatment costs to Maine and its residents.

*Charts represent the total funding to each health-related function.

Prevention

Overview of the FHM• The Fund for a Healthy Maine (FHM) was

created by the Maine Legislature in 1999 to receive and disburse Maine’s annual tobacco settlement payments.  Maine participated in the national tobacco settlement because many Maine people have suffered disease and death as a result of tobacco use encouraged by the deceptive practices of the tobacco industry.

• The Fund for a Healthy Maine is not taxpayer dollars.  Because of its special source, the FHM has a special purpose – to prevent disease and promote good health among Maine children and adults. The FHM is meant to “supplement, not supplant” existing dollars!

Overview of FHM (cont.)

• FHM revenue is not part of Maine’s General Fund account.  It originates in the FHM account and only ends up in the General Fund if lawmakers divert it there.  FHM program allocations are made directly from the FHM account and do not pass through the General Fund.

• By statute, allocations from the FHM must be used to supplement, not supplant, appropriations from the General Fund.  It was intended that the FHM be used for new and expanded programs.  The FHM was not intended to be used to balance the state budget or spent on non-health-related programs.  

90% ProgramSpending

10% FHM Trust Fund

-Child Care -Oral Health - School Health Program -Tobacco Prevention, Treatment & Control -Home Visitation

-Substance AbusePrevention & Treatment

-Prescription Drugs for the Elderly

The Vision:New and

Expanded Health Programs

Allocation Since Inception: The Vision

Overview of FHM (cont.)

• Unfortunately, these provisions Unfortunately, these provisions have been ignored in the past and have been ignored in the past and the FHM has lost 27the FHM has lost 27% % of its of its resources ($219.8 million) to the resources ($219.8 million) to the General FundGeneral Fund – a significant missed – a significant missed investment in getting and keeping Maine investment in getting and keeping Maine people healthy.people healthy.

27% Diverted to General Fund and Sick Care

-Child Care -Oral Health

-Home Visitation

-Prescription Drugs -Tobacco Prevention and Treatment

-Substance Abuse Prevention & Treatment

-School Health Program

The Reality:$219.8 million diverted or

approved for diversion through FY 13

73% PreventionSpending

(allocated or reserved)

Allocation Since Inception: The Reality

Overview of FHM (cont.)

• The Maine Legislature decides how FHM dollars are allocated within the eight FHM categories.  FHM allocations and diversions are currently decided as part of the state’s overall budget process. 

• In FY 13 the Legislature eliminated prevention programs in order support the MaineCare program – supplanting general fund dollars with FHM funds.

Purpose of the FHM

FHM funds should not replace General Fund allocations to MaineCare.

WHY?BY LAW: FHM funds must be used to “supplement, not supplant” General Fund

spending.FUNDING PROVIDED: FHM monies already go to fund healthcare initiatives for

children and parents.ORIGINAL INTENT: Founders believed the FHM should be used primarily to

prevent disease, improve health status, and reduce future health costs.FISCAL RESPONSIBILITY: 75% of healthcare costs are the result of chronic

disease, and most chronic disease is preventable.

The best way to get health care costs under control is to PREVENTPREVENT chronic disease, not pay for it after the

fact. 

FHM Impact-Once in a Lifetime Opportunity

The success of FHM The success of FHM programs will directly programs will directly

affect Maine’s ability to affect Maine’s ability to stabilize health costs and stabilize health costs and

their impact on Maine their impact on Maine businesses, individuals, businesses, individuals, and the state budget.and the state budget.

Purpose of the FHM

•Preventing chronic disease•Improving health status•Reducing future health costs

FHM Programs: Budget Allocations by Major Category in FY 2013

Total Allocations: $54,315,709* Smoking Cessation and Prevention Category includes funding for Vaccines and non-tobacco related HMP work. Total actual Tobacco funding is $7.5M in FY 13.

*

FHM Programs: OverviewThe Legislature established eight categories of

allowable health program spending: o      Smoking prevention, cessation and control activities, including,

but not limited to, reducing smoking among the children of the State;  o      Prenatal and young children's care, including home visits and

support for parents of children from birth to 6 years of age;  o      Child care for children up to 15 years of age, including after-school

care;  o      Healthcare for children and adults, maximizing to the extent

possible federal matching funds;  o      Prescription drugs for adults who are elderly or disabled,

maximizing to the extent possible federal matching funds;  o      Dental and oral health care to low-income persons who lack

adequate dental coverage;  o      Substance abuse prevention and treatment; and  o      Comprehensive school health programs, including school-based

health centers. 

FHM Programs: Tobacco

• High school smoking declined by 61% between 1997 and 2011.

• Maine’s Tobacco HelpLine has served over 75,000 Maine residents since its inception in 2001.

• The Healthy Maine Partnerships (HMPs) are engaged in over 800 health initiatives across the state to change local attitudes about tobacco use, and increase physical activity and healthy eating. The HMPs have enlisted 2,300 volunteer coalition members throughout Maine.

Opportunities

• Every $1 taken from FHM prevention programs will add at least $7.50 to Maine’s future health costs. Savings estimates go higher, but one thing is clear: the FHM is an investment in our future health and financial well-being. Every $1 taken from the FHM today will be $1 that is not available to fund prevention programs for our most at-risk citizens that improve oral health, reduce substance abuse, enhance physical activity opportunities, provide child care and home visits to new parents, support family planning, and prevent tobacco use among Maine children. Every one of these efforts will significantly reduce Maine’s health care costs.

• The FHM is a nationally recognized success story. Maine’s use of tobacco settlement dollars and specifically Maine’s tobacco prevention and treatment program continue to draw both national and international recognition for their comprehensive approaches to preventing costly health care.

Opportunities• Maine has made tremendous progress in reducing

tobacco use, but significant challenges remain. 15.2% of Maine youth smoke, health costs from tobacco use still total over $600 million per year, and 2,200 people still die every year from smoking.

• Tobacco companies are anxious for Maine to ease up. Despite being a small state, Maine has made life difficult for the tobacco companies and their allies. They want Maine to make the same mistakes as Massachusetts and Florida, where youth smoking rates skyrocketed when tobacco programs were reduced.

• Tobacco companies oppose cigarette price increases and want you to believe that “we’re all done” when it comes to keeping kids from smoking. Yet they are far from done in promoting their deadly products - spending $59 million every year in Maine to find the “replacement smokers” their internal documents describe.

Opportunities

Protecting the Fund for a Healthy Maine is Maine’s best hope for getting health care costs under control. Support of the Fund for a Healthy Maine means supporting reduction in health care costs, preventing chronic disease and helping Maine people get healthy!

MPHA Needs You

• MPHA has 3 Policy Committees open to all members:• Tobacco• Obesity• Broad Public Health

• We coordinate the Friends of the Fund for a Healthy Maine.

• We need you to be our ears to the ground in your community.

• We need you to become a member of MPHA.www.mainepublichealth.org