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 common
interest 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 Challenge
Maine’s Current Health Cost Investment Structure*
Investing in Prevention Reduces Overall Health Costs
Prevention
Prevention
Pre-Disease
Treatment
PreDisease
Treatment
Care for Disease
Care for
Disease
Prevention
Greater investment in preventive medicine and education helps to dramatically reduce chronic
disease, thus decreasing long-term treatment costs to Maine and its residents.
*Charts represent the total funding to each health-related function.
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-healthrelated programs.
Allocation Since Inception: The Vision
10% FHM
Trust Fund
-Substance
Abuse
Prevention & Treatment
-Child Care
90%
Program
Spending
-Prescription
Drugs for the Elderly
-Oral Health
- School Health Program
-Tobacco Prevention, Treatment & Control
-Home Visitation
The Vision:
New and
Expanded Health
Programs
Overview of FHM (cont.)
• Unfortunately, these provisions have been
ignored in the past and the FHM has lost
27% of its resources ($219.8 million) to the
General Fund – a significant missed investment in
getting and keeping Maine people healthy.
Allocation Since Inception: The Reality
27% Diverted to
General Fund
and Sick Care
73% Prevention
Spending
-Child Care
(allocated or reserved)
-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
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 PREVENT chronic disease, not pay for it after the fact.
FHM Impact-Once in a Lifetime Opportunity
The success of FHM programs
will directly affect Maine’s ability
to stabilize health costs and
their impact on Maine
businesses, individuals, 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
Child Care and
Development
$3,539,418
Prescription Drugs
$10,434,920
Medicaid Initiatives
$18,175,419
Dirigo Health
Program
$1,161,647
Other Health
Initiatives
$2,038,871
Substance Abuse
$3,123,948
* Smoking Cessation/
Transfers to General
Fund
$3,240,445
* 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.
Attorney General
$119,687
Prevention
$12,481,354
Total Allocations: $54,315,709
FHM Programs: Overview
The Legislature established eight categories of
allowable health program spending:
o
o
o
o
o
o
o
o
Smoking prevention, cessation and control activities, including, but not
limited to, reducing smoking among the children of the State;
Prenatal and young children's care, including home visits and support for
parents of children from birth to 6 years of age;
Child care for children up to 15 years of age, including after-school care;
Healthcare for children and adults, maximizing to the extent possible
federal matching funds;
Prescription drugs for adults who are elderly or disabled, maximizing
to the extent possible federal matching funds;
Dental and oral health care to low-income persons who lack adequate
dental coverage;
Substance abuse prevention and treatment; and
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