SOUTH PORTLAND — Do you know how many local health departments are in Maine? Two. Just two. One in Portland and one in Bangor. Two health departments for a state of 1.3 million residents, across a geographic span of 35,385 square miles.

Just last year, the state dismantled 27 health coalitions that served every community in Maine and ensured local oversight and coordination of public health efforts. Not surprisingly, the termination of those coalitions dramatically cut Mainers’ access to public health resources. Mainers’ lifeline to these critical services then became solely through nine District Coordinating Councils, one in each of Maine’s public health districts. Each council is staffed by just one person. Although volunteers assist the lone staff member, many do not have training in public health.

During the most recent legislative session, the attack on Maine’s public health system continued: This time, when legislators approved a $10 million funding cut. These funds are not from taxpayers – they come from an annual payment Maine receives from the tobacco industry to reduce the state’s burden of chronic illness (incidentally, this funding is also what supported the 27 health coalitions).

This $10 million cut meant that district coordinators lost their jobs. It means that school-based health centers will close. It also means the state is more vulnerable to emerging public health threats, including infectious disease outbreaks, which is particularly concerning at a time when more parents are opting out of vaccinations for their children. While legislators voted to keep 48 public health nursing positions in the budget (passed to be enacted), they also voted to eliminate more than 100 positions from the Maine Department of Health and Human Services.

To make all of this even worse, the $10 million cut wasn’t even needed to balance the budget. Just in the month of June, General Fund revenue, and individual income tax and corporate income tax, were over budget by $72.7 million.

The $10 million cut from Maine’s public health system was, in theory, redirected to fund direct care worker wages. Ensuring adequate living wages is a public health priority; however, these wage increases occurred at the expense of full-time jobs of other Mainers serving in our most underserved areas. What’s more, there were sufficient funds available to pay for both. The budget negotiation was a short-term solution to a now very long-term problem.

Last week, about two weeks after this budget was passed, I sat in on meetings of the Joint Standing Committee on Marijuana Legalization. Legislators were reviewing a list of policy recommendations from substance-use prevention experts. Despite having recently voted to cut public health programs and funding, legislators were under the impression that the state was already investing in local efforts to enforce public health laws, collect and track data and implement other critical components of responsible drug policy.

Legislators made frequent comparisons to Colorado. For a point of reference, Colorado has a state Board of Health, a state Public Health Department and 18 local public health agencies, and they put their annual payment from the tobacco industry into an escrow account.

Maine does not have a state Board of Health. Maine’s state Health and Human Services Department has forfeited nearly $2 billion in federal funds since 2011 for public health initiatives (e.g., child care and opioid treatment). Maine has only two local health departments. And our payment from the tobacco master settlement continues to be gutted for uses other than those outlined in statute. In addition, unlike Colorado, Maine has not expanded Medicaid under the Affordable Care Act, leaving our most vulnerable citizens with even fewer resources.

Colorado is an excellent example of how to organize a responsible and responsive public health system that makes sure that all residents have the opportunity to lead a healthful life; the Joint Standing Committee on Marijuana Legalization is right to look to them. However, Maine’s public health system is nowhere close to Colorado’s. With this latest reduction in funding, policymakers have completely dismantled the state’s public health infrastructure, jeopardizing the health of all Mainers, particularly those who are most vulnerable.

There is currently no system in place to assure local oversight, coordination or assessment, which is a serious problem, particularly if Maine were to be faced with an infectious disease outbreak or other public health emergency. We need to restore funding for Maine’s public health infrastructure and rebuild a system that protects and promotes the health of all Maine people, regardless of where they live.