Acting Commissioner Ricker Hamilton oversees the largest agency in state government, the Maine Department of Health and Human Services. Credit: Courtesy of DHHS

The law is supposed to mean something.

Apparently, it still doesn’t to the Maine Department of Health and Human Services in the era of Gov. Paul LePage, as two recent examples demonstrate.

Last year, overcoming a LePage veto, lawmakers from both parties passed a bill requiring that DHHS restore the state’s public health nursing program to full staffing. The deadline for that restoration was March 1. But the public health nursing program is still missing at least half its nurses, a director, and a full complement of supervisors.

[DHHS misses legal deadline for restoring public health nurses]

Throughout the LePage administration, the Legislature has continued to fund public health nursing positions, but the administration hasn’t filled them as nurses left a program that DHHS leadership was actively working to dismantle.

As the number of babies born exposed to drugs in utero grew, the number of public health nurses available to follow up with them and their parents after they left the hospital dwindled. Staff in former Commissioner Mary Mayhew’s office made sure that what remained of the public health nursing program functioned as poorly as possible. They prohibited the program’s director from emailing his staff without approval from Mayhew’s staff. They eliminated office space for nurses. As nurses in the Portland and Lewiston areas resigned, nurses were dispatched from Aroostook County to staff clinics in Maine’s two largest cities, where they observed patients with latent tuberculosis taking their medications — a change from the more clinically effective practice of checking in with those patients at home.

More recently, the state deployed a new patient referral system that appears to have been most effective at cutting the number of referrals making their way to nurses and keeping medical providers in the dark about whether their patients are receiving the follow-up care they requested for them.

“We’re all trying to figure out if the system is working, and it’s unclear to me that it is,” Dr. Deborah Hagler, a pediatrician at Mid Coast Hospital in Brunswick, told the BDN.

[Maine has sliced the ranks of nurses who prevent outbreaks, help drug-affected babies]

Health and Human Services Commissioner Ricker Hamilton sent a written update to lawmakers in mid-February detailing his department’s limited progress in restoring the public health nursing program to the level required by last year’s law. The public health nurse job postings have disappeared from the department’s website. There’s simply no indication that Hamilton is still trying to comply with the law, even belatedly. The lack of compliance puts the health of Maine people — particularly newborns, their parents, and those with latent tuberculosis as well as those who come into contact with them — at risk. (Those with latent tuberculosis have a 5 percent to 10 percent chance of developing full-fledged TB.)

Hamilton is also sidestepping the oversight that lawmakers are required to exercise over his department. Under the Government Evaluation Act, legislative committees are routinely required to evaluate the performance of the agencies and programs subject to their oversight.

While the Legislature’s Health and Human Services Committee solicited — and the department provided — an overview of the department’s divisions, its activities and its financials, the LePage administration refused to let the committee ask department personnel follow-up questions in person. It’s just not the same asking questions in writing and receiving oftentimes vague answers in response as it is to engage with a public official in person.

“The Committee finds that the lack of in-person participation by the Department undermined the Committee’s ability to exercise this oversight function,” Republican Sen. Eric Brakey and Democratic Rep. Patricia Hymanson, the committee’s co-chairs, wrote in a letter summarizing their attempt to review DHHS activities.

DHHS, under Commissioner Hamilton’s leadership, is acting as if it’s above the law. It’s not.

At the very least, the department owes the Maine people for whom it works the courtesy of a good-faith effort to comply with the law.