Roughly two dozen school-based student health centers in Maine lost their state funding this week because the state’s recent budget deal required the Department of Health and Human Services to eliminate $5 million in funding for the centers and other programs.

“I don’t know when I’ve been any more upset with a decision that’s been made in state government,” said Calais School District Superintendent Ron Jenkins, whose center lost $46,200 in funding. About 80 percent of middle and high school students in the district are signed up to use the center, which provides medical and dental care, suicide prevention and drug and alcohol prevention services.

Jenkins vowed to find the money to keep it open.

“I am not going to allow it (to close) on my watch,” Jenkins said. “If I have to go door-to-door and beg for money, that health center is going to stay open. But I should not have to do that.”

The direct cuts to the health centers, which provide basic medical care and referrals for students who are unlikely to have other access to a doctor, are the result of the final state budget redirecting $10 million over two years from the Fund for a Healthy Maine to maintain reimbursement rates for primary care physicians under MaineCare, the state’s version of the federal Medicaid program. It wasn’t clear Wednesday how many students and workers will be affected by the cut.

DHHS spokeswoman Samantha Edwards said Wednesday that the department was directed to cut the money for Maine Center for Disease Control and Prevention services from the Fund for a Healthy Maine.

“The department recognizes this legislative directive will require significant changes to some programs, and results in reductions to numerous contracts held by the CDC,” Edwards said.

Using money from the Fund for a Healthy Maine – which is financed by the $50 million in tobacco settlement money Maine receives annually – to help pay for MaineCare decreases the amount the state has to take from the general fund.

In addition to cutting funding for the health centers, Edwards said funding also was reduced for District Coordinating Councils’ administrative services, anti-smoking advertising, evaluation contracts and pharmacy benefits regarding nicotine replacement therapy. She did not say how much money was saved by cutting the funding for the health centers, just that it was part of overall cuts totaling $5 million per year in the budget.

Lawmaker Drew Gattine, the House chair of the Appropriations Committee, said the program cuts are “gut punches,” but were part of a compromise needed to hold off more drastic cuts to health services proposed in Gov. Paul LePage’s initial budget.

“This is a battle we fight all the time. It was a debate about how that money should be used,” said Gattine, D-Westbrook. “These are terrible cuts. They are very painful.

“If you look at it over time, the amount of money that has been moved into the MaineCare program and away from other health purposes has increased significantly. I think we really just have to watch for and try to protect our public health infrastructure. Because it continues to suffer under this administration.”

School officials and health care providers who run the health care centers were notified this week that their three-week-old contracts, which began July 1, were canceled.

Portland has four of the state’s centers, all in the high schools. Lewiston and Auburn have four, located in the middle and high schools. The one in Calais serves more than half the student body. Generally, the centers get some, but not all of their funding, from the DHHS contracts.

In Lewiston and Auburn, the funding cut means the health centers will drop all medical care services and try to salvage just mental health counseling services, said Joan Churchill, chief executive officer of St. Mary’s Hospital’s community clinical services, which runs the centers. They lost a $200,000 contract, which makes up one-third to one-half of the centers’ budgets.

“We have a number of students that, absent these health centers, they would not get health services,” Churchill said.

Sheila Nelson, who coordinates the health centers program for the DHHS, made it clear that the cuts resulted from the budget compromise.

“This was not the outcome that any of us were hoping for, obviously, and I know it’s devastating to the staff and the students they serve,” Nelson wrote in an email to Churchill. “I’m heartbroken that the cuts will affect such a valuable service. Please know (and please let staff know) that this was not in any way a reflection on the quality or importance of their work; this was directly a result of decisions made by the Legislature.”

Portland Superintendent Xavier Botana learned of the cuts Wednesday.

“It clearly is not good news,” said Botana, who was working with Greater Portland Health, which provides the care, to determine the impact on the centers and whether it would mean the loss of services to students.

“We need to partner with the city, with Greater Portland Health, to figure out how do we continue to provide those services,” he said.

Edwards said the department was working with the school-based health center vendors to help them find alternative funding.

“In other states, the Department of Education partners with community health organizations to provide school-based health center services,” she said. Edwards noted that there were no cuts made to substance use prevention, tobacco prevention, obesity prevention, and positive youth engagement programs.

The Fund for a Healthy Maine has been reorganized in recent months. In October, the department canceled existing contracts and discontinued the Healthy Maine Partnerships program to transition to a more centralized approach to health education.

The money is directed to a number of prevention and tobacco cessation efforts, and to other health initiatives.

The fund also was the subject of a 2015 political fight between the LePage administration and public health advocates after the administration proposed diverting $10 million from the fund to other areas of the state health budget. But after an outcry from public health advocates objecting to the cutbacks, the Legislature did not approve LePage’s proposal.

The school-based health center cut will be particularly hard-hitting in rural Calais, said Sen. Joyce Maker, R-Calais.

“It’s more important for us up here,” she said. “We don’t have a lot of doctors up here. That takes care of our students, and it does wonders.”

“I’m really anxious to hear” what will happen to the school-based centers, said Maker, a member of the Legislature’s Education and Cultural Affairs Committee.

Jenkins, the superintendent, agreed, saying he didn’t think the DHHS even tried to find the $5 million in cuts elsewhere.

“Instead of looking at all the programs DHHS offers, they went after the 23 school-based health centers,” he said. “They took essentially all that money away from some of the most vulnerable Maine citizens – the youth – and that really upsets me.”

Plus, the health centers provide a critical service.

“They want us to do everything for kids and one of the most important things is keep them healthy. One thing I know is, if they don’t eat and they’re not healthy, we can’t teach them anything”

Noel K. Gallagher can be reached at 791-6387 or at:

[email protected]

Twitter: noelinmaine

Correction: This story was updated at 8:01 a.m., July 27, 2017, to reflect that Joyce Maker is the Republican state senator representing Calais.

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