Bill Summary – FastDemocracy

130th MAINE LEGISLATURE
                    FIRST SPECIAL SESSION-2021
Legislative Document                                                                            No. 1693
H.P. 1258                                                          House of Representatives, May 10, 2021
            An Act To Advance Health Equity, Improve the Well-being of All
            Maine People and Create a Health Trust
   Received by the Clerk of the House on May 6, 2021. Referred to the Committee on Health
and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint Rule

                                                                                     ROBERT B. HUNT
                                                                                                Clerk
Presented by Representative TALBOT ROSS of Portland.
Cosponsored by Senator VITELLI of Sagadahoc and
Representatives: EVANS of Dover-Foxcroft, MEYER of Eliot, MILLETT of Cape Elizabeth,
NEWELL of the Passamaquoddy Tribe, PERRY of Calais, Senators: CHIPMAN of
Cumberland, HICKMAN of Kennebec.
                                       Printed on recycled paper
 Be it enacted by the People of the State of Maine as follows:
                                            PART A
     Sec. A-1. 5 MRSA §12004-G, sub-§14-J is enacted to read:
     14-J.
  Health        Trust for a Healthy Maine Board               Expenses Only         22 MRSA
                                                                                       §1515
75
     Sec. A-2. 22 MRSA c. 260-A, sub-c. 1 is enacted by adding before section 1511
 the following to read:
                                     SUBCHAPTER 1
                            FUND FOR A HEALTHY MAINE
     Sec. A-3. 22 MRSA §1511, sub-§2, as enacted by PL 1999, c. 401, Pt. V, §1, is
 amended to read:
     2. Sources of fund. The State Controller shall credit to the fund:
     A. All If the Trust for a Healthy Maine established in section 1515 is repealed or
     dissolved, all money received by the State in settlement of or in relation to the lawsuit
     State of Maine v. Philip Morris, et al., Kennebec County Superior Court, Docket No.
     CV-97-134;
     B. Money from any other source, whether public or private, designated for deposit into
     or credited to the fund; and
     C. Interest earned or other investment income on balances in the fund.; and
     D. If the Trust for a Healthy Maine established in section 1515 is repealed or dissolved,
     all money transferred from the trust to the fund.
     Sec. A-4. 22 MRSA c. 260-A, sub-c. 2 is enacted to read:
                                     SUBCHAPTER 2
                          TRUST FOR A HEALTHY MAINE ACT
 §1513. Short title
     This subchapter may be known and cited as "the Trust for a Healthy Maine Act."
 §1514. Definitions
    As used in this subchapter, unless the context otherwise indicates, the following terms
 have the following meanings.
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     1. Administrative costs. "Administrative costs" means staffing, overhead and related
 operational costs, including costs for a coordinator, professional assistance and bond
 premiums, incurred by the trust in carrying out its duties under this subchapter.
      2. Board. "Board" means the Trust for a Healthy Maine Board established under Title
 5, section 12004-G, subsection 14-J.
     3. Community health worker. "Community health worker" means a person who
 provides outreach and public health services to a social group using the person's
 understanding of the experiences, socioeconomic needs, language or culture of that social
 group.
     4. Community resilience. "Community resilience" means the capacity of individuals,
 communities, institutions, businesses and systems within a community to survive, adapt
 and grow no matter what kinds of chronic stresses and acute shocks they experience.
    5. Coordinator. "Coordinator" means the coordinator of the Trust for a Healthy
 Maine under section 1519, subsection 2.
      6. Designated agent. "Designated agent" means an entity with which the department
 has entered an agency relationship for the purpose of applying for federal funds to support
 public health research and programming and that is authorized by the Federal Government
 to receive those funds.
      7. Disbursement. "Disbursement" means a decision of the trust governing how
 settlement funds are to be distributed by the trust for the purposes set forth in this
 subchapter.
     8. Health equity. "Health equity" means the attainment of the highest level of health
 for any social group in this State, regardless of whether a social group is subject to a
 structural inequity.
     9. Medical care. "Medical care" means direct health care, including but not limited
 to care provided under the MaineCare program and the prescription drug program
 established under section 254-D. "Medical care" does not include treatments provided
 under the Tobacco Prevention and Control Program established in section 272 or the
 delivery of preventive health screenings or services in a school setting.
     10. Settlement funds. "Settlement funds" means any money received by the State or
 any component of the State in settlement of or in relation to the lawsuit State of Maine v.
 Philip Morris, et al., Kennebec County Superior Court, Docket No. CV-97-134.
     11. Social determinants of health. "Social determinants of health" means the
 conditions in which people are born, grow, live, work and age, as well as the social
 structures and economic systems that shape these conditions, including the social
 environment, physical environment and health services.
     12. Social group. "Social group" means a group of people in this State that share
 similar social, economic, demographic, geographic or other characteristics, including, but
 not limited to, race, ethnicity, gender, gender identity, sexual orientation, class, zip code,
 age or disability.
    13. State health plan. "State health plan" means the most recent plan for improving
 public health and health equity prepared by the Department of Health and Human Services,
 Maine Center for Disease Control and Prevention for accreditation by a nonprofit public
                                         Page 2 - 130LR1927(01)
44
 health accreditation board dedicated to advancing the continuous quality improvement of
45
 tribal, state, local and territorial health departments or any successor plan identified by the
46
 Maine Center for Disease Control and Prevention.
     14. Structural inequity. "Structural inequity" means the systemic disadvantage of one
 social group in the State compared to other social groups in the State as a result of law,
 policy, culture or other social structure, including, but not limited to, poverty,
 discrimination, powerlessness or access to job opportunities, quality education, housing or
 health care.
      15. Systemic racism. "Systemic racism" means the laws and institutionalized policies,
 practices or social structures that maintain and perpetuate domination by and advantages
 for the race that is socially constructed as being white to the detriment of or with the purpose
 of imposing influence or control over any other race that is socially constructed to be non-
 white, including through color-blind discourse or derogatory and inaccurate stereotypes.
     16. Trust. "Trust" means the Trust for a Healthy Maine established in section 1515,
 subsection 1.
     17. Trustee. "Trustee" means a member of the board.
     18. Trust fund. "Trust fund" means the Trust for a Healthy Maine Trust Fund
 established in section 1520-E, subsection 1.
 §1515. Trust for a Healthy Maine; Trust for a Healthy Maine Board
      1. Establishment; purposes. The Trust for a Healthy Maine is established for the
 purposes of receiving all settlement funds and other funds, redistributing that money to
 state agencies or designated agents of the State to fund tobacco use prevention and control
 at levels recommended by the United States Department of Health and Human Services,
 Centers for Disease Control and Prevention and to ensure adequate resources for other
 disease prevention efforts and promoting public health. The purposes of the trust also
 include supporting state agencies in planning and delivering public health and prevention
 programs and services, supporting accreditation of the Department of Health and Human
 Services, Maine Center for Disease Control and Prevention and supporting public health
 workforce development. The trust also provides public health expertise and evidence-based
 information to the Legislature.
     2. Governance; board. The trust is created as a body corporate and politic and a
 public instrumentality of the State and is governed by the Trust for a Healthy Maine Board
 in accordance with this subchapter.
     3. Trustees; appointment. The board consists of 15 trustees in accordance with this
 subsection. A person who stands to benefit from the tobacco products, as defined in section
 1551, subsection 3, alcohol or marijuana industry is not eligible to serve as a trustee.
     A. The Director of the Maine Center for Disease Control and Prevention within the
     Department of Health and Human Services or the director's designee serves as an ex
     officio voting trustee.
     B. The Governor shall appoint 3 trustees in accordance with this paragraph:
         (1) A person who has clinical expertise or public health expertise, or both, in the
         science and prevention of addiction as a brain disease, selected from
         recommendations provided by a statewide organization dedicated to supporting
                                          Page 3 - 130LR1927(01)
44
    physicians, advancing the quality of medicine and promoting the health of citizens
45
    in the State;
    (2) A person who is an employer with experience recruiting and retaining a healthy
    workforce; and
    (3) A person who has experience as a member of an advisory board of a local
    community health coalition, selected from recommendations provided by a
    statewide network of community coalitions working to enhance physical, social,
    emotional, environmental and economic health in the State.
 C. The Governor shall appoint trustees from nominations made in accordance with this
 paragraph within 30 days of receiving the nominations.
    (1) The President of the Senate shall, for each of the following 3 qualifications,
    submit to the Governor within 30 days of a vacancy 3 names for consideration:
        (a) A person who has expertise in epidemiology and infectious disease or in
        hospital-based prevention, screening and early prevention of infectious
        disease, selected from recommendations provided by the integrated health care
        delivery systems in the State and by a statewide hospital organization that
        provides advocacy, information and education in its mission to improve the
        health of patients and communities;
        (b) A person who has clinical expertise or public health expertise, or both, in
        rural primary care, selected from recommendations provided by a statewide
        organization that represents community health centers in the State; and
        (c) A person who has expertise in systemic racism and structural inequity and
        is serving on the Permanent Commission on the Status of Racial, Indigenous
        and Maine Tribal Populations, in accordance with Title 5, section 25002.
    (2) The Speaker of the House of Representatives shall, for each of the following 2
    qualifications, submit to the Governor within 30 days of a vacancy 3 names for
    consideration:
        (a) A person who has expertise in public health policy related to the leading
        causes of chronic disease, selected from recommendations provided by a
        statewide, nonprofit membership organization that promotes a healthy State
        through advocacy, education, community connection and coalition-building;
        and
        (b) A person who has expertise in preventing the use of tobacco products and
        other addictive substances by youth and young adults.
    (3) The member of the Senate who is the leader of the party with the 2nd-largest
    number of members in the Senate shall, for each of the following 2 qualifications,
    submit to the Governor within 30 days of a vacancy 3 names for consideration:
        (a) A person who has expertise in trauma, community resilience and social
        determinants of health, selected from recommendations provided by a
        statewide network dedicated to building community strengths and reducing the
        effects of trauma; and
                                  Page 4 - 130LR1927(01)
             (b) A person who represents a statewide association of public health
             professionals.
         (4) The member of the House of Representatives who is the leader of the party
         with the 2nd-largest number of members in the House shall, for each of the
         following 2 qualifications, submit to the Governor within 30 days of a vacancy 3
         names for consideration:
             (a) A person who is employed as a member of the senior staff or faculty in a
             public health academic program; and
             (b) A person who has expertise in maternal and child health issues, including
             early childhood education and out-of-school child care, or school-based health.
         (5) The chiefs of the 4 federally recognized Indian tribes in the State shall, for each
         of the following 2 qualifications, submit to the Governor within 30 days of a
         vacancy 3 names for consideration:
             (a) A person who has expertise in environmental health; and
             (b) A person who has expertise in health equity or health disparity issues.
 The trustees appointed pursuant to paragraphs B and C must be reviewed by the joint
 standing committee of the Legislature having jurisdiction over public health matters and
 approved by the Senate.
     4. Terms; vacancies. Trustees serve 3-year terms. Trustees may serve no more than
 3 consecutive terms. A trustee shall serve on the board until a replacement is appointed and
 qualified. If a trustee is unable to complete a term, the Governor shall consult with the
 board and appoint a replacement for the remainder of the unexpired term. The replacement
 trustee must hold the same qualifications, set forth in subsection 3, as those of the departing
 trustee.
     5. Chair; officers. The board shall elect a chair, a vice-chair, a secretary and a
 treasurer from among the trustees. Each officer serves a one-year term in that office and is
 eligible for reelection.
     6. Meetings; quorum. The board shall meet at least 4 times each year at regular
 intervals and may meet at other times at the call of the chair or the Governor. A majority
 of the trustees constitutes a quorum. Meetings of the board are public proceedings as
 provided by Title 1, chapter 13, subchapter 1. Notwithstanding any provision of law to the
 contrary, a trustee who is not physically present may participate by telephone or other
 remote access technology in accordance with procedures established by the board.
      7. Election of subcommittees. The board may elect an executive committee of not
 fewer than 5 trustees who, between meetings of the board, may transact such business of
 the trust as the board authorizes. The board may also elect a planning committee.
    8. Liaison to Legislature. The chair is the trust's liaison to the joint standing
 committee of the Legislature having jurisdiction over public health matters.
     9. Advisory groups. The board may establish advisory groups as needed to gather
 technical knowledge on any aspect of public health policy, infrastructure or funding
 disbursement and to make recommendations to the board. Advisory groups may include
 persons who are not trustees.
                                         Page 5 - 130LR1927(01)
     10. Removal of trustee for disciplinary reasons. The board shall develop the process
 of removal and replacement of trustees for disciplinary reasons.
     11. Expenses; reimbursement. Trustees are not entitled to compensation for service
 on the board, except that, in accordance with Title 5, section 12004-G, subsection 14-J, the
 trust may reimburse travel and other board-related expenses.
      12. Fiduciary duties. A trustee has a fiduciary duty to the people of the State in the
 administration of the trust. Upon accepting appointment as a trustee, each trustee shall
 acknowledge the fiduciary duty to use the trust fund only for the purposes set forth in this
 subchapter. It is the duty of each trustee to ensure that the purposes of the trust set forth in
 this subchapter are fulfilled.
     13. Conflict of interest. A trustee is deemed to be an executive employee for purposes
 of Title 5, sections 18, 18-A and 19. In the operation or dissolution of the trust, a trustee,
 employee of the trust, officer of the trust or a spouse or dependent child of any of those
 individuals may not receive any direct personal benefit from the activities of the trust,
 except that the trust may pay reasonable compensation for services rendered and otherwise
 hold, manage and dispose of the trust's property in furtherance of the purposes of the trust.
 This subsection does not prohibit corporations or other entities with which a trustee is
 associated by reason of ownership or employment