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MEMA Home > Programs> Communication> News > Partnership for Public Health in Sagadahoc County

Partnership for Public Health in Sagadahoc County


April 24, 2008


Emergency preparedness requires health preparedness. No Maine county knows that better than Sagadahoc, which has the only county-based Board of Health in the state. “Across the nation Boards of Health advise elected officials,” said County Emergency Management Director Misty Green. “In our case, they advise our county commissioners and allow us to do great things.”

What started in 2001 as a small think tank developed into a pilot project in 2005 called the Sagadahoc County Health Improvement Project, or SCHIP. “It was basically a virtual county public health department,” Green said. “It was created to promote public health – it reached to each corner of the county and even into neighboring jurisdictions,” she said.

In 2005, SHIP was renamed the Sagadahoc County Board of Health and its members were officially sworn in creating the first and only such organization in the state.

Sagadahoc’s progress in public health was inspired by Dr. Hugh Tilson. A practicing epidemiologist whose career in public health spans 35 years, Tilson retired to Maine in 1991 after serving as North Carolina’s Commissioner of Public Health.

After Tilson and his wife moved to Maine, he approached the County Commissioners to volunteer to work in their county-based public health organization. “I assumed there was one,” he said, “and of course learned that there was not,” he said.

Tilson talked with the Commissioners about why other states have turned to the counties to take on the role of public health. “Most public health systems around the nation are either county-based, or at least rely heavily on counties to provide local focus for state decentralized programs,” he said. His argument was successful. “The Chair of the Commission immediately understood, supported and acted.”

Tilson believes that a county health structure has three fundamental bases. “Local public health is important,” he said. “An effort in any public arena which is solely state based and Augusta centered will not work because people need services locally.”

He also believes it requires government efficiency. In Maine, the public health infrastructure has devolved to each of the 486 municipalities. “It is too many,” Tilson said, “because public health requires concerted effort and you cannot muster the necessary skills and energies in 486 individual enterprises. You simply can’t.”

Lastly, he says that public health requires governance. “There is a national consensus that protecting the public health requires a political jurisdiction. We selected counties as a place for that. After all, to enforce health laws today, certainly in Maine, we need the courts and the Sheriff, which are both county based. It made sense to turn to the counties for leadership in this area.” The structure for such a county organization was already in place. “The keystone of the arch was the decision to base emergency management at the county level,” he said. “Others recognized exactly the same truths about emergency management that I was talking about for public health.”

A fundamental role of the Sagadahoc Board of Health is to train and organize local health officers -- individuals required by state law. “We have identified them, convened them and have put together a council of local health officers who become our working cadre on the street,” Tilson said. “They are in every town, they have to make a report to every annual town meeting, and they need to be trained.”

That training is multifaceted.

“We have trained them in the risk of lead in paint chips and dust that cause babies to develop lead poisoning and brain damage,” Tilson said. To address this, local health officers have developed lead paint awareness materials and even created a lead paint familiarization certification program for county contractors.

A second effort of the Board of Health is maintaining healthy beaches. “Maine is nothing if not a maritime state,” Tilson said, “and we have loads of beaches.” He says understanding whether or not a beach is swim safe is not always obvious. “You cannot always smell or see the hazard, so we trained our health officers to test the waters,” he said. “If a beach is hazardous, knowing what it would take to close it is a very complicated public health challenge, so we’ve trained our local officers in that also.”

The Board has also built a strategic alliance with the Healthy Maine Partnerships program called ‘Access Health.’ “They have money to provide smoking cessation programs and more recently substance abuse and obesity education and prevention, so we’ve taken that on as a major priority for the county,” Tilson said.

The most visible current project of the Board of Health is to begin collecting unwanted, outdated and unused medications. “We want to keep medications out of the environment where they can cause harm, and out of the hands of children and even animals,” Green said. “We collect this medicine, to give the citizens a safe way to dispose of it – the program grows each time we do it and we have been able to have two medicine collection events a year.”

For Green and her emergency management operation, the Board of Health has been a great asset as they prepare their communities for potential crisis. “Pandemic flu awareness has been huge for us,” Green said. “All of our towns have an action plan in place now, and the Local EMA Directors went door to door with a pocket guide that the commissioners funded for the County-wide preparedness effort. Law enforcement agencies have signed mutual agreements to work countywide in the event that it hits, and we’ve stockpiled supplies and food so that we can function for a long period of time,” she said. “Those are our biggest accomplishments.”

“The Board of Health was a new concept when I came to Sagadahoc,” Green said. “It really creates that critical relationship between my office and our local health officers, allowing us all to work on public health issues,” she said. “It’s a relationship that isn’t really present in most counties.”

For more information on Sagadahoc County’s Board of Health, contact Misty Green at (207) 443-8210.

—Derek Mitchell



Sagadahoc County EMA


Last update: 07/20/10