It wasn’t unusual for the thermostat in Monica Browne’s Belfast nursing home to read in the mid-80s during the hot, sticky summer of 2022. Residents would sit in the common areas or lay in their beds, sweating and uncomfortable, but unable to do anything to escape the heat.
Jessica Browne was able to install a window air conditioning unit in her mother's bedroom, but other residents, including many who couldn't speak, were not so lucky, she said. Browne recalled one resident begging a nurse for relief.
“With climate change upon us, it is getting to a point, even here in Maine, where keeping cool in the summer is just as critical as keeping warm in the winter,” she said. “It is becoming a necessity, not a luxury, especially for the vulnerable.”
Last summer was Maine's hottest on record.
And data from the Maine Climate Council show the state is getting hotter: we're 3.5 degrees above the historical average already, with projections that it will be up to 10 degrees higher by the end of the century, depending on how successful the world is at reducing heat-trapping gas emissions from the burning of fossil fuels.
The hottest day of the year for the Portland area has historically been around 95 degrees, according to One Climate Future, the 2019 Portland-South Portland climate action plan. That annual high temperature is projected to climb as high as 108 by the end of the century if global emissions are not curbed.
Residents of cold-weather states like Maine feel the health effects of heat at much lower temperatures than those in hotter states, a 2015 Harvard University study found, yet most do not believe local heat waves to be that dangerous, according to a 2019 study from Yale University and University of Utah.
Maine's demographics and infrastructure make it especially vulnerable. Nearly a quarter of the population is 65 or older and the housing stock is among the oldest in the nation. And although the increasing use of heat pumps is helping, the number of Mainers with some form of cooling in their homes continues to lag behind the rest of New England — 78% compared to almost 90%.
While Maine has taken some steps to address the growing issue, including funding new cooling centers and passing a law to prevent utilities from cutting off power during heat waves, lawmakers have passed up opportunities to set temperature limits for nursing homes and workplaces.
So far this year, 294 Mainers have gone to the hospital to seek heat-related treatment, according to Maine Center for Disease Control and Prevention's public health tracker. The largest number of those, 46, occurred on June 24, the hottest day Maine has recorded so far this year.
Across the country, the number of heat-related deaths have been on the rise, more than doubling from 1999, when there were 1,069 deaths, to 2023, when there were 2,325, according to a study published last year by the Journal of the American Medical Association.
On paper, fewer than one Mainer a year dies from the heat on average, according to the Maine CDC. But environmental epidemiologist Rebecca Lincoln thinks that statistic is misleading because a doctor treating a heart attack, stroke or fall caused by heat may not attribute it to heat exposure.
Maine CDC data suggests people who are homeless, have low incomes or are sick also face higher health risks when it is unusually hot. So do renters, athletes, pregnant people and people on a wide range of medications, according to the data.
During a heat wave in July, Portland outreach workers passed out water and popsicles to homeless people pushing carts, strumming guitars and napping on benches in Monument Square, Lobsterman Park and Tommy's Park.
According to Lauren Chan, program coordinator of the city's homelessness prevention and diversion program, people who live outside are vulnerable twice over due to their high exposure to the sun and the high likelihood they have pre-existing physical and mental health problems exacerbated by heat.
Dora Anne Mills, now the chief health improvement officer at MaineHealth, said she was often asked during her 14-year tenure as the state director of public health, what threats kept her up at night. Her reply: extreme heat.
It still keeps her up, even now.
“Maine thinks of itself as a cold weather state, but now we've got to learn to think like a hot weather state, too,” said Mills, who is the younger sister of Gov. Janet Mills. "Heat is deadly. It's deadly here, too, but we don't know how deadly, at least not yet.
"Unfortunately, I think we're about to find out."
'Once the heat gets a hold ... it won't let go'
The heat exacerbates the chronic pain, arthritis and degenerative disc disease that has afflicted Paul Armstrong since a 2004 construction accident left him partially disabled and reliant on a network of Social Security, Medicare, MaineCare, food stamps and fuel assistance.
The 65-year-old Palermo man lives in an off-the-grid solar and wood-powered house he designed to stay warm during Maine's bitter winters. Over three decades, however, Armstrong's two-story house has become a hotbox in the summer.
"Once the heat gets a hold of me, it won't let go," Armstrong said. "It just drains me. It's a struggle just to breathe."
The solar panels can't generate enough electricity to power an air conditioner, he said. During a heat wave, he uses fans, window shades and open windows to cool his house. He uses a medical device to help him breathe while sleeping, but on hot nights it is hard to keep the mask on when he is sweating. On those nights, he trades his second-story bedroom for a slightly cooler first-floor couch.
When the heat becomes unbearable, Armstrong said he strips down and mists himself with a garden hose to amplify the cooling power of his fans. It's a trick the Navy veteran learned while stationed in the Philippines — one he never thought he'd use in Maine.
"I can feel it getting hotter every summer," Armstrong said. "I don't know what I'm going to do."
Older people are especially vulnerable to high heat, according to researchers at the Harvard School of Public Health. They can't cool themselves down as efficiently and pre-existing conditions and medications they take can increase their heat intolerance.
Many older Mainers can't afford to buy an air conditioner or to use it even if they have one installed, according to Noël Bonam, state director of AARP Maine. Almost one in 10 Mainers age 65 and older — about 29,000 people — live at or below the poverty line, according to the U.S. Census Bureau.
Bonam said more older Mainers are worried about extreme heat, but that doesn't make it more important than their other day-to-day challenges, like paying for food, medicine or shelter.
Dana Morrell at SeniorsPlus — the area agency on aging that serves Androscoggin, Franklin and Oxford counties — said a lot of people call asking for a donated air conditioner or help paying a summer power bill bloated by heavy AC use. SeniorsPlus can help match callers with benefit programs and direct donated ACs to people in need, but there are no programs set up in Maine to help someone like Armstrong pay specifically for cooling assistance, she said.
'Not an ideal tool, but we have a tool'
Jessica Browne turned to her local lawmaker for help with her mother's situation at the nursing home in Belfast.
Rep. Jan Dodge, D-Belfast, introduced a bill requiring that certain long-term care facilities, including nursing homes, follow a temperature range of 71 degrees to 81 degrees unless equipment or power fails. The proposal mirrored existing federal temperature limits. The federal rule only applies to facilities initially certified after Oct. 1, 1990.
According to the Maine Department of Health and Human Services, all of Maine's nursing homes were certified before then, so they are exempt from the federal temperature limits. DHHS confirmed Wednesday that there are currently 78 nursing homes in the state.
William Montejo, the head of the state health department's licensing and certification division, told lawmakers in written testimony in February 2023 that Maine has rules around heating at long-term care facilities, but not cooling. He said the state has a tool to keep these residents safe, noting the federal regulation requires all long-term care facilities maintain "safe" temperatures.
"The onus is on us as surveyors to go out and interview residents and families to find the evidence that shows that yeah, I don’t have a temperature range, but yeah it is hot," Montejo told lawmakers during the legislative workshop. "I think we have a tool. It's not an ideal tool, but we have a tool."
Some facilities have central air systems, but most nursing homes and many residential care facilities don't, Montejo told lawmakers. Instead, they may allow personal fans or AC units. Some of the oldest ones wouldn't even support a window AC unit, he said, even if a resident could afford one.
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Nursing home operators said an American Health Care Association study conducted in 2021 found that renovations needed to install cooling systems in U.S. nursing homes alone, not including other residential care facilities, would cost about $2.8 billion.
Residents and their families sometimes complain about the heat, Montejo said, but DHHS doesn't specifically track heat complaints. In response to lawmaker questions, DHHS and the Maine Long-Term Care Ombudsman Program reported that five residents or their families had complained about excessive heat in 2022. Montejo said nursing home operators are generally quick to resolve such complaints.
The Portland Press Herald filed a public records request last month for all complaints about physical conditions in Maine nursing homes, but DHHS has not yet filled or denied it.
After introducing the bill, Dodge said, she was flooded with calls and emails from people worried about loved ones living in overheated long-term care facilities. The committee eventually voted to kill the bill. It directed DHHS to start tracking heat complaints and report back in January 2024 — something the agency has yet to do.
Dodge said she never heard back from DHHS after the bill died. She said she was disappointed by the lack of follow-up, the bill's failure and the committee's unwillingness to consider a half-measure, such as requiring facilities to install cooling systems in future renovations.
'Too hot to work'
People strolled hand in hand through Portland's Woodford Corner on what felt like a perfect July day: the sun was out and it was about 80 degrees — a typical high for July 13 in Portland, according to federal weather records.
But a wall thermometer read almost 20 degrees hotter inside Bayou Kitchen, a tiny space packed with hungry Sunday brunchers. Kitchen manager Dan Lasley flipped shrimp, sausage and pepper-stuffed omelets over a crackling griddle.
"This isn't too bad today," Lasley said, as he mopped his shiny brow with a towel. "I had to close early last month on a few of those really hot days because it was just too hot to cook. It was too hot to work, to eat, to do anything. I couldn't put my staff through it. It's hard enough to find good workers."
In a study of emergency room visits to Maine hospitals from 2017 to 2021, Maine DHHS found most people treated for a heat-related injury were workers who either couldn't escape the sun, like roofers or farmhands, or work in very hot environments, like welders or warehouse workers.
Across the country, between 2011 and 2021, 436 workers died from extreme heat exposure, according to federal data. The Bureau of Labor Statistics said it could not provide state-level data for workplace heat deaths. It lumps those in with exposure to harmful substances, a much broader category.
The future of a proposal to implement a nationwide rule protecting workers from extreme heat is uncertain. States like California, Colorado, Minnesota, Oregon and Washington have enacted standards around heat in workplaces, according to OSHA.
In Maine, state lawmakers considered two bills in 2021 intended to protect workers from high heat.
One required the state to set minimum and maximum temperature limits for indoor workers. The other required employers to provide employees drinking water on high heat days, a cooling area when temperatures top 80 degrees and four 10-minute breaks when temperatures top 90 degrees.
The bills died in committee after critics said they threatened Maine's pandemic-battered economy.
"This bill would put us in uncharted waters," Greg Dugal, who at the time was the chief lobbyist for HospitalityMaine, a restaurant and hotel trade group, told lawmakers during the committee hearing in 2021. "A one-size fits all approach to temperature control could put many industries, most notably the restaurant industry, at risk."
'Live to work another day'
Under state law, Maine's agricultural workers aren't allowed to discuss working conditions, much less demand heat protections. But Fairfield apple grower Steven Meyerhans said many Maine farmers do what they can to keep their workers safe.
"If it's too hot for me, it's too hot for them. ... If it's too bad, we call it a day and start again in the morning," Meyerhans said. "Live to work another day, I say."
In the summer, before apple picking season begins, Meyerhans employs two people from Jamaica who come to Maine on temporary work visas to help plant, prune and prepare the orchard. Come harvest time, he hires another four workers to pick and press the apples into cider. Meyerhans puts them up in housing near the orchard.
On a recent hot July day, Meyerhans' two-man crew started the work day watering plants in the hoop house. It is extra hot inside, so they do that work while it's cooler outside. They irrigate outdoor vegetable fields and clear brush from the apple trees, working from the shade whenever possible.
When he's in Jamaica, 41-year-old Ryan, who is back for his fifth year of work at the farm, said he works several jobs that put him in hot conditions: construction worker, chef and soccer coach. That experience has taught him to respect heat waves in Maine.
"It's not Jamaica hot, but it's not, not hot, so I am still careful," said Ryan, who asked to be identified only by his first name because his employer doesn't want to attract unwanted attention during the national immigration crackdown.
In the fields, workers wear hats, sunglasses and sunscreen. They take shaded breaks, drink a lot of water and sometimes even go for a swim in a nearby pond. On that day in July, the crew only worked half of the day due to the afternoon heat that was forecast to climb into the upper 80s.
Given Maine's fast-warming summer nights, Meyerhans said he'll likely have to install window air conditioning units inside the workers' bedrooms in addition to the table-top fans he already provides.
"It'll cost me, not just to buy the units, but to run them, too, because of Maine's high electricity rates," Meyerhans said. "But it is hard to find good workers."
'The heat, it got me that day'
Joseph Lluvera collapsed on Saco's Main Street on June 24, Maine's hottest day of the year so far.
The 51-year-old man, who is homeless, said he woke up at the hospital, where doctors and nurses spent the next three days treating him for severe dehydration and heat stroke. He was one of the 46 Mainers taken to the hospital for treatment of a heat-related illness that day.
"The heat, it got me that day," Lluvera said in July. "I spent years with the heat and the cold and the cops hassling me, always on my trail, but I outran them, you see? Now it's hotter and I'm older and it seems like it's all catching up to me."
Lluvera said he had spent most of that 98-degree day in June carrying his belongings from one air conditioned spot to another: talking to friends at Seeds of Hope shelter in Biddeford, charging his phone and reading magazines at McArthur Library, and catching a nap at the Saco train station.
Seeds of Hope extends its hours when temperatures climb to give people a cool place to stay during the day so they are not forced to shuffle from place to place. On a typical day, about 100 people will stop by; 35 to 50 will bed down there overnight.
"We believe in the dignity of choice, so we don’t push them to come inside, but we offer them a cool, safe place to get water, take a shower or get a bed," Executive Director Vassie Fowler said. "For the medically fragile, the risk of heatstroke is as real as hypothermia, and most of our people are fragile."
When it gets hot in Bangor, Wayne Pomeroy finds relief at the Brick Church. The former Burnham-area man said the cooling center has been a lifeline for himself and many others who spend most of their summer days outside. He has been homeless in Bangor for the past three years.
On a recent July weekday, Pomeroy quietly discussed his situation. Clad in jeans and a cut-off Bruce Lee t-shirt, drained by the oppressive afternoon heat, he said the center doesn't have air conditioning, but it offers free water, which is hard for people like him to find.
“Yeah," Pomeroy said, "I love this place.”
'Not a lack of caring, but a lack of resources'
The state has taken some steps to address the growing problem: installing 210,000 heat pumps in Maine homes and businesses that can be used for cooling; using climate grants to fund the opening of cooling centers; passing a law that prevents utilities from cutting off power during heat waves, and adopting a law that requires local school boards to set temperature standards for schools.
Also, Efficiency Maine, the independent agency in charge of Maine's energy efficiency programs, has committed just over $800,000 of federal American Rescue Plan funds for climate control upgrades in seven long-term care facilities in the state.
State officials are also beginning to study deaths that could have been heat related, but were not reported that way, in an effort to better understand the current public health risk and prepare for the future.
Lincoln, the state epidemiologist, and the Maine CDC are digging into hospital admission records and vital statistics data to try to tease out those indirect deaths and to round out Maine's heat-related illness data. Lincoln said there needs to be more public education around heat risks for groups that may not realize they're vulnerable, such as people who are taking certain common medications, like anti-depressants.
Both the Maine Climate Council and the Infrastructure Rebuilding and Resilience Commission have singled out heat waves as a growing public health and economic concern according to Sarah Curran, who is head of the Governor's Office of Policy, Innovation and the Future, or GOPIF, and co-chair of the Maine Climate Council.
GOPIF has awarded nearly $19 million in community resilience grants and technical assistance to communities for vulnerability assessments and preparedness projects, like cooling centers and shade tree plantings.
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Maine’s climate action plan, Maine Won’t Wait, and the Resilience Commission's final report calls upon state, regional and local emergency response networks to help communities plan, prepare and respond to extreme weather events like heat waves, with special emphasis on vulnerable groups.
"Addressing the impacts of extreme heat and other severe weather," Curran said in an email, "will require long-term commitment and investment across all levels of government and in partnership with Maine communities."
According to Hannah Pingree, a former Maine House Speaker and former co-chair of the Maine Climate Council, the state has always known climate-fueled extreme heat was coming, but it's now grappling with the reality that it is already here.
"It's an emerging issue that I don't think anybody's denying, but how do you make policy around it?" said Pingree, who is one of four Democrats running for governor. "How do we help you do this thing that we know you want to do, you just can't afford?...
"It's not a lack of caring, but a lack of resources."
Sun Journal Staff Writer Joe Charpentier contributed to this report.
This story was reported as part of a collaboration between the Portland Press Herald and Maine Public.