The Portland health clinic that has served homeless people for 23 years is in danger of closing its doors unless Portland officials can make up for the loss of a long-held federal grant.
The Healthcare for the Homeless clinic, opened in 1989 and housed at Preble Street, a social services center, for the past decade, lost hundreds of thousands of dollars in funding through a competitive grant application, the city of Portland learned in December, all because city staff entered a number in the wrong place on the federal grant application.
The nonprofit Portland Community Health Center then applied for and won the three-year grant. But 1,300 low-income people may lose access to consistent non-emergency health care while the new provider ramps up services.
The city has not decided whether to close its homeless clinic, try to come up with more money or continue at a reduced funding level. But the federal funding shift is a disappointment to city officials and those who work with low-income and homeless people.
The federal grant money accounted for nearly $670,000 of the clinic’s $1.8 million budget last year, said Doug Gardner, Portland’s director of health and human services.
“We’re disappointed in HRSA’s decision,” Gardner said, referring to the U.S. Health Resources and Services Administration. “It was a human error. We put the wrong number in the wrong box. It’s a mistake that a lot of grantees made.”
About 2,300 people are currently served by city doctors, nurses and social workers at the clinic, which works hand in hand with social workers and outreach staff at the Preble Street center. The clinic has a staff of about 30, Gardner said.
The new provider, Portland Community Health Center, already serves more than 600 homeless or low-income Mainers among its 4,300 patients and has the immediate ability to accept 1,000 more, said CEO Leslie Clark Brancato.
That means if the city of Portland clinic, with its 2,300 patients, shuts its doors, about 1,300 people could be left without a clear place to see a family doctor at little to no cost.
“If they close, then we’d need to look at how, as a community, we should make sure everyone is taken care of,” Brancato said. “We’ll have to figure out how to expand more quickly.”
Brancato said that with its experience in serving homeless and low-income residents, it’s well-positioned to add more services where they’re needed. The center is accustomed to working with the homeless, who require more complex care, she said.
The center’s board of directors decided to apply for the grant after the city was rejected because board members were concerned that the needs of homeless residents would not be met, Brancato said.
For years, Portland had applied for the grant without competition, Gardner said. But federal officials informed the city in 2013 that its application would not be considered because of a technical error: The city entered the number of clinic patients in the wrong place.
The grant application process was reopened in mid-2013, and Brancato’s group applied for and won the funding – nearly $680,000 for 2014. The health center’s application received a score of 97. The city, which submitted a second application, was scored at 88.
Federal rules allow for a transition period of 120 days before services must begin at the new provider’s site, but Brancato said she plans to be open and accepting new patients by March 1.
The center currently has 37 employees, including five physicians, four clinical social workers and two nurse practitioners, she said. The grant money will pay to hire new medical staff: a doctor, a medical assistant, a nurse, a dual-licensed mental health and substance abuse counselor, one outreach worker, and a half-time team of a dentist and a dental hygienist, she said.
In year two of the center’s three-year expansion plan, Brancato plans to open a second location in the city beside its primary offices at 180 Park Ave.
Mark Swann, executive director of Preble Street, said he was deeply disappointed by the shift in funding.
“I think it’s a terrible decision, and from our perspective makes no sense at all,” he said.
Both the city and Portland Community Health Center spoke with Swann before submitting applications. Swann said he supported the city’s effort, and asked the health center not to apply.
Swann also questioned how the nonprofit provider plans to serve the roughly 1,300 patients for whom there is no immediate capacity, and who could be forced to seek regular treatment through costly emergency room visits or at urgent care centers.
Swann said he has reached out to federal officials to request that they reconsider the funding decision, or short of reversing course, find a way to keep the city clinic open.
“We’re able to provide a fairly strong continuum of services collectively,” he said. “I think this is an example of bureaucrats in Washington, D.C., who have no idea what’s going on in a city like Portland, Maine.”
For the short term, the city clinic continues to operate as usual. But in the coming months, Portland officials will have to decide its future.
“There is some hope that the clinic may continue on at some level,” Swann said. “Let’s not panic yet, because we don’t know what the city’s plans are.”
Matt Byrne can be contacted at 791-6303 or at: