More than 40 patients, advocates, state lawmakers and others at a downtown rally Thursday urged the Portland City Council to fully fund the India Street health clinic for at least one more year.

City Manager Jon Jennings has proposed closing the city-run clinic and moving services and patients to the Portland Community Health Center, an independent nonprofit clinic on Park Avenue.

But speakers at the rally in front of City Hall, including three candidates running for a Maine Senate seat, said the city should expand access to health care, not limit it.

“Let’s not close the India Street clinic,” state Rep. Diane Russell, D-Portland, said to loud applause. “Let’s have a conversation about expanding it.”

Russell, whose district includes the clinic, is running for the state Senate’s District 27 seat, which covers the peninsula, islands and Back Cove. Two other candidates, Peaks Island resident Chuck Radis and Rep. Ben Chipman, also spoke at the rally.

The proposal to close the India Street clinic, which provides services for HIV-positive patients, testing for sexually transmitted diseases and a needle exchange program, has emerged as the most contested component of the proposed $236 million budget for the fiscal year that begins July 1. The proposal would reorganize several city departments in an effort to refocus municipal government on core services such as maintaining roads and sidewalks.

The City Council’s Finance Committee voted unanimously on April 21 to endorse the proposed budget with only a few modifications that included extending the time line for winding down services at the India Street clinic.

Opponents are concerned that breaking up the clinic’s services will make it more difficult for vulnerable people to receive medical care. The city clinic offers a constellation of services under one roof. Its needle exchange also provides drug users an entry point to other health care. They also question whether the nonprofit clinic will receive enough grant funding to operate.

Backers of the proposal argue that Portland Community Health Center is better equipped to provide clinical services and that only 11 percent of municipalities in the U.S. still provide direct medical care. They say moving clinical services to the federally qualified health center, which the city helped create in 2007, has always been the plan. The independently-run clinic would also receive higher MaineCare and Medicare reimbursements, making it more fiscally sustainable.

Mayor Ethan Strimling on Monday surprised his fellow councilors by strongly criticizing the closure plan and questioning whether the city should be putting “public works over preventive health” and “serving people or pavement.” Virtually every other councilor fired back at Strimling, saying he had unfairly criticized city staff and Jennings and misrepresented the budget.

Supporters at the rally Thursday said the city-run clinic, which includes several separate programs under one roof, serves not only vulnerable patients such as homeless people, drug addicts and members of the LGBT community, but also young professionals without primary care doctors and people without insurance who work in the service industry.

“I am here telling my story because India Street is vital to the community,” said David Timm, who was diagnosed HIV-positive in 2004. Six months after starting treatment, his HIV was undetectable, he said. He continues to receive primary care there and can call his doctor anytime. “I do owe them my life. To the city of Portland, I urge you not to close this facility.”

South Portland resident Karine Odlin commended the clinic for its outreach to commercial fishermen. Odlin, who comes from a fishing family, said many fishermen struggling with opioid and heroin addiction have come to trust the clinic and staff as a safe place to get clean needles and access to other services.

“Fishermen are an independent lot and quite honestly they have been slow to acknowledge the problem,” Odlin said.

Others said details were lacking about where and how services would be offered by the Portland Community Health Center.

Marcia Goldenberg, a professor at the University of Southern Maine who was a nurse at India Street from 1999 to 2013, said the city needs to explain whether city staff will be hired at the clinic, whether related services would be provided under one roof, and how the city would ensure that the quality of care will not be sacrificed.

“These remain unanswered questions and we want answers,” she said.

Thursday’s rally, organized by Joey Brunelle, who knows several patients who use the city clinic, was the first of two leading up to a public hearing Monday. The Southern Maine Workers Center, a coalition of labor unions, as well as the Homeless Solidarity Project, clinic clients and volunteers, are planning a rally at 1 p.m. Sunday in Lincoln Park. And an online petition to save the clinic was launched by Timm on Tuesday night. As of Thursday morning, it had over 1,200 signatories.

The City Council public hearing is scheduled for 5 p.m. Monday in council chambers. The council is due to vote on the budget on May 16.

Randy Billings can be reached at 791-6346 or at:

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Twitter: @randybillings