The Portland City Council voted 8-1 Monday night to close a city-run health clinic on India Street as part of a $236 million budget for the fiscal year beginning July 1, prompting activists to storm out of City Hall chanting “Shame!”
The time line for winding down services at the India Street Public Health Center and transitioning services to the nonprofit Portland Community Health Center will be slower than first proposed by City Manager Jon Jennings, who originally envisioned the transition by the end of the year.
The city-run clinic offers a constellation of related services, including treatment for HIV-positive patients, testing for sexually transmitted diseases and a needle exchange program.
It serves roughly 1,640 patients, including 220 HIV-positive patients, according to the city, and employs 15 people. The patient count does not include over 900 people who use the needle exchange, which distributes more than 140,000 clean needles annually, or those who use the anonymous STD services.
About 220 HIV-positive patients would be transitioned, if they so choose, to the nonprofit clinic by the end of the calendar year. The needle exchange and the HIV-sexually transmitted disease testing and treatment would remain at 103 India St. indefinitely, although the nonprofit would take over management of those programs on July 1, 2017.
The Portland Free Clinic, an independent nonprofit, will continue to operate out of 103 India St.
The proposal was amended to include two HIV-positive patients from India Street on the transition team, as well as two Portland Community Health Center patients and one community member selected by Jennings. City staff will report progress to the council’s Health and Human Services Committee at least once every other month.
City councilors noted that the decision is being driven by the potential loss of a $356,500 federal Ryan White grant vital to providing HIV services to patients, and by the costs of meeting federal requirements to institute electronic medical records at the clinic. They also noted that few municipalities provide direct clinical services.
Mayor Ethan Strimling, who frayed his relationship with councilors and city staff by delivering a scathing budget message on April 25, ended up supporting the plan, declaring that the India Street clinic “has been saved.”
That assertion seems to be based on the fact that about 90 percent of the patients, excluding those with HIV, would not see a change in location of services, while ignoring a change in management and potentially staff. Strimling pointed to a series of amendments increasing oversight, extending the time line and involving patients for winning his support.
“The structures in place give us a better chance of getting this right,” Strimling read from a written statement before the vote. He vowed to call on the council to take action if the transition doesn’t go as planned.
Councilor Jon Hinck voted against the budget, saying that he felt it would be a “leap of faith” to assume that relationships and services could be replicated at the Portland Community Health Center. He also had concerns about including such a significant proposal in the city budget.
A few councilors lamented the vitriol and misinformation that has been directed at them and staff. Some advocates have characterized the city as prioritizing golf courses over health care, giving tax breaks to businesses and simply leaving patients out in the cold. None of that is true, they said.
“I have never seen the type of campaign on this issue by a few people, and to me there’s no room in our political discourse for personal attacks,” Councilor David Brenerman said, shortly before a woman shouted from the balcony, “You’re the one behaving badly!”
At least one advocate stormed out of the chambers while accusing Councilor Jill Duson of showing poor taste by saying the transition plan is one that “people can live with, pun intended.” Several advocates and patients worry that they will lose their doctors, health care and potentially their lives.
The decision came after another emotional evening of public testimony dominated by people seeking to keep the city clinic open and intact. At several points, the mayor used his gavel to restore decorum, as audience members either applauded or reacted negatively to speakers, including the council.
Before Monday, there had been several public rallies supporting the clinic, and an online petition to save it has collected more than 1,900 signatures.
One man said that 200 patients might not seem like a lot of people to affect while saving money, but he assured the council that those lives, including his own, were priceless. That prompted a strong response from John Newton, a member of the Maine AFL-CIO executive board.
“Did you hear the man? You guys didn’t know what you were getting yourselves into. The city manager put this on the table and it shouldn’t be on the table,” Newton said loudly, slamming his hand on the lectern. “It’s morally outrageous.”
Joey Brunelle, who has organized rallies to save the city clinic, said he was pleased that the transition will be slowed. But he didn’t celebrate keeping about three-fourths of the services intact, because of people he knows who receive care for HIV.
“I hesitate to call that victory because it doesn’t feel like a victory,” Brunelle said. “I may not agree, but I understand the rationale, and if it is the city’s decision I am prepared to do everything I can to make that transition suck as little as possible.”
Three former city councilors, however, said they supported the proposal as a way to contain property taxes. “In my view it is way past time for the city to focus on the basics,” said West End resident Anne Pringle, a former mayor.
The budget contains a property tax increase despite a development boom that has added more than $68 million to the city’s overall property valuation and is estimated to bring in an additional $1.4 million in taxes each year. It also comes as the city is expecting to receive $10.6 million in excise taxes next year, a $700,000 increase, and a 13 percent increase in building permit and business licensing revenue.
However, the city’s expenses also are growing, including a 14 percent increase in health care costs that is adding $2 million to the budget. City employees also are getting a 2 percent cost-of-living raise, and the city’s new minimum wage law has added nearly $50,000 to the budget. Also, county taxes will increase by $177,000.
When combined with the school budget of $103.6 million, the overall city budget increases property taxes by 2.3 percent, bringing the tax rate to $21.10 per $1,000 of assessed value from $20.63 per $1,000. That would result in a $141 property tax increase on a home with an assessed value of $300,000.
Tax increases in each of the past three years have ranged from 3 percent to 3.1 percent. Jennings said a status quo budget would have added 5 percent to the tax rate.
The budget approved Monday eliminates eight full-time positions, but it’s unclear whether there will be layoffs.
Before approving the budget, the council eliminated a part-time bike-pedestrian coordinator position and a school resource officer position that was recommended by the Finance Committee. Councilors believed that existing staff could handle bike issues, and were concerned that the resource officer was added without the School Board’s recommendation.
CORRECTION: This story was updated at 10:10 a.m. on May 17, 2016 to include the amount of the increase in total excise tax revenue budgeted.