Members of the Portland City Council’s Finance Committee expressed concern Thursday about the city’s plan to close a public health center on India Street and move patients and services to a nonprofit clinic.

The proposal would affect about 15 employees and 1,114 patients receiving services at the city-run India Street Public Health Center, according to the city’s health and human services director. The city wants to shift the patients to the Portland Community Health Center, a privately run nonprofit.

No public comment was taken at the meeting, but a public hearing will be held on the entire budget on April 21. The three-member committee, which will vote next week on a budget recommendation to the full council, was particularly concerned about where the Portland Community Health Center would provide the services now offered by the city. Those services include India Street’s needle exchange program, which serves hundreds of people and distributes more than 100,000 clean intravenous needles annually.

City Councilor Belinda Ray said none of the nonprofit health center’s five locations are suitable for a needle exchange serving intravenous drug users at risk of spreading disease by sharing needles. Its main location on Park Avenue is too close to King Middle School, and other locations, including a clinic near the Preble Street day shelter and soup kitchen, also would be inappropriate, she said.

City Councilor Nicholas Mavodones, who leads the committee, agreed. He was also concerned about whether other services – including medical care for HIV and sexually transmitted diseases – would continue to be offered at one location.

“I think it’s going to be important to have an answer to that question before we vote on it,” Mavodones said. “It may drive how people vote on the budget.”

City Manager Jon Jennings has proposed closing the India Street clinic as part of his $236 million budget proposal. However, he cautioned that details about potential locations may not be available before the council vote.

The clinic closure has emerged as the most controversial aspect of the budget, with patients and health care advocates worried that the move will reduce services. Some worry they will need to see more doctors at different locations, rather than having them all under one roof.

Jennings said that would not be the case. As a federally qualified health center, Portland Community Health Center is eligible for higher reimbursement rates for MaineCare and Medicare, allowing it to provide services for more patients, he said.

“I can guarantee you it will be a successful transition” by the end of the year, Jennings said. “I understand the emotions around this, but to me this is one of the most logical things we can do.”

Two years ago, the city closed its homeless health clinic and moved services to Portland Community Health Center, which serves 6,600 patients. That resulted in a greater-than-expected shift of patients to the nonprofit but fewer services for oral health, substance abuse and behavioral health.

Jennings said a key component of the transition would be whether the nonprofit could secure a federal grant for HIV services. That $344,000 grant expires Dec. 31 and city officials are exploring whether they can transfer it to the nonprofit, or if it would have to apply for its own.

Jennings said he believes the federal government is looking for opportunities to provide more grant funding for federally qualified health centers. He noted that Portland is among only 11 percent of U.S. communities that provide clinical services to patients.

City Councilors Edward Suslovic, who serves on the Finance Committee, and Jill Duson, who does not, were supportive of the proposal, as long as patients continued to receive access to quality health care.

They noted that the city played a key role in establishing a federally qualified health center for under-served populations. They also noted that the nonprofit clinic’s operations are overseen by a board of directors, the majority of whom are patients at the clinic.

“I think this plan is a good government plan,” Duson said.

Councilors asked whether Portland Community Health Center would be willing to take over the space currently used for the city clinic at 103 India St. to ease the transition for patients. The city lease expires in November.

Leslie Clark, the nonprofit’s CEO, said she is open to taking over the city’s space but warned that upgrading the building may be too expensive. She estimated it would cost $250,000 to set up the clinic for an electronic medical record system.

“I think there’s still lots of discussion to be had about how to keep the services integrated in one or more than one location,” Clark said.

Councilors also asked for more details about the transition plan, a comparison of staffing and quality of service reports from each clinic, as well as grant information.

 

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