A city council committee voted Thursday to endorse a municipal budget that calls for closing a health clinic on India Street that provides healthcare to more than 1,000 patients.

Dozens of people turned out Thursday for a public hearing on a Portland city budget proposal that includes closing the India Street Public Health Center and transferring services and patients to a nonprofit clinic.

City Manager Jon Jennings’ plan to close the clinic has become the most contentious piece of the $236 million budget proposed for the year that starts July 1.

Programs and patients would be transferred to the Portland Community Health Center, an independently run, nonprofit, federally qualified health clinic that is eligible for higher reimbursement rates for MaineCare and Medicare.

After a 40-minute public hearing on the proposal, the Finance Committee voted unanimously in support of closing the clinic, though on an amended the timeline.

Instead of transitioning all services by the end of the year, only the health care services for HIV-positive patients would be moved by the end of the year, while the STD/HIV testing and needle exchange may remain at India Street until June 30, 2017.

That timeline was suggested by Dr. Caroline Teschke, the program manager of the city clinic, during a meeting with Jennings on Thursday.

The city and council would conduct regular check-ins to see how the transition is working.

That change was enough to win support from Councilors Nicholas Mavodones and Belinda Ray, who were concerned about the lack of details about the transition.

“I think a little more time will let us know if this will work and how it will work, so I’m pleased with that,” said Mavodones, who chairs the committee.

‘CAN’T TRANSFER … RELATIONSHIPS’

The committee also added nearly $181,000 to the budget to fund another school resource officer, and a part time bike-pedestrian coordinator, which passed with Mavodones opposed, and Ray and Councilor Edward Suslovic in support. An additional $11,000 was added to allow the Milestone HOME Team to operate seven days a week was passed unanimously.

Many of the people at Thursday night’s hearing appeared to be supporters of the city-run clinic. Some carried signs saying “India Street Works” and “Portland 4 the People.”

Supporters of the closure say that the higher reimbursements would enable the Portland Community Health Center to help more patients, and that the city had long planned to transfer those services to the federally qualified health clinic, which the city helped create. The nonprofit clinic is overseen by a board of directors, whose majority is composed of patients.

But the proposal has alarmed some of the 1,114 patients who rely on the India Street clinic for a range of services that are offered under one roof. Health advocates and some patients who have long histories with the clinic’s staff worry that the programs will be broken up, making it more difficult for patients – many of whom are low-income and lack transportation – to get the care they need.

“You can’t transfer those relationships,” said Michael Anthony, who opposed closing the city clinic. “You can’t teach those relationships.”

SUPPORT FOR KEEPING CLINIC OPEN

The city transferred its health clinic for the homeless to the nonprofit two years ago. The clinic has exceeded projections for medical visits, but has provided fewer services for substance abuse, behavioral health and oral health.

Leslie Clark, CEO of the nonprofit, noted that during a federal review the homeless clinic met or exceeded all 19 categories evaluated.

She reminded councilors that the city approached the clinic for help.

“I think there is some sense in the community we’re trying to take over something and that is not the case,” Clark said. “We are not here to compete or take something away from anyone.”

Most of the public testimony was in support of keeping the city clinic open. Some patients of the Portland Community Health Center complained about long wait times to get into the nonprofit clinic. Others said they had been turned away.

PCHC Chief Medical Officer Renee Fay-LeBlanc said the current wait times for a new patient are two weeks, rather than months described by some, while walk-in times vary. The clinic doesn’t turn people away, but she said if someone has a primary care doctor elsewhere, the clinic will encourage them to get treatment there.

About a dozen people spoke in support of keeping the India Street clinic open, including Severin Beliveau, a prominent Portland attorney and Democratic political activist who implored councilors to allow clinic staff to testify.

The city has prohibited clinic staff from speaking to the media, saying it would not be appropriate to speak with staff.

Beliveau speculated that the city’s stance would be different if the proposal involved closing a school, fire station or a library. “Do not accept opinions and observations of people not involved in the day-to-day operations of that clinic,” he said.

AN INCREASE IN STDS PREDICTED

Teschke was invited to address the committee to help explain the proposed change to the timeline. She said the extended timeline would “increase (the) chance of making it as smooth as possible for outpatients,” especially for HIV-positive patients.

Supporters of the city’s clinic warned that the city could see an increase in HIV and STDs if it closes the clinic and breaking up trusting relationships that took years to form.

“It is personal. It affects a lot of us,” said Chris Buerkle, who said he receives STD services at the clinic. He warned that the city would see “an alarming increase in STDs” if the clinic closes.

“It’s really shocking to me you’re going to take this service away and I don’t trust where it’s going,” he said.

City officials and staff at PCHC pushed back against that notion, saying that the nonprofit clinic would provide the same services at some or all of its five locations. The nonprofit is working to hire its own HIV and infectious disease experts, rather than relying on Maine Medical Center.

“I’m really committed to that,” said Fay-LeBlanc.

Suslovic, who serves on the Finance Committee, and fellow Councilor Jill Duson, who doesn’t, co-authored an op-ed published before Thursday’s hearing signaling support for the plan. The Finance Committee is expected to make a budget recommendation to the full council.

Supporters of the city-run clinic, including the Southern Maine Workers’ Center, a coalition of pro-union members that advocates for better lives, working conditions and jobs for poor people, plan a rally in Congress Square Plaza on May 1, a day before the City Council holds a public hearing on the budget. The council is scheduled to vote on the budget May 16.

The budget contains a property tax increase despite a development boom that has added more than $68 million to the city’s property tax base and is estimated to bring in an additional $1.4 million in taxes each year.

When combined with the proposed school budget of $103.6 million, the overall city budget would increase property taxes by 2.4 percent, bringing the tax rate up to $21.12 per $1,000 of assessed value, from $20.63. That would result in a $147 property tax increase on a home with an assessed value of $300,000.

Tax increases in each of the last three years have ranged from 3 percent to 3.1 percent.


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