Mayor Ethan Strimling on Monday strongly criticized the budget plan proposed by City Manager Jon Jennings, suggesting it gives public works a higher priority than public health.

Strimling’s budget message was a reaction to Jennings’ proposal to cut dozens of public health staff positions and close the city-operated India Street Public Health Center, and devote more resources to development-related activities and city infrastructure, such as roads and sidewalks.

“These cuts, in part, will end up eliminating city-led direct medical service to our most vulnerable neighbors, drug education and treatment for our residents, and enforcement methods that keep cigarettes out of the hands of our children,” Strimling said.

Strimling’s budget address, which is mandated by the City Charter and was delivered three weeks late because the mayor had been ill, prompted two councilors to come to Jennings’ defense during a public comment period in the meeting.

City Councilor Jill Duson, one of four councilors who supported Strimling’s successful bid to unseat former Mayor Michael Brennan, said she felt compelled to “protest” the mayor’s remarks.

“What happened in my presence this evening was a message that unfairly characterized the budget forwarded by the Finance Committee as choosing public works over public health, and unfairly painted the city manager as the villain in that choice,” Duson said. “I couldn’t sit through this public castigation.”

City Councilor Jon Hinck said some of the arguments were “a little unfortunate.”

“Even though the core of some of those points I have a tendency to agree with, I feel as though a public response is the way to go to show support for the city manager, staff and the Finance Committee for their work on the budget,” Hinck said.

Jennings’ $236 million budget proposal puts more focus of municipal government on core functions. He has proposed closing the India Street Public Health Center, a city-run clinic that, among other services, provides medical care to people who are HIV positive, testing for sexually transmitted diseases and a needle exchange for intravenous drug users. The clinic serves over 1,000 patients.

Jennings has proposed moving about 220 HIV-positive patients to the independent, nonprofit Portland Community Health Center by the end of December and the remaining patients by June 30, 2017.

Meanwhile, Jennings has proposed eliminating more than two dozen other public health positions because of a loss of state grants.

Strimling specifically noted that Jennings’ proposal calls for cutting 35 positions in public health and social services, but would add about 20 staffers to the permitting and inspections office.

“When we choose to spend increased revenue somewhere, we are also choosing not to spend it somewhere else,” Strimling said. “And when we choose to cut one program in a city, we are also often choosing to spare or increase another.”

But Duson called that assessment “wrong and inaccurate.” She noted that the increase in staffing for permitting and inspections is being funded through increased permit fees, and public health staff cuts result from a loss of state grant money. She also criticized Strimling for failing to mention his hiring of an assistant who earns $64,000 a year.

“I wonder if that was taken from public health,” she said. “I know it wasn’t, but if we’re going to characterize all of the others that way then that’s fair to characterize this that way.”

Strimling also called on the council to use local tax dollars to make up for the loss of state public health grants, as it did when it retained 12 firefighter positions that had been covered by federal grant money.

“This is a decision I support and is an example of how we can find the money when we consider it important enough,” he said. “In essence, does choosing public works over preventative health reflect our shared values?”

Strimling laid out a list of questions and concerns about closing the India Street Public Health Center. He noted that Jennings presented a detailed transition plan when he created the new inspections and permitting office, but provided the council only an outline for closing the clinic and transferring patients to the Portland Community Health Center.

He also said staff have given evolving responses about whether the nonprofit would be able to secure a $344,000 federal Ryan White grant necessary to treat HIV positive patients. Staff initially said it could be transferred India Street to the Portland Community Health Center, but later said the nonprofit might have to compete for the grant, but was still likely to get it, he said.

The budget recommended by the Finance Committee last week envisions HIV-positive health care being transitioned to the health center by the end of the year, while the STD-HIV screening and needle exchange would be moved later..

Proponents of the changes say patients will receive the same quality care, but that it would be more sustainable because the health center receives higher MaineCare and Medicare reimbursements than the does the city. Opponents, however, worry that patients will lose valuable relationships with their doctors and face increased barriers to receiving care, including having to go to more than one facility for services that had all been available at the India Street clinic.

Strimling said the council has only three weeks to decide whether to support the proposal.

“That’s not a lot of time for the questions that have been raised to be addressed in the detail they require,” Strimling said. “But these questions must be answered adequately for me to vote in the affirmative on the proposal before us.”


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