About 60 residents, patients and advocates of the India Street Public Health Center packed council chambers in City Hall on Monday night to pressure councilors to keep a city-run public health center open.

Speakers during the nearly three-hour public hearing asked the councilors, who are scheduled to vote on the budget proposal in two weeks, to take more time to study how closing the clinic would affect more than 1,000 people, many of whom have complex medical conditions such as HIV, sexually transmitted diseases and drug addiction.

City Manager Jon Jennings has proposed closing the clinic and moving services and patients to the Portland Community Health Center, an independently run nonprofit the city helped create in 2007. Jennings has said his budget seeks to focus on the core services of government. He has acknowledged that his proposal to close the clinic would provoke a community conversation about the role of government.

But on Monday night speakers made it clear they believe there has not been enough time to have an informed conversation about the plan, and that knowledgeable voices – namely staff at the city run clinic – have not been heard, since the city is not allowing them to speak. Critics of the proposal lamented that it was made within the budget, which the council has had less than a month to review.

“This needs to be driven by medical professionals, not accountants, and that has not happened,” said Donna Yellen chief program officer at Preble Street, a nonprofit that operates a soup kitchen and day shelters.

The $236 million municipal 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.

Although the budget would reorganize several city departments, the proposal to close the city-run public clinic has emerged as the most controversial. 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. There have been two public rallies supporting the clinic, and a online petition to save it has received more than 1,900 signatures.

Proponents of closing the clinic argue that patients will get quality health care at the nonprofit Portland Community Health Center. As a federally qualified health center, the nonprofit is eligible for higher MaineCare and Medicare reimbursements. They say that there is plenty of time to work out the details of the transition.

Opponents, however, have been concerned about how quickly the proposal is advancing and the lack of details about whether the nonprofit will be able to offer all the same services in one location. A one-stop shop is not only a matter of convenience for patients with complex medical and transportation issues, they say, but also a way to bring people into the health care system, especially people addicted to heroin.

Opponents argued that the closure would severely impact the gay, lesbian, bi-sexual and transgender community, many of whom feel alienated from traditional medical environments.

Drew Christopher Joy said severe anxiety was a barrier to accessing medical care.

“India Street feels safe. I go there and they know how to talk to trans people. They know who to ask the right questions. They send in the nurses to double-check the pronouns to make sure they got it right,” Joy said. “I don’t want to find another safe place. I have one.”

Bayside residents expressed concern Monday that PCHC, in an April 21 memo to the council, indicated that it was seeking a federal grant to expand its clinic at 63 Preble St. to accommodate the needle exchange, where drug addicts can drop off old needles and get new ones. Already the epicenter of social services, Bayside residents for years have sought to disperse the social services to make the area more livable.

Steve Hirshon, president of the Bayside Neighborhood Association, noted that the nonprofit did not want to put the needle exchange at its clinic at 180 Park Ave. because of a nearby middle school, but on Preble Street it would be near Portland High School, a day care and a learning center for troubled youth.

“I also am quite concerned that this proposal was made without any community conversation whatsoever,” Hirshon said. “That wouldn’t happen in Oakdale and certainly wouldn’t happen in North Deering. I’m sorry, but we’re better than that. We pay taxes, too.”

Other speakers suggested that the explosion of market-rate condominiums may be factoring into the city’s decision to close the clinic.

About a half-dozen people testified about the quality of care delivered at the Portland Community Health Center, including staff, patients and board members.

“It bothers me to think we’re hearing such negative things about such a wonderful, wonderful health center,” said Eileen Skillings, a PCHC patient who serves on the nonprofit’s board of directors, which is made up of a majority of patients.

Advocates on both sides were upset that the proposal has turned one clinic against another.

“We need more than one community health clinic,” said Munjoy Hill resident Adinah Barnett.

The proposal has put Mayor Ethan Strimling at odds with fellow councilors and city staff.

Strimling was rebuked by fellow councilors last week for raising a series of questions about Jennings’s budget priorities.

In an address to the council, Strimling wondered whether the city should be putting “public works over preventive health” and “serving people or pavement” without knowing all of the potential impacts and details of the transition. Councilors criticized Strimling, saying he mischaracterized the budget. Jennings shot back with a written statement the following day.

Jennings originally proposed closing the clinic by the end of the year, but amended that time line after councilors expressed concern. The new proposal would move HIV-positive services and patients by the end of the year, while transferring STD testing and the needle exchange by June 30, 2017.

The India Street clinic serves 1,114 patients, including 220 HIV-positive patients, according to the city, and employs 15 people. The clinic also distributes more than 140,000 clean needles annually through its needle exchange, which in 2015 had 808, enrollees.

The council’s Finance Committee voted unanimously to send the budget, including the clinic closure, to the full council with a positive recommendation. They made other minor changes to the manager’s budget. They added nearly $181,000 to fund another school resource officer, a part-time bike-pedestrian coordinator, and an additional $11,000 in funding for the Milestone HOME Team.

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.

The additions increased the proposed tax increase, from 2.3 percent to 2.4 percent.

Strimling said the public would have another opportunity to comment on the proposal before the council’s May 16 vote.

 


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