Portland city councilors on Monday quizzed city staff and the leader of a nonprofit health care provider about a controversial plan to close a city-run clinic on India Street that serves members of the gay community and people addicted to drugs.

City Manager Jon Jennings has proposed closing the India Street Public Health Center and transferring clinical services for roughly 1,600 patients to the Portland Community Health Center, an independently run nonprofit health clinic on Park Avenue, as part of his budget proposal.

Joshua LeClair, shop manager at The Higher Concept on Congress Street in Portland, takes a cigarette break outside the store Monday. The store is one of many businesses in Portland displaying an "I stand with India Street" sign as they oppose a plan to close the India Street Public Health Center. Shawn Patrick Ouellette/Staff Photographer

The clinic provides a constellation of separate but interrelated services, including primary care and specialized care for people living with HIV, as well as screening and treatment for sexually transmitted diseases. It also houses a needle exchange – where intravenous drug users can get clean needles, preventing the spread of diseases – as well as the Portland Community Free Clinic, which is a separate nonprofit that benefits from free rent and utilities provided by the city.

The budget meeting was an opportunity for councilors to ask questions about the budget before voting on it next week, so there was no public comment period.

But activists trying to save the city-run clinic gathered at City Hall, making their presence known. Before the meeting, about 30 people gathered in City Hall plaza holding signs saying, “I stand with India Street.” They occasionally broke into chants, such as “Save India Street now,” “Stop the war on the poor,” and “No ifs ands or buts, reject all the cuts.”

Supporters of the budget proposal say the Portland Community Health Center is better positioned to provide services and sustain them, since it is eligible for higher reimbursements rates through MaineCare and Medicare. They also say the federal government prefers federally qualified health centers to provide health services, rather than municipalities.

But opponents worry that the transfer will break up doctor-patient relationships that have taken years to establish, especially the trust earned for members of the gay, lesbian, bisexual and transgender population, as well as those addicted to drugs, that use the clinic.

Opponents of the proposal dominated a nearly three-hour public hearing last Monday. The council will hold another public hearing prior to voting next May 16.

Councilors on Monday questioned the Portland Community Health Center’s ability to ramp up services to meet demand and sought details about how well a previous transition of the city’s Health for the Homeless Clinic went. They also wondered whether the city was in jeopardy of losing a $356,500 federal Ryan White grant that funds the HIV Positive program at India Street.

“That’s the broad question I am wrestling with,” City Councilor Justin Costa said.

Dr. Caroline Teschke, program manager of the city clinic, said the federal grant is periodically opened up to a competitive bid, including this year. Three grants are awarded for Maine, covering its northern, central and southern regions. The grant awards would be announced in November, with the current grant expiring in Dec. 31, she said.

“We’ve never been competed against for the southern Maine award,” Teschke said.

Leslie Clark, CEO of the Portland Community Health Center, said the nonprofit has no desire to compete for the grant, but would be there to help the city if it decided to close the clinic.

Clark was then questioned by Councilor David Brenerman about lessons learned in 2014, when the nonprofit won a federal grant for homeless health care services that had traditionally been awarded to the city. She said transferring medical records of people who are highly transient was more complicated than anticipated.

In terms of service, PCHC has provided far more direct medical services to homeless people, but has not been able to provide as many oral health, substance abuse or behavioral health services.

Clark said that is largely because the city transferred its dental equipment to city schools, rather than the clinic, and awarded some federal grant money for behavioral health services to another nonprofit. The city also transferred a substance abuse program to Catholic Charities, she said.

“These services were not lost to the community – they are just not provided all through the Health Care for the Homeless program,” said Clark, who described the transition as having gone “very well.”

Keeping the India Street clinic open through June 30, 2017, would cost an additional $452,982, according to a May 2 memo from city Finance Director Brendan O’Connell.

The budget recommended by the Finance Committee would transition HIV-positive health care to the community health center by the end of the year, while keeping the HIV/STD testing as well as the needle exchange on India Street until June 30, 2017. The additional six months at India Street would cost around $40,000.

The Portland Community Health Center originally proposed housing the needle exchange at 63 Preble St., upseting Bayside residents. More recently, the center indicated it would be open to other options.

City Councilor Belinda Ray said she plans to offer an amendment next week that would keep those services, excluding HIV-positive care, at India Street in definitely. That proposal would benefit the Portland Community Free Clinic, which benefits from the city paying its rent and utilities, she said.

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.

There have been two public rallies supporting the clinic, and an online petition to save the clinic received more than 2,100 signatures. Those petitions were delivered last week to Mayor Ethan Strimling, who has been skeptical about the proposal.

The India Street clinic serves roughly 1,640 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. The committee made other minor changes to the manager’s budget. It 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.

Keeping the India Street clinic intact for an additional year would increase the tax rate 0.2 percent over the current proposal, bringing the total increase to 2.6 percent, resulting in a new mil rate of $21.17 per $1,000. For a home assessed at $300,000, that would add $15 a year to the tax bill.

Related Stories