When Jon Jennings was hired as city manager of Portland, he made clear that he intended to evaluate everything the city does, with an eye toward “right-sizing” municipal government. His goals are: 1) to achieve efficiencies and increased productivity by better delivering those essential services that can be supplied only by the city; 2) to reduce costs; and 3) to improve customer service.

Reflecting these goals, his recommended operating budget, now before the City Council, proposes (among other structural changes) to transfer clinical health care services currently provided by the city’s India Street Public Health Center to the Portland Community Health Center.

Not affiliated with the city, this highly regarded nonprofit provides comprehensive, team-based primary care for underserved and vulnerable populations. This is the same treatment approach that the India Street clinic uses, and these are the same populations currently served at India Street.

Understandably, some clients of the India Street clinic and others in the community are concerned about the impact of this transfer on the essential services on which they depend. Unfortunately, in recent weeks, what has emerged is an emotional response to this issue, as opposed to the considered “community conversation” that City Manager Jennings envisioned.

It seems to me important to focus on some facts regarding this proposed change.

Fact: The services provided at the India Street clinic will not be eliminated; they are being transferred to a fully qualified service provider.

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Fact: The city took the lead in establishing the Portland Community Health Center in response to a 2007 federal initiative to bring quality care to underserved populations.

Fact: The detailed plan to transfer services will be developed under the direction of two capable professionals – Portland Community Health Center CEO Leslie Clark and city Health and Human Services Director Dawn Stiles – who have made career-long commitments to serving vulnerable populations.

Fact: Individual transfer plans will be developed and implemented for each client.

Fact: The city’s Health and Human Services Committee, ably chaired by Councilor Edward Suslovic, will actively monitor the implementation plan until it is completed, to ensure that there is a seamless transfer of services.

Fact: Portland is an outlier to comparable New England cities in providing direct care clinical services.

Fact: Federal and state funds that have supported these services are being reduced, shifting a greater funding burden to Portland taxpayers.

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Fact: The city of Portland has one of the highest tax rates in the state, if not the highest, and can no longer continue to provide services that can be provided by other qualified organizations.

Fact: Portland is not alone in focusing on core services that can be provided only by a municipality, such as police, fire protection, road and sidewalk maintenance, parks and open spaces, etc.

With these facts in mind, one must ask two very fundamental questions:

Why should Portland continue to provide taxpayer-supported services that another community-based service provider is fully qualified and prepared to assume?

Why should Portland’s taxpayers continue to provide duplicative services when much of our basic infrastructure, hard-scale and parks/open spaces, is in dire need of attention?

For these fact-based reasons, I believe that the proposed transfer of direct health care services makes a great deal of sense and is totally consistent with Portland’s community values and the city manager’s overarching budget goals.

These health care services can be provided by another fully qualified community entity with an identical service approach. The city will save money by eliminating the cost of duplicative services and not having to invest significant taxpayer dollars in needed systems upgrades. Client satisfaction may well improve under one service provider and with additional support services provided.

This is a win-win for vulnerable people needing reliable and responsive health care services and for the city’s taxpayers. Please join me in letting our city councilors know that you support the city manager’s well-thought-out recommendation.


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