The Portland City Council is scheduled to decide Monday on the fate of a publicly run health clinic on India Street and a $236 million proposed city budget for the upcoming fiscal year.

The closure of the India Street Public Health Center and future medical services for its roughly 1,600 patients have been the focus of debate since City Manager Jon Jennings released his budget plan at the beginning of April.

Opponents of the closure have held several rallies, filled council chambers for two public hearings and launched an online petition drive that garnered over 2,100 signatures to keep the clinic open. They have openly questioned the city’s motives, and some have intimated that the rapid development of luxury condominiums in the area is to blame.

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City Manager Jon Jennings

Jennings says development pressures are irrelevant. Based on conversations with federal officials who administer $356,500 in grant funding for the clinic, he is concerned that Portland could lose that vital funding, he said. If that occurs, the city would have to either hastily close the clinic, or devote more tax dollars to its operation.

“If we felt as though the India Street clinic should remain there and we could afford it, I wouldn’t care what a developer would have to say,” Jennings said, pointing out that only 11 percent of municipalities nationwide continue to provide direct clinical health care. Jennings’ plan calls for patients and services to be transferred to an independently run nonprofit clinic that qualifies for greater federal reimbursements.

Opponents, including several candidates for the Maine Senate, are calling on the council to delay the clinic’s closure to allow more time for discussion. Some have criticized plans for the transition of health services, and warned about loss of life and spread of disease. Critics argue that the city conducted prolonged public reviews on issues such as privatizing its golf course and a street lamp sculpture at Woodfords Corner, but is looking to close the clinic as part of an annual budget.

Jennings said his plan has been thoroughly researched. City budget staff and Mayor Ethan Strimling had been told about the plan as far back as Feb. 25, according to a memo to councilors. Councilors were informed in mid-March.

“I feel very comfortable with the process we have gone through,” Jennings said. “We haven’t taken this lightly at all. I feel as though we have a good path forward on this.”

The India Street clinic treats HIV-positive patients, offers confidential screening and treatment for sexually transmitted diseases, and hosts a needle exchange where intravenous drug users can access clean needles to prevent the spread of diseases. It boasts a 95 percent success rate in decreasing the viral loads in HIV-positive patients, meaning the virus is no longer detectable. It has established strong relationships with a population that has historically been difficult to reach, primarily gay, lesbian, bisexual and transgender people, advocates say.

But the independently run nonprofit that is poised to take over these services and patients also has a strong track record, supporters say.

The city helped create the Portland Community Health Center back in 2007 as a way to bring in more federal health care dollars for underserved populations. As a federally qualified health center, the clinic receives higher MaineCare and Medicare reimbursements than the city.

Patients of the city-run clinic are worried about losing relationships they have had for decades, because the independent health center has indicated that it will not be able to provide employment to all city staffers, although it’s open to hiring as many as possible. They also worry about the impact of relocating and separating interrelated services, such as lab testing and the needle exchange, that are currently in one location on India Street.

Jennings originally proposed closing the clinic by the end of the year, a timeline that coincided with the end of its lease at 103 India St. and the end of a federal grant that funds its HIV-positive health care. He has since endorsed a plan to move only the HIV-positive care by the end of the year, while leaving the HIV and STD testing and needle exchange on India Street through June of next year to allow more time for a transition.

Mayor Ethan Strimling

Mayor Ethan Strimling

On Monday, councilors are expected to consider an amendment from Councilor Belinda Ray to keep those services at India Street indefinitely – a move that would benefit the Portland Free Clinic, an independent nonprofit that has its rent and utilities paid by the city.

Keeping the India Street clinic open through the end of next fiscal year – June 30, 2017 – would cost an additional $452,982, according to a May 2 memo from city Finance Director Brendan O’Connell. That would add $15 to the annual tax bill on a property assessed at $300,000.

Throughout the discussion, a majority of councilors have appeared supportive of Jennings’ proposal, although they have at times pressed the administration for details about the transition. Only a minority, including Strimling and Councilor Jon Hinck, have expressed doubts about closing the city clinic.

“I haven’t come around to the view that we should adopt the proposal even with the amendments, but I’m still paying attention to the arguments on the merits of that,” Hinck said Friday. “(It’s) just really good positive health care. I think that’s obviously critically important for the patients, but also critically important as a matter of public health. I really don’t want to risk disturbing that.”

Strimling has strained his relationship with the council by questioning the priorities of Jennings during a speech about the budget on April 25. Councilors interpreted the criticism as an attack on the council’s own Finance Committee and were quick to fire back at Strimling as misrepresenting the budget.

Strimling said Friday in an email exchange that he is still “wrestling” with the proposal to close India Street. He is supportive of Ray’s amendment, as well as an amendment expected to be proposed by Councilor Justin Costa to include India Street patients on the transition team. However, he is undecided about whether he will support the overall budget.

If Strimling feels strongly that more time is needed to discuss the closure of the India Street clinic, he has the power to veto the budget within five days. The City Charter would require Strimling to lay out his reasons for doing so in a written message to the council and “at a minimum, be posted to the city’s website or similar location.”

It takes five votes to pass the budget and six votes to override a mayoral veto. If the council fails to override the veto, it would be required to negotiate a resolution at the next meeting. If the impasse is not resolved by the start of the fiscal year on July 1, the council would have to pass continuing resolves appropriating money to keep the city in operation.

When asked whether he would consider vetoing the budget if it passes with the India Street closure, Strimling said: “I’d rather not deal in hypotheticals.”

The council’s three-member Finance Committee has 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, including adding a 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.