The issue:
Portland City Manager Jon Jennings has proposed the city close its India Street Public Health Center and transfer services to the private nonprofit Portland Community Health Center, headquartered on Park Avenue. The India Street clinic houses the city’s needle exchange, as well as its HIV and STD treatment services, among other things.
Why does he want to do that?
Jennings has argued the federally recognized PCHC can demand double or triple the Medicare reimbursements that the city facility can, increasing the flow of health care dollars into the city and potentially expanding capacity for more at-risk patients. He also wants the city to focus more on traditional municipal services, like infrastructure maintenance and public works.
What do other people think about it?
Mayor Ethan Strimling has expressed serious concerns about the proposal, questioning the city manager’s priorities. He said he wants more information about the transition — such as where the needle exchange will be moved to and whether federal Ryan White Program HIV funding is transferable to the new facility — before he supports it.
The mayor’s criticism of Jennings’ proposal has come under fire from the other members of the City Council, who will ultimately vote whether to approve the budget. That vote is scheduled to take place on May 16. City Councilor Justin Costa, described Strimling’s remarks as “not appropriate.”
BDN columnist Chris Busby defended Strimling’s stance in an April 28 blog post:
“Jennings is promoting this idea despite the fact there is no plan to guide the transition and ensure patients are not left without access to life-saving services. Furthermore, data related to a previous consolidation effort, by which patients at a city-run health clinic were directed to the Park Avenue facility, clearly indicate that services dramatically declined as a result.”
Portland Community Health Center CEO Leslie Clark explained her organization’s perspective in a commentary for the Portland Press Herald on May 2:
“We understand that some India Street patients may feel concerned about what will happen to them if the city decides to close the clinic. If the city decides to make this transition, we want to assure the community that we will willingly expand our services to accommodate all patients and provide continuity of care. … It is important to remember that the proposed transition time provides ample opportunity to create a thorough, thoughtful plan that puts the safety and care of patients at the forefront.”
BDN blogger Rob Korobkin wrote about the “5 myths about the plan to close the India Street clinic” on May 3:
“We’re kidding ourselves if we think that PCHC is truly prepared to become a viable substitute for India Street. PCHC has no experience operating an HIV clinic or a needle exchange and doesn’t have a proven track record of providing care specifically to LGBTQ people, just to name a few things, and their staff is stretched so thin that patients frequently have to wait weeks to see physicians.”
What’s new?
May 18: PCHC changes name, opens South Portland facility
Portland CBS television affiliate, WGME 13, reported that the Portland Community Health Center has changed its name to Greater Portland Health and held a ribbon-cutting for a new facility in South Portland in the aftermath of the council’s vote two days earlier.
May 16: City Council votes to keep clinic partially open
May 6: City staff reports on costs of keeping clinic open
In advance of the City Council’s Monday evening workshop, the administration of City Manager Jon Jennings compiled information and data reinforcing the reasoning behind the move.
Finance Director Brendan O’Connell reported in a pre-workshop memo that keeping the clinic open would add more than $450,000 back into the city budget. Restoring a number of other administrators and public health positions that had been cut, due to losses of grant funding that had supported them, would drive that total to nearly $1.6 million, he wrote.
The resulting overall tax rate increase would be 3.3 percent, O’Connell wrote.
In the 25-page packet to council members, Jennings also responded to several of the concerns expressed by the mayor during his now famous April 25 public critique of the plan.
Read those remarks, as well as memos describing the prospects of current India Street clinic employees moving over to take positions at the Portland Community Health Center, below:
More information on the proposed India Street clinic closure, transition
May 4: Clinic supporters submit petition to mayor
Members of a group behind a petition drive to save the India Street clinic announced that on Wednesday morning they submitted more than 2,100 signatures — about 1,100 of which are from Portland residents — to Mayor Ethan Strimling.
India Street patient David Jon Timm started the petition drive through the website MoveOn.org about week earlier (see below).
“The support we’ve gotten online has been overwhelming, from Portland and from around the state,” said Joey Brunelle, a clinic supporter who organized the April 28 news conference featuring remarks by state lawmakers (see below), in a prepared statement.
“In the middle of a nationwide opiate crisis, it would be irresponsible to close one of our city’s most effective and most trusted public health facilities and needle exchanges, especially since it costs the city a fraction of other budget items, such as the public library,” he continued. “An ounce of prevention is worth a pound of cure. … It was reductions in public health just like that helped precipitate that [opioid] crisis in the first place.”
May 2: The public weighs in
The Portland City Council held a public hearing on May 2 on the budget proposal.
Public comment now over. @CityPortland Council will vote on the budget at the May 16th meeting. pic.twitter.com/hWsGuTS7Ih
— Jeff Hogan (@NewsPhotoJeff) May 3, 2016
The Portland Press Herald’s Randy Billings reported that about 60 people filled the council chambers for the public hearing, many of whom urged city councilors to take more time to study a potential transition of services from India Street to the Portland Community Health Center.
Steve Hirshon, president of the Bayside Neighborhood Association, expressed concerns about the prospect of moving the India Street needle exchange to his neighborhood, where it would be near Portland High School and a day care, among other things, according to the Press Herald.
But others spoke up in defense of the Portland Community Health Center, arguing the nonprofit has been unfairly maligned in the public debate over whether it should take over the services now offered at India Street, the newspaper reported.
May 1: Demonstrators protest clinic closure
About 200 people marched to Monument Square holding signs supporting the India Street Public Health Center and protesting its proposed closure, according to Maine Public Broadcasting Network.
Annie Spencer, a local doctoral candidate who helped organize the rally, said shutting down the clinic is a bad idea at a time when Maine is battling a serious opioid epidemic.
“We have already grieved so many losses in this community in the last few years,” she said, according to MPBN. “And in the midst of this crisis, politicians here at the local level don’t even acknowledge that this crisis has been produced by exactly these kinds of benign, administrative-seeming measures that seem apolitical — but that are absolutely about the distribution of life chances to so many people in our community.”
April 28: State lawmakers enter the fray
Democratic state Reps. Diane Russell and Benjamin Chipman were the latest elected officials to weigh in on Jennings’ proposal to close the city-run India Street clinic, saying at a rally in front of City Hall Thursday morning the move would put some of Portland’s most vulnerable patients at greater risk.
Russell and Chipman — as well as physician Charles Radis — are all seeking the June party nomination to replace the term-limited Justin Alfond in the state Senate. All three took the opportunity Thursday to decry the clinic closure, by far the most controversial recommendation in Jennings’ fiscal year 2017 budget proposal.
The state lawmakers are the latest to pick sides in the debate, which has divided public officials up through the highest ranks of City Hall.
Chipman: “We’re talking about people’s health care, we’re talking about their livelihood, we’re talking about their ability to live in some cases. The services provided at this center are very, very important.”
Radis: “There are so many people [for whom] this has been such a critical part of their health care. My thought on the City Council’s way forward on this would be to reassess and to slow down. I don’t see the [importance] of going into the process of closing this clinic immediately and then transferring services over the next year. I think the decision about whether to close it should be a public conversation.”
Russell: “The India Street clinic is in my district and I’m categorically opposed to seeing it closed. In my early 20s, it was when the AIDS epidemic was at its height. There was very little good information. There was no ‘undetectable.’ Either you were free of it, or you had a death sentence. … The one sanctuary in this city was the India Street clinic.
“The reason people are so passionate about this clinic is that they built trust, they provided us with the information and the resources and the health care at a time when very few places would.”
April 28: Petition to save clinic gathers more than 1,000 signatures
David Jon Timm, a longtime patient of the clinic, said he was diagnosed with HIV — and then AIDS — at the facility a decade ago. But he said that thanks to treatment he received at India Street, the virus was subdued to “undetectable” status just six months later, and has remained undetectable since. He said he started a petition to save the clinic on the website MoveOn.org and that it gathered more than 1,000 signatures in its first 24 hours, a number roughly the same as the number of patients treated at the center every years.
April 22: Jennings agrees to delay needle exchange, HIV clinic closures
The city manager told the City Council’s Finance Committee he’s agreeable to keeping the needle exchange and HIV/STD services open at the city’s India Street Public Health Center site for six months longer than originally planned.
Here is that proposal, as well as additional details about the transition of services as they were known at the time:
