Debate over clinic shift likely to continue at Portland budget hearing

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PORTLAND — The first opportunity for extended public comment on the $236 million fiscal year 2017 municipal budget will come at 7 p.m. Thursday, April 21.

The City Council Finance Committee, with Councilor Nick Mavodones Jr. as chairman, will hold a public hearing before making its budget recommendations to the full City Council. Last year, the committee deadlocked 2-2 on whether the budget should be adopted as written.

The hearing culminates committee meetings held since the introduction of the budget by City Manager Jon Jennings on April 4, and follows an April 14 committee meeting where his proposal to shift publicly funded health care to the Portland Community Health Clinic was the focus.

If the budget is passed as proposed, medical services provided at the India Street Public Health Center, 103 India St., would be shifted to the Portland Community Health Center.

The PCHC is based at 180 Park St., but also provides services at Franklin Towers on Cumberland Avenue, at the Riverton Community Center off outer Forest Avenue, on Preble Street, and in South Portland at 100 Brickhill Ave.

Jennings on April 14 defended the plan as one that will provide more health care for all because of increased reimbursements from the federal government, while allowing the city to focus more on core government tasks.

“It brings more reimbursements, so we can treat more people. To me, this is one of the most logical things we can do,” he said.

The transition of services is expected to be completed by Dec. 31, 2016, and would include needle exchange and treatment and prevention programs for HIV and other sexually transmitted diseases.

But where to put the needle exchange remains a lingering question, because the main PCHC office is essentially across the street from King Middle School, the Riverton office is near Riverton Elementary School, and the Franklin Towers office is in subsidized housing.

Information provided to councilors suggests the needle exchange, which has about 800 clients, could be placed at 63 Preble St., where the PCHC already provides services for the city’s homeless population. Jennings has allocated $15,000 to fund the needle exchange program in the new budget.

Councilor Belinda Ray said she hopes for some kind of “cohesive unit” that would allow needle exchange users to access the HIV and STD services at the same place.

Because PCHC is a Federally Qualified Health Center, it receives almost $182 in MaineCare reimbursements per visit, from the U.S. Department of Health and Human Services.

By contrast, the city and India Street Public Health Center are reimbursed at rates from $45 to $145 by MaineCare, depending on the type of treatment.

Because the PCHC also uses electronic medical records and offers case management and interpreters, and already serves about 6,000 patients annually, Jennings sees it as a good fit for continued care.

Records show more than 1,600 cases ranging from HIV treatment and counseling to immunizations were recorded at India Street in the last year. About 1,050 of those cases were for Portland residents, with 231 people using the Portland Community Free Clinic and 110 cases at the teen clinic.

Leslie Clark, chief executive of PCHC, said the health center will consider adding staff now working at India Street as the transition progresses after Mavodones asked how many jobs might be affected by the switch.

Jennings said he is confident the transition can be completed by Dec. 31.

Councilor Jill Duson expressed her support for the transition. She said she sees the switch as a potential expansion of services, instead of the reduction she expected 

“I think this plan is a good government plan,” she said.

But Chris Buerkle, a volunteer at the needle exchange, did not share her trust.

“I don’t see how they can offer those services in such a positive way,” he said.

As a member of the gay community, Buerkle said trust has been critical for people using the India Street location, which has been open since 2007.

Continued anonymity for patients and a nonjudgmental approach are what has drawn people to use the HIV, STD and needle exchange programs, he said.

“I would not feel comfortable accessing (PCHC),” Buerkle said. “These people are experts, and I see them losing their jobs.”

David Harry can be reached at 781-3661 ext. 110 or dharry@theforecaster.net. Follow him on Twitter: @DavidHarry8.

Members of the public will have a chance to comment April 21, at City Hall, on a city plan to shift health care services from the India Street Public Health Center, shown here, to the Portland Community Health Center.

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Portland City Hall reporter for The Forecaster. Baltimore native, lived in Maine since 1989. A journalist since 2005, covering much of Cumberland and York counties. I joined The Forecaster in 2012.