Funding loss threatens India Street free clinic in Portland

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PORTLAND — The Portland Community Free Clinic will lose its funding from the city in September, but staff and volunteers say they will fight the odds to continue offering free health care to those in need.

Word that the clinic would have to close was met with “outcry from the volunteers, and panic from the patients,” said Caroline Teschke, Public Health Department program manager and administrator of the clinic.

Now Teschke and her four-person staff are scrambling to come up with a shoestring budget to keep the clinic going after September.

The clinic, which offers primary and some specialized medical care to Cumberland County residents without health insurance, was supported for nearly two decades by a partnership between Mercy Hospital and the city.

The hospital took care of funding and the city provided a small staff and space in its Public Health Center at 103 India St., Public Health and Human Services Director Doug Gardner said.

Mercy stopped providing money to run the clinic last July, leaving the city to pay clinic staff salaries. The Public Health Department fiscal 2013 budget proposal includes funds for those salaries only until September.

“We never provided any financial assistance for the programming up until recently. So the entire program would have to be shifted onto the general fund, and we can’t,” Gardner said.

The partners had decided in early 2011 to focus their resources elsewhere, in part because of increased capacity for primary care at Mercy and Maine Medical Center, and at the city’s federally qualified health center at 180 Park Ave., he said.

Officials believed they could shift care of the more than 500 patients the free clinic treats each year to those facilities. But the process of transferring patients to new care centers has been harder than anticipated.

“We haven’t been as successful as I think anyone thought we would,” Gardner said.

Almost a year after the clinic began trying to refer patients to other care providers, the clinic’s patient roster has barely shrunk. The city has continued to underwrite the program to have enough time to strike a balance between the clinic’s services and others in the city.

“I’m hoping that we will be able to get people connected to other primary care practices in the community,” Gardner said. “I don’t know how that’s going to play out.”

For patients being shuffled from the clinic to other care providers, even to other free programs at Mercy and Maine Med that Teschke said provide excellent care once a patient is enrolled, “there are barriers that our patients find it hard to overcome.”

Other free programs often have long waiting periods before new patients can even fill out the paperwork needed to join and harsh penalties for missed appointments, Teschke said. They may not have evening hours, as the free clinic does, or they may not have a phone system that the patient can navigate, she said.

Often, patients of the free clinic are reluctant to join other programs out of fear of being charged, even for small co-pays or diagnostic tests, she said.

All are deterrents for the clinic’s patients, 85 percent of whom work but don’t have any health insurance or even MediCare, Teschke said.

“They’re the real working poor,” she said, ranging from employees of the city’s hotels and restaurants, to construction workers, and self-employed yoga instructors and massage therapists. 

For many patients, the clinic is a “medical home,” said Kathleen Fairfield, a Maine Med doctor who has volunteered as the clinic’s medical director for a decade.

The volunteer medical and administrative staff, about 120 in all, thinks of the clinic as a reminder of years past, when doctors had “years of oral history” and time to treat individual patients thoroughly, staff public health nurse Bob Barrett said.

When Mercy provided funding, the clinic’s annual budget was about $210,000, said Teschke. She is the administrator for all six programs housed in the India Street health center, including the free clinic, and would not lose her job if the free clinic shuts for good.

She and the clinic’s four paid staffers – a program coordinator, a nurse, a volunteer coordinator, and a special projects coordinator – hope to raise between $150,000 and $200,000 to keep the clinic going for a year after city funding disappears. Their first fundraiser, an invitational dinner event at a doctor’s home, will take place in May.

If they can raise the money, the city would continue to act as a partner and  provide space for it, Gardner said.

Andrew Cullen can be reached at 781-3661 ext. 100 or at Follow him on Twitter: ACullenFore.

Sidebar Elements

Portland Community Free Clinic volunteer Dr. John Saucier, right, discusses a patient’s paperwork with clinic program coordinator Leslie Nicoll, left. The clinic at 103 India St., which provides health care to those with no insurance, is set to lose all city funding in September and is scrambling to find new financial resources to continue its work.