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- The Forecaster
PORTLAND — A contested shift in city health-care services will be completed Jan. 1, 2017, and officials and a former critic agree the transition has been successful.
The federally funded Positive Health Care program for HIV patients was one of the most enduring services at the India Street Public Health Center at 103 India St. It will begin the new year at Greater Portland Health, at 180 Park Ave.
“I think it is a good example of something that was really difficult and highly charged and people came together for good solutions,” Greater Portland Health CEO Leslie Clark said Nov. 17.
Positive Health Care patients who move to Greater Portland Health will be able to get care at the Park Avenue and 63 Preble St. locations in the city, and at the 100 Brick Hill Road offices in South Portland.
Joey Brunelle served on a patient advisory committee for the transition as a community member, after being highly critical of the move in the spring. On Nov. 15 he said he is now more confident Greater Portland Health can provide the care, trust and the welcoming atmosphere patients valued on India Street.
“Where we are now, through immense effort from the staff at India Street, it has gone as well as we could have hoped,” Brunelle said.
Brunelle cautioned that patients may still be hesitant, and city Health and Human Services Department Director Dawn Stiles said Nov. 15 that about 50 of the 229 patients who get care at the India Street Positive Health Care program may make the move to Greater Portland Health.
“I’m not concerned about the number of people who come here so long as everybody has a place and nobody loses care. Our goal was to make sure a resource remains in the community,” Clark said.
On Nov. 10, Stiles reported to the City Council Health & Human Services Committee that all but 11 patients had been contacted about the shift, and 205 patients wanted their records to be sent to another health-care provider.
The advisory committee also included four India Street patients, who were instrumental in guiding the transition process and outreach to other India Street patients. The transition team also reached out to the nonprofit Frannie Peabody House for advice, Clark said.
The shift of all medical services at India Street was proposed by City Manager Jon Jennings in his fiscal year 2017 budget as a way to increase access and quality of public health care at what is known as a Federally Qualified Health Center.
City officials also worried about complying with revised guidelines governing the Ryan White Grant from the U.S. Department of Health and Human Services Health Resources and Services Administration.
“It wasn’t a money thing at all; it was about saving the grant,” Jennings said Nov. 18. The annual grant, now $356,000, was due to expire Dec. 31 and getting it renewed at India Street would have required upgrades such as electronic record keeping.
The proposed shift was not met warmly by the public, who criticized Jennings for cost-cutting in the wrong areas and not understanding how essential, integral and discreet services at India Street were.
“As a gay man, I know a lot of other gay men who are HIV positive and patients at India Street. It was not widely understood at the time how disruptive the change would be,” Brunelle said.
In his April 25 address to the City Council on the proposed budget, Mayor Ethan Strimling questioned closing India Street as well, and wanted to be sure the Ryan White grant could be transferred to Greater Portland Health, which was then called the Portland Community Health Center.
Ultimately, city councilors approved the budget with the conditions the needle exchange and HIV/STD testing services remain on India Street through June 30, 2017.
Jennings said he is committed to keeping those services there beyond that date, and the city is working to extend its lease. The Portland Community Free Clinic, not funded by the city, also continues to operate on India Street.
Stiles said the Ryan White Grant has been extended another year as federal officials continue working on changes to the funding formula. The grant still must be transferred to Greater Portland Health.
“We are just waiting for the final word, which should come in the next few weeks,” Stiles said.
Brunelle said he is pleased with the Greater Portland Health staff additions, noting physician Dr. Jen Rogers is highly regarded in the gay community.
“HIV is not like having a cold, it is a very specialized thing not all doctors know the ins and outs of,” Brunelle said.
Clark said the committee contributions also led to a wider understanding of the LGBTQ community and its needs.
Brunelle remains critical of how the city communicated the transition, but is optimistic about the shift.
“I have total faith in them to build an HIV program, but it takes time,” he said.
Greater Portland Health, based at 180 Park Ave., will become the new home of the federally funded Positive Health Care for HIV patients program and will offer services at three locations beginning Jan. 1, 2017.