Municipal budgets are more than just pages of numbers. They’re a reflection of the values of the community that funds them.
The budget proposed earlier this month by Portland City Manager Jon Jennings is an ugly, reckless plan that does not reflect the values of the people who pay his six-figure salary. As the City Council considers this proposal in the coming weeks, it’s crucial that Portlanders tell them loudly and clearly that Jennings’ vision does not reflect the values of the compassionate and progressive city in which they live.
Jennings’ budget calls for the closure of the city-run health clinic on India Street that serves over 1,100 impoverished patients suffering from HIV, hepatitis, opiate addiction and other afflictions. Jennings seems to think all those patients can be just as well served by a privately owned and operated clinic based on Park Avenue, but that’s really just a guess — or, more starkly, a gamble he’s willing to make in which the stakes are the lives of some of the poorest and sickest human beings among us.
Neither the operators of the Park Avenue clinic, called the Portland Community Health Center (PCHC), nor city officials have a coherent, workable plan to transition patients from the public health care facility to the privately run one. The director of Portland’s Health and Human Services Department, Dawn Stiles, told the Press Herald the city has a “skeleton of a transition plan laid out.”
This skeleton is missing many vital parts, most notably a brain and a heart.
For example, where will the over 800 addicts who rely on the needle-exchange program run by the India Street clinic get the clean needles they need to avoid contracting and spreading deadly diseases? Nobody knows. The PCHC’s Park Avenue clinic is right across the street from King Middle School. It seems to have dawned on city officials only recently that such a location is a terrible place to run a needle-exchange program, but no one can identify an alternative. The midst of a raging heroin epidemic is not the best time to say, “Trust us, we’ll figure it out later.”
Jennings’ confidence that his skeletal transition plan will not result in a reduction of services is not supported by any evidence. The evidence that does exist indicates there would be a drastic reduction in health-care services for the poor.
Two years ago, the city shuttered a clinic that served homeless people under the assumption that PCHC could provide those services instead. As Press Herald reporter Randy Billings discovered when he looked at the numbers, dental visits fell by two-thirds and counseling sessions for health and substance-abuse issues were roughly halved.
Stiles and her boss, Jennings, are either ignorant of those reductions or they just don’t care. Stiles told Billings the city has not analyzed the effects of the transfer of services two years ago and has no intention of looking at the numbers now.
There appear to be two principal justifications for Jennings’ push to close the India Street clinic, neither of which involves improving health care for the destitute.
One is that the PCHC can get more money from Medicaid and private insurance companies than the India Street clinic is qualified to receive for the same services. That additional cash will supposedly allow the PCHC to hire enough staff to provide care to the thousand or more patients who’d show up at its door after the India Street clinic closes.
But it’s unclear how much more money PCHC would receive and how many people it would have to hire to provide the same or better services to all those new patients. (The India Street clinic has 15 employees who’d lose their jobs if Jennings’ plan is enacted.) The PCHC’s ability to get federal grant money for HIV services is also a big question mark — another gamble Jennings is willing to make with people’s lives. And again, if the previous transition of services from a city-run clinic to PCHC is any guide, those services will be slashed.
Jennings’ other justification is that Portland is among the relatively few American cities that still directly provide health care to poor residents. Rather than take pride in Portland’s well-deserved reputation as a compassionate community, Jennings thinks the city should join the pack and ditch its responsibilities to the poor and the sick.
With the money the city would save by closing the India Street clinic — about $375,000 in a $236 million budget — it could focus on Jennings’ priorities, like filling potholes and fixing sidewalks. “Paving roads or fixing broken sidewalks may not be the most glamorous of undertakings, but they are the foundation of what makes a great city,” Jennings said in a press release announcing his budget.
Statements like that prove it’s time the people of Portland tell Jennings to hit the bricks.