City Councilor Belinda Ray
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About Portland Community Health Center

5/5/2016

 
At the May 2, 2016 Council meeting, many questions and concerns were raised about the services provided at Portland Community Health Center and their ability to add more patients to their practice. There were also issues raised around the closing of the City's Health Care for the Homeless Clinic in 2014. Dr. Leslie Clark, the CEO of Portland CHC has provided answers and information addressing these questions and concerns, and I'm posting them below.

Capacity
There have been questions raised about our capacity to add this many patients as currently seen at India Street.  Our target patient population number (as set by the federal guidelines for our health center) is just over 10,000, and we have a solid business plan in place to achieve it.  We currently serve over 6,600 patients (patients seen within a 24 month period) and seek to increase this number to 10,000 (annually) over the next several years.  This number is established by an in-depth community needs assessment.
 
Scheduling
Portland Community Health Center closely monitors available appointments to assure access to care, and offers same or next day appointments at every location.
​

For example:
This morning, we had 18 open appointments at 180 Park Ave.
We have walk-in/open access today from 8-12 at 63 Preble. (Two days until 3:00. New medical provider will expand hours this month to 3:00 pm five days per week.) 
We have three open appointments at Brickhill.
We have same day access for new patients at all sites. ​
STD Care
We currently screen patients based on the CDC guidelines for HIV, syphilis, GC/chlamydia, herpes and Hepatitis.
We can and do check extra-genital sites for GC infection.
We follow the CDC guidelines on sexually transmitted diseases.

We currently do not have a stand-alone STD clinic. If the City were to close its STD clinic, we would provide the same model they currently provide, which is a combination of walk-in hours and scheduled appointments throughout the week.  Currently, about 20 patients are being cared for each week. We would offer these services at our three largest sites. People would be able to come for STD testing without being patients of the health center. 

They would be required to give a name, birthdate, and telephone number just as they are currently required to do at India Street. We will do all that we can to continue the contract with the State of Maine which funds free testing for high risk groups.

​As a federally qualified health center, we do not turn people away if they are unable to pay for services.
Needle Exchange
We were recently awarded a substance abuse grant from the federal government.  Part of the grant is focused on harm reduction.  We plan to include overdose prevention education including Narcan administration,  as part of this program, regardless of what happens with the needle exchange. 

​We are applying for a needle exchange license. We have recommended several possible sites for the exchange and are open to continuing the conversation about where the exchange should be located. 
Staffing
The current staff at Portland CHC includes:

6 physicians
6 NPs
6 LCSWs
4 RNs
​

We are currently hiring more staff/providers, in general and particularly for our substance abuse grant and would bring on more staff/providers if we take on additional services (Positive Health, DTS, Needle Exchange).

We will be bringing in HIV expertise for the Positive Health program.
Homeless Health Care
There seems to be confusion in the community about this.  The City did not decide to transition the Health Care for the Homeless program.  The federal funder, HRSA, did not approve and fund the City’s application due to its inability to meet the requirements of the grant.  The City was found noncompliant in nine out of nineteen areas in 2012.  HRSA decided to put the grant out for competition, in what is called a Service Area Competition.  It was awarded to Portland CHC. 

The responsibility for notification and transfer of patients when a practice closes is with that practice, in this case the City.  The City staff assured Portland CHC that it had contacted and transferred the records of all active patients; the rest of the patients were considered inactive by the City staff and unable to be reached. Each patient needed to sign for records individually with the City of Portland to provide permission to transfer the record. Portland CHC had to depend on the City staff to locate and transfer patients.  

Please Note: We have received legal counsel on how to transfer all records in compliance with State and federal health care law, so that we have ability to contact every patient if India Street closes. 


Portland CHC has served more homeless patients, has better access and availability and a wider array of services for patients than at the previous HCH program.  Homeless patients are able to access care not only at 63 Preble Street but at any of our locations.  Many prefer to come to 180 Park Avenue or to our other four locations.  

We provide care to children who are homeless, as well as adults.  We work closely with the family shelter and provide care onsite, as well as transportation from the shelter to our 180 Park Avenue site for establishing a medical home, group visits and school readiness.

Patients experiencing homelessness are very satisfied with their services as evidenced by our patient satisfaction surveys. 

We have done all of this, despite not having support from one of our most important community partners.

Portland Community Health Center’s Health Care for the Homeless Program, and all of our services, are closely monitored by the federal government, as well as reported to the National Quality Improvement Council to demonstrate that we meet highest standards for Patient Centered Medical Home recognition.  Our health center, like the City’s federally funded health care programs, undergoes rigorous review. 

​The City’s programs have struggled with compliance, risking loss of federal funding (Health Care for the Homeless, now Ryan White Part C).  Portland Community Health Center consistently meets all requirements and excels.  We received a quality award from the federal government this past year, and an incentive payment for Patient Centered Medical Home development just yesterday, including specifically for our Health Care for the Homeless program.

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