Institutional memory is a set of facts and knowledge held by people who have worked within an organization. On behalf of those who worked at the India Street Health Center at 103 India St. for many years before the city proposed closing it in 2016, I would like to offer several corrections to the op-ed by Kristen Dow, director of Portland’s Health and Human Services Department, published in the Press Herald on Aug. 6. My goal is to set the record straight.
I witnessed the sequence of events firsthand and am confident that my narrative will withstand rigorous fact checking.
In the spring of 2016 it was announced that all of the services at the India Street Health Center would be closed. These were an interrelated and overlapping group of programs providing essential clinical services. The central program was Positive Health Care, which offered comprehensive primary and specialty services for those living with HIV and AIDS, including treatment for hepatitis C, mental health and substance use disorders. Experienced medical providers were experts in delivering care to complex patients and were leaders in several areas of treatment. For example, when medically assisted treatment for opiate users was first offered at the India Street Health Center in 2012, we were pioneers with this initiative.
Other programs at the India Street Health Center included a needle exchange, which was the first in Maine to offer Narcan to those who might need it. An affordable immunization program provided accessible TB testing for newly arrived immigrants and helped their children to safely enroll in the school system. India Street immunization staff also organized many seasonal flu clinics throughout the city and mounted an effective response at the time of the H1N1 epidemic. The immunization program no longer exists, and the services provided have ceased.
The sexually transmitted infection clinic was the biggest in the state and saw patients on both a walk-in and an appointment basis. The STI clinic started Pre-Exposure Prophylaxis (PrEP) well before the proposed closure of the India Street Health Center. Medical residents had been coming to the clinic under the supervision of the medical director for over 20 years. Teaching residents at the India Street Health Center was not an innovation developed in the past two years.
At the time the proposal to transfer the Positive Health Care program was made, the federally qualified health center, the Portland Community Health Center (now called Greater Portland Health), did not have the specialist staff in place to treat complex cases of people living with HIV and AIDS. There was no need or requirement to transfer our grant. Far from it! The federal granting agency overseeing our program was blindsided and confused by the city of Portland’s decision.
Positive Health Care had maintained an excellent record for more than 10 years. The fact that over 95 percent of our patients had an undetectable viral load made us one of the best programs in the country, and we were cited as a gold standard at national conferences. Learning of our closure, our federal project officers called us to ask why this was being done and expressed great concern about ongoing appropriate care for a vulnerable and marginalized group of patients.
The needle exchange and the STI clinic survived largely because of strong public outcry. The India Street Health Center as it was for many years no longer exists, though it has not closed. Perhaps the persistence of the impression that India Street has shut its doors is a reflection of the pain and sadness that people still feel about the loss of something precious that was a resource for the poor and vulnerable and is now gone.
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