In 2007, the city of Portland and its partners applied for and received a federal grant to establish a federally qualified health center to serve the Portland area, now known as the Portland Community Health Center. The vision at that time was to create a high-performing, patient-centered, not-for-profit entity that could provide affordable services to vulnerable populations, including those whose care was being provided through the city’s Public Health Division at the India Street clinic.
In 2012, the city successfully transitioned the PCHC from a service model that functioned as part of the city’s public health services to a stand-alone not-for-profit with a patient-majority board of directors. And in 2014, the city successfully transitioned the Health Care for the Homeless program to the community health center. Today, they provide high-quality, comprehensive care to almost 7,000 patients at five different sites.
City Manager Jon Jennings’ proposed budget asks us to act now, in partnership with the PCHC, and transition the services currently offered at the India Street clinic to ensure continued access to comprehensive care for those in our community who need it most. This transition is the final piece of the original 2007 vision.
By making the proposed transition now, the city would be taking steps to ensure the long-term sustainability of these services. By acting now to develop and implement a fully vetted and monitored patient-centered transition plan, the city can make sure that patients are not left without critically needed health care, or forced to transition under emergency conditions in reaction to decisions outside of the city’s control.
We believe this is a good government decision. Making this decision now and implementing it within the eight-month transition process will allow the city to ensure all members of our community have ongoing access to fully integrated health care services.
The Portland Community Health Center will offer the same services and quality standard of care to patients transitioning from India Street that it already offers its existing patients. As a federally qualified health center, the PCHC receives a significantly higher reimbursement rate for its comprehensive services, which include transportation, case management, free or no-cost medications and integrated mental health care services.
Because they are federally funded, they are required to provide primary, preventive and supportive health services at times and locations that are convenient to its target populations, and they must ensure that no patient is denied services because of an inability to pay. And patients who transition from India Street to the PCHC will be eligible to serve on its governing board.
We believe that a carefully monitored transition of direct care services to the Portland Community Health Center is the well-timed next step for the city. It makes sense for the patients and caregivers at India Street to be concerned about the impacts of this transfer and the challenge of new relationships at an unfamiliar location. To ease this anxiety, city staff will partner with PCHC staff to manage the transition of patients according to a detailed transition plan that will minimize disruptions in service.
And while access to quality community-based care is the driving factor for this decision, transitioning the city away from the direct care service model to the more sustainably funded, consumer-controlled, federally qualified model makes sense insofar as it may allow the city to focus on many other safety net priorities.
This partnership between the city and the PCHC will not dissolve as soon as these services have been transferred. The City Council’s Health and Human Services Committee will remain involved at the policy level to monitor implementation of the programmatic details. The city and its staff will remain invested in the ongoing relationship with the community health center to ensure that the transition continues to provide our most vulnerable citizens with the care they need and deserve.
The Portland Community Health Center was created to deliver these services. It is mission-driven and funded to do so. State and federal sources have made it clear that these centers are to be the primary recipients of funding to provide these services. Based on what we know about the options available, it does not makes sense to hold vulnerable patients captive to the city-run service model and jeopardize access to more sustainable comprehensive care out of a fear of change.
We look forward to continuing this conversation at the Finance Committee’s public hearing Thursday night and at the City Council’s public hearing May 2.
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