Concerns over the possible closure of a Portland health clinic are intensifying.

A proposed city budget would close the India Street Public Health Center and transfer patients to the federally qualified Portland Community Health Center. City officials say the switch would be more cost-effective while still providing the same quality of care.

But some in the community worry that patients could get lost in the shuffle due to the loss of critical relationships and lack of capacity.

For awhile, Richard – who asked that his last name not be used – just couldn’t accept that he needed to go to a free health clinic. But he lost his insurance when the company he worked for closed, and last fall he developed a fever he just couldn’t kick.

“I was running a fever consistently over 103. I had lost 40 pounds, and I was sleeping sometimes 18 hours a day,” he says.

It got so bad that in January, Richard swallowed his pride and went to the India Street Public Health Center.

“I sort of expected the worst. And what I found was, it was the best medical experience of my life,” he says.

He says the staff treated him with kindness and respect as he got various blood work and testing. When the results came in he got devastating news. He tested positive for HIV.

“Everything ended for me in that moment. I thought, ‘My life is over. I’ve made some bad decisions along the way, and everything is done now,’” he says.

When India Street staff told Richard he needed to come in as soon as possible, he reminded them that he didn’t have health insurance. They told him that didn’t matter, that they would help him get better. And, he has.

“They do HIV, they do a needle exchange, they do mental health — all right there in the building, all of which is linked to this disease,” he says.

Now, three months later, Richard’s gained some weight back and his outlook is more optimistic. But he’s terrified at the prospect of the India Street Public Health Center closing and losing the provider he says saved his life.

A proposed city budget would transfer India Street’s services and patients to the Portland Community Health Center, which receives higher reimbursement rates as a federally qualified health center. Portland’s director of Health and Human Services Dawn Stiles says there are several reasons to make the switch.

“One of them is the fact that none of the Northeast cities are providing direct health care anymore. And when you look at the trends and what the real purpose of public health is, it’s really to do population health, policy and making sure emergency systems are in place rather than providing direct primary care services,” she says.

And the city has a nonprofit, federally qualified health center that’s well positioned to provide cost-effective, quality care, says Stiles. The Portland Community Health Center already took on the health care needs of the city’s homeless population when a city clinic closed a couple years ago.

But Mark Swann, the executive director of the Preble Street Resource Center, says it hasn’t been a seamless transition.

“They do a great job with their homeless health clinic, but the fact is, it’s significantly reduced services than when the city ran the program,” he says.

Swann says the Portland Community Health Center just doesn’t have the clinical bodies to keep up with the demand for dental care, mental health and substance abuse treatment.

But Community Health Center CEO Leslie Clark says all of their services are team-based and include a social worker. She says they’ve grown their homeless health clinic despite cuts to MaineCare, and they’re prepared to take on more patients.

“The goal is to makes sure every single patient has a plan and a place to receive their care,” she says.

If India Street closes, Clark says she’ll work with their staff to better know and understand their patients. She also hopes to hire some of the India Street staff.

But that’s all a big “if” right now, she says. She doesn’t have a position on whether or not it should close.

“We were asked by the city if we’d be able to step up and help if this were to happen, and we admire very much the work they do there, and we’d be honored to making sure it continues,” Clark says.

A public hearing on the possible closing of the India Street Public Health Center is scheduled for 7 p.m. next Thursday.