PORTLAND, Maine — First through the door of the Portland Community Health Center on Thursday morning was a stick figure of a man, oblivious to the homemade signs and the White House advance team across the street. He had a bald eagle drawn on his sweatshirt, a street-hard weariness in his eyes and a throbbing pain in his right hand.
Sarah Andel, a nurse practitioner, knew this man, James Hierl: how he lived in a shelter; how his depression made eating seem futile. As she held his numbed hand, working to remove a painful wart with a blade, she coaxed and coddled him: You have to eat; you have to see your psychiatrist; and please, James, eat.
“You’re going to come back in a week,” Andel said, as her patient headed for the door, finger bandaged, cheeks concave, looking older than his 53 years. “OK, James?”
Hierl gave a hesitant nod. Soon he was out on Park Avenue, where a line was forming outside a brick bandbox called the Portland Expo. The reason: President Barack Obama was to speak there in the afternoon about new health care legislation that, among other things, will provide a huge increase in money — $11 billion — to community health centers like this one.
Across the country, more than 1,200 of these centers are providing treatment to low-income patients who would otherwise linger in expensive emergency rooms. The law is intended to reduce the burden on Medicaid and help the centers serve 20 million more people.
So the day progressed. On one side of the street, Obama aides scurried, the police blocked off traffic, and people waited in the sun, holding signs that said “Thank You” — though by lunchtime, hundreds were chanting the opposite. And on the other side, uninsured and underinsured people sought care, beginning with a man who saw little reason to eat.
A year ago, there was no Portland Community Health Center, though for years the city had been seeking federal money for a center that would provide care regardless of income or insurance. One that would reach the many new immigrants and refugees — from Rwanda, Iraq, Congo — who are finding their way to this southern Maine hub; save money; offer help.
Then, last year, the city received $1.3 million in stimulus money to open a community health center. It created a board, hired a staff and found some vacant but tired space in a building on Park Avenue. On Nov. 2, the doors opened.