A plan for a new city-run HIV case management program is facing criticism from some members of the local recovery community.
After years of inaction on spending Bangor’s opioid settlement money, the City Council approved a proposal Monday that will fund the $550,000 program using about half of the funds it’s received thus far from national litigation with companies accused of contributing to the opioid epidemic.
But some in the local recovery community have said they don’t think the opioid settlement money should be going to a program specific to HIV rather than substance use disorder. Critics have also taken issue with the money going to a city agency and with the opioid settlement funds advisory committee’s process.
The disagreement shows the tension between the local government and community members affected by the opioid crisis regarding how these funds should be spent and who should make those decisions. Bangor has already faced backlash for taking so long to use its opioid money, of which it’s expected to receive at least $3.4 million by 2038.
“If the goal is to remediate the opioid crisis, that’s not the same as remediating HIV,” Amy Clark, board chair for the advocacy group Maine Recovery Action Project, told the Bangor Daily News.
Clark said that she was frustrated to see that the proposal’s goal was simply to reduce HIV transmission and did not directly address substance use recovery and treatment.
Twenty-eight people have been diagnosed as part of the ongoing HIV outbreak in Penobscot County since October 2023, and nearly all of them reported injecting drugs and being homeless in the year before their diagnosis.
Bangor’s public health department will use the money to hire two intensive case managers who will work with clients diagnosed as part of the HIV outbreak to do paperwork, connect them to medical care and other services, and check in on them multiple times per week to make sure they’re getting the care they need.
The committee’s proposal references substance use in the case manager job description, which states that the employee will “work collaboratively with medical, mental health, substance abuse and community service providers,” but does not otherwise address drug use.
Additional concerns arose when the committee, which is made up of both city officials and members of the public who have personal or professional experience with the opioid crisis, initially began discussing using opioid funds to address the HIV outbreak. Some members expressed hesitancy about awarding such a large chunk of the money to a city agency.
The debate hints at underlying disagreements over the city’s decision to close the homeless encampment known as “Camp Hope” in February, which some in the recovery community have said damaged their trust of city government.
Still, all of the committee members ultimately voted for the proposal on July 23 — some begrudgingly — after agreeing that there was an urgent need that likely would not be met otherwise.
“We definitely had to do something” about the outbreak, committee member Scott Pardy told the BDN, but he wishes the committee had more time to discuss alternatives that could have reduced costs, such as only funding the program for one year instead of two.
“I felt shamed into voting for it, for the HIV money,” Pardy said at an Aug. 6 committee meeting. “I felt that we were put in a position where I felt like we didn’t have a choice, and that’s why I voted for it.”
He said he’s not sure he would vote in favor of the proposal if given the chance to do it over.
The decision also raised questions about why the state and federal governments aren’t taking more responsibility for responding to the HIV outbreak in Penobscot County.
Council chair Cara Pelletier was initially opposed to the plan because she thought “the state CDC and the federal CDC should be stepping in in a bigger way,” she said in a July 28 council workshop.
But Pelletier changed her mind after talking with those agencies, which said federal funds were not immediately available and that any new case management funding from the state would have to go through the legislative process, which could take one or two years.
“I personally don’t think we can sit on this. We have funds that are here to help people who are impacted by substance use disorder. We know that the majority of people who are part of the HIV cluster are impacted by substance use disorder,” Pelletier said. “I think it makes sense for us to take action.”
Beyond questions about the city’s role in mitigating the outbreak, Clark also took issue with the committee’s process, telling the BDN that voting members affiliated with the city should have recused themselves from the vote and surrounding discussion since the proposal allocates money to the city’s public health department.
“I understand that the HIV outbreak is a serious and urgent issue that needs to be resolved,” she said at the council meeting Monday. “But even in urgent situations, these funds must be handled ethically and transparently. And unfortunately, that did not happen here.”
Of the nine voting members on the committee, three — Councilor Susan Hawes, Police Chief Mark Hathaway and Bangor Public Health Prevention Program Manager Jamie Comstock — are city councilors or employees. Those three members were appointed by city manager Carollynn Lear, according to city spokesperson David Warren.
The other six members — Pardy, Scott Knowles, Jayson Hunt, Lisa Williams, Shelly Yankowsky and Alison Small — are community members with personal and professional experiences related to substance use recovery who were appointed by city councilors.
Knowles works for Community Health and Counseling Services and was selected for the committee for his personal experience in recovery, and Yankowsky brings a perspective of a family member who lost children to substance use disorder.
Hunt works for Wabanaki Public Health and Wellness; Pardy runs Fresh Start Sober Living of Maine, a network of recovery houses; and Small works for Community Care, which provides services to youth and families affected by mental illness, abuse and poverty.
Most committee members seemed to remain firm in their decision to approve the proposal, in contrast with Pardy’s statements.
Yankowsky defended the proposal in the Aug. 6 meeting, noting that the majority of people in the HIV outbreak use drugs and that the idea came from the committee, not Bangor Public Health.
“The city didn’t ask us to give them that money,” she said.
Hunt also stood by the proposal, which he drafted at the committee’s request.
“I feel like we are impacting immediately many people’s lives,” he said. “Not just the people within the HIV outbreak, but all the people that are connected to those people and all the people who will not be getting HIV because we made that action.”
