Bangor advisory committee recommends $550,200 for two intensive case managers to address HIV cluster among unhoused residents

The Bangor opioid settlement funds advisory committee recommended the city hire two intensive case-management staff for a two-year period and allocate $550,200 to fund the roles and related transportation and operating costs to respond to a local HIV cluster affecting people who are unhoused and have co-occurring substance use disorders.

The recommendation came to the City Council at the July 28 workshop from committee members who said the collaborative of local providers lacks a coordinated, intensive case-management model to find, engage and retain people in care. Committee member Jason Hunt and Health Promotion Manager Jamie Comstock described how providers across the Greater Bangor area have been coordinating contact tracing, outreach and treatment but identified gaps in intensive case management that a time-limited city-funded intervention could fill.

Committee members described the reasoning for a two-year, time-limited model: intensive case managers would work to find and link people to care, support medication adherence until viral suppression (which committee members said can take up to three months after treatment begins), and then transition clients into lower-intensity, often reimbursable services. The committee considered a smaller budget without a transportation line item and an intermediate budget that included transportation; the committee voted to recommend the intermediate budget that includes transportation and provider mobility to take clients to services.

The proposed intermediate budget total is $550,200; the alternative “basic” budget (without the transportation component) was $510,200. Committee members said figures were developed using city salary ranges and prior expense data. Jamie Comstock, Jason Hunt and Scott Hardy (executive director of Fresh Start) emphasized the need for immediate action given the current outbreak and the time required for state or federal funding to be allocated through other channels.

At the workshop, councilors asked for background on the seizure and projected settlement funds. Staff said the city currently has roughly $1.1–$1.2 million in opioid settlement funds on hand and that the full settlement receipts to the city through 2038 were estimated in the meeting at about $3.4 million total; staff also noted the city currently spends roughly $100,000 on needle-exchange or related services under existing contracts. Committee members said the recommendation was the first phase of planned work; the advisory committee intends to continue meeting and to bring subsequent phases and additional grant or partnership options back to council for review.

Council discussion addressed trust-building with people displaced from a recent encampment closure, partnerships with community organizations already engaged with affected populations, and long-term sustainability beyond the two-year funding window. Several councilors urged including organizations with established relationships to the affected population; committee members said they plan to coordinate closely with existing outreach partners and to develop benchmarks and transition plans to reduce reliance on city funds over time.

There was a motion and second at the workshop to advance the committee’s recommendation to the council agenda; the meeting record indicates the committee’s recommendation will be placed on the next council agenda for final action. Committee members said the vote at the advisory-committee level was effectively unanimous among attendees (one member was absent), and the council indicated it would schedule the item for formal consideration.

Why it matters

Committee members said a short-term, intensive model could halt additional HIV transmission by accelerating linkage to care and viral suppression among a high-risk subgroup. The recommendation directs settlement funds to a targeted public-health response rather than to broader, longer-term programs at this time.

What’s next

The committee’s recommendation will be listed on the upcoming regular council agenda for formal action. If council approves, staff and the committee plan to implement the two-year intensive case-management program, set benchmarks for transitions to reimbursable care, and continue outreach to community partners and the county to coordinate further work.