On January 5, workers at Howard Brown Health Center ended a three-day strike that was spurred by the sudden layoffs of more than five dozen employees at the organization’s clinics. The workers are vowing to continue to fight to reinstate their jobs and have lingering concerns about the organization’s finances and leadership.
The crisis began in November 2021, when workers learned of impending layoffs that were initially scheduled to happen on January 3rd. But several workers who spoke to the Reader say Howard Brown’s management enacted the layoffs without warning four early, on December 30th.
D’Eva Longoria didn’t know that her last day working at Howard Brown would end so abruptly. She was aware she was among the 60 people Howard Brown Health Clinic planned to lay off, but was surprised when her computer screen went blank while she was in the middle of assisting a patient during her last shift. Without warning, Longoria says, everyone being laid off lost access to their work emails, work phones, and the platform the organization uses to speak with patients. Longoria was letting a patient know when they’re next PrEP appointment was, who she isn’t sure will be able to make it now. “I have no way of reaching out to that person. I don’t know their number,” she said.
Longoria has been a PrEP Community Engagement Specialist at Howard Brown since March 2019. She technically worked out of the Sheridan clinic, but her real office hours were spent out in the community, passing out condoms at 71st and Pulaski, doing outreach at La Cueva in Little Village, and talking to queer and trans immigrants newly arrived about how to get queer and trans affirming health care.
Longoria says that management had told those being laid off nothing about what to expect or what to tell their patients. She and the others only just learned they were getting laid off less than a month before. She hopes that people who rely on her for the outreach and programming she does see the video she posted in Spanish on her social media.
Protesters delivered a list of demands to CEO David Munar’s home in December. Jennifer Bamberg
Munar says that the new clinic, located on Halsted and Cornelia, will help them generate more visits, which means more non-340B revenue, and keep them financially afloat. According to the union, Howard Brown Health said in an email to employees that nearly half of their patients are served by two out of the five clinics on the north side and the extra space is direly needed.
The union says that the heavy use on the north side is due to people being willing to travel across the city for better resources.
According to Flowers, the clinics on the south side have had consistent issues with utilities, sanitation and safety. Throughout the four years she worked at the 63rd Street Clinic, there have been issues with “brown water coming out of the faucet, no air in the summer, no heat in the winter. Sometimes there’s rodent issues . . . . The doors don’t work half the time. Even our emergency buttons, if there’s an emergency in the clinic, they don’t work half the time.”
She said that the maintenance team does the best they can, but “there’s only so much you can do.” She says the conditions are not safe for the workers or the patients.
Because of the staff cuts, the south side clinics are now completely without any long-term councilors and the substance use group Recovering with Pride has been slashed, according to the union.
Munar says that several programs will be combined and case managers will receive additional training in order to continue to provide behavioral health services on the south side.
Lindsay Martin, a therapist at the Halsted clinic and a bargaining committee member who was laid off, said that this will harm patients. “[Munar] doesn’t know that because he’s not a health care worker. He’s a businessman, and it’s about business for him. And that’s not how healthcare works.”
The clinic has promised to build a new health care center in Bronzeville by 2024, but a representative said in a written statement to the Reader that “Howard Brown will need to stabilize its finances before any further growth plans advance” and that “discussions are in preliminary stages” regarding the south side clinic.
When Gilead announced they were ending the era of lush reimbursements back in April of 2021, advocates worried that it would spell utter doom for HIV care and prevention programs and the patients who depend on them.
“It’s a reminder . . . that our country needs more sustainable ways to support public health and our communities,” wrote a representative from CrescentCare, a LGBTQ+ centered health clinic in New Orleans. It was founded in 1983 in response to the HIV epidemic, and like Howard Brown, focuses on prevention and making PrEP accessible to those who need it the most.
But unlike Howard Brown, CrescentCare hasn’t had a significant dependence on Gilead’s Advancing Access patient assistance program, and only 28 percent of their budget comes from 340B, as opposed to the approximately 81 percent from Howard Brown from their last fiscal year ending in June 2022.
“Howard Brown . . . has an outsized dependence on this funding source,” Munar said.
Munar took the helm at Howard Brown in 2014, secured FQHC status for the clinic in 2015, and started making the clinic more money thereafter. His salary in 2020 was $308,435, part of which was a $20,000 bonus, according to the most recent tax filings. That bonus totaled more than the 6 percent pay cut he and others in executive leadership took to contribute to the clinic’s recent belt tightening. Several past and current staff members are calling for Munar’s resignation.
“It’s very evident that this problem could have been prevented,” said Julia Bartmes, executive director of the Illinois Nurses Association. “And it’s also evident that these layoffs don’t need to happen . . . . Our members who were laid off are paying the price for [Munar’s] and the executive leadership team’s mismanagement. We’d like to see him gone.”
She said that the union doesn’t have a right to bargain over non-bargaining unit member’s employment, so it’s not something they can demand in the context of bargaining.
“But I think that the organization would be better off with someone else at the helm,” Bartmes said.
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