Howard Brown Health, a nonprofit community health center in Chicago that is the largest provider of health and wellness care for the LGBTQ+ community and people living with HIV in the Midwestern US, has announced who wants to lay off at least 100 employees, or about 15% of the staff.
The layoffs were originally proposed as voluntary, but the company says “a reduction in the workforce is required,” suggesting that if 100 volunteers are not found, the layoffs will be mandatory.
They come at a time of high-profile attacks on queer and trans healthcare across the country. The lost jobs would include roles in behavioral health, health education, PrEp navigation, Covid testing and other teams. Many of the positions are filled by union members, following the decision by Howard Brown employees to form a union in August of this year.
After hearing rumors of layoffs, the union expressed its concern to management and was told in a written response on November 9 that “there is no current plan or decision to lay off any union member.”
The first indication to the contrary was 10 days later, on November 19. In a letter to board employees citing the financial strain, Howard Brown outlined the goal of “recouping $12 million in our annual operating budget” and said he would “consider all available measures” to do so. Union members said they met with management later that day, which is when the organization proposed a “voluntary separation” package of a week of severance pay for employees to leave their jobs.
Despite Howard Brown claiming to be in financial difficulties, ProPublica data shows that in 2021 the organization brought in $30 million more than it spent and that CEO David Munar earned a salary of more than $300,000.
Many employees argue that Howard Brown should cut funding elsewhere before considering losing employees. They point to the construction of a new $19.5 million clinic in North Halstead, where Howard Brown already has a clinic. Union members said they refuse to bargain until management releases the 2022 financial books.
“As a union member, I would never accept that workers have to quit their jobs if it’s not necessary to keep the organization alive,” said Margo Ginslain, a lead organizer for the Howard Brown Union.
“Howard Brown refuses to show us his 2022 financial books and has therefore been unable to convince us that these layoffs are financially necessary. We want to be able to see the finances of the organization so that we can suggest other budget cuts that do not involve the loss of workers.”
Several Howard Brown employees said they find the timing of the firings, which came just months after the organization unionized, suspicious. “I have no doubt that this is retaliation,” Ginslain said, saying that many of the potential cuts would affect union members, “many of whom were very involved as organizers.”
Recent years have seen widespread cutbacks to queer and trans healthcare across the country as states ban or limit access to gender affirming care. As the largest public health center for queer people in the Midwest, Howard Brown serves not only Chicago’s LGBTQ+ population, but also those in surrounding states who travel for care.
Employees said they are already overworked and understaffed, and they fear a smaller workforce will be overwhelmed and unable to provide prompt patient care. Shakia Flowers, a behavioral health provider and member of the union bargaining committee representing the Englewood 63rd Street clinic, said that during her four years at Howard Brown there has always been a waiting list for behavioral health treatment. The layoff strategy would cut the behavioral health team in half, leaving just four specialists to care for 30,000 patients annually.
Erik Roldan, Howard Brown’s director of marketing and communications, blamed “drastic reductions in federal dollars” for what he said was a $12 million revenue gap. “Specifically, the agency’s revenue shortfall since the start of the new fiscal year on July 1 comes from changes to the 340B pharmacy program,” he said.
“Since 2020, 18 pharmaceutical manufacturers, including Eli Lilly, Merck, and Gilead, have restricted or eliminated access to 340B-priced drugs through contracted pharmaceutical partners, with 8 manufacturers specifically targeting FQHC contracted pharmacies. These changes are putting a strain on the agency’s finances, which requires a reduction in operating expenses.”
Roldan said the organization was exploring other ways to cut expenses at the same time as the layoffs, that layoffs would not occur before January 1 and would be subject to negotiation with the union.
Howard Brown employees have planned a public protest for Saturday and are accepting charitable donations.
“These layoffs would deeply affect the communities we serve, which are already vulnerable,” Flowers said.
“We’re talking about queer people, black and brown people, the uninsured, the impoverished. It is vitally important that these patients come here and see providers that they can relate to, who can understand their plight, and who can be their support system when they don’t have one.”