Munar`s Entire Speech

HOWARD BROWN HEALTH CENTER
2015 ANNUAL MEETING
“We Grow Stronger As We Focus On Our Health”
By David Ernesto Munar, President and CEO of Howard Brown Health Center
Taking stock in the prior year and reflecting on the year ahead is one of my favorite
traditions. As we look back on 2014, we also reflect on the lessons of four decades of
community service. For me, the fundamental lesson of 40 PROUD YEARS is simple but
elegant: Our community grows stronger when we focus on our health.
40 PROUD is not just a slogan. It’s a call to action. It’s a reminder of what guides and
motivates our work.
It has been particularly relevant for me as the incoming CEO to understand the genome
of Howard Brown Health Center (HBHC). To ponder, what’s at our core? From where did
we spring? Where does our moral compass point as we map the organization’s path
forward?
The LGBTQ community grows stronger when we focus on our health. That’s it. That’s
what 40 PROUD means to me.
It’s a powerful beacon that has kept us moving forward through so many trials and
tribulations. That core belief guided four University of Chicago students to form the Gay
Medical Association in the mid 1970s. Student leaders David Ostrow, Reed Schulsky,
Kenneth Mayer, and Mark Behar joined other pioneering gay-rights activists to form
what would become Howard Brown Memorial Clinic and the Center on Halsted.
An unwavering belief in compassionate care for our community motivated Nancy
Lanoue in 1990 to form the Lesbian Community Cancer Project (LCCP). With fierce
activists including Jessica Halem, Cat Jefcoat, Mary York, Lisa Tonna and many others,
LCCP took residence at Howard Brown in 2004 and became a part of our agency in 2008.
With our very lives on the line, Howard Brown built medical and policy expertise to fight
AIDS and grew an institution in its wake.
The charge was led by people like Steve Wakefield, a volunteer in the late 1970s who
would later chair the Board. Executive Directors Harley McMillen, Judith Johns, and
Eileen Durkin who expanded medical care, education, testing and research programs
and were pioneers for the Brown Elephant and the campaign to give Howard Brown its
own home at 4025 N. Sheridan. People like Paul Lutter who led the capital campaign to
build our own freestanding building; Roger Brown whose grand mosaic welcomes our
patients; Drs. David Blatt and David Moore who brought their medical practice to
Howard Brown; and Lois Bates who spearheaded our transgender programming.
Where the needs demanded it, Howard Brown turned to partners. In 2004, Howard
Brown joined forced with Children’s Memorial Hospital (now Lurie’s), The Night
Ministry, and Teen Living Program to launch the Broadway Youth Center. Joe
Hollendoner, Rob Garofalo, David Meyers, Barbara Bolsen and many other early
leaders cared enough to take a stand for the health, wellness and future of homeless
and LGBTQ youth.
The list of our past leaders and collaborators is vast. We stand on the shoulders of tens
of thousands of pioneers who gave with their hearts, minds, wallets, time, and talent to
advance the health and welfare of our community.
For too many, their time on earth was cut short. But we had the privilege to care for
them in their hour of greatest need. Commemorating 40 PROUD YEARS demands that
we honor them, not just with words but also with actions and deeds, securing a better
future for our diverse LGBTQ community.
***
In 2014, I joined HBHC and it’s been an amazing journey. The people, the programs, the
passion have inspired me. The organization is a hub of activity 24/7 – the institution
never rests.
In fact, as we gather here tonight, our linkage to care team, our clinic staff, our patient
service representatives, our sales associates, our facilities staff, our prevention workers,
our youth development team, and many others are hard at work delivering the very
services we will discuss tonight.
Please join me in a round of applause for the valiant and committed staff of Howard
Brown.
Here are four proud achievements we accomplished in 2014:
1. We served more people than ever before.
Our patient base expanded by 25%! With no advertising or concerted campaign, more
than 1,700 new patients turned to Howard Brown for their primary care.
Most new patients arrived without insurance. We helped them explore their options
and assisted hundreds of patients in gaining access to public or private insurance
through Medicaid and the Health Insurance Marketplace. Since 39% of our population
is uninsured, we spend nearly $1 million on subsidized healthcare care.
In 2014, our primary care numbers grew but so did our PrEP clinic, which today is
helping more than 500 patients prevent HIV infection with a daily pill. The cutting-edge
therapy is called pre-exposure prophylaxis or PrEP.
Our screening clinic for STIs also served more people and broadened its focus on viral
hepatitis. In 2014, we tested more than 4,000 patients for the Hepatitis C Virus – nearly
a 200% increase in screening over 2012 figures. As a result, 91 patients learned of their
infection with Hepatitis C, which can cause advanced liver disease. Armed with this
knowledge, our patients can benefit from our experienced clinical team to carefully
monitor and if needed, control or even cure their Hepatitis C infection. For patients
testing negative for hepatitis, we offer education and vaccinations for Hepatitis A and B.
2. Howard Brown took extra care in 2014 to connect with the communities we serve.
We hosted a five-part series of town-hall meetings to invite community members to
share with us their needs and health concerns.
Our trans health program has grown by leaps and bounds thanks to a twice-monthly
drop-in night inaugurated in 2014. At drop-in, we offer no-appointment medical visits,
group services, food, and other activities. We are so proud that more than 1,600 transidentified patients choose Howard Brown as their primary healthcare provider.
Another important way we connect with the community is with our Community
Advisory Board (CAB). The CAB is comprised of 11 passionate volunteers, representative
of all parts of the agency. In 2014, the newly-formed group selected three projects to
help make Howard Brown a better place for patients to receive care. The CAB as we call
them is working closely with staff to evaluate our PrEP program, assess Howard Brown’s
linguistic accessibility, and assist with our march toward Patience-Centered Medical
Home accreditation. Thanks to the CAB, Howard Brown will submit our accreditation
application later this week!
3. In 2014, we took concrete steps to improve our infrastructure for continued growth. It
may not sound sexy, but it’s critically important.
For example, we commandeered the atrium at our Sheridan Road clinic to create a new
waiting-room experience. No longer must our patients wait for their care appointments
in a crammed windowless room. Now they bask in natural light, next to one of finest
pieces of mosaic art in all of Chicago. This subtle yet powerful change has transformed
the clinic and lifted everyone’s spirits. We pride ourselves in delivering care that
upholds the dignity of all our patients. Dignifying our patients begins immediately when
individuals walk through the door.
Checking in for appointments at Sheridan has also become easier, faster and more
private with the addition of new registration stations.
Callers to Howard Brown will also notice positive changes. We added four full-time
professionals to staff a new call center designed to accommodate the nearly 20,000
service- and schedule-related calls we receive each month.
In 2014, we invested in our talented staff. We revised our benefits packet to be more
competitive. We raised the minimum wage, a change that was especially welcome at
the Brown Elephant. And we are taking other measures to offer professional
development, advancement opportunities, and accolades for our most valued resource:
our dedicated workforce.
4. Perhaps, our greatest source of pride last year … Howard Brown became a stronger
non-profit. Thanks to the resilient Howard Brown staff, a surge in new patients and
new insurance options, we are on a solid path toward future growth and long-term
sustainability.
No surprise to anyone in the room that has not always been the case. We started 2014
with unpaid debts to the federal government and Northwestern University, a mortgage
in forbearance, a folder of unpaid bills, and hundreds of thousands of dollars owed to us
from government funders.
One by one, we tackled these challenges. We struck a 10-year settlement agreement
with Northwestern University and refinanced our mortgage. We paid the Feds – of
course, that was the first thing we did – and slowly we whittled down our unpaid bills.
After covering our costs, we initiated a careful plan to build a reserve fund equivalent to
90 days of operating costs. Ninety days is a standard for financial stability among
nonprofits.
It will take us time to get there, but I’m thrilled to say that we are already a third of the
way toward our goals.
Make no mistake, caution is our friend and we will continue to manage a frugal and tight
operation. We are mindful that healthcare is a volatile, competitive and rapidly changing
environment. And as you heard from Duke, nonprofits are especially exposed to
capricious government agencies.
But for the first time in many years, Howard Brown is setting its sights on growth and
thinking about how to improve our impact on the community.
***
Now, here are just a few of ways we plan to advance the mission in 2015.
1. Research – Thanks to a grant award from the Alphawood Foundation, Howard Brown
will partner with the Center for Gender, Sexuality and HIV Prevention at Lurie Children’s
Hospital to expand LGBT-focused research among adults and adolescents. We could not
be happier to have Lurie’s staff advising us in this area. Lurie’s has a long history of
collaboration with Howard Brown and this project is likely to spark many new research
ideas aimed at improving services for our clients. Rebuilding our research portfolio is an
important goal at Howard Brown. We are thrilled Lurie’s will provide us with technical
assistance and support to deepen our bench in this important area.
2. This year we are making all sorts of improvements to patient and client services.
Working with the AIDS Legal Council and Legal Assistance Foundation, we launched a
partnership offering patients access to basic legal services at our Sheridan Road clinic
once a week. The schedule has filled up quickly with patients needing assistance
processing appeals for public benefits, addressing housing or eviction issues, or dealing
with a wrongful termination. The partnership recognizes that legal challenges can
impede good health and adherence. While our case managers and social workers are
trained to help patients navigate an array of basic needs, some topics require legal
expertise. Thanks to AIDS Legal Council of Chicago and Legal Assistance Foundation, ,
this service is now more convenient than ever.
One of our most popular programs is the STI and HIV walk-in clinic offering noappointment and comprehensive screening services for a fixed price of $95. Our
patients appreciate the flexibility of the walk-in clinic but some cannot afford the fee
and must forgo the full battery of STI tests. In order to make screening more affordable
and accessible, we will be adopting a sliding-scale fee structure at the walk-in clinic early
this summer. Similar to our primary care philosophy, no one is turned away based on
ability to pay. Patients with documented low income will be charged a reduced rate for
walk-in services. The new fee structure will greatly enhance public health by removing
at least one barrier to high-quality and affirming preventative care. In a survey of walkin clinic clients, we found overwhelming support for the new fee structure. In fact,
some of our middle-income clients said they would be willing to pay more for walk-in
services knowing their fees help subsidize care for someone else.
Longer Hours: We recognize that many patients must fit in their care appointments
around their busy work and lives. This is why we are committed to making healthcare as
convenient as possible. Late this summer, we will expand our Saturday hours until 3pm
and extend our clinic hours into the evening four days a week. Based on current
appointment patterns, we expect our evening and weekend schedule will fill up quickly.
3. This year, we’re going to give some TLC to the Brown Elephant – We are so grateful to
our loyal shoppers and donors for supporting the move of our flagship Brown Elephant
store from N. Halsted St. to Lincoln Ave. This new location has been fabulous and we
have found creative ways to make the store and its merchandise more appealing. And
it’s paying off as donations and sales are outpacing our 2013 metrics. Net proceeds
from the stores help us subsidize care for the uninsured and develop creative programs
uncovered by grants and insurance revenue.
Based on our positive experience opening the new store, we have decided to give our
Andersonville store a full “make over.” We are evaluating the layout, the lighting, the
merchandising, the signage (and even the bathrooms), to make the store the best
experience possible for our customers and donors. We are so happy that Kip Rodrigue
of Kip Rodrigue Design has agreed to donate his services to help with this project. Stay
tune for a re-dedication of the store later this year.
4. A permanent home for the BYC – The Broadway Youth Center (BYC) is an oasis from
the harsh realities youth face daily surviving on the streets. Since 2004, BYC has
provided an array of vital services for LGBTQ and homeless youth ages 12 to 24. Our
incredible staff provides clients with comprehensive services, such as day respite care,
food, group services, individual counseling, HIV/STI screening and treatment, laundry
and storage assistance, case management, linkage to care, tutoring, a GED program and
referrals to other needed services.
Without exaggeration, the Broadway Youth Center is at the core of our mission. Sadly,
the program has had its ups and downs in its 10-year history. Most recently, the
Wellington Avenue United Church of Christ and Alderman Tom Tunney have heeded the
call and allowed the program to operate from shared space in the basement of the
church at Wellington and Broadway. We are so enormously grateful for the continued
support, which has allowed our program to continue uninterrupted. Unfortunately the
program requires more privacy, more autonomy, more space and other core facilities –
such as laundry, storage and showers – than the church can provide.
It’s time for the BYC to grow deep roots at a permanent home it can call its own. This is
why today we are announcing the formation of a planning process to design the BYC’s
future on the second floor of our Sheridan Road facility.
This is a big change for BYC and for our other programs and services we deliver at
Sheridan. We need to get this right, which is why we are starting with this community
planning process to inform the strategy and every detail of the plans to make the
eventual transition a full success.
The process will help us define when and how to make the space we have suitable for
the BYC. Through the process, we will develop a detailed work plan, timeframe, and
budget to ensure BYC has all that it needs to increase its reach.
For me, there is no better way to commemorate 40 PROUD YEARS than to begin a
deliberative process to secure the future for life-change youth development work.
We will need your help and support along the way, and I pledge we will keep our many
constituents informed as our plans take shape.
In closing, thank you for supporting Howard Brown Health Center in our quest to
make the LGBTQ community healthier and stronger.