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Friday, December 23, 2016

Chase Brexton’s Public Accountability Problem

Accountability. We demand it from our presidential candidates, police chiefs, Wall Street executives. What about those who lead our taxpayer-funded nonprofit organizations?     Chase Brexton Health Care is a nonprofit Federally Qualified Health Center with deep roots in the LGBTQ community and a mandate to provide affordable, appropriate health care to Baltimore’s low-income people. It is funded by taxpayer dollars through the Bureau of Primary Care, Medicare, Medicaid, the ACA Exchange, and by the tax-free status conferred by the IRS on 501(c)(3) nonprofits. In return, we taxpayers expect Chase Brexton leaders to deliver on the organization’s mission and to soundly, ethically, and legally manage its public resources.

Chase Brexton staff recently voted to unionize after a series of new administrative directives gravely compromised working conditions and patient care. The clinic’s collaborative, integrated care delivery model had been dismantled, salaries cut, and productivity-based bonuses instituted to shorten visits and increase patient numbers. In an unsuccessful attempt to stop the union, CEO Richard Larison fired five long-time managers – high-performing, widely respected leaders in HIV, transgender, and elder care.

The National Labor Relations Board is investigating the blatantly retaliatory firings. The Chase Brexton patient community has roundly condemned the loss of these beloved providers and their collective knowledge, networks, and voice for LGBTQ health in our city. They’ve held protests and taken to social media to describe the critical community impact of the firings and how the institutional changes threaten safe, comprehensive, quality care.  CEO Larison and the Chase Brexton Board have ignored their stakeholders’ response, censored online comments and questions, and refused to publicly address the matter.

In the wake of the firings, many other examples of mismanagement at Chase Brexton have come to light. A forged “resignation” letter was sent to patients, claiming to be from one of the fired five, a nine-year veteran nurse practitioner with a slate of devoted patients.  A member of the Executive Leadership Team was found to have had his social work license suspended in another state for failing to disclose a criminal record including a conviction for embezzlement. In a video statement released to staff, the board president dismissed well-publicized concerns, affirmed the board’s unqualified support for Larison’s retaliatory behavior, and suggested that the dire management moves are merely business as usual.

Chase Brexton, long one of Baltimore’s most cherished health care assets and a source of pride for the LGBTQ community, is now known for linking providers’ pay to their ability to meet unrealistic patient quotas. For firing exemplary staff in order to retaliate and intimidate. For sending forged letters to patients. For placing an individual convicted of financial fraud in a supervisory position. For scrubbing public organizational information and ignoring stakeholder feedback. Is this what we want from a taxpayer-funded nonprofit charged with serving our city’s most vulnerable people?

Nonprofits are essential to our quality of life in Baltimore. They provide jobs and spur economic development, they catalyze knowledge and cultural creation, they fight for equity and justice, and they maintain the health and social services safety net so many depend on. For members of the LGBTQ community, these organizations are often life-saving. Most do a lot of good with few resources. We all benefit from a thriving nonprofit sector, and we’re all invested in ensuring nonprofits deliver on their missions. We expect them to be good stewards of the public funds, grant dollars, and private donations that support their operation. This means transparent management, effective financial leadership, legal and ethical HR practices, and a governing board that is representative of and responsive to its constituents.

Under current leadership, Chase Brexton has failed to uphold these expectations. It has demonstrated the inability to serve its organizational mission and federal mandate as a community health center. It has eschewed decent working conditions, patient outcomes, and community dialogue. Stakeholders have called for Larison’s resignation (which was finally announced on November 15th), the appointment of a new CEO with the wisdom and skills to repair and rebuild the organization, a re-examination of board composition, and the rehiring of the fired five.

The CEO’s departure is a welcome first step, but until Chase Brexton leadership can demonstrate an unqualified commitment to integrity and responsible management, we will call on federal grantors, elected officials, and donors to withhold funding and shift their support to other organizations with the capacity to better serve our community.

We may not be surprised when Fortune 500 companies mismanage funds, commit fraud, and exploit clients to line their executives’ and shareholders’ pockets. But Chase Brexton is not Wells Fargo. We – patients, taxpayers, citizens – can and should hold this publicly funded nonprofit and its Board of Directors responsible for its actions, its impact, and our dollars. As Senator Elizabeth Warren told Wells Fargo CEO and Chairman of the Board John Stumpf, explaining the obvious need for his immediate resignation, “this is about accountability.”

Emily Sachs

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