Support the New Title IX Rule Protecting Transgender, Non-Binary, and Intersex Athletes!
What is the new Title IX Proposed Rule?
The Department of Education has released a proposed rule that will require and enforce protections for trans, non-binary, and intersex student athletes under Title IX. The Department of Education makes it clear in this proposed rule that policies that categorically ban trans students from participation in school sports are a violation of Title IX. This would thereby make all current anti-trans sports bans enacted by states across the country unlawful. The proposed rule also establishes a stringent standard preventing schools from using overbroad generalizations, false assumptions, transphobic myths, and sex-stereotypes as grounds to ban trans students from participating on sports teams aligned with their gender identity.
Why has this new rule been released?
This new proposed rule is in response to the increased number of legislative bans restricting participation of trans athletes in school sports introduced and enacted in states across the country. There are currently 21 states that have enacted blanket bans on trans athletes, and the U.S. House of Representatives recently passed an anti-trans sports bill that would ban trans women and girls from competing on school sports teams aligned with their gender identities.
How does this proposed rule help trans, non-binary, and intersex youth?
2023 has seen a record surge of anti-LGBTQ legislation with over 400 anti-LGBTQ+ bills being introduced across the county. Over 200 of these bills are aimed at LGBTQ+ youth in school settings. In a recent survey by the Trevor Project, 86% of trans youth said that their mental health was negatively impacted by recent debates over anti-LGBTQ+ bills in state legislatures. Many of these bills are aimed at preventing trans students from participating in sports. In 2021, 16.0% of TNB students reported that they were prevented from playing on sports teams consistent with their gender, and this has likely worsened in recent years due to the proliferation of these anti-trans sports bans.
These anti-trans bills only serve to harm trans youth, who already experience stark health disparities compared to their cisgender counterparts. Trans youth experience higher rates of poor mental health, suicide, substance use, and violence. Around 44% of trans youth reported considering suicide in the previous year in part due to the harassment and discrimination they experience at school specifically. The new proposed rule is a critical step for the federal government to take to intervene against anti-trans legislation and improve educational experiences and well-being for trans youth. Sports participation has been associated with increased self-esteem and self-confidence,improved academic performance,and broader social capital and community connectedness. All students deserve to access the benefits of participation in school sports and this proposed rule helps to ensure that trans youth are not robbed of those opportunities and health benefits.
I hear there are exceptions in the proposed rule that would allow for trans athletes to be banned. Is this true?
The proposed rule sets very strict criteria that needs to be met in order for a school to restrict participation of trans athletes. Schools can only limit students’ participation in sports consistent with gender identity if the restriction is substantially related to an important educational activity and it minimizes harm to any student whose opportunity to participate is restricted. Enforced properly, this will sharply restrict schools’ ability to enact policies to ban trans athletes from participating on teams that align with their gender identities. Schools are also prohibited from excluding trans athletes based on generalizations or myths that extremists rely on to pass anti-trans sports bans. The Department of Education can strengthen this proposed rule by providing clear examples in the regulatory text of problematic and transphobic “justifications” for restriction of trans athletes that would be prohibited by the rule. This will limit ambiguity that anti-trans extremists may seek to exploit in order to advance their agendas.
I support trans athletes and these protections. Is there some way to let that be known?
This proposed rule is open to the public submitting comments in support! The Department of Education wants to hear from you about how important it is for trans, non-binary, and intersex athletes to be protected and not discriminated against. You have until May 15 at 11:59 pm EST to submit a comment in support of this important rule. You can use the Let Us Play submission portal to submit a comment, or you can write your own comment to submit directly to the Department of Education. For more information you can read HB’s blog on trans sports bans.
Thank you for your advocacy! For more information, please be sure to check out our Advocacy website.
Make sure to take these steps to avoid losing your Medicaid coverage!
During the COVID-19 pandemic, Congress required that states keep Medicaid recipients continuously enrolled through the end of the public health emergency. Due to the economic downturn from the pandemic and this provision that prohibited states from disenrolling people from coverage, Medicaid enrollment increased drastically from 23.3 million in February 2020 to nearly 95 million in March 2023. Now that the public health emergency has expired, states are beginning the process of unwinding the continuous enrollment provision and disenrolling people who are no longer eligible for Medicaid. The Kaiser Family Foundation estimates that between that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period. If you are currently enrolled in Illinois Medicaid, read below to understand the redetermination process and take steps to ensure that you remain covered!
What is redetermination?
Redetermination is the process when the state Medicaid programs confirm that people are still eligible to receive Medicaid coverage. This process usually happens once a year, but because of the continuous enrollment provision, it has not happened for the last 3 years. That means if you gained access to Medicaid during the pandemic, this may be your first redetermination period.
How does redetermination work?
Medicaid recipients will receive a letter in the mail from the Illinois Department of Human Services and the Illinois Department of Healthcare and Family Services about 30 days prior to the deadline to renew coverage. This letter will explain if you need to complete paperwork or if you have been renewed for another year. People who need to complete paperwork will receive the Medical Benefits Renewal Form in the mail. This form should be completed and returned as soon as possible, as failure to complete the form by the due date could result in termination of Medicaid coverage.
What is the redetermination timeline?
Illinois will start mailing out redetermination paperwork in early May 2023 with the first renewal due date being June 1, 2023. Not all Medicaid recipients will have the same renewal due date, with approximately 1/12 of all Medicaid members being up for redetermination each month between May 2023 and April 2024. Medicaid members will receive their paperwork about 30 days prior to their renewal deadline date. If you miss your renewal date, you should still try to submit your renewal paperwork! If you are not more than 90 days late, there’s a chance you’ll still be able to renew coverage without having to reapply with a completely new application.
How can I prepare for redetermination?
Since paperwork is sent through the mail, it is imperative that Medicaid members ensure that their mailing address is up to date with the state. You can update your mailing address online at www2.illinois.gov/hfs/address or by calling 1-800-843-6154. You can also go online to check when your redetermination due date is by creating an account for “Manage My Case” at https://abe.illinois.gov. Your redetermination renewal date will be in the “Benefit Details” section about one month before your due date. If it is time to renew your benefits, you will see a “Renew My Benefits” button on your “Case Summary” page. You can also opt in for email alerts and reminders about renewal through the “Manage My Case” portal under the Account Management tab.
How can I get additional help?
For patients at Howard Brown, you can call 773.388.1600 and ask for an appointment with Benefits Navigation team. You can also send an email to insuranceenrollment@howardbrown.org or ask front desk to schedule you an appointment. For your convenience, insurance navigation appointments are offered over the phone!
You can also call the Illinois Department of Healthcare and Family Services at 1.800.843.6154 or you can message them directly through the “Manage My Case” portal.
As we recognize all of our wonderful volunteers this week, we sat down to speak the volunteer that has the most logged hours working with Howard Brown: Bruce P.
Bruce has been volunteering with us since the mid-90s and has worn many different hats in that time! Check out our conversation with him below!
How did you first hear about Howard Brown and what made you want to start volunteering with us?
A friend of mine who I met through Chicago House. I volunteered at Chicago House and he lived in one of their facilities at Augusta House. I got very friendly with him and took over as his conservator to take care of his money and things like that. And all of his medical care was through Howard Brown. I used to take him to his appointments and they always treated him with such dignity that I said, “If I ever volunteered a little longer, I would do it at Howard Brown because I loved the dignity that he had.” He had such a very sad story too.
When was this?
That was in the early 90s, when people died of AIDS. He died in 2001 but I met him in 1993 or 1994. And Chicago House is a great organization too, but I don’t hear too much about it.They used to have us go to Augusta House. It’s a big building and people live independently there. They were big apartments and they had maybe three to four men there. And then they had another building right next door that housed families with AIDS. And these were not people that were HIV positive, these were people living with AIDS.
I worked at the time. I used to go there, take them shopping, take them to restaurants, take them places that they didn’t get to go out to during the day. Because they had no transportation. It was a very secluded area, too, and nobody knew about it because the neighborhood would have been in an uproar if they would have known that it was an AIDS house. Sorry, that was a long answer.
Long answers are good! I appreciate them for sure. So you’re volunteering with the Brown Elephant now. But you mentioned that in the past you’ve done hospital visits and things like that. What has your volunteer work with us looked like over time?
I started handing out condoms on National AIDS Day. That was the first thing I ever did for Howard Brown. Then I did a couple of special events. And then I helped open the Clark St clinic with DaVon Anderson. It was a doctor, DaVon, me at the front desk, and a pharmacist. And now it’s huge! It was just four people at first.
So I used to work three days a week and then there were other volunteers there, too. And I did that for almost six years. After that, I decided to transfer to the Lakeview Brown Elephant and I’ve been happy here ever since. Matt is great. Logan is great. All the people, everybody is just great.
What do you think is one of the best experiences or memories that you’ve had volunteering with Howard Brown?
Definitely working with DaVon and opening up Clark St. I think that was, you know, it was just all new. It was really, really new and I really enjoyed that, that was fun. But that was the highlight. And meeting her! Because we have a personal relationship now, which is very nice. She’s a wonderful, wonderful person.
Why do you like and spend so much time volunteering?
I don’t know. It always feels good to do something for someone else. It feels good to me. To do something that I know is important in the bigger picture. It’s Important. I know that the work that I do and the money that we make here will benefit someone.
How much time do you think that you spend in a given week volunteering? How often do you do this here or anywhere else?
Just once a week. And then I also do some volunteer work for ALIVE animal rescue. When they need a transport, I’ll go pick up a dog at Midway Airport. Or if someone is fostering a dog and they don’t have means of transportation, I will take them and their dog to a vet and then bring them back home. And then I have a friend who had a stroke who’s 83 years old and I take him to the grocery store once a week. I like to try to fill my days doing things for people because someday there will be a day when someone needs to do that for me.
What other things do you do in your free time?
I’m close to being fluent in French. So I study at least an hour to an hour and a half a day. And I walk. I try to walk ten thousand steps a day. And what else do I do? I do Wordle every morning. And I’m very social with my friends, as far as going out and having a coffee or going to dinner. And I like to travel.
Do you have any words of advice for people who might be thinking about volunteering with Howard Brown?
Just in general, volunteering is rewarding for the person. You get as much out of volunteering as you put in. And I don’t know if that’s a spiritual thing or the way it was set up in the universe, but you always gain something from volunteering. Whether it’s knowledge, or meeting people, or something else. So many people I know, I wouldn’t know them if not for volunteering. Do it for the experiences and for the people you’ll meet. You get a lot from giving, it’s the way of the world.
Volunteer Appreciation Spotlight: Jerry, Lex, and Potter
As we recognize all of our wonderful volunteers this week, we sat down to speak with three of our most active volunteers: Jerry, Lex, and Potter. Check out our conversations with them below!
If you’re interested in becoming a volunteer yourself, you can learn more at our Volunteer page.
Jerry C.
What are some of your favorite things?
Volunteering ranks high on my list of favorite things to do. Trying new foods. Visiting new areas of the city like the Pullman neighborhood recently.
What do you like to do in your free time?
I fill much of my free time with volunteering. It means a lot to me and it’s something I always make time for.
Why do you like volunteering?
I say what I don’t have in money, I have in time. So, I’m giving back in the form of time as much as I can. I grew up in the housing projects of Chicago and faced food and housing needs as a child. So giving back as much as I do is, in my eyes, a way of returning what the community gave to me.
How long have you been volunteering with HBH?
Several years, not sure the exact length of time.
How did you hear about HBH?
I had volunteered here with a group doing safer sex kits and decided to stay on as an independent volunteer.
What is your favorite campaign, program, or service we offer?
The ability for people to use vouchers in the Brown Elephant stores for things like clothing, shoes, and household items.
Do you have a favorite memory with HBH?
Everyday day I volunteer is a favorite memory, especially with my friends at the Brown Elephant Andersonville.
Where do you see yourself in 5 years? Still volunteering?
Still giving back, here at Howard Brown and the many other places throughout Chicago that I volunteer for such as PAWS, The American Red Cross, The Chicago Food Bank, and numerous food pantries across the city.
What’s the best advice you can give to someone who is interested in volunteering with Howard Brown Health?
Complete the process, ask a current volunteer what experiences they’ve had, jump right in.
What are your hobbies?
Hiking, taking pictures of flowers and landscapes, and travel.
Lex M.
What are some of your favorite things?
Some of my favorite things are my cats, plants, and equitable healthcare access!
What do you like to do in your free time?
In my free time, I like to design and sew my own clothes, run, and try out different coffee shops.
Why do you like volunteering?
I like volunteering because I think it helps bring the community together. Volunteering has allowed me to meet so many great people, and I really appreciate forming those relationships with other people that have similar goals. I also like that volunteering, hopefully, helps to make HBH workers jobs slightly easier as they are doing such important work.
How long have you been volunteering with HBH?
I’ve been volunteering with HBH for nearly 1.5 years
How did you hear about HBH?
I heard of HBH through research to which Howard Brown Health has contributed.
What is your favorite campaign, program, or service we offer?
I think all of the programs and services offered by HBH are absolutely essential and integral pieces in keeping our community healthy, but my favorite is the Howard Brown Health Workers United. We have to support those supporting our communities. The Union is doing an inspiring job of working to ensure HBHs actions align with their mission statement.
Do you have a favorite memory with HBH?
A favorite memory with HBH is working in the BEB section at Brown Elephant and getting to see all the interesting and odd items that come are donated (beautiful coats, cryptic letters, locks of hair, etc.)
Where do you see yourself in 5 years? Still volunteering?
I can see myself still volunteering in outreach settings with HBH in five years.
What’s the best advice you can give to someone who is interested in volunteering with Howard Brown Health?
Advice that I would give to someone interested in volunteering with HBH is – do it! Everyone I’ve met through volunteering with HBH has been a real positive energy in my life.
Potter
What are some of your favorite things?
Quality time at the gym, fitness, time with friends, and food (pizza).
What do you like to do in your free time?
Looking up new vineyards to try and running.
Why do you like volunteering?
Volunteering aligns with my values and morals with the individual I’m becoming.
How long have you been volunteering with HBH?
A little over two years.
How did you hear about HBH?
Asking questions, writing the medical community, and doing my own research.
What is your favorite campaign, program, or service we offer?
Sex education and sexual abuse counseling.
Do you have a favorite memory with HBH?
Certainly being at theWit hotel and having dialogue with my peers about other volunteer experiences.
Where do you see yourself in 5 years? Still volunteering?
Stupid question, volunteering with Howard Brown Health.
What’s the best advice you can give to someone who is interested in volunteering with Howard Brown Health?
Trust the process and be open to be vulnerable and continue to grow and be humble
What are your hobbies?
In my free time, I like to spend my time outside, traveling, finding new taco spots or pizza, reading novels, volunteering, and fitness.
Celebrating Global Volunteer Month and Volunteer Appreciation Week
Dear Friends,
I am elated to celebrate our volunteers for this year’s Global Volunteer Month and Volunteer Appreciation Week (Celebrated Annually in April). As an organization founded by 4 volunteers, we are grateful for everyone who continues to support our mission through volunteerism.
In 1974, four volunteers from the Gay Medical Students Association decided to show up for their community and created Howard Brown Health. That same passion still lives today in the hearts of every community member that supports the vital resources we provide by donating and volunteering. As a client and champion for Howard Brown for over twenty years, I’ve seen firsthand how volunteers and community involvement have helped to grow our mission.
To celebrate our volunteers this month we will share volunteer spotlights on our social media accounts, host our 2nd Annual Youth Service Day on Friday, April 28th, 2023 in Uptown, and provide awards to exemplary volunteer program members.
Howard Brown Health’s Volunteer History
In 1974 HBH was created by four volunteers from the Gay Medical Students Association in Chicago. They gathered with the goal of creating a discreet testing clinic.
David Ostrow
Reed Schulsky
Kenneth Mayer
Mark Behar
What is Global Volunteer Month?
National Volunteer month in the United States takes place in the month of April. This month is dedicated to honoring all the volunteers in our communities as well as encouraging volunteerism throughout the month.
Volunteer Appreciation Week
Volunteer Appreciation Week is celebrated during the 3rd week of April every year. It is an opportunity to recognize the impact of volunteer service and the power of volunteers to tackle society’s most significant challenges, build stronger communities, and be a force that transforms the world.
Almost 50 years later here we are continuing to expand and improve care for our clients with the support of our volunteers and donors.
Community empowerment is the guiding light in our approach to volunteerism and honoring those that keep our foundation of volunteerism alive is another step in that commitment.
Please join me in thanking the volunteers at Howard Brown Health and across the world that do their part in helping to make the world a better place!
Warm Regards,
Terra A Campbell Community Impact Coordinator
Transgender Day of Visibility: Debunking Transphobic Myths
Transgender Day of Visibility takes place each year on March 31st to celebrate transgender and non-binary (TNB) people and to take action against discrimination and transphobia. This year, it is more important than ever to use your voice and stand with TNB communities as we’ve seen a huge surge of legislative attacks on the rights of TNB people all across the country. This year, there have already been over 435 anti-LGBTQ bills introduced across the United States. Many of these bills are focused specifically on TNB people, restricting their ability to participate in sports, access necessary healthcare, and even just exist in public spaces. These legislative attacks are fueled by transphobic myths and misinformation. One way that we can all take action against these bills is by educating ourselves and others about why these myths are wrong and what the truth is.
Myth: Gender affirming care (GAC) is dangerous and not evidence-based.
Proponents of anti-trans medical bans often assert that GAC is experimental and harmful. This even comes into how these acts are named, with many such bills deemed SAFE Acts, standing for “save adolescents from experimentation.” In reality, there are decades of sound and comprehensive scientific evidence that clearly demonstrates that GAC results in dramatic reductions in suicide attempts, reduced rates of depression and anxiety, and improved overall quality of life for TNB people. In fact, the scientific evidence is so sound that GAC is supported by every major medical association in the country. Recently, the American Medical Association urged states to stop introducing bans on GAC. It is also important to note that GAC includes a wide variety of medical and social interventions, some reversible and some irreversible. Each patient’s journey with GAC is different, and the ultimate goal of the provider is to work hand-in-hand with the patient and the patient’s support system to ensure that everyone has a full understanding of the risks and benefits involved with each treatment so that patients can give informed consent and make decisions that are right for them. While political extremists often focus on irreversible consequences of surgery, it is critical to note that there are also many irreversible and harmful consequences of no medical intervention, which they are trying to mandate. Because of the complexity and variety of care options and outcomes, these decisions should be left to the medical experts and the patients. Intervention from politicians is inappropriate and can be life-threatening.
Myth: TNB people don’t really exist.
Political extremists often focus on instances of regret, detransition, or so-called “rapid-onset gender dysphoria (ROGD)” to indicate that TNB people don’t really exist and are just experiencing social pressure to transition. First, it is important to note that the study that supposedly proved the existence of ROGD and “social contagion” to transition has been soundly debunked. The study included no input from TNB youth themselves, and participants were recruited from anti-trans websites. Several reputable studies have since been published that further disprove the “social contagion” myth. There are many reasons why more youth identify as TNB now, including increased visibility, social support, and legal protections in some states. Detransition does occur, but context for detransition is important. A recent study found that while 13% of TNB people reported detransition at some point in their lives, over 80% of those reported that detransition was not due to no longer identify as TNB, but rather the result of external factors like lack of family support, employment discrimination, or increased exposure to violence.
Myth: LGBTQ+ people are grooming/recruiting children.
Increasingly, politicians are spreading hateful rhetoric and conspiracy theories framing LGBTQ+ people as “groomers” intent on indoctrinating and victimizing children. These false narratives are perpetuated to support a wide range of anti-LGBTQ+ legislation, including bills censoring LGBTQ+ educational material, bills preventing TNB individuals from using public restrooms, and bills banning drag performances. These accusations are completely baseless, and data from the FBI actually shows that LGBTQ+ people are actually much more likely to be the victims of violent victimization and domestic abuse. These accusations are not meant to be factual; they are meant to be extreme to rile up panic and anger. We’ve seen this tactic used many times in the past, from the Lavender Scare to Anita Bryant to the fight for marriage equality. Conservative extremists have consistently demonized LGBTQ+ people as “groomers” and predators in an attempt to score political points and mobilize their voter base. This hateful and untrue rhetoric has real consequences, as we’ve seen a recent surge of attacks at LGBTQ+ community events and online. Political Research Associates recommends not to engage with these baseless accusations and instead pivot the conversation (e.g. “I find that very offensive” or “Stop, you don’t actually believe that’s true.”).
Track and respond to anti-LGBTQ+ legislation across the country:
Understanding Drag Bans: The Latest Legislative Attacks on Queer Communities
Recently Tennessee enacted the nation’s first “Drag Ban,” prohibiting all drag performances in public or in the presence of minors. Anyone who violates the drag ban could face misdemeanor charges punishable by a fine of $2,500 and/or up to a year in jail. Repeat violators could face felony charges and up to six years in jail. At least 14 states have introduced similar legislation to criminalize drag, and many of these bills could also prohibit any public expression of gender nonconformity. In North Dakota, a proposed drag ban categorizes drag shows as an “adult-oriented business,” putting all drag shows in the same category as sexually explicit performances like exotic dancing. In Arizona, the proposed drag ban penalizes drag performers with at least ten years in prison and registration as a sex offender. These bans are incredibly harmful, and many broadly impact queer communities, not just drag performers. One version of a West Virginia drag ban included language that would prevent minors from being around any “transgender exposure, performances or display.” These broad definitions could criminalize trans and non-binary (TNB) individuals being around minors under any circumstances, and prevent TNB individuals from holding a job, accessing healthcare, or simply leaving their homes due to the potential legal risks. Below, learn about both the historical and current political context of drag bans, and find out about action steps you can take to advocate for TNB communities!
While this current wave of legislation is the first to specifically target drag as an art form and a job, these drag bans are rooted in a long history of legislation in this country aimed at preventing nonconforming gender expression. For example, “cross-dressing” bans and other laws restricting gender expression have existed in this country for over 100 years. San Francisco was the first city to enact a cross-dressing ban in 1863, prohibiting people from going out in public “in a dress not belonging to his or her sex.” This led to a flurry of similar laws in other states and cities aimed at restricting gender expression. Some jurisdictions, like Columbus, Ohio, would simply copy San Francisco’s legislation. Other jurisdictions, like New York state, would reinterpret existing masquerade laws to criminalize gender nonconformity. New York’s masquerade law made it illegal to have your “face painted, discolored, covered, or concealed, or [be] otherwise disguised… [while] in a road or public highway.” These bills were intended to prohibit people from participating in illegal activities while disguised or in costume, and they often did not mention cross-dressing at all. Even so, in New York and in other states, masquerade laws were used to arrest queer and gender nonconforming people for simply existing in public. These new drag bans are the continuation of a long legacy of political attacks on queerness and gender expression, and we must take a stand to break the cycle.
Drag bans are just the latest in a surge of horrible legislative attacks on LGBTQ+ communities, including increasingly severe and dangerous bans on gender-affirming care. In 2023 alone, over 340 anti-LGBTQ+ bills have been introduced across the country, with at least 150 bills aimed specifically at TNB individuals. At least 21 states have enacted legislation or administrative policy attacking TNB people. Currently 19 states ban trans youth from participating in the sports aligned with their gender identity. At least 10 states have passed laws or policies that restrict access to gender-affirming care. This is all part of a larger strategy to score political points at the expense of marginalized communities. Politicians are spreading misinformation and hateful rhetoric—for instance, that drag performers are “groomers” or that gender-affirming care is “child abuse”—in order to manufacture problems that they can then solve with a slew of anti-LGBTQ+ legislation. These legislative attacks on TNB communities are being used to rally voter support, especially heading into a contentious election year.
The constant debate around anti-LGBTQ legislation and our right to simply exist in public spaces has increased negative health outcomes and safety concerns for queer people. A report from Human Rights Campaign and the Center for Countering Digital Hate revealed that the average number of tweets per day using the terms “groomer” and “pedophile” in reference to LGBTQ+ people increased 406% in the month after Florida passed its “Don’t Say Gay” bill in March 2022. In response to hateful rhetoric and legislation, there have been several high-profile protests by the dangerous right-wing group the Proud Boys at various drag shows in California, Texas, and North Carolina. The current political climate has also taken a significant toll on LGBTQ+ individuals’ mental health. Based on a survey from the Center on American Progress (CAP), more than half of LGBTQ+ adults (51%) reported that recent debates about anti-LGBTQ+ state laws had affected their mental health or made them feel less safe to a moderate or significant degree, including more than 8 in 10 TNB individuals (86%). According to the Trevor Project, 93% of TNB youth are worried about being denied gender-affirming care while 83% worry about being denied the right to play sports.
While these new drag bans may seem narrowly focused on drag, it is important to understand both the historical context and current political context surrounding these bills. Drag bans are about the continued policing of gender expression, and they work in tandem with other current anti-LGBTQ+ legislation to advance extremist agendas at the expense of LGBTQ+ human rights and health equity. If you are concerned about this new drag ban legislation and other anti-LGBTQ+ legislation, there are many ways you can become involved!
In July 2021, the Chicago City Council passed the Empowering Communities for Public Safety (ECPS) ordinance, which created a new model for police oversight, accountability, and public safety. The ECPS ordinance created District Councils to be comprised of several dozen members elected by Chicagoans to help increase accountability by law enforcement to citizens. The District Councils will be a body separate from other law enforcement bodies in Chicago. The establishment of the District Councils was a long overdue and necessary response to increasing police brutality in Chicago and across the country. In this year’s city elections, we will be electing members to these District Councils, so it is important to be informed about what the Councils do and who is running.
Why Do We Need District Councils?
Police brutality is a public health crisis in the United States, and it is also a health equity issue. Many of the issues of modern policing can be traced back to racial segregation and the marginalization of minority populations, including Black, Latinx, and LGBTQ+ communities. Research shows that marginalized groups are disproportionately impacted by police violence and murder. For example, LGBTQ+ individuals experience many negative interactions with law enforcement. A 2014 national survey by Lambda Legal showed that 21% of LGBTQ+ respondents reported encountering hostile attitudes from officers, 14% reported verbal assault by the police, 3% reported sexual harassment, and 2% reported physical assault at the hands of law enforcement officers. Black men are about 2.5 times more likely to be killed by police over the life course compared to White men. The number of Latinx individuals killed by police increased about 24% between 2014 and 2021.
Chicago, like many other cities, has a historically tumultuous relationship between law enforcement and citizens, especially citizens of color. Once such incident of police violence is the fatal shooting of 17-year-old Laquan McDonald in Chicago. McDonald was shot 16 times by a police officer on the southside of Chicago and a subsequent campaign to cover up the video footage of McDonald’s murder lead to a multitude of calls for increased civilian oversight. This led to the City Council’s creation of the District Councils. This comes after many years of community organizing and several proposed plans on how this council would be structured. This upcoming Chicago election will be the first-time citizens will have direct interaction with this new plan of accountability.
Key Responsibilities of the District Councils
District Councils will be created in each of the City’s 22 police districts. Each District Council consists of three people who are elected in municipal elections every four years. The main goals of the District Councils are to build stronger connections between the police and the community, and to work with the police to solve problems and set priorities. They will hear residents’ concerns around topics including police interactions with youth and undocumented residents, race relations between police and citizens, and restorative justice initiatives.
To increase community input and oversight of police activity, the District Council members will be responsible for holding monthly public meetings where residents can work with the police on local initiatives and police department policies and practices. Collaboration between the community, District Council members, and law enforcement will be critical in the development and implementation of community policing initiatives. Since specific agendas are not pre-established, each of the elected members of the District Councils will have their ideas of what law enforcement initiatives to focus on. Some of the current candidates are working towards abolition of the police or alternative safety structures such as increasing access to mental health professionals working in crisis situations. Some candidates support increased policing, and others have opinions in between. So, who you vote for will establish the focus of the District Councils in your neighborhood.
Another important function of the District Councils is that they nominate members for the Community Commission for Public Safety and Accountability (CCPSA) — a seven-member citywide body with wide-ranging oversight over the Chicago Police Department, Police Board, and the Civilian Office of Police Accountability (COPA). The CCPSA reviews the Police Department budget and can recommend changes to the police budget appropriation. The CCPSA also has the power to appoint and remove the COPA Chief Administrator with City Council approval. When there are openings for Police Superintendent or Police Board members, the CCPSA will develop a shortlist of candidates for the Mayor to choose from. While the Mayor has sole authority to remove the Police Superintendent and Police Board members, the CCPSA can hold a vote of no confidence in that official, triggering a City Council hearing and requiring a public response from the Mayor. To provide more oversight into policing policies, the CCPSA can draft Police Department General Orders, and General Orders cannot become policy without a majority vote from the CCPSA. To increase transparency, the CCPSA can require the Police Superintendent and other key officials to provide data and to appear in public forums to address concerns. Since District Council members will help nominate the CCPSA, its vital to vote for candidates who you believe will shape the culture and financial priorities of law enforcement in the city for the better.
Chicago is having a municipal election on February 28th! This is our opportunity to elect officials who will be responsible for making laws and regulations that affect the safety and health of all Chicagoans. Participating in municipal elections can have a deep impact on our communities. Make sure that you are prepared to vote so that your voice is heard on important policy issueslike affordable housing, healthcare, public transit, and policing!
Because Chicago is the third largest city in the U.S., the Mayor of Chicago is responsible for a multitude of important laws and initiatives that garner a lot of public visibility. Many of the decisions that the Mayor makes have ripple effects for the state of Illinois and even the whole of the Midwest. For example, past executive orders issued by the Mayor have designated Chicago as a sanctuary city for undocumented immigrants and for those receiving reproductive care from all over the country. Elected for a four-year term, the Mayor oversees the city’s public works departments including police, emergency medical, and utility services. The Mayor works directly with and is a permanent member of the City Council. The Mayor and the City Council work together to pass budgets, draft and enforce legislation, and oversee city departments and appoint departmental heads. The Mayor is a major driver of policy issues and focus in the city, so picking a mayoral candidate with similar policy priorities to yourself is crucial. This year, there are nine mayoral candidates, and it is important to research which candidate you feel best suits what the city needs.
The City Council serves as the legislative branch of government of the City of Chicago. It creates, passes, and amends local laws, and approves the city’s budget every year. We elect one alderperson for each of the 50 wards in Chicago to a four-year term. Your alderperson will also generally be your first stop whenever you have concerns about your neighborhood. The city ordinances that the City Council creates and passes have an enormous impact on public health. For example, during the COVID-19 pandemic, the City Council passed an ordinance preventing employees from disciplinary action for taking time off work to get a COVID-19 vaccine. Your alderpersons create meaningful change city-wide and block by block. Be sure to look up who is running in your ward and their positions.
In the upcoming election, you will be voting for a City Clerk and City Treasurer. Both offices are responsible for providing transparency around what Chicago city offices are doing and how they are spending taxpayer money. The City Clerk is responsible for making official legislation, records, laws and reports available to city residents. Some of the documents City Clerks maintain include business licenses, executive orders issued by the mayor, city budgets, and City Council legislative records. The City Treasurer receives all money belonging to the city and is responsible for maintaining records and providing reports on the state of the City’s finances. A main function of both these positions is to maintain and publicize records of the actions of city government so that city residents can be informed and hold elected officials accountable.
For many years now, advocates for called for more community oversight and accountability for the Chicago Police Department due to a history of injustice and violence, especially against Black communities. In response, the City Council created District Councils that you will be able to vote on in this election. Up to three people will be elected to a District Council in each police district for a 4-year term. District Councils members will aim to bring police officers and Chicago residents together to plan, prioritize, and build mutual trust; strengthen the police accountability system; give Chicagoans a meaningful new role in oversight; and explore and advance alternative effective approaches to public safety. This Council is also responsible for nominating members of the Community Commission for Public Safety and Accountability who have oversight over policing budgets and policies regarding law enforcement behavior. This is an opportunity for Chicagoans to have more input and a voice in how their neighborhoods are polices. You can visit this reference guide on whom is running for the District Council in your area.
To prepare for the upcoming election, early voting is currently open and the last day to request a mail-in ballot is February 23. You can visit the Chicago Board of Elections for more information on how to register to vote, early voting and mail-in ballots.
Advocate for Culturally Responsive Care in Illinois!
This legislative session, Howard Brown Health and a group of advocates and providers are supporting a legislation (SB 2427/HB 2280) that would establish cultural competency requirements as part of continuing medical education (CME) for healthcare providers. There is a strong need for increased cultural competency training among providers to help improve patient experiences and health outcomes, especially for patients from historically marginalized and underserved communities. You can help ensure that providers in Illinois are trained to provide inclusive and affirming care by telling us your health care story!
Many people face barriers to healthcare that stem from discrimination based on race, religion, sexual orientation, gender identity, and disability. For example, transgender and nonbinary (TNB) patients are often misgendered or called by the incorrect name due to lack of provider education and training on gender identity and affirming care. In a national survey conducted by the Center for American Progress, 3 in 10 transgender or nonbinary (TNB) respondents reported that they had to “teach [their] doctor or other health care provider about transgender or nonbinary people in order to get appropriate care.” For example, TNB patients may not receive important and appropriate health screenings such as cervical, breast, or prostate exams because providers make incorrect assumptions and do not ask about gender identity or history of gender affirming care. This lack of understanding of TNB health leads many TNB patients to avoid or delay necessary and preventative care, resulting in worse health outcomes. With more and more legislative attempts to ban gender-affirming care introduced and passed across the country, it is more critical now than ever to use tools such as cultural competency training to help reduce and eliminate discrimination patients may face in healthcare.
Lack of education and training also leads to poorer health outcomes for other marginalized communities. For example, far too many providers still believe the racist myth that Black people possess thicker skin or experience less physical pain than their White counterparts. One study asked patients to report how much pain they were experiencing and compared that to providers’ perception of how much pain the patients were in. Results showed that providers are more likely to underestimate Black patients’ pain (47%) relative to nonblack patients (33.5%). These incorrect beliefs result in suboptimal care: Black patients are 22% less likely than White patients to receive any pain medication. These negative experiences often result in Black patients avoiding or delaying care due to not being believed or being given care that doesn’t address their healthcare needs. Patients with disabilities also often experience suboptimal care due to lack of knowledge and training amongst providers. A study by National Disability Rights Network and Disability Rights Washington chronicled instances where physicians recommended denials of needed transplants; withheld medical treatment, and even sterilized people due to provider misperception of disabled patients’ quality of life. Providers in this study noted a lack of sufficient knowledge, experience, and skills when it comes to providing care for people with disabilities.
Cultural competency training would help providers to deliver better care to marginalized communities by addressing generalizations, misunderstandings, and gaps in knowledge. However, this training isn’t a requirement for all providers. Currently only seven states require providers to engage in cultural competency or implicit bias training as part of their CME criteria for licensing. CME around cultural competency and working with varied patient populations is especially necessary given that these topics are still inadequately covered in medical schools and other formal education settings for healthcare workers. According to a 2016 National Academies of Science report, 40% of first- and second-year medical students endorsed the belief that Black people’s skin is thicker than that of White people. Furthermore, research shows that LGBTQ+ focused curriculum was “scant” and highly varied among U.S. medical institutions. Findings show medical students only received an average of 2.22 annual curricular hours of LGBTQ+ related education, leaving students feeling unprepared to treat LGBTQ+ patients.
Given the lack of cultural competency education in formal education and training curricula, CME courses are necessary to help providers become more affirming and knowledgeable when treating their patients. There is evidence to show cultural competency training helps increase provider knowledge about culturally, linguistically, and socio-economically diverse patients. Patient attendance and adherence to provider advice improved significantly among providers who had engaged in cultural competency training versus providers who had not (Horvat et al., 2014). Research has also shown that cultural competency training resulted in increased satisfaction by BIPOC patients. You can help ensure that providers in Illinois are trained and educated to provide inclusive and affirming care by telling us your health care story! Please provide your stories of instances of discrimination or bias in healthcare and how it affects health outcomes. For anyone who speaks or would prefer to, you can provide your story in Spanish.
Recently, Illinois concluded its lame duck legislative session and several crucial health equity bills supported by Howard Brown Health passed both houses of the Illinois General Assembly!
With the increasing number of mass shooting in the U.S., the Protect Illinois Communities Act will go a long way towards protecting Illinoisans by enacting desperately needed bans on the sale of assault weapons and high-capacity magazines. This bill will require the registration of all assault weapons so law enforcement can better track assault weapons moving in and out of Illinois. It will also increase the Firearm Owners Identification eligibility age to 21. The identification allows someone to legally possess firearms and ammunition in the state of Illinois.
This bill is especially important for marginalized communities who are disproportionately the victims of gun violence, including LGBTQ+ communities. LGBTQ+ people are more than twice as likely to be a victim of gun violence than their cisgender and straight peers, with trans individuals experiencing even higher rates of violence. Reported murders of trans individuals increased 93% between the years of 2017 to 2021, and 73% of those individuals were killed using a firearm. Targeted attacks on LGBTQ+ people are also on the rise due to a recent increase in anti-LGBTQ+ legislation. In 2022 alone, over 230 anti-LGBTQ+ bills were introduced in states across the country. These attacks against LGBTQ+ individuals range from prohibiting gender-affirming care for youth to “Don’t Say Gay” bills banning discussion of sexual orientation and gender identity in schools. These legislative attacks are fueled by fearmongering and discriminatory rhetoric, which in turn has led to increasing attacks on the community. Anti-LGBTQ+ rhetoric has spurred hostile demonstrations at drag shows and Pride events all across the country, including in Illinois. This hateful rhetoric has escalated to multiples tragedies, including the recent Club Q shooting in Colorado Springs. The bill will go a long way in helping to protect people most vulnerable to gun violence, including LGBTQ+ individuals. We commend Governor Pritzker for quickly signing this bill into law.
Reproductive and gender affirming healthcare protections: Patient and Provider Protection Act (HB 4664)
Over the past few years, more and more states have been restricting or eliminating access to gender affirming care. In 2022, at least fifteen states—including neighboring states such as Iowa, Missouri, and Ohio—have enacted or introduced legislation to deny access to gender affirming care for trans youth. These bills often criminalize supportive parents and providers who offer gender affirming care, making it very difficult for trans youth to feel safe accessing necessary care in their home state. These gender affirming care bans mirror anti-abortion legislation, which is also increasing. With the Dobbs decision in June 2022 resulting in very restrictive or total bans on abortion and certain reproductive rights in many states, the need for millions of people to find safe and comprehensive gender affirming and reproductive care is vital.
The Patients and Provider Protection Act will protect any patients who must travel to Illinois to seek reproductive or gender affirming care not legally allowed in their home states and will protect providers in Illinois from any legal action for providing that care. For example, providers won’t have to worry about losing their license or being extradited due to court order or subpoena from another state for providing gender affirming or reproductive healthcare. This bill will protect patients by making it illegal for health care workers to disclose to law enforcement care being provided such as being prescribed hormone therapy or seeking an abortion. Illinois will not use any part of its court system or law enforcement agencies to help other states attempt to prosecute, fine, or sue any provider or patient from providing or receiving this care.
Along with providing protection for performing and receiving necessary care, this bill also includes several provisions to expand access and reduce cost barriers to gender affirming and reproductive healthcare. For example, patients will not be charged out-of-network insurance rates if they must go out of their network to receive care, which is increasingly important as more and more providers claim religious or moral objection to providing gender affirming or reproductive services. The bill also requires insurers covered under the Illinois Code of Insurance to cover abortion medications, PrEP/PEP, and hormone therapy medications with no-cost sharing to patients. This is critical as we know that lack of insurance coverage and cost are common barriers to accessing hormone replacement therapy. We commend Governor Pritzker for signing this bill into law.
Name Change Registration (HB 2542)
Illinois has one of the strictest name change laws in the country for anyone seeking legal name change with a felony background. HB 2542 will allow for anyone in Illinois who has a previous felony charge to be able to change their name due to marriage, human trafficking, or gender identity with approval from a judge. This bill will remove the 10-year waiting period to be eligible to change your name, and it removes a lifetime ban for those with identify theft convictions. These restrictions were very harsh and potentially dangerous for trans and non-binary people, or anyone who may be fleeing a domestic violence or human trafficking situation. The inability to change your name for a trans or non-binary person could result in discrimination or being unintentionally outed due to their legal paperwork not aligning with gender identity. HB 2542 will increase efficiency and transparency for the name change processing including waivers to bypass any public publication of their name change for an individual’s safety. You can help! Please reach out to Governor Pritzker and let them know the importance of signing HB 2542 to help improve access to legal name change and decrease the potential discrimination faced by trans and non-binary individuals.
Howard Brown Health has issued a statement on the conclusion of the union work stoppage. Following a three-day labor strike, Howard Brown recommits to working with union staff as they return to work and maintaining its high-quality services and program for patients and the communities it serves. To read the press release, click here.
Howard Brown Health has issued a statement in response to an incident that occurred this afternoon at the Brown Elephant Andersonville store. To read the press release, click here.
Howard Brown Health announces cost-saving measures to address FY23 revenue shortfall. A workforce reduction is a part of the action plan to strengthen the agency’s position. To read the press release, click here.
A Message from David Ernesto Munar, President and CEO
Dear Community,
On Wednesday, Howard Brown Health’s efforts to reach agreement with the union’s bargaining committee reached impasse, which means that Howard Brown and the union are in fundamental disagreement over the urgency of Howard Brown’s revenue shortfall and the need to respond swiftly. Unfortunately, Howard Brown will need to move forward with the proposed workforce reduction on January 3, 2023. This decision is legal and critical for the organization. We will do our absolute best to assist staff during this transition into future career endeavors.
As leadership works to close the $12 million revenue shortfall caused by changes to the 340B federally negotiated pharmacy program and the conclusion of COVID-funding, the organization is working to ensure all its vital healthcare services are available to our patients now and in the future. As the President and CEO, I take the ultimate responsibility for stabilizing our organization and offer my heartfelt commitment to our community to set things right.
During the months ahead we will continue to stabilize our budget, restore operations, and begin to mend labor relations. We are whole-heartedly committed to each of these priorities and will not waver as we move forward together. We are also taking stock of the conditions that led to our current revenue crisis so we may adopt measures to mitigate the risk of destabilization in the future and ensure the availability of our services for years to come.
Moving forward, we must continue to optimize our patient centered investments like our new patient portal and take advantage of all available revenue opportunities needed to close the financial gap this fiscal year. We must build trust with our constituents and with each other. And let us not forget to celebrate our commonalities and the achievements of our colleagues in meeting the needs of our diverse community.
On behalf of our tens of thousands of patients, thank you for your continued support of Howard Brown and our vital patient care.
Today, Howard Brown Health staff members represented by the Illinois Nurses Association gave notice of their intent to strike commencing Tuesday, January 3, 2023, and ending at 11:59 p.m. on January 5, 2023. Howard Brown values our employees and respects the right of its workforce to strike.
Howard Brown will continue to provide patient care and services, regardless of the strike. In the event of a work stoppage by unionized employees, Howard Brown will implement a contingency plan that ensures all patient appointments are completed or rescheduled as soon as possible, while following all labor regulations.
Howard Brown remains committed to closing a revenue shortfall, minimizing the impact on employees at maintaining the high-quality services and programs. While painful, cost-saving measures will help ensure Howard Brown’s ability to serve patients and communities for decades to come.
The notice of intent to strike follows a series of proposals involving a reduction in Howard Brown’s workforce, including 60 union-represented positions. It is important to note that we are still in the middle of bargaining these proposals with the union with our next negotiation session set for December 28.
While difficult, Howard Brown believes that a workforce reduction is needed to help stem the agency’s losses of over $1 million each month. The losses stem from the unexpected cuts in in pharmacy revenue through the federally negotiated 340B pharmacy program supporting some Howard Brown services.
The last proposal to the union by Howard Brown included 60 positions proposed for elimination on January 3, 2023. The proposed separation package for laid-off staff members includes two weeks of salary for staff with less than 2 years of employment and four weeks of pay for staff with over 3 or more completed years of employment. Under the proposal, both categories of staff would also receive health insurance and Employee Assistance Program benefits through the end of January. The Union has yet to respond to this last proposal, but has promised to do so no later than our December 28 bargaining session.
We thank our valued staff members in meeting patient needs as we work together towards any necessary changes to protect care for patients now and well into the future.
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December 17, 2022
Please see our Frequently Asked Questions (FAQs) on the 2022 revenue shortfall for more information.
There’s a few different numbers referencing the deficit Howard Brown is facing. What’s the actual deficit?
Through November 30, 2022, Howard Brown experienced a deficit of $5.2 million and is experiencing more than $1 million in losses each month. If not addressed immediately, Howard Brown will have a +$12 million deficit through the end of the fiscal year (June 30, 2023).
The financial imbalance will destabilize the organization and threaten patient care if not addressed immediately.
How have other community health centers who rely on 340B dealt with the funding shortage?
Other FQHCs have been dealing with similar but not identical revenue shortfalls. Howard Brown’s 340B program relies on Truvada, which recently went to generic formulary, and antiretroviral medications. As one of the top 20 340B programs in the nation, 340B has played a greater role in our overall trajectory, covering operational expenses.
How has Howard Brown advocated against changes in the 340B program?
Howard Brown has been actively working since 2020 to stop changes in the 340B program with a coalition of organizations led by the National Association of Community Health Centers (NACHC). Under the leadership of Director of Advocacy, Tim Wang, Howard Brown will continue to advocate for this critical funding not just for our agency, but for all FQHCs across the country. Howard Brown has held briefings for government agencies and elected officials, pushed for enforcement against pharma, advocated for the passage of federal and state legislation that supports 340B, etc.
Are there ways that our community members can advocate around 340B?
Yes. www.340bhealth.org/ and https://www.cv340b.org/get-involved/ are helpful tools for identifying what you as an individual can do. Howard Brown will continue to notify its community of opportunities to advocate around 340B through its advocacy blog, newsletter, emails, and social media.
If Howard Brown received donations to help fill the gap, would that help solve the revenue shortfall?
Howard Brown has shared the revenue shortfall with its community including donors. Philanthropy should not be used to address an ongoing structural change in operating revenue, which requires improving and enhancing the overall operations of the organization.
Why is Howard Brown decreasing the size of the behavioral health department? How will it increase access to services by decreasing staff numbers?
Under a model that centralizes care teams within clinics, Howard Brown expects to be able to better serve its community. Across all departments, including Behavioral Health, we have identified issues with siloing services that create patient confusion and inefficiency in the delivery of care. We are choosing to simplify and improve workflows. By improving operations, we will be able to see more patients.
The agency is cross-training staff to eliminate siloes, building in patient assessments, and ensuring that there are staff within the care teams across clinical sites. The challenge of small teams with a singular specialty is that schedules are restricted, sites lack equitable access to personnel, and patients lack access to care.
Why is Howard Brown building a large clinic on Halsted even after knowing about revenue gap? How will Howard Brown expand services at the new building on Cornelia if it is cutting staff?
Howard Brown has been planning the development of new clinics for more than five years, and is contractually obligated to finish the Halsted building. The completion of the building will create expanded revenue and increase access to HIV-specialty care.
Opening the new building will afford Howard Brown the chance to reach new patients with primary care, dental care, and other services – new visits that will help the agency financially through billing revenue and pharmacy revenue and help better express the agency’s mission.
Additionally, the new site’s primary care practice will take physicians from Sheridan and Halsted and move their panels, as well as the staff associated with those care teams, into the new building. The agency also plans to slowly grow into the space, opening the second floor first, and eventually adding the third floor of primary care services.
Is the Executive Leadership Team taking a paycut?
ELT is taking a net 6% reduction in pay effective December 1, 2022. As with staff across the agency, competitive compensation is important to retain staff and ensure expertise in leading the agency. Howard Brown will continue to pay its leadership at a rate comparable to similar work in similar size organizations. The leadership team has set a goal to achieve 25 – 30% of the cost-saving goal from administrative allocations.
Howard Brown Health staff expanded as a response to the COVID-19 pandemic. What was the plan to make these staffing numbers sustainable?
In 2020 during the COVID-19 pandemic, Howard Brown made a choice to grow our staff to serve our community. We were among the most responsive community health centers supporting the public health in the city. The agency also made an effort to keep every staff person on payroll in a time where so much was unknown. We are incredibly fortunate that we have not had to make cuts until now.
While we were aware of 340B changing, we could not predict the speed and scale of the changes. Thanks to our dynamic 340B operations and compliance team, Howard Brown’s 340B program has grown to one of the top 20 in the nation which has allowed for sustainability of the agency over the last ten years.
Howard Brown did not begin seeing major shifts in 340B revenue until new restrictions were put in place in Summer of 2022. Additionally, the introduction of generic Truvada (PrEP) has created pricing instability and unpredictability for the past two years for both name brand and generic PrEP products.
In 2019, we reported seeing 30,013 patients across our network of clinics and had 428 staff. In 2020, while in the heart of the pandemic, we saw 27,336 patients with 507 staff. In 2021, Howard Brown returned its patient numbers to pre-pandemic levels seeing 30,430 patients with 617 staff. In 2022, the agency has more than 720 staff and has seen approximately 31,310 patients. We share these data points, which can be accessed via a nationally recognized annual reporting database called the Uniform Data System, to create a shared understanding of the growth the agency experienced in serving the community during two public health crises, the COVID-19 pandemic and the MPV outbreak.
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December 16, 2022
A message from Chef Fresh Roberson, Board Chair
Dear Howard Brown Community,
For nearly 50 years, Howard Brown has saved and changed lives, including my own. As a patient for nearly 20 years and more recently as Board Chair, I am committed to Howard Brown continuing to save lives for another 50 years into the future. Under my leadership, the entire Board is dedicated to making sure our vital organization takes important steps to secure our organization’s future.
Howard Brown continues to face a $12 million revenue shortfall from 340B pharmacy revenue. This is a critical moment in our organization’s history. In this moment, the commitment from every corner of our organization, from the Brown Elephant to our care teams to our Board of Directors, will help us succeed. To be successful, we must prioritize our patients and clients as we examine our clinical operations, agency goals and initiatives, strategic plan, and much more.
We will be making significant changes to protect patient care as we address the revenue shortfall. These changes will create uncertainties and stress, especially for Howard Brown’s committed staff. I don’t take this lightly. And with every tough choice, we get closer to the goals: securing Howard Brown’s ability to meet the needs of our patients now and well into the future; better operations for a more fulfilling patient experience; and healthcare that is affirming and culturally competent. Those goals are only possible with our dedicated staff.
We employed a record number of people in 2020 and 2021, quickly adding over 200 new positions to help with COVID-19 health education, outreach, testing partnerships, vaccination events, enhanced infectious control measures, telehealth, mobile services, contact tracing, and other services. I am proud of what we accomplished during that unprecedented time. We have been reluctant to reduce our staffing levels in case another public health emergency should occur. Changes in 340B pharmacy revenue—and an end to federal COVID relief funding—have sadly left us with very tough choices.
Making these difficult adjustments is urgent. With losses exceeding $1 million per month, inaction now will shortchange our shared future. Adjusting to smaller teams—and saying goodbye to trusted co-workers—will impact the entire organization and be extremely challenging. The affirming care our staff provide our patients is vital, and we’ll work together to continue to support our communities in every way we can. By supporting our care teams and leaning into patient-care as a driver of our entire agency operations, we will make Howard Brown stronger. Comparable data from peer organizations shows that we can.
Thank you for the care, concern, and generosity you have shown for Howard Brown’s mission to affirming and culturally competent healthcare.
The union is publicizing that it is calling for a strike authorization vote. To strike is our staff’s right, and Howard Brown Health will respect that right. Howard Brown has a commitment to bargaining in good faith, and to keep patients and the community up-to-date.
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December 7, 2022:
A Message from David Ernesto Munar, President and CEO
Dear Community,
I am writing today to share an update on Howard Brown Health as it navigates a challenging time. Across the country, LGBTQ+ and HIV-serving healthcare organizations like Howard Brown are navigating significant shifts in pharmacy revenue that now allow pharmaceutical companies to keep a greater share of federally negotiated savings through the 340B pharmacy revenue program.
A message from David Ernesto Munar, President and CEO of Howard Brown Health
Much like our sister organization Fenway Community Health Center in Boston, and other FQHCs across the country, we are feeling the pressure of changes with pharmacy revenues. Over the last ten years, this funding supported program expansion, personnel, and operations. With federal funding for COVID-related services ending, we are work toward lowering our operating expenses and enhancing our earned revenue.
Right now, we are facing a $12 million revenue shortfall which we are taking urgent measures to address.
Howard Brown’s leadership is exploring multiple mechanisms to help close the revenue gap, of which 75% is sought from non-personnel cost-cutting measures. This includes strategies to boost revenue generated from medical visits and other efficiencies such as the implementation of a new electronic medical record. Our urgent plan to close the revenue gap will not impact Howard Brown’s commitment to quality, culturally compassionate healthcare, and Howard Brown has no intention of eliminating services.
While a reduction in workforce is required to close the revenue gap, no positions will be let go until after Jan. 1, 2023. We are working collaboratively with leaders across the agency and our union to advance compassionate plans for departing employees and continuity plans to reset teams for success in meeting patient needs. In all cases where changes may impact union members, Howard Brown will bargain with the union first and in good faith.
Howard Brown will continue to address financial challenges with integrity. We pledge to show our values in a plan that is thoughtful and respectful– keeping our patients and mission at the forefront.
While we face new challenges, our commitment to serving our patients and clients is unwavering. We are confident that we can emerge from this challenge stronger than before and in a way that ensures our communities will be able to count on us in the next 50 years and beyond.
In gratitude and respect,
David Ernesto Munar
President and CEO
For more information, see our previously published statements about the ongoing work to address the fiscal crisis:
