Letter to Staff: Important Steps to Position Howard Brown for the Next 50 Years

This letter was distributed to all members of Howard Brown Health staff on the morning of July 1, 2024.

Dear Colleagues,

Today, Howard Brown begins a new fiscal year, and with it comes the commemoration of our 50-year anniversary. This is an incredible milestone for our organization, which for so long has provided affirming and accessible patient care to Chicago’s LGBTQ+ community. I wanted to take a moment to reflect on the state of our institution and share with you important – and, in some cases, tough – steps we are taking to ensure that we’re best positioned to deliver on our mission for the next 50 years.

Our History

Founded in 1974 as an STI clinic by queer medical students, Howard Brown has expanded to meet the broad-based needs of LGBTQ+ community members and address the many barriers they face. Today, when patients want to receive care for their whole selves in a safe and compassionate environment, they come to Howard Brown. And time and again, we have stepped up to meet their evolving needs.

Over the last 10 years, not only did we become a federally qualified health center (FQHC) – the only LGBTQ+ one in the Midwest – we also grew from three healthcare centers to eight locations across Chicago. From 2015 to today, we have seen at least 5% growth in our patient numbers every year; last year alone, we added more than 2,500 patients to our network.

Navigating a Changing Environment

Our growth has no doubt been impressive and cemented our role as one of the nation’s largest LGBTQ+ organizations today – but it has come with challenges.

We expanded staffing and services to address as many patient needs as we could; however, in doing so, we became that over-extended caregiver who always tries to show up to serve others, while not always focusing on what they need to sustain themselves.

On top of this, the economics of healthcare have significantly changed, including the expiration of millions in federal COVID funds, a reduction in local public health grants, and substantial reductions in federal drug savings programs.

This is why, as you know, we have already rolled out a number of targeted initiatives to enhance our operational efficiency and the experience of both patients and providers. This includes implementing a state-of-the-art electronic medical records system and other measures to decrease patient wait times, improve access to appointments, and facilitate faster referrals to other providers and specialists.

However, it is critical that we definitively address a $6.6 million budget gap from our most recent fiscal year, and additional losses projected for FY2025, which are holding us back. This is the third year in a row we have run an operating budget shortfall, and we cannot continue to do that if we want to sustain our organization and continue to serve the patients who rely on us for the long term. As we enter our 50th year, we need to evolve to ensure our organization can continue to meet and exceed patient expectations.

Actions Impacting Our Workforce

Looking ahead, we must center ourselves around our core mission and what is demanded of us by our community: excellent primary care, accessible dental care, and supportive behavioral health services. To best meet our patients’ needs in those areas, and to put Howard Brown on stronger financial footing, we’ve made every effort to drive savings and maximize revenues, including by renegotiating non-labor related contracts and improving our billing model. This has all been with a view to minimizing the impact on our people.

However, our largest investment is in our people, and so we needed to evaluate that too. After careful consideration, we must implement reductions that will impact certain management, administrative, and other staff positions on August 30, 2024. These include roles funded by more than $1.6 million in expiring government grants and reduced savings from federal drug programs – a reality FQHCs across the country are facing – and, in total, represent approximately 7% of our workforce (43 positions). Importantly, we were able to reduce the impact on our employees by first eliminating vacant positions and accounting for attrition.

Please know that we will treat impacted employees with compassion and empathy and do everything we can to support them in their next steps. To that end:

  • Today, all impacted employees will be notified of a meeting with their Executive Leadership Team member and an HR representative.
  • Impacted employees will receive:
    • A 60-day notice period, beyond what is contractually required, for union and non-union represented staff, where pay will end on August 30, 2024;
    • Severance pay;
    • Outplacement assistance services;
    • Healthcare through the end of severance payments, and eligibility for COBRA; and,
    • All other benefits provided for in our employee agreements, including 401k matching.

To those who will be leaving Howard Brown, I want you to know that this decision is not a reflection on your many contributions or steadfast commitment to our patients. We are incredibly grateful for all that you have done for our organization.

For those who are staying on, the best thing we can all do right now is support our teammates and stay focused on serving our patients with the excellent care they deserve.

Looking Ahead

While I know today’s news is difficult to hear, I want to emphasize that Howard Brown’s future is incredibly bright. We have so much to look forward to as we continue our legacy of empowering patients and advancing health equity.

In fact, over the coming months, we will be making many meaningful improvements to our core services – such as expanding providers and hours at our South and West Side locations, increasing the number of infectious disease specialists on staff, and doubling down on our efforts to Get to Zero. We will also be focused on achieving excellence in medical care for Trans and Gender Diverse patients. All of these initiatives – and more – will be aimed at ensuring we can serve our patients with high-quality, affirming healthcare for decades to come.

Tomorrow morning at 8:30 a.m., we will use our regularly scheduled site visits to host a virtual conversation where we can discuss this news and answer any questions you may have. In the meantime, thanks to each and every one of you for your commitment to Howard Brown and to our patients. Let’s be there for one another in the coming days.

With gratitude,

Robin Gay, DMD
Interim President & CEO
Howard Brown Health


Rooted in LGBTQ+ liberation, Howard Brown Health provides affirming healthcare and mobilizes for social justice as an agent of change for individual wellbeing and community empowerment. Howard Brown envisions a future where healthcare and transformative social policies actualize human rights and equity for all. Howard Brown offers primary care, behavioral health, and social services at 10 clinics across the city, regardless of ability to pay.

Please direct all media inquiries to Becky Carroll at becky@cstrategies.com


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