Reflections on Love: 2018 Annual Meeting Address

David Ernesto Munar, Howard Brown Health President and CEO

In reflecting on our work in 2017 and the year ahead, I’ve been thinking a lot about love. I’m talking about the kind of love that you feel in your core, the kind of love that defines you. For last year’s Pride month, we launched the TRUE LOVE campaign at all of our sites to complement the interactive art installation on display at our Clark St. clinic in Rogers Park.

The artwork by artist Bob Faust invites the public to help build a treasure chest of our greatest hopes and good intentions. The installation has been on display for nine months and the response has been overwhelming.

The letters L.O.V.E. are gigantic plexiglas repositories for colorful love notes. The prompts invite individuals to contribute three personalized messages, one to yourself, one to your true love, and one to the world. I would like to share my three love notes with the Howard Brown community.

Like so many cards already submitted, my first love note is gushing with gratitude and pride for the audacious, the dedicated, and the hard-working Howard Brown staff!

In 2017, Howard Brown stretched its mission like never before. Our hard working teams opened two sites on the south side, expanding LGBT affirming healthcare to the Hyde Park and Back of the Yards neighborhoods.

On the north side, we opened a satellite location at TPAN to partner on a comprehensive set of services for people living with and affected by HIV. In September, we also opened Howard Brown Health Diversey at the corner of Diversey and Sheridan. This new site caters to the loyal patient base of Dr. Todd Hargan who joined our practice in August. Our network now boasts nine clinics spanning 20 miles from end to end!

More clinics means more people can gain access to our services. In 2017, we served more than 30,000 patients. This includes a growing primary care practice for more than 18,000 patients; nearly 10,000 patients who used our walk-in sexual health services, and more than 5,000 others we reached through outreach, education and other services.

In 2017 we broke all prior records and provided more than 100,000 patient visits for primary care, behavioral health, walk-in and other services. In terms of new patients, more than 7,500 patients had first time appointments at Howard Brown. Our social services team also assisted more than 3,000 patients with housing, food, transportation, medication assistance, and other needs. Our call center fielded more than 200,000 calls and our website logged more than 64,000 hits a month.

Beyond primary care, our contributions to public health and sexual health are a source of pride. In 2017, we conducted 70,000 gonorrhea tests, 70,000 chlamydia tests, 20,000 HIV screening tests, 18,000 hepatitis C tests, and 17,000 syphilis tests. Our patients were busy and so we were! Combined, all of these services bring peace of mind, healing, prevention and health to tens of thousands of patients.

People like Sheri, 19.

Sheri learned about the BYC thanks to our trans youth program called VOICES.  Long wanting to further her transition, Sheri came at BYC to start hormone replacement therapy.  Erica Gaddy, the BYC nurse practitioner, guided her through the process as part of a comprehensive, primary care visit.  The day Sheri started hormones her house mother attended to cheer her on and offer emotional support.

Unfortunately, her biological mother was not as understanding and their contact has diminished greatly.  At age 16, she dropped out of high school due to persistent bullying and left home.  She discovered a Ball house that welcomed her and connected her to a new circle of support.

Besides Gaddy, her care team at BYC includes Benjii D’Costa, a benefits navigator, who enrolled Sheri in Howard Brown’s sliding scale fee program to help make care more affordable.  She is working with Pharoah Swain, a resource advocate, who connects her to other agencies to meet her housing and social service needs.  And she meets weekly with Adriana Collis who is tutoring her to achieve a GED high-school equivalency diploma.  At Tyra, a monthly support group for trans youth, she shares her life goal of going back to school to become a veterinarian tech.

While some facts have been altered to protect patient confidentiality, Sheri’s story is real and represents the experiences and hardships our clients face daily.  More than two thirds of the 2,000 participants at the BYC disclose homelessness or housing instability among other life challenges.

My second love note addresses our beloved patients, who trust us to help meet their health and wellness goals. Our patients inspire us every day with their tenacity and their resilience.

And we’re committed to maintaining that trust. To better respond to our patients’ growing needs, Howard Brown is working closely with another ally organization: La Casa Norte. We are thrilled to announce that La Casa Norte selected Howard Brown as its onsite medical provider. Howard Brown Health at La Casa Norte is expected to open in November with a focus on serving La Casa’s residents and community members in Humboldt Park. Our philosophy of care in working with vulnerable young people persuaded La Casa officials to seek a stronger partnership with us; we could not be more excited.

This year we are also expanding the depth and breadth of services on the south side. Following more than a year of planning, our 63rd St Clinic in Englewood has begun offering dental care. Huge thanks to Dental Director Dr. Robin Gay and support from our clinical leadership, operations, finance, legal, and facilities departments who worked so hard to deploy this needed service. With virtually no marketing, our two-day-a-week schedule is already full for several months but we hope to expand access later this year with the help from dental school students. For our patients, the impact can be transformative.

For our patients, the impact can be transformative.  Meet Corrine, 57.

Corrine had a horrible toothache when we met her.  She lives with her daughter and son-in-law in Englewood and looks after her two grandchildren when their parents are at work.  The persistent toothache and fatigue sapped her energy, disrupting child care, work schedules and income for the whole family.  Missed work resulted in smaller paychecks for her daughter who already struggles to pay the bills.  Corrine worried there would not be enough money left over to adequately feed the family.

She found Howard Brown almost by accident, having received care over the years at the Englewood Neighborhood public health building where our 63rd St. clinic is located.  Shemeka Irby, a physician assistant at 63rd, diagnosed Corrine with diabetes and prescribed her medication and counseled her on better nutrition and glucose monitoring to stabilize her blood sugar.  Shemeka connected Corrine with Dr.Gay who filled her cavity.

Happy with her care, Corrine brought her grandchildren to see Family Nurse Practitioner Zyra Gordon Smith.   Our social service team connected the family to Fresh Moves, a mobile provider of free produce, and enroll them in a program to receive CTA cards to help make healthcare more accessible.  These efforts have made of difference for this family.

I would like you to meet Julian, 37.

Last year, the Chicago native began accessing sexual health screening services at our Clark St. location in Rogers Park.  He came to walk-in with concerning symptoms.  We diagnosed an STI and started him on treatment to cure the infection.

Dorothy Austin, the health educator who met with him, conducted an affirming and non-judgmental intake on his sexual health needs.  Based on the assessment, she suggested that he consider PrEP, which is a daily prophylactic medication to stay HIV negative.  She also referred him to one of our medical providers in Rogers Park.

Julian scheduled an appointment with Rick McEwan, a nurse practitioner, who provided an overall wellness check.  Rick started Julian on PrEP and educated him about the importance of adherence and regular check-ups.

During routine visits, the behavioral health consultant working with RIck assessed Julian’s quality of life and mood to better understand any barrier to health he may be experiencing.  The discussions allowed Julian to raise a potential new issue – recreational drug use that had become more frequent in the past year following a stressful break-up.  Megan Marker, the behavioral health consultant, talked to him about whether he felt his drug use had become unmanageable and whether he wanted support with this issue.  She educated him about Recovering with Pride, our outpatient substance abuse treatment program.  He declined the referral but agreed to continue discussing his drug use a part of his routine primary care.

For people like Julian, Howard Brown is expanding access to no-appointment sexual healthcare.  Walk-in screening is now available at three locations: the Sheridan clinic in Uptown, the Clark clinic in Rogers Park and the 63rd St. clinic in Englewood.

We are also working hard to expand access to behavioral health. In the past year we expanded access to psychiatry services with coverage at seven of our nine clinics. Psychiatry is in short supply for all patients, especially those who are uninsured. And psychiatry with sensitivity to LGBT issues is even harder to access. Thankfully, we have an amazing psychiatric team. We even have a psychiatrist one day a week at the BYC.

Special thanks to Thresholds, the state’s largest provider of mental health services, for partnering with Howard Brown on a dedicated site in the Back of the Yards neighborhood and supporting our deployment of psychiatry on the south side. And next month, our north side individual and group counseling services will begin occupying a new home at the corner of Sheridan and Irving Park. The team is moving out of our busy and cacophonous Sheridan clinic in Uptown. For patients in therapy, the new site will provide a quiet and serene destination to focus on mental and emotional wellness.

I want to profile one more patient.

Meet Eduard, 28.

He’s the kind of person who draws attention whenever he enters a room.  Having moved to Chicago 3 years ago from a small town in Ohio, Edward strings together several part-time gigs from personal training, massage therapy, and bartending.   He’s also supplements his income with sex work to afford his share of the rent.

At Market Days last year, Edward approached our wellness tent and accessed rapid HIV screening.  Of the 350 people screened that weekend, Edward was one of 5 who received life-changing news.  Our team connected him to Darcie McDonaugh, a nurse practitioner at the Halsted clinic, who helped him grieve, educated him about the living with HIV, and started him on treatment.  In August of last year, his viral load was over 80,000 and his t-cells were at 350 – indications that HIV was starting to affect his immune system.  Thanks to the care team at Howard Brown and his own determination, he is now virally undetectable!  By fully suppressing viral replication, he can enjoy a near normal life expectance.  He is also biologically unable to transmit the virus to others.

Last year, Joshua Gutierrez, our Partner Services Counselor, coached Edward on ways to notify his sex partners and even offered to anonymously encourage them to seek HIV testing as they may have been exposed. Another concern was how to afford healthcare.  To his great relief, our insurance navigator Rachel Maher helping him enroll in the Affordable Care Act.  He is now fully insured with a Marketplace plan and receives government subsidies to afford the premiums.

Edward is not alone in the way he earns a living.  In fact, many of our patients work in hospitality, fitness, modeling, dance, the arts, and other cash-based economies. Because Howard Brown intends to be the provider of choice for these workers, today we are announcing a new needs assessment targeted to students, artists, and service workers. Take the Hard Work & Health Needs Assessments here.

We just concluded a similar survey assessing the needs and preference of trans and cisgender women in our community to determine how to better serve them. These assessment tools provide valuable direction that we will rely on in the year ahead to expand, improve or re-imagine how we communicate and serve populations that may not be adequately served elsewhere. Please stay tune as we analyze the data to guide us in making service improvements.

My last love letter is to you: We simply adore our quirky community. I hope that’s apparent.  If true love means anything to you, we hope you will reciprocate the love.

This institution is a gem we hope you will treasure as your very own and support and protect it. Though governed by an independent Board of Directors and professionally managed, Howard Brown belongs to Chicago, it belongs to the LGBTQ community, it belongs to you. Our true love at Howard Brown is you – in all your glory, your camp, your sorrows, your needs, your fabulousness.


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