By Mary Retta

Howard Brown Health, a nonprofit community health center in Chicago that is the largest provider of health and wellness care for the LGBTQ+ community and people living with HIV in the midwest, has announced it wants to lay off at least 100 employees, or about 15% of staff.

The layoffs were proposed as voluntary in the first instance, but the company says “a reduction in workforce is required”, suggesting that if 100 volunteers are not found then layoffs will be compulsory.

They come at a time of high-profile attacks on queer and trans healthcare across the country. Jobs lost would include roles in behavioral health, health education, PrEp navigation, Covid testing and other teams. Many of the roles are filled by union members, following Howard Brown employees’ decision to form a union in August of this year.

After hearing rumors of layoffs, the union raised its concern with management and was told in a written reply on 9 November that “there is no current plan or decision to layoff any union members”.

The first indication otherwise was 10 days later, on 19 November. In a letter to employees from the board of directors citing financial strain, Howard Brown outlined a goal “to recover $12m in our annual operating budget” and said it would “consider all available measures” in order to do so. Union members said they met with management later that day, which is when the organization proposed a “voluntary separation” package of one week’s severance pay per year of service for employees to leave their jobs.

Despite Howard Brown claiming rough financial straits, data from ProPublica shows that in 2021 the organization brought in $30m more than it spent and that the chief executive, David Munar, earned a salary of more than $300,000.

Many employees argue that Howard Brown should cut funds elsewhere before considering losing employees. They point to the construction of a new $19.5m clinic in North Halsted, where Howard Brown already has a clinic. Union members said they are refusing to negotiate until management reveals the 2022 financial books.

“As a union member, I would never accept that workers need to quit their jobs if it is not necessary for the organization to stay alive,” said Margo Gislain, a lead organizer of the Howard Brown Union.

“Howard Brown refuses to show us their 2022 financial books and therefore has been unable to convince us that these layoffs are financially necessary. We want to be able to see the organization’s finances so we can make suggestions of other budget cuts that don’t involve losing workers.”

Several Howard Brown employees said they find the timing of the layoffs suspicious, coming mere months after the organization unionized. “There is no doubt in my mind this is retaliatory,” said Gislain, saying that many of the potential cuts would affect union members, “many of whom were highly involved as organizers”.

The past few years have seen widespread cuts to queer and trans healthcare across the nation as states ban or limit access to gender affirming care. As the largest public health center for queer people in the midwest, Howard Brown serves not only the LGBTQ+ population of Chicago but those in surrounding states who travel to receive care.

Employees said they are already overworked and understaffed, and fear a smaller workforce would be overwhelmed and unable to provide swift patient care. Shakia Flowers, a behavioral health provider and a member of the union’s bargaining committee representing Englewood’s 63rd Street clinic, said that during her four years at Howard Brown there has always been a wait list for behavioral health treatment. The layoff strategy would cut the behavioral health team in half, leaving only four specialists to serve 30,000 annual patients.

Erik Roldan, director of marketing and communications for Howard Brown, blamed “drastic reductions in federal dollars” for what he said was a $12m revenue gap. “Specifically, the agency’s revenue shortfall since the beginning of the new fiscal year July 1 comes from changes to the 340B pharmacy program,” he said.

“Since 2020, 18 pharmaceutical manufacturers – including Eli Lilly, Merck, and Gilead – have restricted or eliminated access to 340B priced drugs through contract pharmacy partners, with 8 manufacturers specifically targeting FQHC contract pharmacies. These changes are putting a strain on the agency’s finances, requiring a reduction in operating expenses.”

Roldan said the organization was exploring other ways of cutting spending at the same time as layoffs, that no layoffs would occur before 1 January and that they would be subject to bargaining with the union.

Howard Brown employees have planned a public protest for Saturday and are accepting solidarity donations.

“These layoffs would deeply impact the communities we’re serving, which are already vulnerable,” said Flowers.

“We’re talking about queer people, Black and brown people, the uninsured, the impoverished. It’s so vitally important for these patients to come here and see providers they can relate to, who can understand their plight, and who can be their support system when they don’t have one.”