Washington Blade - February 4, 2009
Amy Cavanaugh

Catania (I-At Large) joined other Council members last week to aggressively question Blanchon regarding possible mismanagement of the Clinic.

Disappointed by what he heard, Catania is now in the process of submitting questions to Blanchon and the Clinic's board of directors in preparation for a second hearing.

The Clinic announced in December that it would close its Northern Virginia location, outsource some programs and lay off 45 employees. Blanchon has said the changes were spurred by declining revenue and an increase in patients coming to the Clinic for uncompensated care.

But during the Jan. 28 oversight hearing, Catania noted that Blanchon did not ask the Council for help to better navigate the financial woes. Catania said the lack of any request for help was confusing in part because he'd helped secure $6 million for the Clinic during the last three years.

Catania also criticized Blanchon for laying off the 45 employees shortly before Christmas and without severance pay. Among those who were laid off was longtime Clinic staffer Pat Hawkins, who told the Blade that Clinic staffers referred to the cutbacks as the "Christmas massacre."

Catania seemed to suggest at the hearing that some of the layoffs could have been avoided because Blanchon did not collect thousands of dollars in Medicaid reimbursement funds.

But in his first full interview on the topic since the hearing, Blanchon told the Blade that early estimates show no more than $50,000 in Medicaid payments went uncollected in 2008.

"There are a number of policy and technical issues that not only apply to the Clinic but all community health centers that work with D.C. Medicaid," he said. "They are fully aware of those issues and are working to resolve them. There's a meeting [Feb. 6] that D.C. Medicaid is pulling together. So it's not a Clinic-specific issue, but a broader issue of how payments are made to health centers. We can still apply for the money."

'Unrelenting pressures'

At the hearing, Blanchon said in his opening statement that the Clinic "is facing two unrelenting pressures from the economic recession."

"First, we are caring for more patients - almost 10,200 - at the start of 2009 - than any time in our 35-year history," he said. "Second, our major revenue sources - government funds and private donations - have declined in recent years. Left unaddressed, these two realities would threaten the Clinic's very existence."

Chip Lewis, the Clinic's deputy director of communications, told the Blade that, "private donations at the end of 2008 were down 35 percent from 2007."

Catania said that Blanchon overestimated how much money the Clinic could net through donations and did not address a projected shortfall in a timely manner.

"You knew two weeks before the end of the fiscal year what the numbers were, and you left no choice to the [Clinic] board [but to have cutbacks and layoffs]," Catania told Blanchon at the hearing. "That's gross negligence not to consult the board and not the work of an executive director who should continue in that position."

Catania told the Blade this week that it's "no surprise" private contributions have fallen since Blanchon became the Clinic's CEO, attributing the trend to the Clinic's growing disconnect from local gay patients and supporters.

"I have no objections to expanding service to the non-GLBT community, but what I object to is abandoning the core mission in pursuit of that expanded constituency," he said.

But Blanchon said that the Clinic's "commitment to the LGBT community has never been stronger."

"Because of the board's decision in 2005, we've transformed from offering health and supportive services to focusing on primary medical care, HIV care, mental health and addiction and dental care," he said. "We're trying to be a medical home for the gay community.

"People say that they're seeing a shift or that we're not doing anything for the LGBT community, but we're doing more direct medical care and mental counseling and less supportive services that others do better."

Services that were scaled back include the food bank, while support groups that did not have a health care component were shifted to other agencies, such as the parenting support groups, which moved to Rainbow Families.

D.C. Council member Jim Graham (D-Ward 1), a former Clinic executive director, attended part of the hearing and said he has "remained silent about what has happened at the Clinic in the last 10 years," since he left, but noted that "it's finally time to say something."

Graham said that Blanchon "has severed relationships [between Clinic and Council leaders] that were built over several decades."

Graham declined to be interviewed for this article, telling a Blade reporter that the topic was too painful for him to revisit following the hearing.

'Totally leaderless'

Catania said this week that he plans to have questions addressing the Clinic's financial situation and community standing sent to Clinic leaders within the next 10 days.

He said he hopes to receive responses by early March, when the issue will be revisited in the Council chamber.

"The Clinic seems totally leaderless," he said. "The existing director was brought on board because he had all this experience in federal financing, but he turned a blind eye to reimbursement. I want to know why the board hasn't taken a more active role."

Catania noted that if he is "not satisfied with the response, we will launch a full-scale investigation into the operation of the Clinic."

"It's my hope that it won't be necessary," he said, "but I'm prepared to do it."

Catania said that in the days following the hearing, he received "an avalanche of e-mails" from current and former Clinic staff and patients, and others "who are so excited that someone is finally looking at the current leadership of the Clinic," which has led him "to believe that people have a lot of pent up anxiety with the existing management of this Clinic."

Catania also said that Clinic leaders performed the December layoffs with a very specific intent.

"It's no accident how they have gone about very targeted layoffs of senior officials and people of long-standing tenure and with deep ties to the community," he said. "Those who would stand up to the leadership have been removed and replaced with those who don't have ties to the community. It's easy to scale back and close services when you remove those voices that could have stood in your way."

One former longtime Clinic employee who was among those who were laid off is Hawkins. A psychologist who began volunteering at the Clinic in 1984, she was most recently the Clinic's associate executive director for policy and external affairs.

Hawkins said Blanchon has a different philosophy in his approach to running the Clinic than his predecessors.

"When Jim Graham was in charge, he looked at what people needed and then got it and that worked pretty well," she said. "Now the focus is narrower, and not so much on social services but on primary medical and behavioral health services. It's a change in philosophy and that explains some program closings. But that doesn't explain the Northern Virginia clinic shutting down, since a lot of folks there still need primary medical services."

Some patients are concerned that the Clinic is no longer serving the gay community. Mark Thweatt, who received AIDS-related services from the Clinic for 20 years, said he was turned away last year because he didn't have health insurance.

Thweatt said he was told in late October or early November to get insurance or "take a hike."

"I heard from my doctor since then that they can do my blood work," Thweatt said. "But as far as everything else goes - my wellness exam they did every year, and hepatitis and flu shots, and the other tests they used to run - they said they can't do that anymore."

Thweatt, who lives in Northern Virginia, originally went to the Clinic's offices there but later transferred to the D.C. offices.

"The Clinic had always been able to cover me under Ryan White funding but then they told me, 'We can't cover you under Ryan White anymore since you don't live in D.C.' I said, 'Where does everyone from Northern Virginia go?' And they said, 'Someplace else.'"

Lewis told the Blade that the situation was a miscommunication and apologized. He said the Clinic's policy is not to turn patients away, but clients are often referred to other agencies that can cover care through a funding source the Clinic cannot.

"Since we are prohibited from using D.C. Ryan White funds to care for non-D.C. residents, this client should have been referred to a Ryan White-funded provider in Northern Virginia," Lewis said in a statement.

"Such a provider would have been able to give him access to a variety of services that would be covered by Ryan White dollars so that he would not have to pay for these services out-of-pocket."

'The board is just as guilty'

But patients and public officials aren't the only ones expressing their disappointment. Some donors are equally upset.

Richard Mangus, a former Clinic patient, recently sent an e-mail to the Clinic board saying he was withdrawing his financial support. Mangus, who is gay, shared the e-mail with the Blade.

"After seeing the hearing held by Councilman Catania on Jan. 28 with you, Chair Donald Blanchon, I am stopping any future gifts to the Clinic," Mangus says in the message. "Further, I will urge all my friends and other members of the GLBT community to do the same until Mr. Blanchon is removed as chair and that all members of this board tender their resignation for gross financial misconduct."

Mangus told the Blade that he stopped seeking medical treatment at the Clinic three years after seeing "a lot of changes which weren't good and I felt I wasn't getting the proper services." He switched to a private clinic.

"I feel that the board is just as guilty as Blanchon," Mangus said. "They rubber stamped everything he wanted without asking any questions, and they should tender their resignation as well as him. The Clinic should be independently audited and should be placed in trusteeship for a period of time until it returns to customer and financial stability."

Catania said he's hopeful that the Jan. 28 oversight hearing and any future hearings will cause the board to "reevaluate the direction of the Clinic and pursue new leadership."

"I want to see a restoration of the Clinic's core function of service to the GLBT community, and I want to see a reconnection to the community," Catania said. "I believe the Clinic is best served with the departure of senior management and a fresh start with the principal funder being the District of Columbia."

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