Heartland Alliance Health – the federally qualified health center where I have worked for the past 8 years, that has provided healthcare for the homeless and people living with HIV in Chicago– announced this week that we will be closing in the next two months. 

I have worked with HAH since February of 2017, and have appreciated the meaningful work, flexible hours, and business model that valued providers. I had left a toxic community health center with a business model of burning out providers. HAH was unique in relying on federal housing grants to support homeless patients, allowing us to focus on quality instead of quantity. Instead of being triple booked every 15 minutes, I had 20 minutes per patient, never double booked unless I said so, with an incredible team to help me in the management of each patient. Behavioral health, psychiatry, dental, case management, benefits, housing – I could rely on a team to take care of the spectrum of my patients’ needs. HAH has been a very special clinical home that has allowed me to do meaningful, manageable work – with a schedule tailored to my needs – while raising my son from his toddler to preschool through early elementary school years. HAH may have frequently been dysfunctional, but it was never abusive.

And the work was always fascinating. Every Monday morning was refugee clinic, where I saw survivors of international violence – Burmese, Iraqis, Afghanis, Somalis – in partnership with our refugee care management team. I supported the physical health and they supported the mental health of the most vulnerable refugees. Every Monday afternoon, telehealth. Tuesdays all day was administrative time. Wednesday morning and afternoon in clinic. Wednesday evenings in rotating shelters – family shelters, refugee shelters, domestic violence shelters. Thursday morning suboxone clinic, Thursday afternoon and Friday morning general clinic, where I saw patients with mental illness, the recently incarcerated, those transitioning from recovery centers, the homeless, people living with HIV and hepatitis C. Transgender patients. Refugees. Political asylees. People who had moved into the rapidly gentrifying neighborhood of Uptown, and wanted a doctor nearby – and who stayed, appreciating the integrated care provided in a welcoming, non-judgmental environment.

This era of my life is now ending. We are saying goodbye to the 8000 unique participants who found their care with us in the past year. We are saying goodbye to patients who have been with us since the time we were founded to provide healthcare for the homeless in 1985, who travel from the suburbs to continue receiving care with us even after they stabilized their lives. We are saying goodbye to patients who were with us as we integrated HIV care in the nineties, as it transitioned from a death sentence to a chronic illness. We are saying goodbye to all the refugees and people with severe mental illness and people recovering from substance abuse who made their medical home with us over the years. I am scrambling now to directly connect my most vulnerable patients with ongoing care, before we close completely.

I feel sad that thousands of vulnerable patients will no longer have the medical home that has sustained them over years. Worried for how – if at all – they will connect with new primary care providers. Angry at the fiscal mismanagement and national landscape that has led to our closure.

Even as I mourn the loss of the health center I loved working at, and fear for the futures of the people we served, I am grateful for the years I enjoyed doing beautifully meaningful work with amazing colleagues. Despite frustrations with resource limitations, it has been a pleasure and a privilege to work with the team at Heartland Alliance Health, providing quality health care for society’s most vulnerable populations.