[[{“value”:”
SOUTH END, MA – Eighty people gathered outside of Boston Health Care for the Homeless’s (BHCHP) headquarters on Tuesday, October 28th after BHCHP Workers United, a subsidiary of 1199SEIU, sounded the alarm on stalling bargaining efforts and threatened cuts.
BHCHP is a community health center that provides medical care and specialized social work services for people experiencing homelessness. The union first won bargaining rights in March of 2024.
BHCHP emerged from a grant by the Robert Wood Johnson Foundation and the Commonwealth of Massachusetts with a clear mandate: provide medical care, continuity, and compassion for Boston’s unhoused population. In 1985, founding physician Dr. Jim O’Connell joined the staff, working from a van to meet individuals experiencing homelessness and connect them with medical services. Staff were driven by an urgent need to address the then-record number of people freezing to death on the streets. In 1987, BHCHP’s HIV team launched as a pilot program. Its success was so remarkable that it became a national template for HIV care units across the country during a time when the disease carried heavy stigma.
The organization will retain most of its clinical services, though management closed one respite care center in Jamaica Plain in early October. Cost-cutting included 25 layoffs, starting with the departments in BHCHP that do not provide direct medical care, but the workers who maintain key infrastructure to support and uplift those who utilize BHCHP services.
Remaining workers are faced with paltry insufficient increases and some with reduced benefits. A union worker shared with Working Mass that BHCHP was offering insultingly low yearly increases, cutting benefits in half for new employees, and raising healthcare premiums. These figures are lower than staff had received consistently for years, especially juxtaposed with the 10-13.5% raises offered to other, non-bargaining unit staff. Many of these roles pay $22/hour- simply not enough to meet the skills of the workforce nor the ballooning cost of living crisis in the Greater Boston area.
The union’s demands are not just for dignity and adequate compensation; they are demands for workers’ survival.
Organized Case Managers Speak Out
Despite the specialized, crucially important, and profoundly moral work the non-clinical staff at BHCHP provide; management has determined that Boston’s unhoused would be better served with those funds for wages and benefits redirected elsewhere.
The afflicted workers are crucial boots on the ground support for Boston’s most vulnerable. Case managers and recovery workers assist patients navigating a mind-numbingly obtuse and confusing patchwork of social safety net programs, including sober houses, MassHealth, and rehabilitation centers. So dedicated are these staff that many will leave their work cells on and pick up calls from patients 24/7.
Perhaps counter-intuitively, non-clinical staff provide crucial revenue-generating functions, making their mistreatment even more perplexing. Worker-organizer and case manager Astrid Mora spoke about the regarding and significant increase given to the agency’s caseload at previous rally in September:
Let’s be clear, if the nurses and providers generate revenue, it is our labor – our case management, our outreach, our advocacy – that links and retains patients in care and allows that revenue to generate.
One patient who spoke at that rally underscored the vital need served when they shouted:
I spend more time here than I do at home! And now what do I do? Where do I go? I’ll be back out here in the streets.
Organizers argue that the cuts were avoidable, predicated on financial predications, and Boston’s most at-risk people will surely suffer. Staff at BHCHP have consciously chosen to work with housing insecure populations because the mission matters, with most turning down more lucrative roles elsewhere. Yet even the most righteous workers are facing a financial breaking point. The burden of losing key staff will certainly fall onto the unhoused population who needs them.
Leslie, a BHCHP non-clinical staff worker, said:
Rents are going up, public service is going up, a lot of us are going to be homeless if we don’t get this raise…the company claims to care about the people and the patients that they serve – but how can you say you care about the people when you don’t recognize the workers that bring those people in?
BHCHP management, however, contends that the layoffs and minimal wage increases are necessary given the murky funding environment from federal healthcare cuts. These have led to what management calls “one of the most difficult financial periods in our 40+ year history.” According to management, offsetting those costs to impact the most vulnerable workers trying to make rent and groceries was a “painful decision.”
Bargaining committee member Pam Rivas disputes this:
During a supposed hiring freeze, new management positions have been created, existing managers have received promotions, and clinical staff have received above market rate adjustments. Meanwhile, we are told no funding is available for essential patient programs.
And meanwhile, the company has money for its other projects. The company hired an external consultant for evaluation in early 2025.
The President and New Management
Some of the problems with BHCHP are downstream of the risks policymakers run when they outsource social work, typically understood to be the responsibility of local government, to charities and non-profits. No steady funding leaves Boston’s unhoused subject to the whims of the free market, or in this case, broadsided by the arbitrary fiscal whims of the U.S. Congress.
BHCHP, like community health organizations and hospitals across the country, was asked to tighten belt loops after the passage of the One Big Beautiful Bill and respective cuts to Medicaid, grants, and other needed funding sources. Already reported are the over 300 rural hospitals set to close due to Medicaid cuts on funding that has been redirected to $50,000 sign-on bonuses with the U.S. secret police: Immigration and Customs Enforcement (ICE).
Management justified the layoffs by citing internal funding projections. Given that BHCHP has admitted to having funds to pay people for at least another year using their own analysis, the decision to lay off key staff now – particularly with limited notice, is an active choice.
Out of the past ten years of BHCHP tax filings, only one indicated that the charity was losing money. As Rivas said during the recent rally:
Management would like you to believe that they have no money and that we, as workers, should shoulder the burden of their poor financial and strategic direction. But this is not true. They have money…They keep saying we need to just weather this storm and survive. But I and many of my coworkers believe; it matters if we morally debase ourselves while weathering said storm.
BHCHP spent $1,455,376 on executive compensation in fiscal year 2024. With compensation this lucrative, the reason cuts are necessary becomes clear: meeting the material needs of the unhoused is big business.
Commonwealth residents may recall the closures for three hospitals in Massachusetts owned by Steward Health Care, a vampiric private equity-owned firm affiliated with the Healey administration, as identified by Working Mass reporting. Before joining BHCHP as CEO earlier this year, Stan McLaren was formerly President of Carney Hospital in Dorchester. Carney was the only hospital in the Dorchester area and served populations who otherwise had limited access to care.
Carney Hospital was closed by Steward Health after Steward went bankrupt in August of 2024. This certainly cannot be blamed on McLaren, but it does demonstrate the private equity-friendly background with which he joined BHCHP. What McLaren can be blamed for, however, are the numerous Unfair Labor Practices (ULP) filed by Carney’s Massachusetts Nurses Association (MNA) local.
Mayor Michelle Wu appointed McLaren to be on Boston’s Board of Health in March.
When Non-Profits Act Like For-Profits
This mindset appears to have translated to the new management of BHCHP. They undoubtedly face financial headwinds – as do their workers. Management may have forgotten that BHCHP’s IRS designation is as a charity, not a for-profit machine that must cut costs and maximize shareholder value, with a requisite responsibility. Each worker facing cuts provides invaluable labor that not only sustains them as workers through an economy beset by misery, but provides essential and already-underfunded healthcare services to those experiencing homelessness.
The layoffs at BHCHP are especially ironic given the incessant emphasis on public safety within the broader mainstream discourse in Boston, particularly around sites like Mass and Cass and Davis Square, where the state has waged its own one-sided class war on homeless people. The suffering of the unhoused as a component of the homelessness epidemic, driven in part by private equity firms purchasing single family homes and apartment buildings, the lack of democratic control of the housing stock by tenants, and insufficient investment in solutions for the housing insecure by state and local policy makers. These crises are set only to worsen as a result of BHCHP’s cuts.
BHCHP non-clinical workers are not the only non-medical staff suffering under executives using cuts to attack the stability of their jobs in the Greater Boston area. Other hospitals and medical institutions reportedly face similar conditions. While BHCHP is a union shop, there are even fewer protections at large medical facilities where non-clinical staff are not as organized to fight back for both their coworkers and patients.
According to 1199SEIU speakers at the rally, organizing is working. Since a previous rally in September, management conceded to providing severance packages for laid-off workers – direct evidence that when workers fight, they win, and why continuing the public pressure campaign on BHCHP is critical for these workers.
BHCHP is one of the most directly impactful organizations in Boston today for the most materially-oppressed tenants: the unhoused. This impact is due to the labor of its worker-organizers in non-clinical roles. Allies of the afflicted BHCHP staff should follow 1199SEIU communications for future rallies oon their Instagram.
Chris Brady is a public sector unionist and a member of the Working Mass Editorial Board.
The post Health Care For the Homeless: Non-Clinical Staff Demand Fair Treatment in Bargaining with BHCHP appeared first on Working Mass.
“}]]