Howard Brown Health Center (HBHC) recently hosted an award presentation in honor of Congressman Mike Quigley (5th District) and a panel discussion of LGBTQ health issues. The event took place Aug. 9, during National Health Centers Week.
Howard Brown CEO Jamal Edwards made introductory remarks, including praise for Quigley, whom he commended for having supported the repeal of "Don't Ask, Don't Tell," opposing the Defense of Marriage Act and supporting the Respect for Marriage Act. He said that Quigley also has shown an interest in health care, with his support for removing the blood ban on LGBT participants (who are not allowed to donate blood) and his support for health care reform.
HBHC applied to be a Federally Qualified Health Center (it is currently an FQHC look-alike) and Quigley supported the application. Edwards said that the congressman has been generally supportive of community health centers, which was why the National Association of Community Health Centers awarded him the 2011 distinguished community health advocate award, asking HBHC to present it to him.
In his acceptance speech, Quigley praised HBHC and remarked upon the state of health care reform, emphasizing that recent gains were under threat: "This is our trench warfare, a battle for what kind of people and country we are. ... This is an ideological war and will affect our lives for generations to come. You don't zero in on NPR and Planned Parenthood to balance the budget."
After Quigley's speech, but was followed by a panel of six HBHC administrators and health care providers: Joe Hollendoner, vice president and chief program officer, who also facilitated the panel; Dr. Magda Houlberg, vice president and chief medical officer; Kelly Ducheny, director of behavioral health services; Christina Santiago, manager of programming at Lesbian Community Care Project; Mark Pineda, direct interventions specialist and Lois Bates, manager of transgender services. [Editor's note: A piece on Santiago's untimely passing starts on the cover.]
Hollendoner began by asking what the panelists thought of the recent news that HIV rates were on the increase, especially amongst young African-American men who have sex with men. Bates said that the news was "not surprising" for a generation of men who have grown up "always knowing HIV" and for whom HIV/AIDS had become "normalized." She said that the task for health care providers was to change how people think about the epidemic. Houlberg added that part of the problem lay in a lack of intergenerational communication and mentorship within the community.
Recent events in Boystown, where clashes between largely African-American youth and residents and business owners have resulted in tensions, came up often during the discussion. Ducheny explained it as a matter of a "clash between generations," much of it stemming from the tensions of the times and a general feeling of hopelessness and anxiety: "People don't know where to direct fear and energy; there's so much uncertainty that people are breathing fatigue and fear." Santiago said that one way to address the current issue would be to provide more spaces for young people in the city.
The topic of women's health came up in light of recent guidelines from the department of health and human services. Insurance companies must now provide for birth control, amongst other mandates. Santiago said the new guidelines were long overdue but cautioned that communities were not completely prepared to follow them: "Do we assume that women will flock to community centers and know to ask for [what they're now supposed to receive]? Or that providers will be saying, 'It will be covered, trust me, it will be covered?'" She also wondered how the new guidelines will affect the trans and genderqueer communities: "Will insurers be more inclusive in who gets to be more included?"
Speaking of men's issues, Pineda said that gay and bisexual men were often undeserved by the emphasis on HIV and STD/STIs, and Hollendoner added that this resulted in a hypersexualization of the community.
Hollendoner brought up a recent report that clinical research should address the needs of the LGBTQ community, and panelists were enthusiastic about it. Houlberg said the report would have significant impact in the long term, and that it "identifies the LGBT community as a community at risk. For that to happen on a federal level means that government agencies have a way to see what we see every day." She pointed out that the report would also enable identifying some areas of vulnerability, as in the increased rates of smoking in the community, a fact that is used by tobacco companies "in a way that's destructive," to target a population that is happy to be recognized at all by commercial entities.
The recent passage of civil-unions legislation prompted Hollendoner to ask panelists what the negative and positive consequences might be. Bates said that it would allow people to benefit from their partners' insurance and to be acknowledged financially as taxpayers. Ducheny said that it would lead to some relationships "turning upside down" because people would have to respond to the new question of "Have you done it yet?" and "negotiate the whole foundation of their relationship" if they had not thought too much of civil unions or marriage. Houlberg said she felt there was now an emphasis on the idea that "you are nobody unless you are a couple; it reinforces that people come in couples and not as individuals." Pineda added that a plus side of all this was that "we get to define relationships however we want, and we can set an example of normalizing" the kinds of relationships not seen before.
Asked about what their biggest concerns around LGBTQ health might be, panelists spoke of issues most affecting the people they worked with. Houlberg, who is a geriatric specialist, addressed the relative invisibility of caregivers, particularly those lesbians and gays who were left to look after their partners in old age, often with little structural support. She said there needs to be more resources for them: "Caregiving cuts across financial justice and gender justice lines." Bates said she was concerned about the criminalization of trans people by Chicago Police Department, saying that the Daley administration had been working to make changes to processes but those were stalled somewhat in the new administration. She stressed that Emanuel's administration was not hostile to changes, but that trans activists felt the process "went back a little." Bates felt that changes would definitely happen, especially since other cities like San Francisco and New York had already instituted new processes.
On Aug. 9, the U.S. Department of Health and Human Services announced the names of the health centers that had received funds to expand access to health care and become FQHCs; HBHC was not amongst them. The HHS awarded a total of $28,816,384 to 67 organizations. In Illinois, the Macoupin County Public Health Department in Carlinville received $566,667 while the Community Health Partnership of Illinois, based in Chicago, received $400,000.
In an email statement relayed through spokesperson Aviva Gibbs, Congressman Quigley said, "Unfortunately at a time when we should be investing in our community health centers, last year's budget cuts meant HHS was only able to award a fifth of their health center grants. While we have to [rein] in our debt, we must do so in a responsible way that still allows us to invest in the life-saving and cost-effective health services provided by Howard Brown and other essential community health centers."
Amy Simmons, director of communications for the National Association for Community Health Centers responded, via email, to a question about the future of funding for health centers: "The good news is that we've received enough federal funding to maintain our existing operations, but obviously we're concerned about expanding our reach to the 60 million Americans who currently have no access to basic health care...Our vision to expand health centers has not changed, but now the speed with which we will make it a reality has been significantly slowed by [sic] because of the reductions in the 2011 budget and the expectation that more are to come in 2012."
In a press release, Jamal Edwards congratulated the recipients of the HHS grants, adding that "HBHC remains optimistic about a second opportunity to achieve full FQHC status."
