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Emanuel pitches privatization of HIV/AIDS primary care clinics, cuts to training

Chicago Mayor Rahm Emanuel is strongly considering privatizing primary care services for HIV/AIDS patients on the South and North sides. He is also ending an HIV/AIDS training program for city agencies. Local advocates and community health groups say the Chicago Department of Public Health has already informed them of their intentions.

Currently, the city’s public health department runs two primary care clinics - one in Englewood and the other in Uptown - that provide medical care, mental health assistance and other support to any Chicago resident living with HIV/AIDS.

Officials with American Federation of State, County and Municipal Employees, the union that represents the at least 17 employees who would be affected by the changes, said they’re concerned about job losses and access to quality care.

“We’re especially concerned about the services provided in Englewood, because there aren’t as many other options for folks to go to and we’ve already made it pretty clear from research that having services in close proximity makes a difference in terms of people being able to get the care they need and follow the regime they need to do,” said Jo Patton, Director of Special Projects for AFSCME.

The mayor’s office is selling the outsourcing proposal as a way to “expand community-based primary care services.” In the 2016 budget book, the city pledges to serve 2,000 low-income HIV positive residents through  a $1.5 million investment, granting access to a “wide array of services through the City’s delegates, including primary medical care, mental health, substance abuse treatment, case management and other supportive services.”

A budget office spokeswoman said right now, the city provides care to less than 500 HIV-positive residents, and outsourcing would allow them to reach an additional 1,500. The city is planning on including a requirement in the request for proposal, which isn’t available yet, that the new care provider works within the current Englewood facility.

The city also confirmed it would be ending the HIV prevention training program, and union officials estimate that at least six jobs will be lost. A city spokeswoman said the health department is in talks with the Illinois Department of Public Health and other agencies to make sure that the training is covered.

David Ernesto Munar, President and CEO of the Howard Brown Health Center, said he agrees with the plan, as the city currently can’t provide the different levels of care (like behavioral health or mental health) that some HIV-positive patients need, but he’ll be watching the city’s execution.  

“It’s really all about how it’s done, and making sure that the transition is handled carefully, and particularly that the transfer of care for patients is done in a way that nobody is lost,” Munar said. “That’s been the concern of HIV activists around the city that in this system redesign we don’t lose sight of making sure the patients are stewarded to the new model of care or that nobody’s care is interrupted.”  

Munar said Howard Brown recently hired Dr. Cori Blum, the physician who used to staff these city clinics, which he hoped would alleviate some of the pressure on patients who might want to leave the Uptown clinic. He also added that Howard Brown might compete in the future bidding process to take over the city’s private clinics.  

Roman Buenrostro, Director of Special Projects for the AIDS Foundation of Chicago, says the idea to privatize is not a new one. Buenrostro also serves as community co-chair for CAHISC, where the idea has come up a number of times in the past as a way to maximize resources. Buenrostro said his number one concern is also to make sure no patient is left behind in the transition, but that outsourcing could be a “creative” way to continue care in an era of budget crises on both the city and state crises.

“What the city is saying is, if we turn this money over to community-based organizations to provide these services, we can serve a lot more people with the same amount of money,” Buenrostro said. “And why wouldn't we want to do that? So that’s where I don’t think that the word privatization is necessarily a bad word.”

Privatization has been a popular word lately around city hall, as the mayor is also considering outsourcing the city’s 3-1-1 services, which would cut 72 jobs. Officials have said the non-emergency phone system requires costly upgrades, potentially $25-30 million dollars over four years, and private vendors could suggest better or cheaper options.

The Chicago Department of Public Health is scheduled to appear in front of aldermen Thursday for a budget hearing. On Wednesday, both aldermen who represent the clinics said they hadn’t heard definite details about the potential privatization.

Lauren Chooljian covers Chicago politics for WBEZ. Follow her @laurenchooljian

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