They began meeting quietly in September 2011, a small band of frustrated and anguished health center employees, concerned that the community bedrock they served was falling apart.
They were employees of Roxbury Comprehensive Community Health Center, better known as RoxComp. The center is located in the heart of Roxbury, and they needed a meeting place where they would be sure not to encounter any of their bosses – or patients, for that matter. A Panera Bread in Coolidge Corner fit the bill perfectly, even though traveling there was a huge headache for the many workers dependent on public transportation.
But meet they did, and from those sessions came a list of problems at RoxComp that, as it turns out, foreshadowed last weekend’s temporary shutdown of the landmark health center.
Even now, after so many of the ills they alleged have been verified, they are reluctant to speak openly. Originally, they feared reprisals from their boss. Now, as some face layoffs and a search for work elsewhere, they worry about being labeled malcontents.
Actually, they were dedicated employees in an organization that ignored their warnings, their letters to superiors, their requests to meet, their pleas for recognition that things were seriously amiss. But through sheer persistence, they helped puncture the wall of silence around RoxComp.
The changes they helped force have been seismic. Last weekend, the center’s longtime director, Anita Crawford, resigned under pressure. A task force is being assembled to help the center start over in the face of medical and financial woes and federal and state scrutiny.
On Tuesday, Dr. Keith Crawford, the chairman of the board (no relation to Anita), struggled to explain how so much had gone wrong. He had just spent a long weekend trying to put out fires, an effort that has included putting aside his own medical research to focus on RoxComp.
“All these circumstances hit at the same time,” Crawford said. “I’m sure if these things had been dealt with, we wouldn’t be here.”
By circumstances, he was referring to the loss of state support for several programs, the inability to pay staff, and — the final blow — a surprise inspection by Department of Public Health officials that definitively established that the center was in no condition to dispense care.
In fact, a key issue has been the failure of the board to listen to the employees who tried to sound the alarm. As in many failing organizations, the group that should have provided oversight listened to only one voice, the CEO’s, for far too long.
Keith Crawford met with the center’s employees Monday, the same employees who had asked to talk to him last summer. “I told them, ‘I failed you,’ ” he said. “And I told them I won’t fail them again.”
As a physician, Crawford understands both the importance of the center and the need to save it. He said he’s appointing a task force of stakeholders to help identify problems and ways to correct them. He’s been getting a lot of advice, from public health experts, from the city’s public health department, from the state.
“All the big players out there want RoxComp to be successful,” he said. “Now is the time we can make big changes.” He hopes the center will reopen to patients in a week, though that is an estimate.
The most important change RoxComp can make might be the simplest: listen to the people who are there every day. The problems at RoxComp were not secret. They were simply ignored, by powerful people who assumed the employees were simply disgruntled. I hope Crawford finds plenty of room on his task force for the people who actually deliver care at RoxComp.
“I’m just hoping the community can be patient with us,” Crawford said. “We’re trying to do the best we can for the community.”