PCHC recently laid off more than 40 caseworkers tasked with ensuring its most vulnerable patients had access to quality health care and social services.
PROVIDENCE − Crystal Rosario knew something was wrong when she woke up one morning and found that all of her meetings on her work calendar had been canceled.
“All my weekly meetings, all my check-in meetings, all my company meetings, all my meetings with the agency — all I saw was canceled, canceled, canceled,” she recalls.
For the past five years, Rosario has worked as a supervisor of case managers at Providence Community Health Centers. PCHC is a nonprofit organization in Providence and the only federally qualified health center, an organization that receives government funding and provides primary care to underserved communities. In many ways, it serves as a health care provider of last resort.
Rosario and her team were tasked with ensuring that the most vulnerable patients served by the nonprofit organization had access to health care and other social services. The patients assigned to Rosario’s team included youth escaping foster care, homeless individuals, and undocumented immigrants.
“We have patients who literally depend on being able to see their health care provider to be able to work a day,” Rosario said.
She was stunned by the cancelled appointments, but still had responsibilities to fulfill: it was a colleague’s last day at work and the office had planned a farewell party.
She bought food for the potluck, but on the way there she began to hear rumors that something was going on. There was a mandatory department-wide meeting scheduled with human resources, and PCHC CEO Merrill Thomas was on the scene.
After asking a few questions, the pieces fell into place and Rosario realized what was going on: she and most of her department were about to be laid off.
Providence Community Health Centers Laid Off 40 Employees
Brett Davey, a spokesperson for PCHC, confirmed that about 40 employees were laid off on Friday, June 28. Most of them were part of PCHC’s team of caseworkers housed in the nonprofit’s Accountable Entity, which is “responsible for quality health care, outcomes and the total cost of care for its population,” according to the Rhode Island Department of Health.
PCHC employees said they received no prior notice and were unable to access their work equipment that day.
“It was like a funeral,” said a former social worker who asked not to be named for fear of professional reprisals.
Davey said PCHC’s Accountable Entity was funded by a six-year grant from the Centers for Medicare & Medicaid Services that was set to expire in 2024. The grant was extended for another year but with a $3 million cut, leading to layoffs.
Employees surprised by layoffs
Rosario and the caseworkers who spoke to The Journal said they were caught off guard and hurt by the sudden layoffs. In the weeks leading up to the layoffs, PCHC had requested documents detailing workflows and presentations about the department and how it was run, which Rosario sees in retrospect as a sign of things to come.
PCHC offered them severance, though some were reluctant to accept it. According to a former nurse who worked as a case manager, the severance package included paid time off and performance bonuses for the first two quarters of the year.
Davey said PCHC is hiring for several new case management and community outreach positions, but they are no longer within the nonprofit’s Accountable Entity. He added that the positions are being offered to those who have been laid off, though former employees said they had to apply for the new positions to be considered.
Some former employees said they were unaware their positions were dependent on subsidies and were skeptical that funding had dried up.
In 2021, its most recent year ever, PCHC’s net assets were more than $57 million. That year, CEO Thomas earned more than $540,000.
Last December, PCHC also received a $9 million grant from Yield Giving, the philanthropic foundation of billionaire MacKenzie Scott known for awarding grants with no strings attached. However, Davey said those funds were used for capital projects, improvements to a new electronic medical records system, workforce development and services such as diabetes care.
Why Providence Community Health Centers’ Role in the Community is Critical to Area Health Care
But whatever pity Rosario and the others feel for themselves will have to wait. Their biggest concern is the patients the caseworkers have been caring for, who Davey said number fewer than 100. Rosario, however, estimated the unit was following about 600 patients.
Former caseworkers said their responsibilities went far beyond scheduling appointments. They helped patients find clothing, food, housing, hygiene products and transportation. They even conducted mock interviews to help with job applications.
“We were the ones literally guiding them, walking with them, going with them,” the former social worker said.
Davey said PCHC is working with other organizations focused on managed care and will retain some case management functions. However, the future of PCHC’s Accountable Entity will depend on the availability of more funding.
“We are working to maximize our internal and external resources to ensure patients receive the support they need,” Davey said.
Still, Rosario and her former colleagues worry about what will happen to the patients they worked with.
“We actually had to drift away from them, when we were probably the only stable element they had at that time,” Rosario said.
