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Howard Brown Health Center: Speculation rises [14 April, 2010]

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Howard Brown Health Center (HBHC) recently placed two of its key personnel, CEO/President Michael Cook and CFO Mark Joslyn, on paid administrative leave.  Since then, some hints about the reasons for their ouster have emerged.  The Windy City Times report prompted an open letter from David Ostrow, soon followed by a press release from Michael Cook announcing his resignation; both documents have brought more questions and speculations into the open.  Meanwhile, HBHC’s press releases have also prompted more unanswered questions.

Ostrow is a co-founder of HBHC, a founding physician investigator (PI) of the Multicenter AIDS Cohort Study (MACS) and the chair of the Behavioral Working Group of the MACS.  His open letter, sent to WCTfollowing an article run in its April 7 issue, was published online that same day.  In it he wrote, “As the founding PI of the MACS, I first became aware of major problems at Howard Brown when I was told approximately 10 days ago that the MACS grant to Howard Brown was being transferred on an emergency basis to Northwestern University.”  He went on, “Only days after Mr.  Cook supposedly requested the transfer of the MACS grant to Northwestern, the Board placed both him and their Chief Financial Officer on Administrative Leave, and have since stonewalled anyone asking for more information about what is going on.”

On April 8, Cook sent out a press release announcing that he had “terminated his Employment Agreement and his employment with Howard Brown, pursuant to his contractual right to do so under the terms of his Agreement [citing] internal disagreements about ongoing responsibilities and duties as the basis for his decision to exercise his right to sever his employment relationship with the agency…”

WCT has repeatedly asked Cook for an interview, but he had not responded as of the press deadline.  WCT also continued to ask HBHC for interviews with its personnel but only received, on April 9, a press release stating, “Howard Brown Health Center confirmed today that Michael Cook resigned on Thursday as CEO of the organization, and that the former CFO, Mark Joslyn, is no longer employed.  … At this time, Howard Brown is working closely with its lawyers to address the situation.”  It also said, “As soon as more information can be shared without disrupting the work of the organization, a statement will be made and questions will be answered.”  The release also acknowledged “there are questions in the community and rumors surfacing about what happened at Howard Brown.  Our team is working closely with our Board to ensure that the successful work of Howard Brown continues despite the distraction of these personnel changes.” It added that an interim CEO announcement would be made this week.

The center’s silence, combined with Ostrow’s letter and the proliferation of questions and rumors, will probably fuel more speculation in the community, given that the ouster included the chief financial officer and that the MACS involves a significant sum of federal money.  According to Ostrow, who spoke to WCT, the budget for the total MACS grant (which includes other institutions in addition to HBHC) is 10 percent of the total National Institutes of Health (NIH) budget for AIDS research; the Web site for the NIH Office of AIDS Research states that its budget for AIDS research for the fiscal year 2010 is $3,055,494,000.  In light of this, any hint of mismanagement of funds or could prove highly detrimental to the prestige and standing of Howard Brown.  WCT contacted Northwestern University for confirmation and clarification about Ostrow’s points regarding the MACS, but has not yet been able to speak to anyone as the paper went to press.

The sheer magnitude and importance of the MACS in the history of Howard Brown and the history of AIDS cannot be overemphasized.  MACS marked its 25-year anniversary last year.  It is the longest-running longitudinal study on HIV and has generated more than 1,000 publications.  The study takes place in four sites in Chicago, Pittsburgh, Baltimore and Los Angeles.  It derives “behavioral and biological data and specimens from men who have sex with men, before and after they became infected with HIV, before and after they were diagnosed with AIDS, and before and after they began highly active antiretroviral therapy—along with data from a control group of same-aged, HIV-free men who have sex with men.  Comparing these before-and-after specimens and data from HIV-infected and uninfected individuals has yielded numerous seminal discoveries,” according to the NIH Web site.

The scientific results of such research have proven to be immense and include studies that have shown how to diagnose HIV infection and how to best care for those with HIV/AIDS. In Chicago, MACS is located at HBHC, and its research partner is Northwestern University.

Ostrow said he only received his first hint that something was awry when he began to file papers for the fiscal year and was sent an e-mail from Northwestern University informing him that the grant was to be transferred to that institution. Until that point, he said, HBHC carried the entire grant.  “Several million and overhead went to [HBHC], which was then distributed to other sites like [Northwestern], the CORE Center and Cook County,” Ostrow said.  He added, “They get overhead on all of it. Because of that overhead, [HBHC] has been able to grow. Now, with the transfer, all the money goes to [Northwestern] and they will be distributing it.”

In an effort to find out more, Ostrow sent e-mails to the project officers at the National Institute of Allergy and Infectious Diseases, which administers the grant. They responded that the change in the grant had come as a result of a request from HBHC. He said it was unclear what had happened, "whether Howard Brown and Northwestern tried to save the grant by transferring it rapidly or someone moved it without discussing with the board. From an administrative or a or a research perspective, it’s not a big deal not a big deal whether Howard Brown or Northwestern has the grant, but financially it's a big deal. The MACS has been a source of pride since Howard Brown is a community-based organization; it put it on the map as an independent research institution.”

Frustrated at the lack of details from HBHC, Ostrow pointed out that the WCT report was the first he heard of Cook's departure and that there needed to be more transparency in the matter: “The facts need to get out before the speculation runs wild and before Howard Brown loses financial support. It’s a community organization; it owes to the community a full and fair account of what goes on. The loss of millions of dollars must not be kept behind closed doors.”

The MACS is not only well-funded and prestigious but a source of tremendous pride for its participants who have, over the years, formed tight-knit communities in the four cities. According to the HBHC Web site, there are currently 285 participants in the study in Chicago; their sense of engagement and participation might be affected by any hint of financial misappropriation.  Also at stake is the working relationship between HBHC and its community partners like Children's Memorial Hospital, Teen Living and the Night Ministry with which it opened Broadway Youth Center in 2004.  Funders and donors are also likely to keep their distance until HBHC comes forward with all the facts.

What remains clear is that the story is potentially large enough that HBHC feels the urgent need to clamp down on communications beyond press releases. Regardless of what the facts turn out to be, there may be a lack of confidence in HBHC from which it will be hard to recover.  The Web site chronicles its rise from a small volunteer-run collective in 1974 to an organization with a budget of over $15 million.  Howard Brown still uses volunteers and goodwill in a community long beleaguered by health crises like hepatitis and AIDS made worse by a ravaged health care system.  It remains to be seen how much longer it can test that goodwill without more transparency in the coming weeks.

Windy City Times will continue to follow this story.

Originally published in Windy City Times, 14 April, 2010

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