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Employees question quality of care at Rox health center

Howard Manly

In a series of internal letters, medical personnel at Roxbury Comprehensive Community Health Center painted a picture of woeful operations at the center and layed the blame squarely on its CEO, Anita Crawford.

The damaging letters detail financial problems ranging from the loss of “significant grants” that helped pay for medical and psychological programs, to an almost chronic shortage of medical equipment, paper towels and toilet paper. In some cases, the letters allege, the center had no hot water.

In addition, the RoxComp employees report that the center is under “assessment” by federal and state health regulatory agencies, including a recent local investigation which determined one of RoxComp’s labs to be “insufficient.”

Crawford questioned not only the validity of the unsigned, anonymous letters but also the timing. “None of the letters,” Crawford said, “ accuse me of stealing money or running a center that is delivering poor health care.”

Without commenting on specific allegations, Crawford explained that RoxComp has undergone several routine surveys by both federal and state regulatory agencies. If there were deficiencies, Crawford said, they were fixed in a timely manner.

Crawford then said she believes the letters were sent “in retaliation” for her role as chairman of the board of Roxbury Community College.  She did not explain the link between the two institutions or how her role in one affected her role in the other.  

The series of letters began Feb. 24, 2012 and included the names of two registered nurses, Alyssa Harris and Iris Montijo, as well as Drs. Wendy Pavlovich, Samuel Rivers, Guity Valizadeh and Michelle Villarta.

The letter informed RoxComp senior management that the medical center’s supply shortage “has significantly affected our ability to accurately diagnose patients, determine severity of disease, develop treatment plans and treat patients.”

The letter also stated that the center lacked supplies necessary to stabilize patients in an emergency situation. “We are professionally responsible for providing a standard of care that gives us the capacity to make triage and referral decisions,” the letter stated.  

In another letter asking for a meeting with the board of directors on or before June 29, 2012, an unnamed RoxComp staff member said the professional staff had concerns about “the lack of transparency, the lack of growth both in the number of patients we serve and in programs and services.”

Detailing the loss of several “significant grants” and the increased scrutiny from both “federal, state and local agencies,” the letter writer stated that “the staff understands that RoxComp cannot continue to exist and function…We have lost faith in the CEO and the senior management team.”

A letter dated June 17, 2012 repeats earlier charges on the “lack of confidence” in senior management’s ability to “create and maintain an environment that allows them to provide quality clinical care.”  The letter states that “insufficient and inconsistent” inventory of supplies and equipment has led to “serious delays in lab results prompting cancellation of patient appointments in both medical and dental departments.”

“From a public safety concern,” the letter charged, “RoxComp has experienced a lack of drinking water in the building, no hot water to properly wash our hands, no toilet paper or paper towels and an improper retention of biohazard materials on the premises.”

The letter suggests the staff is experiencing “burnout” as a result of several unfilled key positions, including a permanent medical director. The unfilled positions come at a time when RoxComp has lost key programs due to a lack of funding. Gone is a long-term behavioral health program that provided services to individuals who experienced murder in their families. RoxComp also lost its HIV department.

In response to these serious allegations, Dr. Keith Crawford, RoxComp’s chairman of its board of directors, wrote that the staff would be invited to a “State of the Health Center” meeting in August or early September.  Crawford’s letter, dated July 28, 2012, did not address issues raised in the staff letters.

Instead, Crawford wrote about the recent U.S. Supreme Court decision upholding President Barack Obama’s Affordable Health Care Act. “Clearly this will have an impact on the health center,” Crawford wrote. “…With change comes challenges and opportunities. We are all responsible for preparing and positioning the institution to respond to both…”

Crawford’s invitation was received harshly by RoxComp employees. In a letter dated July 6, 2012 and signed by RoxComp staff members, Crawford’s letter was characterized as “dismissive and void of any inclination that a meeting will be scheduled with the staff members of RoxComp to specifically address the concerns we have.”

One of the letters also reported that a RoxComp lab was under review by the Department of Public Health and was found to have “significant deficiencies” and was subsequently closed.

“Unless the infrastructure is strengthened in a very basic way, RoxComp is in no way viable enough to sustain itself in a changing patient care model that it will face in the not too distant future,” the letter stated.