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New Chase Brexton CEO wants to create more trusting culture

Patrick Mutch, the new CEO of Chase Brexton Health Care, prides himself on being a straight shooter.

"I tend to not sugar coat anything," Mutch said.


On the job since February, Mutch hopes an open door, straightforward approach will help him guide Chase Brexton through an unusually tense time for the iconic organization that has served Baltimore's lesbian, bisexual, gay and transgender population for four decades.

He is working to mend staff relations and restore Chase Brexton's image in the community, while helping the organization remake itself as a broader health care provider and adjusting to a challenging fiscal environment in the health care industry that stresses cutting costs and treating more patients.


"There is going to be constant pressure always about seeing more patients because that is how the organization financially gets paid. So let's be honest...," Mutch said of his message for Chase Brexton's employees, "I do need you to see a certain number of patients, but I do need to support you to be able to do it as well."

He succeeded Richard Larison, who left the job amid eroding relations between staff and management at the chain of community health clinics.

Trouble at the organization started last year as employees sought to unionize and have more say in the decisions. They said union representation was needed as the number of patients they treated swelled and they began to worry about the quality of care being provided.

Despite resistance from management, led by Larison, workers overwhelmingly voted to join the 1199 SEIU United Healthcare Workers East union in August. By then the relations between staff and management had become frayed.

Tensions rose amid speculation that five mid-level managers were fired because they supported the unionization effort. Critics protested outside the nonprofit's Mt. Vernon headquarters and signed an online petition expressing their disapproval of management's actions and treatment of longtime employees.

Local politicians wrote Larison asserting their concern over the state of affairs.

Mutch, 64, said he wanted the job despite what he knew about tensions at the organization. The health industry veteran said he always wanted to head up a federally-funded health clinic, especially as the role of such clinics increased under the Affordable Care Act. In his last job at St. Agnes Hospital in Baltimore, he also was a liaison for a community health center located within the hospital.

He came to lead Chase Brexton with four goals, including enhancing operations, restoring confidence among doctors and other providers, improving the organizations image in the community and building a more trusting culture.


He pledged to answer emails, follow-up on questions and listen to people's ideas, particularly those of doctors, nurses and other providers whom he wanted to give a "voice."

"They are critical," Mutch said. "They are our engine."

Chase Brexton started in 1978 to serve gay men. While known as place that is welcoming and understanding of the lesbian, gay, bisexual and transgender community, in recent years the institution has positioned itself as a clinic that serves everyone.

The organization moved its headquarters and primary clinic to the Monumental Life Building on Charles Street in 2013 and recently expanded its Glen Burnie location. It also has offices in Columbia, Randallstown, Easton and at the Maryland Institute College of Art.

It saw an influx of new patients as the Affordable Care Act made insurance accessible to more people. About 20 percent of Chase Brexton's patients remain uninsured and many of its patients have complex health histories that are challenging to treat, such as multiple chronic conditions.

To help the bottom line and reduce unpaid bills, Chase Brexton counselors have been working to sign up more patients for Medicaid, the federal-state health program for low-income residents that already covers about half of those it serves.


Mutch said those efforts would be undermined by a Republican push to overhaul the health care law known as Obamacare and scale back an expansion of Medicaid. The U.S. House of Representatives already passed a bill and the U.S. Senate plans a vote in coming weeks on its own version.

Rebuilding faith in Chase Brexton, even under new leadership, could take some time, observers said.

Chase Brexton has yet to finish negotiating a contract with the new union, though Mutch said the nonprofit is negotiating it in good faith.

"We do believe that management has yet to recognize the problems that fully exist at Chase Brexton, however, we hope we will be able to reach an agreement soon," said Brian Owens, a lead SEIU organizer.

Union members, while acknowledging a more open atmosphere, said a fair contract will determine if the efforts are genuine.

"While we appreciate the new leadership's effort to engage staff in conversation about organizational culture, with initiatives such as the ongoing focus groups, our experiences have taught us that we need a legally binding contract to adequately address the concerns that led us to unionize last summer," said Natalie Spicyn, a primary care doctor at Chase Brexton.


Some local politicians also said it is to early to tell if change is really to come.

"The power is in action," said Del. Cory V. McCray, a Baltimore Democrat. "I think the verdict is still out."

Del. Mary Washington, also a Baltimore Democrat, agreed.

"The commitment is in the contract," she said. "We will see whether they work out a fair labor plan."

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At least one patient said Chase Brexton still has a long way to go to regain trust.

Kate Riley, a patient since 2009, said she left the health system last year when her main medical provider was fired. Jill Crank, a nurse practitioner who served as assistant medical director, was one of five employees let go as the unionization efforts were underway.


"After what they did to Jill Crank and the others, I would never return to Chase Brexton," said Riley, who initiated rallies at the health system last year to support the unionization efforts aimed at improving work conditions for medical providers.

Mutch contends that Chase Brexton hasn't lost sight of its mission to serve the community, but acknowledges improvements must be made.

"It is just a journey," he said. "It just doesn't happen overnight."