By Jack Mirkinson
Over a year after the passage of the American Recovery and Reinvestment Act—more commonly known as the stimulus bill—hundreds of billions of dollars have flowed from the government’s coffers to state and local agencies and countless community organizations. Quite a bit of that money has gone to Brooklyn.
According to ProPublica’s Recovery Tracker tool, Brooklyn has received over $400 million in stimulus funds. Carl Hum, president of the Brooklyn Chamber of Commerce, said in an interview that the borough has received “more than our share” of funds in proportion to its population. This is the story of one of the organizations that has received money from the government. It is a health center called the Brownsville Multi-Service Family Health Center, or BMS, and its constant fiscal struggles have been eased—for now—by the stimulus.
The center was given two separate grants from the government; together, they total $1,079,672. BMS’s president, Harvey Lawrence, says the funds will help the center finally do things it has been wanting to do for years. More importantly, the money comes during a particularly hard time for BMS, which serves a low-income community of color in dire need of health care services.
BMS has its roots in the Brownsville Community Development Corporation, which was founded by civil rights activists in 1974 as part of a citywide anti-poverty initiative. In 1982, BCDC opened a medical center, which was staffed by one doctor, one clerk and the director, Joseph Francois. Now, the center has 260 employees. The main building, whose turquoise paint job makes it stand out amidst the housing projects that surround it, sits a few blocks away from the Rockaway Ave. subway station. It has 27,000 square feet, but that is not enough to house the full range of services BMS provides. The center thus maintains eight satellite sites around Central Brooklyn. They cover four zip codes and serve around 20,000 people a year.
The services run the gamut, from primary and OB/GYN care to HIV/AIDS treatment to dental care to social work and counseling. The center also works with a shelter for homeless women, runs a small halfway house for substance abusers, gives parenting and job training classes, provides alternative therapies like acupuncture, and helps operate a health care-focused charter high school in Brownsville. It is not exactly an oasis in a health care desert, but it comes close.
Though it often flies under the radar—several schools of public health in New York City said they had never heard of BMS—the center has a prominent place in Brownsville. In an interview, Assemblyman William Boyland, who represents Brownsville, called BMS a beacon in the community. “At a time when there was no health care in Brownsville, it was the organization that took care of basic health needs,” he said. “It’s been one of the top job creators in our community for a long time.”
On a recent Thursday afternoon, the BMS lobby was filled with people. There were not enough seats to accommodate everyone, so people stood waiting to be seen by a doctor, or going in and out of the pharmacy that sits in the center of the lobby.
The population inside the center, like the population in Brownsville, was overwhelmingly black. Upstairs, Harvey Lawrence sat behind a massive desk in his office, surrounded by pictures of Nelson Mandela, Malcolm X, Frederick Douglass and, of course, his wife and children. Lawrence has been at BMS since 1994, and he became the president in January of last year. Before coming to BMS, he worked at the Port Authority and as an investment banker. He speaks softly but intensely, and displays a politician’s knack for remembering names and figures, especially those involving the center he oversees.
BMS has a yearly budget of $20 million, and relies heavily on public money to cover its costs. According to Lawrence, the center gets 40% of its funding from state and city grants. The dental center, the halfway house, the women’s shelter, the HIV services—all these, and more, are funded either partially or wholly through state grants. Almost all of the remaining money comes from patient fees. Most of the people who come to BMS, though, are covered by public health programs like Medicaid, which require the government to reimburse the organization after it has already spent money. Then there are federal subsidies to cover any other patients who cannot afford to pay in full.
The center gets barely any money from philanthropic donors; Lawrence put the figure at around 1% of the BMS budget. It is difficult, he said, for BMS to attract attention from the people he calls “the folks across the river”—wealthy donors in Manhattan who, in his opinion, crave the validation of seeing their names grace a plaque in a sumptuous hospital waiting room. “If I go into the hospital, I can see my name in the lobby,” he said. “You give to us, the folks who are gonna see our name are the poor people, and unfortunately, in some places, poor people don’t count. They don’t have the same cachet.”
This adds up to a climate of almost eternal precariousness. It is like relying on a carpenter to fix a hole in your roof: if he falls through, so does the rain. As Lawrence said, “My profit margin is so thin that if a mosquito sneezes, we get the flu.”
The last year or so has not given the center the flu, per se, but BMS has been catching colds more often. For example, the center often applies for vouchers from the New York Department of Health for various items it has spent money on. The state then reimburses BMS in full. In February, though, BMS got word from the state that it would only be paying 31% of a crucial technology voucher, and only 77% of one given to provide for services for women and children. As a result, some services had to be cut back, and Lawrence had to confront a big hole in his budget. He said he is bracing for another, more painful round of cuts in the upcoming state budget. “We’re all in a state of denial or avoidance about how this will play out,” he said.
All of this is a long-winded way of saying that nearly $1.1 million in stimulus grants from the federal government was extremely welcomed—a seemingly obvious point, but one that is especially true for a cash-strapped organization like BMS.
Like any huge government undertaking, the stimulus money has been doled out of innumerable different federal, state and local agencies. In the case of BMS, the money came from a $2 billion pot given to the federal Health Resources and Services Administration to provide funding for community health centers across the country. Of that $2 billion, over $851 million has been used for so-called “Capital Improvement Projects,” or CIPs. On its website, the HRSA says that around 1,500 health centers nationwide are getting stimulus money for “construction, repair and renovation” of their sites.
Getting the money required submitting a long list of details that the HRSA requires from its CIP grant applicants. Lawrence said the center scrambled to complete the application in time. BMS had to specify what it wanted the money for, and submit outside verification that its operations were above board. Given that just 31% of the stimulus money allocated for contracts, grants and loans has actually been paid out so far, BMS was lucky to get its funds so quickly: the bill passed on February 17th, and by March 27th, the center had an $274,298 check to cash. (Another grant, for $805,374, was given in June.) The government arrived at the specific sums by using a formula that allocates funds based on the precise number of patient visits an organization gets every year. If a center is awarded a grant, it gets a minimum of $250,000. Each patient visit is worth $35, and that sum is added to the minimum award.
So what is the money being used for? Lawrence said that the grants will allow 2,500 more people to use the center’s services. BMS will, among other things, be able to hire an architect to expand and upgrade the space it has for clinical care, as well as add a nurse and a dietitian to its staff. In addition, the center wants to move its pharmacy to the basement, freeing up space for people to wait. BMS has to do all of this while making sure that patients—who, apart from needing vital services, also pay the bills—can still be treated during all of the new construction going on. All told, the money will create 2.6 ”FTE’s”—that is, the equivalent of 2.6 full-time, 40-hour week jobs, since the people hired will work part time.
Beyond using the stimulus money, Lawrence is trying to attract those “folks across the river” to give more money to his organization. They should realize, he said, that in such a poor area, “$100,000 really helps. $10,000 really helps. $1 really helps. Anything helps.”
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