A clinic that helps mostly Black, brown and immigrant clients in East Boston announced Tuesday that it launched a patient advocate office in November in response to allegations of poor medical treatment at the facility.
Greg Wilmot, the CEO of the East Boston Neighborhood Health Center, said the new office allows the center to more quickly respond to people’s concerns.
“The Office of Patient Advocate serves as an additional resource for more for our community members and our patients to be able to share their feedback around their experiences with the health center,” he said. “What we learned in hearing the feedback from last year was that folks weren't always feeling safe or comfortable coming to us.”
Previously, patients could complain at the front desk, or directly to their provider. Patients are now able to contact a patient advocate for issues like concerns about being misled by a nurse, worry about lack of follow-up from a doctor or an interaction that generally made them uncomfortable.
“They can contact the Office of Patient Advocate and they would manage on behalf of the patient, making sure that their concerns are documented, understood, and that we’re following up on it as an organization,” Wilmot said.
The announcement comes about a year after group of Central American families, mostly undocumented, alleged poor medical care and misconduct at the center. That included the case of Ligia Guardago, who told GBH News that she went to the clinic in 2020 with her infant who was listless and ill. She alleges that she was told the issue wasn’t significant in a 20-minute check-up. He died the next day and was taken by ambulance to Boston Medical Center.
Without going into details about the infant death case, Wilmot said that a case like Guardago’s would go through significant follow-up, including reporting to federal and local agencies, and an internal review involving a panel of health care professionals.
Other allegations involve children, long wait times and lack of trauma-informed care for patients.
Last year, the nonprofits Centro Presente and Lawyers for Civil Rights took these complaints to then–Attorney General Maura Healey seeking an investigation. Healey’s office launched an inquiry, but not a formal investigation.
“We were in communication with all of the parties and encouraged them to work together to address the concerns raised by the community and identify opportunities to improve the health care experience for immigrant women at the health care center,” said a spokesperson from the attorney general's office on Tuesday.
A spokesperson for East Boston Neighborhood Health Center told GBH that the new Office of the Patient Advocate has "engaged with 31 patients since the beginning of its function in November 2022. All of those issues have since been resolved." The spokesperson also wanted to provide context, saying that the health center sees more than 100,000 patients yearly.
There are three new staff members in the Office of the Patient Advocate and the center hopes to hire more personnel. Wilmot says the facility also is launching a new behavioral health urgent care service later in the year, with the help of $7 million in funding from the state, which he described as the first initiative of its kind for a Massachusetts community health center.
Wilmot stressed the importance of the center in the immigrant community, where in 2022 there were approximately 205,000 interpretations — meaning the number of times the center provided patients with translation services — a number that rivals large hospitals in the area.
Tuesday’s announcement was received with lukewarm praise by local advocates who’d sought an official inquiry into the center.
“It is really good that they are doing that, that they’re finally doing that,” said Patricia Montes, executive director of Centro Presente, the immigrant advocacy organization helping a dozen patients with their complaints. “Why did they have to wait until we have a mother who lost a baby?”
Montes said there have been additional complaints. Iván Espinoza-Madrigal, executive director of Lawyers for Civil Rights, says the center needs to do more to address them. Among improvements, he says the center needs more translators, a reduction in wait times and specialized training on overcoming implicit biases.
“It is not enough to have one office dedicated to patient advocacy to address the deep concerns patients and community members have about health equity and discriminatory treatment,” he said.
Both sides have not met to discuss the patient cases. The clinic is aware of the patients’ names and the details of their cases, Espinoza-Madrigal said, but declined to meet with Lawyers for Civil Rights and Centro Presente. Meanwhile, the clinic said that the parties had declined to meet with them.
Wilmot said there haven’t been any actions against providers involved in the complaints, but that the office has cooperated with the attorney general’s office and regulators on any questions they’ve asked. Those include the Center for Medicaid and Medicare Services and the state Department of Public Health.
“We’ve had a number of regulators investigate the claims,” he said. “Out of that there was, as I’d describe it, a finding, but I can’t speak to which cases or concerns. It was remedied ‘satisfactory’ to all the regulators.”
Wilmot said that the center collected data on patient complaints and poor outcomes to report to regulators, but the patient advocate office is an additional resource. A spokesperson later told GBH News that quality and incident reporting happens in partnership with Boston Medical Center.
“In 2021 and 2022 calendar years, there were no cases determined necessary to report to DPH or any other regulatory body. All cases undergo a methodical review to identify any quality improvement opportunities and ensure the highest quality of care for all patients,” the spokesperson said.
Wilmot said the clinic has given the nonprofits information related to the patients and allegations. But Espinoza-Madrigal said that the patients are still seeking accountability.
“They want the clinic to examine and reexamine its protocols and safeguards against misdiagnosis and substandard care,” he said. “This should involve a third-party review of all treatment protocols. Together with these suggestions should be the blueprint that the clinic uses to improve its services and its connection with the community.”
