Canceled appointments, low wages, and poor staffing among problems at R.I. health clinic, workers say – The Boston Globe

“We have a very hard time maintaining appointments. This happens every day,” Peixoto, a health center associate at PCHC for the last 14 years, said in an interview. “We have a shortage of providers. It would be nice if some of the doctors out there could come work here and provide care to those who need it the most.

“We, ourselves, are understaffed,” she said of her fellow health center associates (also known as HCAs). Peixoto said she last knew of about 50 HCA job openings across PCHC’s centers. “It affects us, but it also affects our patients and our ability to care for them. Without us, there is no PCHC. And yet, we are not treated with the respect or dignity we deserve.”

Peixoto was just one of dozens of health care workers that held pickets on Thursday across the six PCHC locations, which is the city’s only Federally Qualified Health Center (or FQHC). The health care workers, who are still reeling from pandemic burnout, are demanding their employer improve staffing levels and increase their wages. FQHCs are federally-funded nonprofit health centers that serve medically underserved areas and populations, and treat patients regardless of their ability to pay. While FQHCs are supposed to be a “safety net” for primary care services, PCHC is the largest primary health care provider in Providence, caring for more than 80,000 residents in the area. With a primary care shortage throughout New England, and Rhode Island’s emergency rooms facing some of the US’ longest wait times, PCHC workers said community health centers are more vital than ever — but only if they can provide the care patients need.

But their union — District 1199 SEIU New England, which represents about 300 PCHC workers — said the PCHC has given employees a “drastic increase” in their workload since an alleged hiring freeze was put in place “earlier this year.” The freeze took place “from about January to May” this year, said Jesse Martin, the executive vice president of District 1199 SEIU New England.

Brett Davey, a spokesman for PCHC, told the Globe in an emailed statement that the centers do “not have a hiring freeze.” “We are always actively recruiting for health care professionals,” he said.

Peixoto said the centers recently adopted a new electronic health record system. Employees, she said, had to attend training for the new system during their regular meal breaks. Davey said employees are paid for “all the time they work, including training.” But because of the additional work HCAs have had to take on during a staffing shortage, Peixoto said they’ve regularly had to skip lunch breaks.

Melissa Nelson, a patient referral coordinator, has worked at PCHC for two years since leaving a private practice. She detailed a list of complex issues that frontline workers at the center have to juggle just for a patient to be seen that she said she “never had to do in any role before.”

“There’s a lot of barriers some of these patients face to get the care they need. We have to coordinate case management, transportation, get them enrolled with insurance, and a whole lot more,” said Nelson. “In other cases, our patients don’t even have anywhere to live. Sometimes you’re trying to get a hold of patients, but they don’t even have a [phone] number for you to reach them. It’s challenging, and there’s a lot of pressure.”

Speaking on behalf of PCHC, Davey said “the vast majority of” the centers’ patients use same-day scheduling. “So their visit happens the same day they call,” said Davey, who did not answer questions related to canceled appointments due to the lack of providers. “The number of available appointments is dictated by the number of staff working that day.”

On Tuesday, after a long Columbus Day weekend, there were approximately 600 patient calls in the “queue,” which meant workers had to scramble to call patients back. “The lines were frozen for a period of time,” said Nelson, who called it a “nightmare situation.”

Some of the workers, most of whom are women of color, have also had to get a second job to make ends meet, said Nelson.

After 14 years on the job, Peixoto said she earns $20.14 per hour, which Martin called “the average” pay for health care associates at PCHC. Prior to their new contract in 2022, workers were earning around $16 to $17 per hour. He said he wants the average worker to earn a starting wage of $25 per hour, especially as workload has only increased.

During contract negotiations last year, PCHC’s management allegedly “assured” workers that pay would improve for HCAs this past summer — in addition to the July 1 raise that Davey said all unionized employees at PCHC received — for “the additional tasks they’ve had to take on” due to the staffing shortage, said Martin. The two parties were supposed to meet in July. But, he alleged, management responded with a one word email that said “no.” Davey did not answer questions related to Martin’s claims.

“That’s a major concern when our members are doing more work with less help, less respect, less break times. The employer responds by simply saying ‘no’ without looking us in the eye and having a discussion about the resources that are or are not available to the institution,” Martin told the Globe. “That’s just a matter of respect problem.”

Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.