On a rainy January day, Angela Alvarez looked out the windows of the Boston Public Library Brighton Branch to Brighton Common, where last summer, the Brighton Farmers Market drew crowds hours before opening.
Lines of people formed around the sidewalk, with residents waiting to get a low-income food voucher to help them stock up on produce.
“Having that help, it’s a blessing,” said Alvarez, a Guatemalan immigrant and single mother living in Brighton. “It’s a blessing, because you know that you are going to have something for you and your daughter.”
The veggie voucher program, which helps low-income residents get access to fresh produce and healthy food, is a lifeline for her. But when the market reopens for the season this year, that lifeline could be gone.
The program was run by the Allston Brighton Health Collaborative — a community health nonprofit dedicated to serving low-income and under-resourced residents — with $50,000 per year in grant funding from St. Elizabeth’s Medical Center. The vouchers that market workers handed out each week stated in large letters on the back, “Supported By St. Elizabeth’s Medical Center.”
But the hospital never paid.
St. Elizabeth’s Medical Center has long been a pillar of funding for community groups that provide essential services to low-income residents of Allston and Brighton. But a GBH investigation has found that under the private ownership of the struggling hospital chain Steward Health Care, the hospital has quietly backed away from more than $600,000 in community giving — including for the vouchers program — and still owes money that it signed agreements to provide.
“It’s a well kept secret,” said Jo-Ann Barbour, executive director of the Charlesview, Inc., a group that provides affordable housing in Allston-Brighton and funds other community organizations.
Steward Health Care System, a for-profit network of hospitals that has come under severe financial duress, acquired St. Elizabeth’s in 2010. In the years following, Barbour said, she’s witnessed a near-complete retraction of community support from the hospital, particularly after the onset of the COVID-19 pandemic. That includes major funding cuts for the Allston Brighton Health Collaborative; years of lapsed support for Allston-Brighton PAUSES, a substance abuse prevention organization; and the discontinuation of several smaller grants.
Another nonprofit, the Coalition of Racial Equity in Mental Health, has not received a portion of grant funding it was promised by St. Elizabeth’s, according to someone familiar with the matter, who spoke with GBH on the condition of anonymity. Advocates are also concerned a $15,000 yearly scholarship for neighborhood residents pursuing a degree in health care is on the chopping block.
“It’s upsetting,” said Anna Leslie, executive director of the Allston Brighton Health Collaborative.
According to documents and correspondence obtained by GBH News, in 2022, St. Elizabeth’s signed a commitment to fund the nonprofit’s veggie vouchers program at $50,000 per year for three years beginning in 2023, totalling $150,000. The hospital still has not paid, and the health collaborative now has no confidence that St. Elizabeth’s will follow through on its promise.
A series of emails reviewed by GBH show hospital leaders stringing along the collaborative’s staff for months, first saying the money was on the way and then eventually ceasing to respond entirely.
“I’ve submitted the invoice for payment and have escalated to get the cash out the door quickly,” St. Elizabeth’s President Paul Smith said in a May 2023 email. “Will let you know when the check is issued.”
“It is in the queue for payment but payment is not imminent at this time,” St. Elizabeth’s Chief Financial Officer David Callum wrote in September.
That was the last time the collaborative heard from the hospital, Leslie said, despite several requests to the hospital’s CEO and CFO.
Now, the Allston Brighton Health Collaborative is worried that it will have to cancel the program.
“It means really difficult conversations with frustrated community members,” Leslie said. “It means less money going to our small, local vendors. It means less healthy food going into our neighborhood homes.”
In a statement, St. Elizabeth’s CEO Paul C. Smith apologized for stiffing the health collaborative, saying that the hospital has had to shift resources to patient care and hospital operations but does plan to honor the agreement.
“I can understand their perspective completely around our delay in meeting our obligations,” he said. “It was not my intent to string them along, and I apologize.”
St. Elizabeth’s commitment to fund the farmers market program was made as part of a proposal to the Boston Planning and Development Agency to construct a new garage. To offset some of the impacts of the garage, the hospital promised a series of “community benefits,” including the food vouchers, funding for the $15,000-yearly community scholarship, $20,000 over four years for a local senior center and $25,000 for street improvements.
Given Steward Health’s mounting financial difficulties, neighborhood leaders believe it’s unlikely St. Elizabeth’s will actually move forward with its garage proposal. For community groups left in the dark, there appears to be no recourse through the city.
“There are no executed and binding legal agreements between the BPDA and SEMC [St. Elizabeth’s] that compel the institution to make these payments,” the BPDA’s Assistant Director of Communications Brittany Comak said in an email.
Smith, the hospital CEO, maintains that St. Elizabeth’s does still plan to construct a new garage and provide the community benefits outlined in the BPDA agreement. He also said St. Elizabeth’s plans to provide $45,000 in grant funding for the Coalition of Racial Equity in Mental Health this year.
But that could be a tall order given the monetary situation of the hospital’s owner.
Steward Health System runs eight Massachusetts hospitals in addition to St. Elizabeth's. According to the Boston Globe, Steward is facing deep financial troubles, with mass layoffs and hospital closures on the horizon. The newspaper found that Steward’s monetary issues forced the repossession of medical equipment at St. Elizabeth’s, which may have contributed to the death of a new mother. The situation has sparked concern among state and national leaders, with Steward reportedly considering selling some of its hospitals, including St. Elizabeth’s.
“Our first job is to protect patients and to protect access to health care, and also to protect and stabilize our health care system,” Gov. Maura Healey recently told reporters.
Smith did not directly answer questions about Steward’s finances or plans for the hospital’s future, but said that the aftermath of the COVID pandemic has devastated community hospitals around Massachusetts. “We are committed to working productively with public officials to ensure that we can provide uninterrupted and high-quality care for the communities we serve,” he said.
For Allston-Brighton community leaders, the situation is dire, not only for the thousands of patients who rely on St. Elizabeth’s, but for the community groups that have lost a financial lifeline.
“What’s happening is not okay. It’s really not okay,” said Rosie Hanlon, a longtime community advocate who formerly served on the St. Elizabeth’s Community Funding Task Force and currently works for the Boston Center For Youth And Families’ Jackson Mann Community Center.
Charlesview, Inc. has worked to fill some of the void created by St. Elizabeth’s, providing roughly $600,000 in recent years to help keep the Allston Brighton Health Collaborative and PAUSES running, according to Jo-Ann Barbour at Charlesview. St. Elizabeth’s funding for PAUSES did return in 2022 after being put on hold for years, and the hospital said it plans to provide another round of funding in 2024.
St. Elizabeth’s is the largest employer in the Allston-Brighton area. City Councilor Liz Breadon, who represents the neighborhoods at City Hall, said she is dismayed by the hospital’s waning support for the community, but that her concerns run deeper, given the state of Steward’s finances.
“We have noticed this pulling back,” she said. “But this is a national and international crisis, because the scale of their [Steward’s] holdings across the country is immense.”
State lawmakers are exploring an array of responses to Steward’s financial crisis, including potentially ordering some of the system’s holdings into receivership. Breadon said she agrees with Gov. Healey that the company should not receive a state bailout. But what should happen next — and how lawmakers can avoid pulling out a medical safety net from under the Allston-Brighton community — is unclear.
“That is the $60 million question,” Breadon said.