McLaren did not respond to multiple calls for comment, and leaders of the Boston Health Care for the Homeless Program declined to discuss details of his departure.<\/p>\n
McLaren\u2019s exit came months after the nonprofit carried out the first layoffs in its 40-year history<\/a> \u2014 a decision that drew widespread opposition from clinicians and others inside the organization, according to four current and former staff who spoke on the condition of anonymity for fear of retribution. His resignation also signals rising strain within the nonprofit as it braces for massive cuts to Medicaid<\/a>, the government insurance program for the poor that funds most of its services.<\/p>\n While the reasons for his departure remain unclear, employees said McLaren\u2019s lack of clinical experience and top-down management style occasionally put him at odds with staff.<\/p>\n De Las Neuces declined an interview request but said in a written statement Tuesday that the program faced an operating deficit that \u201crequired difficult strategic decisions.\u201d The nonprofit in September issued layoff notices to 25 people, or about 4 percent of the agency\u2019s workforce, and moved to close a 20-bed medical respite facility<\/a> in Jamaica Plain, where people who are homeless can recuperate after hospital stays or injuries.<\/p>\n \u201cI agreed to take on the role of interim CEO because I\u2019ve been part of BHCHP\u2019s senior team for the past 10 years and am deeply committed to the mission of the program,\u201c De Las Nueces said. \u201dThe focus of our leadership team this year is to preserve clinical services and continue to provide high-quality, comprehensive care for homeless individuals and families in Boston, even in light of anticipated Medicaid cuts.\u201d<\/p>\n De Las Nueces added, \u201cStan [McLaren] guided us through many tough changes, always keeping patients as our top priority.\u201d<\/p>\n The layoffs have been broadly unpopular within an organization known for its passionate and highly dedicated workforce. Many strongly objected to a move to lay off three front-line recovery coaches<\/a> who provide one-on-one support to homeless people struggling with addiction, and who play a critical role in helping get them into treatment and on medications (such as methadone or Suboxone<\/a>) that help suppress their cravings and painful withdrawal symptoms. <\/p>\n Also unpopular, employees said, was a decision by the organization to alter its approach to providing outreach to people outside its main clinic and headquarters at 780 Albany St. in Boston\u2019s South End. <\/p>\n Especially in warmer months, the sidewalks outside the building have been a busy gathering spot for people who are homeless and sometimes using illicit drugs. Last summer, leaders at the nonprofit asked outreach staff to gently redirect people outside into the building lobby to decrease congestion and keep pathways clear.<\/p>\n The move drew criticism from some staff at Boston Health Care for the Homeless, who saw it as a symbolic step back from the organization\u2019s longstanding commitment to street-level outreach and meeting people where they are, even in the toughest conditions. Clinicians said the sidewalk interactions are crucial for building trust with patients experiencing mental health challenges like paranoia, many of whom are unwilling to step inside a medical facility. <\/p>\n \u201cPeople were . . . angry\u201d over the change, said a physician at the organization who asked to remain anonymous. \u201dMeeting patients on the sidewalks and in the streets is core to what we do. Those are our people.”<\/p>\n Other employees said they objected to a scolding email that McLaren sent to employees soon after the decision was made, in which he criticized unnamed staff for spreading \u201cinaccurate and deeply misleading information\u201d to its partner agencies and state officials.<\/p>\n In the email, obtained by the Globe, McLaren accused staff of falsely claiming that city officials and law enforcement had ordered leadership at the Boston Health Care for the Homeless Program to close all services at Massachusetts Avenue and Melnea Cass Boulevard, also known as Mass. and Cass<\/a>, an intersection that has long been the epicenter of illicit drug use and homelessness in the city. A spokeswoman for the nonprofit said assertions that the nonprofit had stopped providing outreach at Mass. and Cass are \u201ccompletely inaccurate.\u201d <\/p>\n In his email to staff, McClaren said the alleged misrepresentations by staff were \u201cdamaging our credibility\u201d and \u201cplacing us in a precarious position with funders, policymakers, and partner agencies.\u201d <\/p>\n \u201cLet me be clear: this behavior is unacceptable,\u201d McLaren wrote. \u201cIf individuals feel they can\u2019t align with the organization\u2019s direction and are prepared to undermine BHCHP by circulating falsehoods to external funders, they should reconsider whether this is the right place for them.\u201d<\/p>\n Several employees said they found McLaren\u2019s email to be excessively vitriolic and a distraction from staff members\u2019 primary concern: That cuts threatened to undermine efforts to build relationships with people living on the streets and get them the help they need.<\/p>\n At the same time, the appointment of De Las Nueces as interim CEO was greeted enthusiastically by many front-line staff members. As a physician and the agency\u2019s chief medical director, De Las Nueces is widely respected within the organization and is seen as someone who would prioritize street outreach, several employees said. She previously served as interim CEO prior to McLaren\u2019s hiring.<\/p>\n \u201cI have worked closely with Dr. Denise De Las Nueces for more than 13 years,\u201d said Dr. Jim O\u2019Connell<\/a>, founding physician and longtime president of the Boston Health Care for the Homeless Program, in a statement. \u201cShe is an astute clinician, an exceptional medical leader, a deeply compassionate physician, and a cherished colleague beloved and respected by our BHCHP staff.\u201d<\/p>\n O\u2019Connell did not respond to requests to comment on McLaren\u2019s resignation.<\/p>\n McLaren\u2019s departure marks the third leadership change since 2022 at the program, which serves more than 10,000 people a year at about 30 clinics and has long embraced a direct-to-the-streets approach<\/a> to medical care. Last year, the nonprofit provided substance use disorder treatment to more than 1,500 unique patients.<\/p>\n The organization is especially vulnerable to planned reductions in government-funded insurance programs: About three-quarters of its annual budget comes from programs like Medicaid and MassHealth, the state\u2019s Medicaid administrator, according to its website.<\/p>\n In the coming years, steep cuts to Medicaid, enacted by Republicans in their signature policy bill<\/a> last summer, are expected to destabilize \u2014 and even cripple \u2014 the finances of medical systems across the country. An influx of patients who can\u2019t find or pay for primary care is about to balloon, experts have warned. In Massachusetts alone, approximately 326,000 Massachusetts residents \u2014 almost 5 percent of the entire state population \u2014 are expected to lose insurance coverage under new Medicaid restrictions that call for some members to comply with work requirements<\/a> and recheck their eligibility every six months, according to an analysis<\/a> by the Congressional Budget Office.<\/p>\n In an interview with the Globe last September, McLaren said that, under one projection, the Boston Health Care for the Homeless Program could lose $30 million to $40 million in Medicaid revenue over a four-year period. The nonprofit is hardly alone in its financial struggles: In the 2024 fiscal year, 16 of 22 health systems in Massachusetts operated in the red, in part because of rising costs and low reimbursement rates, according to an analysis<\/a> by the Center for Health Information and Analysis, a Massachusetts state agency.<\/p>\n \u201cI am deeply grateful for the opportunity to have worked alongside you during a period of real challenge and change,\u201d McLaren wrote in an email announcing his resignation. \u201cI am proud of the care we provided, the conversations we began, and the way so many of you continued to hold the mission steady even when the work felt heavy.\u201d<\/p>\n De Las Nueces said the decision to enact layoffs was made only after senior leadership at the organization explored multiple ways to boost revenues and improve efficiency. \u201cThese efforts, while helpful, were unfortunately not enough to close the financial gap,\u201d she said in a statement. <\/p>\n Prior to joining the program, McLaren served more than three years as president of Carney Hospital in Dorchester. Carney closed its doors in August 2024 after its parent company, Steward Health Care, once the nation\u2019s largest private for-profit hospital chain, filed for bankruptcy after years of alleged financial mismanagement<\/a>. <\/p>\n Sarah Rahal of the Globe staff contributed to this report.<\/p>\n Chris Serres can be reached at chris.serres@globe.com<\/a>. Follow him @ChrisSerres<\/a>.<\/p>\n