Changes Afoot at Maitri

On the heels of the announcement that its longtime executive director, Michael Smithwick, was retiring, Maitri Compassionate Care said it was in negotiations with a potential tenant for its ground floor space, which has been empty for almost two years.

Maitri, a 15-bed hospice at Church and Duboce streets, has been unable to fill its 4,000 square foot downstairs space since the AIDS Healthcare Foundation moved its thrift store amid a lawsuit over rent.

"We are this close to an announcement," said Michael Colbruno, a partner in the Milo Group of California, a public affairs firm that represents Maitri.

"Nothing is quick when there are patient and operational issues that take priority," he added. "I can't give you a timeline on the new tenant(s), as it's in negotiation and there is no way to know how much back and forth is required between real estate agents, banks, Maitri and attorneys."

Maitri's ground floor space has been mired in controversy since AHF, which operates a chain of Out of the Closet thrift shops, settled an eviction lawsuit with Maitri over its rejection of a rent increase in 2015.

Maitri then endured harsh criticism earlier this year when it announced plans to lease the space to a sex offender rehab company, without giving nearby residents a heads up. That deal fell apart after a neighborhood uproar, and the space has remained vacant.

The loss of income from the vacant space was "significant," according to Smithwick, and represents about 8 percent of the organization's total operating budget.

But, according to Smithwick, the thrift store's departure "coincided with an even more substantial reduction in Maitri's administrative spending due to our focus on improving our workflows and operating efficiencies. As a result, Maitri has been able to maintain net positive margins even without a performing tenant in our downstairs space."

In the meantime, Maitri's board of directors has launched a search for a new executive director to replace Smithwick, who has been leading the nonprofit for the past six years. As the Bay Area Reporter noted in an August 5 blog post, the board said it was informed of Smithwick's decision more than a year ago so that it could plan for a smooth transition, according to a statement by Maitri.

Smithwick, a 60-year-old gay man who has been HIV-positive for most of his life, said he was looking forward to spending more time with his partner of 23 years and his aging parents, according to the statement.

An executive director transition committee of the Maitri board is starting an active search for his replacement with the input of staff. The goal is to have a new executive director in place by year-end, which will include transition training with Smithwick.

"Michael Smithwick has steadied Maitri at a crucial time in its history. When hired in 2010, the aftermath of the Great Recession and other structural issues created a very challenging climate in which to sustain Maitri's care model," stated board President Michael Niemeyer, who also serves as director of meaningful use at Kaiser Permanente.

Niemeyer said that Smithwick had "creative focus around development and an innovative approach with technology."

"Michael led a transformation of Maitri's operations that created its current period of stability," Niemeyer added. "Most importantly, through his leadership, nursing care has become an even greater focus of the Maitri operating model and administrative expenses currently reside at historically low ratios. We will miss him greatly."

During his six-year tenure, Maitri said Smithwick reversed a serious operating deficit through administrative streamlining and improving fundraising, posted positive net revenues for the last four consecutive years with clean audits, raised $600,000 in capital funds to improve and maintain the facility, enhanced nursing care, implemented a $15 per hour minimum wage for workers, and added benefits for employees.

Gay District 8 Supervisor Scott Wiener praised Smithwick's leadership. "Michael did a phenomenal job keeping Maitri strong and helping it adjust to a changing epidemic," he said in a text message. "He will be missed."

In an email to the B.A.R., Smithwick said his biggest accomplishment has been stabilizing the agency from a financial perspective.

"We were able to significantly reduce administrative spending and increase community support, all while maintaining our traditional high service standards and the number of patients served," he said.

As far as his biggest disappointment, Smithwick said it was "that San Franciscans continue to die of AIDS, despite the wide availability of free testing, effective medications, and safety-net support systems. Eighteen of our residents passed at Maitri last year," he wrote.

Describing changes in hospice care at Maitri, Smithwick said that clinical end-of-life, palliative care has not changed much at all over the years.

"What has changed is the increasing numbers of Maitri residents who we are able to stabilize medically for discharge back to a second chance at life," he said. "In Maitri's early years, there was little we could do other than relieve pain, provide comfort, and ensure that no one suffered or died alone. Today we continue to provide unmatched end-of-life care, but are now able to medically stabilize the majority who seek our care. It feels so good to discharge a stabilized resident back to independent living who had arrived at Maitri thinking it would be their final earthly home," he said.