As City on a Hill wrapped up its final day of operations, the MKE Black Grassroots Network for Health Equity convened a community meeting Thursday to analyze the growing strain on Milwaukee’s safety net health system.
Over 100 leaders, providers and advocates attended a virtual meeting called in response to the sudden close of an organization that served thousands of vulnerable residents.
The shutdown of City on a Hill, announced earlier this week, marks the latest in a series of lost resources for residents.
Quinton Cotton, a co-founder of the MKE Black Grassroots Network for Health Equity, pointed to a pattern of closed clinics, the closure of the Social Development Commission and the Center for Self-Sufficiency, and a general loss of food, medical and transportation access.
“Things are bad in our community, and it’s been this way for a while,” Cotton said. “We are tired of having this conversation after the bottom has already fallen out.”
Why City on a Hill closed
City on a Hill’s leadership confirmed that the organization is closing its doors due to years of financial instability.
Its Board President Mitch Lueck said that for four to five years, the nonprofit struggled to raise sufficient funds. He said the clinic expansion in 2024 temporarily masked deeper issues, including a growing structural deficit.
He said the significance of the problem was recognized in March of 2025. In December, the organization filed for Chapter 11 bankruptcy in hopes of restructuring approximately $3.5 million in debt. By mid-March this year, leadership determined there was no viable path forward.
“We saw that we were going to have a $700- $800,000 a year deficit where we would not be able to cover our expenses,” said Lueck. “We knew that we would not be able to carry on the programs and services and we had to make the decision to wind down.”
Michael Williams, executive director of City on a Hill, said repeated attempts to refinance debt fell through, despite months of negotiations with multiple financial institutions.
He believes that earlier transparency with partners and the public might have changed the outcome.
“We probably should have gone public sooner to ask for help,” Williams said. “That’s one of my biggest regrets.”
The closure of City on a Hill affects around 3,000 patients, many of whom relied on the organization for primary care, behavioral health, dental services and medication access. Staff are now scrambling to contact patients, distribute 30-day medication supplies and provide referrals to other clinics and social services.
Community leaders emphasized gratitude for the organization’s 25 years of service, while urging a forward-looking response.
“We are not here to attack City on a Hill,” said Ericka Sinclair, a co-founder of MKE Black Grassroots Network for Health Equity and founder and CEO of Health Connections Inc. “What is done is done. We need to figure out what happens next.”
Moving forward
Participants agreed that next steps must involve rapid coordination.
A follow-up plan includes collecting information on available resources like job openings, volunteer opportunities and service capacity, through a shared database. Leaders also committed to broader efforts to map resources to better connect organizations and avoid future gaps in services.
Still, a deeper question lingered throughout the discussion: Who is ultimately responsible for safeguarding community health when safety-net providers fail?
“Who do we go to when we’re in trouble?,” Sinclair asked. “Organizations cannot suffer in silence.”
Participants urged the Milwaukee community and funders to realize the immediate reality of the situation. Patients will be arriving at now-closed doors expecting care that no longer exists.
“This isn’t just about one organization,” Sinclair said. “It’s about a system that has to function together, not in silos.”
Attendees said in coming months the focus must remain on both immediate response and long-term reform to ensure that the next time an organization struggles, the community hears about it before it’s too late.
Calls to action
Meeting organizers had some calls of action for the greater community.
They asked for a 90-day emergency fund to support the transition for clients and others. Leaders called on funders to support not only Network for Health Equity but clinics and other groups that will take on former City on a Hill patients.
They also called for community members to share how they can support their transition. Organizations across Milwaukee are being asked to absorb displaced patients, offer jobs to affected staff, and open placements for clinical trainees who suddenly lost training hours.
For more information
To follow up or get involved with these efforts you can go to the MKE Black Grassroots Network for Health Equity website or email info@mkehealthequity.com.
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