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Health Care Without Walls Inc.

 148 Linden Street, Suite 208
 Wellesley, MA 02482
[P] (781) 239-0290
[F] (781) 235-6819
www.healthcarewithoutwalls.org
[email protected]
Roseanna Means
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INCORPORATED: 1999
 Printable Profile (Summary / Full)
EIN 04-3487205

LAST UPDATED: 11/09/2017
Organization DBA Health Care Without Walls
Former Names Women of Means, Inc. (2015)
Organization received a competitive grant from the Boston Foundation in the past five years Yes

Summary


Mission StatementMORE »

Health Care Without Wall’s mission is to improve the lives of women who are homeless or marginally housed through compassionate, high quality health care, education and advocacy. 

Mission Statement

Health Care Without Wall’s mission is to improve the lives of women who are homeless or marginally housed through compassionate, high quality health care, education and advocacy. 


FinancialsMORE »

Fiscal Year Jan 01, 2017 to Dec 31, 2017
Projected Income $1,168,316.00
Projected Expense $1,170,279.00

ProgramsMORE »

  • Bridges to Elders
  • Bridges to Moms
  • Family Shelter Clinic Program
  • Medical Training & Education
  • Shelter-Based 'Gap' Health Care

Revenue vs. Expense ($000s)

Expense Breakdown 2016 (%)

Expense Breakdown 2015 (%)

Expense Breakdown 2014 (%)

For more details regarding the organization's financial information, select the financial tab and review available comments.


Overview

Mission Statement

Health Care Without Wall’s mission is to improve the lives of women who are homeless or marginally housed through compassionate, high quality health care, education and advocacy. 


Background Statement

Founded in 1999 by Dr. Roseanna Means, Health Care Without Walls (HCWW) offers free, “bridging” health care to homeless women and their children, in Greater Boston area shelters, safe houses and family transitional housing sites. Previously known as Women of Means, we changed our name in 2015 to reflect the evolution of our organization, highlighting our commitment of bringing health care directly to where it is needed most – beyond traditional medical facilities.

HCWW is staffed by volunteer physicians, as well as a committed team of paid, part-time nurse care managers and community health workers, who provide over 10,000 visits of bridging medical care and ancillary services to an average of 1,800 homeless women and their children annually. The model is a Free Care Program which allows our clients to be seen as walk-ins in the shelter where other survival needs are being met. Formal registration and billing are intentionally set aside in order to improve access, build trust, and reduce as many bureaucratic barriers as possible.

HCWW’s special programs meet the complex health needs of three vulnerable populations. Through our Bridges to Elders Program, HCWW provides focused care for women ages 60+ to prevent unnecessary hospital admissions and ER visits. In Framingham, we provide ‘gap’ care to homeless families, primarily single mother-headed households with small children, who are disconnected from their regular primary care doctors/pediatricians while they are living in a shelter. And finally, through HCWW’s Bridges to Moms program, homeless pregnant women being seen at Brigham and Women’s Hospital prenatal clinic receive intensive care management with the goal of improving birth outcomes and maternal bonding.

Since our inception, HCWW has received statewide and national recognition for our novel and cost-savings approach to the care of homeless women. We have always taken the long view, recognizing that there are no quick fixes and that the key to a successful outcome is developing a trusting relationship.


Impact Statement

HCWW’s major accomplishments over the past year include:

-In 2016, HCWW provided over 10,400 health care procedure and service visits and served nearly 1,800 women and their children. The top diagnoses among our clients were chronic, disease-related illnesses (diabetes and cardiovascular issues such as hypertension), health promotion (visits for vital signs checks and over-the-counter medicines for minor illnesses), muscular-skeletal illness (arthritis, sprains, fractures), respiratory illnesses (asthma, bronchitis, pneumonia), and psychiatric illness.

-As a result of our frequent, accessible and reliable presence, HCWW patients experience a reduction in preventable illness, emergency room visits, and hospital admissions. In 2016, 191 HCWW clients reported they visited our free medical clinics instead of the Emergency Room saving the Commonwealth an estimated $286,500.

-Since our Bridges to Moms program was launched in January 2016, 69 women have been referred to the program. Sixty-six babies have been born to date. Of the completed pregnancies, 80% of the prenatal appointments were attended. Seven of the moms went to 100% of their prenatal appointments. The post-partum appointment attendance rate is 67%. Typically, in this population, less than 10% of prenatal and nearly zero post-partum appointments are kept.

HCWW’ current goals include:

-Meet the immediate medical needs of homeless women and their children; delivering individualized health, personal choice and nutrition education; and reconnecting these women and their children to mainstream medical care.

-Complete comprehensive evaluations of the Bridges to Moms program and the new Family Shelter Clinic program in Framingham to determine next steps in creating sustainable models of care.

-Replicating the Bridges to Elders program at Rosie’s Place to help women manage their chronic disease-related illnesses and reduce unnecessary ER visits.


Needs Statement

Despite abundant local health, social service and government resources, homeless women still fall through Boston’s health care safety net. HCWW serves these women with the long view. No quick fixes, or hurried office visits. Our top needs include:


1) Support for nurses who are the hub of our clinic activity. They handle the day-to-day clinic operations, ensure effective communication for medical and case management services, oversee record keeping, and take the lead in coordinating referrals for the women in our care.

2) Support for Community Health Workers who conduct culturally and linguistically competent outreach, health education, appointment accompaniment, and care management for HCWW’s elderly patients enrolled in our Bridges to Elders and pregnant and post-partum mothers in our Bridges to Moms program.


CEO Statement

A Dose of Compassion
Dr. Roseanna Means Q&A, Boston Globe By Elizabeth Cooney
Globe Correspondent / September 6, 2010
Doctor fills health-care gap for homeless women
Q. You are one of 10 Americans recently honored by the Robert Wood Johnson Foundation with a Community Health Leaders Award for your work with Women of Means, the network of volunteer physicians providing free medical care to homeless women in the Boston area. What inspired you to create this team?
A. Here we are in Boston with some of the wealthiest and resource-rich medical institutions in the world and yet the women that I was take care of in the shelters did not have their voices heard.
Q. How is connecting to the health care system different for a homeless woman?
A. Suppose you wake up in the morning with a sore throat and you think you have strep. It's reflexive for you and I to think, "Oh, I better call my doctor.'' So you get an appointment, you go there, get seen, get a prescription filled, and within 24 hours you're feeling better. But if you are a homeless woman living in a shelter or running away from a batterer, you might not wake up in a place that is safe or healthy. You certainly won't have access to a phone, you might not have a primary care doctor, you might not have insurance, you might not speak their language, you don't have transportation. More importantly, in the world we live in, you don't feel worthy of getting care.
Q. You don't have a clinic, so how do you help the women?
A. We go into as many as 12 shelters in the Boston area on almost a daily basis. We provide free medical care and over-the-counter medical supplies.
Q. How do you win their trust?
A. I offer them validation and unconditional love and acceptance and understanding. Now that we're 10 years old, we have on the staff of all the Boston hospitals people who came through our [educational] program as medical students and residents. If a woman comes in and she has a host of illnesses or problems, we can say, "We know a really nice doctor at Brigham and Women's [for example] and she's been to [the shelter] Rosie's Place and knows what it's like. Let me make an appointment with her for you. We'll have someone take you to that first appointment so you don't get lost.'' The big irony is we are providing concierge care for homeless women, and we don't charge a dime.
Interview was condensed and edited.


Board Chair Statement

Please See Above.

Geographic Area Served

Greater Boston Region-All Neighborhoods

HCWW’s shelter-based clinics are located in Boston, Framingham and Waltham. These include Rosie's Place, Women's Lunch Place, and the Casa Myrna’s safe houses for domestic violence survivors, in addition to Framingham's South Middlesex Opportunity Council (SMOC) shelters and Waltham-based Mary’s Home. We also serve pregnant and post-partum mothers and babies through Brigham and Women’s Hospital.  


 

Organization Categories

  1. Health Care - Public Health
  2. Public & Societal Benefit -
  3. -

Independent research has been conducted on this organization's theory of change or on the effectiveness of this organization's program(s)

Yes

Programs

Bridges to Elders

Phase I of Bridges to Elders ran from 2013-2016 and was a partnership between HCWW and Commonwealth Community Care (CCC), supported by an Accountable Care Organization (ACO) contract with Commonwealth Care Alliance (CCA).  During that project, HCWW hired a Community Health Worker who worked with a Nurse Practitioner/Physician primary care team from CCC to provide primary care and care coordination to 45 impoverished women that we referred from the shelters.  These women were 65+ of age and had Medicare and MA Health Standard.  During the three years of the project, we were able to reduce ER visits by 86% and inpatient hospitalizations by 77%, compared to established benchmarks. 

Phase II of Bridges to Elders began in January 2017 when we hired a CHW to reach out to women 60+ years at Women’s Lunch Place. She is supported by a part-time nurse practitioner who oversees the clients’ clinical conditions and reports back to their primary care physicians. In Phase I of Bridges to Elders, the CHW was in the field, stopping only occasionally at the shelters because she was splitting her time between Women’s Lunch Place and Rosie’s Place. Now that we have embedded a CHW right in the shelter where she is more visible to the guests, she has been able to nearly double the number of clients that she can see: currently 75 in the first 8 months of 2017.

In 2018, HCWW will take Bridges to Elders to the next level, with the goal of demonstrating impact on managing chronic disease-related illnesses among our adult and aging clients in the Boston shelter clinic program and reducing ER visits and hospital admissions. With comprehensive data gathered at the end of 2018, we plan to secure an ACO contract or social impact funding to create a sustainable model. Over the next year, we will launch the following activities: 1) Add a second NP/CHW team at Rosie’s Place to complement the successful implementation of such a team at Women’s Lunch Place and track impact (HCWW is modifying its clinical database to include ICD-10 diagnosis codes to capture the HCWW clinicians’ evaluations and treatment of these common conditions.) 2) Secure contracts from 1-2 payors for the evaluation and treatment “bridge” care of chronic diseases that HCWW provides in the shelter clinics. 3) Track the number of encounters and diagnoses. And 4) Get feedback from the PCPs and Medicaid claims data to assess overall impact.
 
 
 
Budget  $98,920.00
Category  Health Care, General/Other Health Care, General/Other
Population Served Homeless Females Elderly and/or Disabled
Program Short-Term Success 
Patients achieve 'milestone' health behaviors. Examples include (a) came to HCWW instead of going to the Emergency Department; (b) took prescribed medications as asked; (c) followed through on advice and returned to see a HCWW clinician as asked; (d) agreed to meet with our volunteer psychiatrist; or (e) agreed to go to a medical appointment she otherwise would have missed with our Community Health Worker.
Program Long-Term Success 
Long-term success will include gathering sufficient clinical data to secure a contract with an Affordable Care Organization to create a sustainable model of care.
Program Success Monitored By 

HCWW’s clinical database system is an encrypted, HIPAA-protected open source medical record system, advocated by Google and Microsoft as the best platform for data collection for mobile teams in the field.

HCWW uses a Clinical Encounter Forms in each program to capture not only common diagnoses and our clients’ clinical status (e.g., blood pressure, blood sugar), but also milestone events that reflect the clients making healthy behavior choices. The underlying hypothesis of our intervention is that when clients continue to achieve milestones over the long-term, there are corresponding positive healthy outcomes (i.e. reduced ER visits and hospital admissions). The Clinical Encounter Form is completed at each visit and entered remotely into the new clinical database via an iPad provided to each clinician.

 
Examples of Program Success 

A HCWW nurse accompanied “Cheryl” to her laboratory appointment to ensure she completed a critically needed CAT Scan. Cheryl did not remember any pre-appointment instructions indicating that she should arrive 2 hours early to drink a contrast agent. The pair arrived only 30 minutes early. HCWW’s nurse asked the technician what options were available and impressed upon the technician how important it was that Cheryl complete this test. Fortunately, the technician allowed Cheryl to drink the contrast agent and take the scan an hour later.

The littlest details can hinder the best intentions of the homeless women in our care to independently manage their own health. For Cheryl, pre-appointment instructions were far down the list of immediate needs that she had to attend to daily. Through Bridges to Elders, patients like Cheryl receive support to navigate the health care system and improve their own health.


 


 

Bridges to Moms

Bridges to Moms began in January 2016. Our clinical team, which includes a physician, nurse practitioner and Community Health Worker (CHW) provides intensive care management for pregnant and post-partum homeless women enrolled at the Brigham and Women’s Hospital with the goal of improving health and birth outcomes and maternal bonding. Through September 30th of this year, 69 women have been referred to the program. Sixty-six babies have been born to date.  Of the completed pregnancies, 80% of the prenatal appointments were attended. Seven of the moms went to 100% of their prenatal appointments. The post-partum appointment attendance rate is 67%. Typically, in this population, less than 10% of prenatal and nearly zero post-partum appointments are kept. In addition to the unexpectedly high percentage of clinic appointments achieved, we are also thrilled to discover that some of the moms are working hard to move their lives forward by taking classes, earning their GEDs, obtaining a certificate from a course, etc. We are now tracking these accomplishments as a reflection of ‘forward mobility.’  The data point is being referred to as a ‘mobility index.’  


pasting
Budget  295,781
Category  Health Care, General/Other Health Care, General/Other
Population Served Homeless Females
Program Short-Term Success 
Short-term success will be measured through the following indicators:
- Actual attendance at prenatal and post-partum clinics vs scheduled visits
- Mother’s actual attendance in the NICU vs number of days that baby is in NICU
- Mother’s clinical status: blood pressure, hemoglobin a1c (blood sugar), medical co-morbidities and other clinical parameters over time
- Baby’s gestational age when born, baby’s newborn weight, APGAR scores, medical conditions, how many days baby is in NICU, baby’s discharge weight and disposition
- Ultimate disposition of family with baby (i.e. apartment vs shelter vs “scattered site”)
Program Long-Term Success 
Long-term indicators of success for the Bridges to Moms program include:
- Change in health outcomes for pregnant mothers participating in the program and resulting reduction in health care costs.
- Comparison of days spent in NICU – Bridges to Moms babies vs benchmark from BWH prenatal clinic and the cost savings. Our research indicates that the average daily cost of NICU care is $3,000.
- Comparison of the number of babies abandoned to foster care in the Bridges to Moms program versus prior benchmark years (data obtained from BWH prenatal clinic and Ob-Gyn department).  
Program Success Monitored By 
Program data is collected by the HCWW team (Dr. Roseanna Means, HCWW pediatric nurse practitioner and HCWW community health worker) and entered into HCWW's client database system.  We are also working closely with a research assistant at Brigham and Women's Hospital to track hospital clinical data. We will continue to track mom’s and baby’s health status, baby’s weight gain, number of sick-child visits and other developmental milestones for up to one year post-baby’s discharge.
Examples of Program Success 
Mom “Rosa” found out late in her pregnancy that she was carrying quadruplets. When she delivered her babies, she was in the process of being evicted from the crowded apartment that she shared with her brother’s family. She is now living temporarily in a motel until she gets housing. We have advocated for her at the housing office and are hopeful the family will get an apartment soon. She delivered 3 girls and one boy. The babies ranged in weight from 740 grams (about 1.6 pounds) to 865 grams (about 1.9 pounds). They have been cared for in the NICU, and “Rosa” visits every day. Two of the babies had severe intestinal defects and had to have corrective surgery. One of the baby girls didn’t make it after the surgery and was buried last week. We have provided taxi vouchers so mom and the father can visit the babies every day. We have given them meal vouchers so the family can eat healthy meals when they are at the hospital. The three babies are all being discharged this week. Bridges to Moms bought strollers and MBTA passes for the babies so the mom could travel more easily. These babies will need intense follow up care after discharge, but they know they can lean on us for help and guidance.

Family Shelter Clinic Program

In September 2017, HCWW launched its Family Shelter Care Program in Framingham.  Here, HCWW provides ‘gap’ care to homeless families, primarily single mother-headed households with children. Previously, HCWW served families living in motel shelters in Waltham and Danvers, until the state closed the program in late 2016 (although we still visit families at Mary's House in Waltham).  Now, HCWW is partnering with South Middlesex Opportunity Council (SMOC), a multi-service anti-poverty agency in Framingham.  HCWW will serve 45 families and their children who have been geographically disconnected from regular medical providers.  HCWW offers two clinic evenings a week and our goal is to help residents improve their health with self-care coaching, avoid emergency room visits and guide them to follow-up with their primary care. 


pasting
Budget  $50,000.00
Category  Health Care, General/Other Health Care, General/Other
Population Served Homeless Families
Program Short-Term Success 
Gap health-care for young homeless families; health education; and referrals to primary care
Program Long-Term Success 
Pediatric health is stabilized, and families are re-connected to primary care.
Program Success Monitored By 
HCWW tracks Family Shelter Clinic utilization, clinical metrics and milestone health behaviors.
Examples of Program Success 
Examples of Program Success to come

Medical Training & Education

HCWW mentors more than 100 medical students, nursing students and medical residents per year. Each trainee receives a copy of Medical Care for Homeless Women: A Curriculum for Novice Providers, written by HCWW. We prepare clinicians to be compassionate caregivers who are skilled at meeting the needs of the underserved.
Budget  $37,557.00
Category  Health Care, General/Other Health Care, General/Other
Population Served Homeless Females
Program Short-Term Success  Clinicians learn about the factors associated with homelessness and trauma in women and how to build a trusting and compassionate, clinical relationship with these patients.
Program Long-Term Success  Long term success is represented by the numbers of physicians and nurses trained at HCWW who carry their experience and commitment to community service on to their future practices. Typically HCWW averages 100 trainees per year. 
Program Success Monitored By  Each clinical trainee completes a written reflection. HCWW prescreens, interviews, and surveys all volunteer physicians formally each year. HCWW also gathers informal feedback to assess the effectiveness of the experience for both the physicians and patients.
Examples of Program Success 
One medical student reflected on her rotation at HCWW, “It made me more thoughtful about the effects of economic hardship on patient’s ability to afford and manage medications, treat chronic disease.

Another said, “It was incredibly helpful to learn about health care access outside of the standard hospital or clinic model, both to see how it works and to know that if I have patients who don’t feel comfortable coming to a hospital or clinic, they have other options for care.
Finally, “I learned to love foot care with Women of Means (Health Care Without Walls) and have remained very tender with feet in my current practice, even to the point of offering foot massages to hospitalized homeless patients.”

Shelter-Based 'Gap' Health Care

In our core program, HCWW provides “gap” health care for 1,800 homeless adult women at Rosie’s Place and Women’s Lunch Place, nearly a third of whom are age 60 or older. HCWW volunteer physicians and nurses staff nine weekday clinics and welcome clients on a drop-in basis. They offer diagnostics, referrals and health education.  Our team helps our clients stay on top of hypertension (blood pressure), diabetes (blood sugar) and skin and musculoskeletal conditions that are common for homeless women. This past year, our clinicians at Women’s Lunch Place and our nursing students at Rosie’s Place also offered weekly progressive muscle relaxation classes, guided meditation classes, reiki, a walking group and four presentations on women’s health issues.  


pasting
Budget  $381,602.00
Category  Health Care, General/Other Ambulatory & Primary Health Care
Population Served Homeless Females Families
Program Short-Term Success 
Short-term successes can be measured by 'milestone events' or improvement in health behaviors such as (a) came to HCWW instead of going to the emergency room; (b) took prescribed medications as asked; (c) followed through on advice and returned to see a HCWW clinician as asked; or (d) agreed to meet with our volunteer psychiatrist. These 'milestone events' are behaviors on the part of the women that demonstrate an intention toward self-healing or improved health. This data shows us that our clients want to get better or has learned how to move themselves forward. These are powerful indicators of the impact made by HCWW clinicians. 
Program Long-Term Success 

Long-term successes include improvements in clinical metrics and access to the health care system. These can be measured through improvements in blood pressure, blood sugar, weight, % completing 2 primary care visits per year, or number of ER visits averted. 

Program Success Monitored By 

HCWW’s clinical database system is an encrypted, HIPAA-protected open source medical record system, advocated by Google and Microsoft as the best platform for data collection for mobile teams in the field.

HCWW uses a Clinical Encounter Forms in each program to capture not only common diagnoses and our clients’ clinical status (e.g., blood pressure, blood sugar), but also milestone events that reflect the clients making healthy behavior choices. The underlying hypothesis of our intervention is that when clients continue to achieve milestones over the long-term, there are corresponding positive healthy outcomes (i.e. reduced ER visits and hospital admissions). The Clinical Encounter Form is completed at each visit and entered remotely into the new clinical database via an iPad provided to each clinician.

Examples of Program Success 

Client Profile: Rhonda was in her 50’s when HCWW first met her in the shelters. She was schizophrenic and living on the streets. You might never guess that she was homeless. To see Rhonda was to see a beautiful, articulate woman, who suffered from mental illness. Yet she was distrustful and did not take advice. She ignored any help for the swelling in her legs. Over a period of time, HCWW nurses and doctors gained her trust. Our volunteer psychiatrist finally convinced her to take an anti-psychotic drug. Her thinking cleared, and she found a primary care physician at the Brigham and Woman’s Hospital who was able to treat her cellulitis. For the ensuing years, she had her health monitored at the shelters by HCWW staff. At age 57, Rhonda died of acute heart failure, but not before she had the opportunity to die with dignity, surrounded by family -  and not on the street.


CEO/Executive Director/Board Comments

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Management


CEO/Executive Director Dr. Roseanna H. Means
CEO Term Start Aug 1999
CEO Email [email protected]
CEO Experience

Dr. Roseanna H. Means is the Founder and President of Health Care Without Walls, Inc. (HCWW, formerly Women of Means, Inc.).

Dr. Means has written and lectured extensively on issues pertaining to homelessness and is a passionate advocate and consultant for the unique needs of women who are homeless or marginally housed, particularly elderly homeless women. She has been recognized for distinguished community service by the Massachusetts Medical Society, Health Care For All, MIT Alumni Association, Tufts University Alumni Association, and Harvard Medical School, among others. In 2008, Dr. Means was awarded an honorary Doctor of Humane Letters by Babson College in recognition of her entrepreneurial leadership. In 2010, she was recognized as a Community Health Leader by the Robert Wood Johnson Foundation and in 2011, she was named as a CNN Hero. In 2012, she was recognized as a Woman of Courage and Conviction by the Boston Chapter of the National Council of Negro Women.

In addition to her role as President of HCWW, Dr. Means is a primary care physician on the staff of Brigham & Women's Hospital in the Division of Women's Health and serves as an Associate Clinical Professor of Medicine on the Harvard Medical School faculty, where she teaches and mentors medical students and residents about poverty medicine, access to care, health policy and social justice. Prior to launching HCWW, Dr. Means was the Program Medical Director of the Boston Health Care for the Homeless Program, where she was also the Medical Director of the Barbara McInnis House, a 75-bed residential recuperative facility for homeless persons.

A graduate of MIT (BS and MSc) and Tufts University School of Medicine (MD), she completed her residency in Internal Medicine at the Brigham and Women's Hospital.

Co-CEO --
Co-CEO Term Start --
Co-CEO Email --
Co-CEO Experience --

Former CEOs and Terms

Name Start End
-- -- --

Senior Staff

Name Title Experience/Biography
Ms. Linda Cundiff Chief Operating Officer Director of Operations Nancy DeFilippis offers 20 years of leadership in nonprofit management at Northeastern's Institute for Emergency Medical Services and the National Autism Center. 
Mr. John Dooley Chief Financial Officer --

Awards

Award Awarding Organization Year
CNN Hero CNN 2011
2010 Community Health Leader Robert Wood Johnson 2010
Point of Light Award Governor of Massachusetts 2006
Outstanding New Member Award Wellesley Chamber Of Commerce 2005
Bristol Lodge Recognition Award Bristol Lodge 2004
Citizens Bank Community Champion Award Citizens Bank 2004

Affiliations

Affiliation Year
-- --
Member of state association of nonprofits? Yes
Name of state association MNN

External Assessments and Accreditations

External Assessment or Accreditation Year
-- --

Collaborations

Health Care Without Walls (HCWW) works closely with shelters, health care providers, and other relevant partners to improve the health and quality of life for homeless women. HCWW partners with Rosie's Place, Women's Lunch Place, and the Casa Myrna Safe Houses in Boston as well as South Middlesex Opportunity Council (SMOC) in Framingham. These organizations administer the shelters, safe houses and transitional family housing sites where HCWW delivers free health care. In addition, HCWW partners with Brigham and Women’s Hospital to provide intensive care to homeless pregnant women in its Bridges to Moms program. 

CEO/Executive Director/Board Comments

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Foundation Comments

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Staff Information

Number of Full Time Staff 1
Number of Part Time Staff 21
Number of Volunteers 13
Number of Contract Staff 1
Staff Retention Rate % 50%

Staff Demographics

Ethnicity African American/Black: 4
Asian American/Pacific Islander: 5
Caucasian: 22
Hispanic/Latino: 4
Native American/American Indian: 0
Other: 0
Other (if specified): 0
Gender Female: 33
Male: 2
Not Specified 0

Plans & Policies

Organization has Fundraising Plan? Under Development
Organization has Strategic Plan? Under Development
Years Strategic Plan Considers 5
Management Succession Plan Yes
Business Continuity of Operations Plan --
Organization Policies And Procedures Yes
Nondiscrimination Policy Yes
Whistle Blower Policy No
Document Destruction Policy No
Directors and Officers Insurance Policy Yes
State Charitable Solicitations Permit Exempt
State Registration Exempt

Risk Management Provisions

Directors and Officers Policy

Reporting and Evaluations

Management Reports to Board? Yes
CEO Formal Evaluation and Frequency Yes Annually
Senior Management Formal Evaluation and Frequency Yes Annually
Non Management Formal Evaluation and Frequency Yes Annually

Governance


Board Chair Ms. Karen A Matjucha
Board Chair Company Affiliation Deloitte Consulting, LLP
Board Chair Term Feb 2017 - Jan 2018
Board Co-Chair --
Board Co-Chair Company Affiliation --
Board Co-Chair Term -

Board Members

Name Company Affiliations Status
Ms. Kristen Ferris Attorney, Morgan, Lewis and Bockius, LLP Voting
Ms. Mary E. Grant MS, RN Adjunct Faculty, Regis College & Endicott College Voting
Ms. Karen A. Matjucha Principal, Deloitte Consulting, LLP Voting
Ms. Omonigho (Omo) Omokwale Deloitte Consulting, LLP Voting
Laura Zug Quimby M.D. Medical Director, Essex County Correctional Facility Voting
Ms. Sarah Troiano Community Volunteer Voting

Constituent Board Members

Name Company Affiliations Status
-- -- --

Youth Board Members

Name Company Affiliations Status
-- -- --

Advisory Board Members

Name Company Affiliations Status
-- -- --

Board Demographics

Ethnicity African American/Black: 1
Asian American/Pacific Islander: 0
Caucasian: 5
Hispanic/Latino: 0
Native American/American Indian: 0
Other: 0
Other (if specified): --
Gender Female: 6
Male: 0
Not Specified 0

Board Information

Board Term Lengths 3
Board Term Limits 2
Board Meeting Attendance % 90%
Written Board Selection Criteria Yes
Written Conflict Of Interest Policy Yes
Percentage of Monetary Contributions 100%
Percentage of In-Kind Contributions 100%
Constituency Includes Client Representation No

Standing Committees

  • Board Governance
  • Communications / Promotion / Publicity / Public Relations
  • Development / Fund Development / Fund Raising / Grant Writing / Major Gifts
  • Finance

CEO/Executive Director/Board Comments

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Foundation Comments

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Financials


Revenue vs. Expense ($000s)

Expense Breakdown 2016 (%)

Expense Breakdown 2015 (%)

Expense Breakdown 2014 (%)

Prior Three Years Total Revenue and Expense Totals

Fiscal Year 2016 2015 2014
Total Revenue $1,006,122 $820,604 $1,225,103
Total Expenses $959,564 $790,980 $773,423

Prior Three Years Revenue Sources

Fiscal Year 2016 2015 2014
Foundation and
Corporation Contributions
-- -- --
Government Contributions $0 $0 $0
    Federal -- -- --
    State -- -- --
    Local -- -- --
    Unspecified -- -- --
Individual Contributions $950,203 $562,491 $1,126,939
Indirect Public Support -- -- --
Earned Revenue $36,500 $144,630 $97,870
Investment Income, Net of Losses $159 $122 $294
Membership Dues -- -- --
Special Events $19,185 $113,361 --
Revenue In-Kind -- -- --
Other $75 -- --

Prior Three Years Expense Allocations

Fiscal Year 2016 2015 2014
Program Expense $671,076 $470,689 $505,779
Administration Expense $155,609 $145,653 $175,005
Fundraising Expense $132,879 $174,638 $92,639
Payments to Affiliates -- -- --
Total Revenue/Total Expenses 1.05 1.04 1.58
Program Expense/Total Expenses 70% 60% 65%
Fundraising Expense/Contributed Revenue 14% 26% 8%

Prior Three Years Assets and Liabilities

Fiscal Year 2016 2015 2014
Total Assets $1,097,672 $1,018,307 $987,462
Current Assets $1,066,028 $1,011,268 $984,560
Long-Term Liabilities $0 $0 $0
Current Liabilities $51,626 $18,819 $17,598
Total Net Assets $1,046,046 $999,488 $969,864

Prior Three Years Top Three Funding Sources

Fiscal Year 2016 2015 2014
1st (Source and Amount) -- --
-- --
-- --
2nd (Source and Amount) -- --
-- --
-- --
3rd (Source and Amount) -- --
-- --
-- --

Financial Planning

Endowment Value $0.00
Spending Policy Income Only
Percentage(If selected) --
Credit Line No
Reserve Fund Yes
How many months does reserve cover? 6.00

Capital Campaign

Are you currently in a Capital Campaign? No
Capital Campaign Purpose --
Campaign Goal --
Capital Campaign Dates -
Capital Campaign Raised-to-Date Amount --
Capital Campaign Anticipated in Next 5 Years? --

Short Term Solvency

Fiscal Year 2016 2015 2014
Current Ratio: Current Assets/Current Liabilities 20.65 53.74 55.95

Long Term Solvency

Fiscal Year 2016 2015 2014
Long-term Liabilities/Total Assets 0% 0% 0%

CEO/Executive Director/Board Comments

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Foundation Comments

Financial summary data in the charts and graphs above are per the organization's IRS Form 990s. Contributions from Foundations & Corporations are listed under Individuals when the breakout was not available.
 
Please note, this organization changed its name in 2015 from Women of Means Inc to Health Care Without Walls Inc. Please refer to the above posted IRS Letter of Determination.

Impact

The Impact tab is a section on the Giving Common added in October 2013; as such the majority of nonprofits have not yet had the chance to complete this voluntary section. The purpose of the Impact section is to ask five deceptively simple questions that require reflection and promote communication about what really matters – results. The goal is to encourage strategic thinking about how a nonprofit will achieve its goals. The following Impact questions are being completed by nonprofits slowly, thoughtfully and at the right time for their respective organizations to ensure the most accurate information possible.


1. What is your organization aiming to accomplish?

Health Care Without Walls (HCWW) offers free, “bridging” health care to homeless women and their children in Greater Boston area shelters, safe houses and family transitional housing sites. This model is a Free Care Program which allows our clients to be seen as walk-ins in the shelter where other survival needs are being met. Formal registration and billing are intentionally set aside in order to improve access, build trust, and reduce as many bureaucratic barriers as possible. Ultimately, our goals include:

  • Improving the health status and quality of life of homeless women and their children;

  • Increasing the number of clinicians trained and dedicated to treating the poor;

  • Meeting the changing health care needs of homeless women aging in the shelter system; and

  • Enhancing the depth of our health care management services.

 

HCWW measures success by-- (i) meeting program utilization and medical trainee target numbers, (ii) increasing 'milestone' health behaviors such as taking medication as instructed; following through with a medical appointment; or completing a psychiatric exam; (iii) improving patients' clinical metrics such as blood pressure, blood sugar (diabetic women), or annual flu shot compliance; and (iv) setting and achieving health-related goals, such as reducing isolation and depression and improving medication understanding and compliance. 


2. What are your strategies for making this happen?

Since our inception, Health Care Without Walls (HCWW) has received statewide and national recognition for our novel and cost-savings approach to the care of homeless women. We have always taken the long view, recognizing that there are no quick fixes and that the key to a successful outcome is developing a trusting relationship. The following strategies and activities are the building blocks for our success today and in the future.

 

I. Shelter-based 'gap' health care is delivered by HCWW volunteer physicians and part-time, paid nurse care managers at Greater Boston clinics on a drop-in basis. They provide diagnostics, treatment, referrals and health education to fill the gap that exists between the needs of this population and their level of access to the health care system. In 2016, we will serve 2,500 women and children.

 

II. Community Health Workers provide culturally competent outreach, case management, individualized health education, patient navigator services, social supports, and advocacy for our most vulnerable populations – homeless elderly women and pregnant and post-partum homeless women who are patients at Brigham and Women’s Hospital.

 

III. Patient navigator services are provided to patients with cognitive impairments and/or mobility problems who need accompaniment to appointments at hospitals, laboratories, or specialists.

 

IV. Medical training and education are provided to over 100 medical and nursing students and medical residents each year. Each trainee receives a copy of "Medical Care for Homeless Women: A Curriculum for Novice Providers," written by HCWW. The HCWW team prepares clinicians to be compassionate caregivers who are skilled at meeting the needs of the underserved, and we emphasize the important role of volunteerism as a way to effect social change.

 

V. HCWW’s special programs meet the complex health needs of three vulnerable populations: elderly homeless women; families with young children; and pregnant and post-partum mothers and their babies. Through our Bridges to Elders Program, HCWW acts as the primary care ‘medical home’ to 50 Medicare and MA Medicaid eligible women. In Waltham, and beginning in Danvers in 2016, we provide ‘gap’ care to homeless families, primarily single mother-headed households with small children, who are being housed in motels and are disconnected from any regular medical provider for their family. Finally, this year, based on the success of Bridges to Elders, we have launched Bridges to Moms, a pilot program serving homeless pregnant and post-partum women and their babies at Brigham and Women’s Hospital – with the goal of improving health outcomes and maternal bonding.

 

3. What are your organization’s capabilities for doing this?

While there are many Boston-based social service agencies providing some services to homeless women and families, many of them operate independently, siloed by their singular missions. To our knowledge there are no programs that are focused exclusively on the holistic approach that HCWW takes with homeless women: identifying, tracking and closing the gaps between what happens to her when she walks away from the HCWW clinician at one of our sites (i.e. shelter, safe house, etc.) until we see her again. HCWW staff are, literally, the “human passports” that link the internal and external services and programs to the client, seeing her as a whole.

 

HCWW's staff team is led by Dr. Roseanna Means, who has practiced primary care on the staff of Brigham and Women’s Hospital for 30 years and was the former medical director of Boston Health Care for the Homeless. She has been identified by the Robert Wood Johnson Foundation as a 2010 Community Health Leader for developing a model for homeless health care delivery and has also been recognized by Harvard Medical School for her dedication to teaching and mentoring medical students about the care of homeless women. Dr. Means oversees our clinical team and is spearheading HCWW’s new Bridges to Moms pilot.

 

HCWW’s 17 volunteer physicians are accomplished, dedicated, and are affiliated with pre-eminent teaching institutions and health systems in the Boston area. They bring a range of specialty expertise including internal medicine, family medicine, pediatrics, psychiatry, OB/GYN, dermatology, and emergency medicine. In addition, HCWW maintains a paid staff of 16 part-time nurse care managers. The nurses support our volunteer physicians and provide responsive medical care and care management in our shelter-based clinics. The clinical staff is multilingual speaking Spanish, Portuguese, and Haitian Creole.

 

We have two multi-lingual, community health workers, both of whom are from Boston and bring cultural competence and essential experience accessing community resources. One works with our elderly homeless women at Rosie’s Place and Women’s Lunch Place. She provides outreach, health education, linkages to community resources, and care management in conjunction with the nursing team. The other has just started with our Bridges to Moms program and provides assistance to pregnant and post-partum women at Brigham and Women’s Hospital, with phone calls, transportation, and accompaniment to prenatal visits as well as specialist and laboratory appointments.

 

Finally, HCWW is governed by a diverse Board of Directors who provide fiscal and administrative oversight and offer core professional skills. All ten Board members donate funds and broaden the organization's visibility. The Board meets bi-monthly and holds an Annual Meeting in January. HCWW also receives guidance from two non-voting Boards including a 28-member Advisory Board and a 3-member Executive Advisory Board that provides professional advice and connections.

 

 

 

 

 

4. How will your organization know if you are making progress?

HCWW has always taken the long view, recognizing that there are no quick fixes and that the key to a successful outcome is developing a trusting relationship with each client.

 

HCWW measures progress in three areas by tracking utilization, clinical metrics, and 'milestone' health behaviors.

-- Utilization data includes the number of health care encounters or visits, health education sessions, patient navigator visits, and referral communications.

-- Clinical metrics are related to blood pressure, blood sugar (diabetic women), or annual flu shot compliance, for example.

-- Health behaviors or 'milestone events' are changes in behavior that reflect an intention toward improved health, such as taking medications as prescribed, getting a cell phone from the state domestic violence program, scheduling and following through with a medical appointment, or completing a psychiatric exam, among many other health behaviors.

 

HCWW’s clients achieve improvements in their health and quality of life because our care is immediate and free, available on a walk-in basis, provided in secure and familiar settings, and delivered by clinicians who are well known to the community of homeless women and skills in treating survivors of trauma.

 
 

5. What have and haven’t you accomplished so far?

In 2015, Health Care Without Walls changed its name to reflect the evolution of our organization, highlighting our commitment of bringing health care directly to where it is needed most – beyond traditional medical facilities.

 

HCWW has created and mobilized a community of long-term serving, volunteer physicians and sustained a modest nursing staff in order to respond to the unmet health care needs of homeless women who have fallen through Boston's health care safety net, despite abundant resources. We have provided free medical care via more than 100,000 clinical encounters to homeless women and their children in up to 12 shelters and safe houses. In addition, HCWW has trained nearly 1,000 medical and nursing students and residents in the principals of trauma informed, compassionate care.

 

As we look ahead to the future, HCWW seeks to demonstrate that contracting with an Accountable Care Organization (ACO) for program services under a global payment contract for a “Patient-Centered Medical Home” could improve health and save medical costs for special populations, including elderly and pregnant and postpartum homeless women. We believe that this “community of services” would fit the criteria for a global payment, creating a sustainable payment model for intensive case management and comprehensive health services, leading to improved health outcomes.