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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
  • Medical Training & Education
  • Shelter-Based 'Gap' Health Care
  • Specialized Care for Families

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 seven 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 shelter-based clinics are staffed by 17 volunteer physicians, ten part-time nurse care managers, and two community health workers, who provide approximately 10,000 visits of bridging medical care and ancillary services to an average of 2,500 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: elderly homeless women, families with young children, and pregnant and post-partum mothers. 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.  And finally, through HCWW’s Bridges to Moms program, our clinical team provides intensive care management to improve health and birth outcome for homeless moms and newborns receiving services at Brigham and Women’s Hospital.

Throughout the year, HCWW doctors “give back” to the community while serving as mentors. Through their own carefully designed curriculum, they train over 100 medical students, nursing students, and residents each year.  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 offers free, “bridging” health care to 2500 homeless women and their children, in seven Greater Boston area shelters, safe houses and family transitional housing sites.

 Our major accomplishments over the past year include:

·        HCWW served 1,863 women at five shelter-based clinics in Boston, and over 600 of these women were over the age of 60. This is double the number of elderly women that we served last year.  In addition, we served 257 individual family members via 774 encounters at our family shelter-clinics in Waltham.

·        In the first six months of 2015, in our Bridges to Elders Program, there was an 86% drop in ER visits and a 77% drop in inpatient admissions, among the 43 women enrolled (having received two years of continuous service), compared to benchmarks established by Boston Health Care for the Homeless on a similar population. This represents a cost savings of $148,000 and $495,000, respectively, just for that period of time and those few patients.

·        In a study of personal goals set by the women in the Bridges to Elders program, 24 out of 25 women had reached all 3 of their goals and 1 had reached 2 of her 3 goals. The top three goals listed were: reducing isolation and depression; obtaining home services; and improving medication understanding and compliance.  All of these achievements result in improved self-esteem and self-worth, and ultimately translate into improved health and health outcomes.

In FY2016, HCWW goals include meeting the immediate medical needs of homeless women and their children in Boston; delivering individualized health, personal choice and nutrition education; and reconnecting these women and their children to mainstream medical care. In addition, building on the success of our Bridges to Elders Program, HCWW is launching a new pilot for homeless prenatal and postpartum women at Brigham and Women’s Hospital called Bridges to Moms with the goal of improving birth outcomes, maternal and newborn health and maternal bonding.


 


Needs Statement

Despite abundant local health, social service and government resources, homeless women still fall through Boston’s health care safety net. Homeless women are most vulnerable to risks of illness and premature death. Among Boston’s homeless women, 94% have multiple and complex medical issues, 70% have depression and 22% diabetes.  Our top needs include:

1)     Nurse leaders are the hub of clinic activity, providing ancillary care and support to volunteer physicians and medical trainees.  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 and community-based services for the women in our care.

2)      Community Health Workers 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. 

3)      Building on the success of our Bridges to Elders program, HCWW is launching Bridges to Moms at Brigham and Women’s Hospital.  Our clinical team will provide intensive care management for pregnant and post-partum homeless women with the goal of improving health and birth outcomes.  


 


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 seven shelter-based clinics are located in Boston 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 Waltham-based Mary’s Home and Home Suites Inn. We also serve pregnant and post-partum mothers and babies through Brigham and Women’s Hospital.  Finally, this year, we will expand our family shelter-based clinic program to Danvers.


 

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

Increasingly, homeless women are aging in the shelter system. This program of targeted outreach serves up to 50 women who are Medicare/MA Health-eligible through an ACO contract in partnership with a primary care team at Boston Medical Center. HCWW’s Community Health Worker (CHW) and onsite shelter-based clinicians provide gap medical care, health education and care coordination to these women at our shelter-based clinics. In addition, enrollees receive assistance with housing placement, transportation, medication management, and accompaniment to medical appointments. Now in our third year, the reduction in ER visits (86%) and hospitalizations (77%) shows the impact that our personalized and age- and context-specific services can have on cost-savings.

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 includes improved health outcomes, self-care and positive health decisions. 

In the first six months of 2015, after two years of continuous services in our Bridges to Elders program, there was an 86% drop in ER visits and a 77% drop in inpatient admissions among our enrolled clients. This represents a cost savings of $148,000 and $495,000, respectively. In addition, in a study of personal goals set by the women in the program, 24 out of 25 women had reached all 3 of their goals and 1 had reached 2 of her 3 goals. The top three goals listed were: reducing isolation and depression; obtaining home services; and improving medication understanding and compliance. All of these achievements result in improved self-esteem and self-worth, and ultimately translated into improved health and health outcomes.

Program Success Monitored By 
HCWW collects Medicare/Medicaid claims data, clinical metrics, and milestone behaviors to measure progress.
 
 
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

Building off of the successful model of Bridges to Elders, HCWW launched Bridges to Moms in 2016 for homeless pregnant women receiving services at Brigham and Women’s Hospital. Because of the myriad of barriers faced by homeless women compared to housed counterparts with adequate social supports, this population often struggles to show up for pre-natal appointments, follow through on medical orders, and adopt appropriate maternal care practices. A HCWW’s Nurse Practitioner and a Community Health Worker provide intensive care management, assisting the women with housing, transportation, parenting education, personal safety and food security; with the goal of improving health and birth outcomes and maternal bonding, especially for moms whose babies stay in the NICU. The HCWW team collectively speak 5 languages, and are available to meet each woman in the places she feels safest, from pregnancy through the first six months post-discharge, striving to close gaps in services.

Budget  $123,284.00
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 encrypted Open MRS client database system.  We are also working closely with a research assistant at Brigham and Women's Hospital to track hospital clinical data and track it to prior women seen at the hospital for comparison.
 
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  This program was launched in January 2016.  Already, HCWW has successfully advocated for new mothers to be placed into safer and appropriate housing and strengthened mother/baby bonding in the NICU. HCWW looks forward to sharing more comprehensive outcomes and success stories over the coming months.

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

Health Care Without Walls core program offers free 'gap' health care following a relational medicine approach to an average of 2,500 women and children at our 8 shelter-based clinics. Through weekly 2-4 hour clinic sessions, HCWW doctors and nurses establish trusting relationships with even the most hard-to-engage patients. Almost half of HCWW clinical encounters involve some form of case management such as patient education, chronic disease self-management, primary care and specialty referrals, medication management, transportation assistance, or escort to medical appointments. These supports are delivered in response to the access barriers experienced by the homeless, and they are important to the development of trusting clinical relationships. HCWW also outreaches to those challenged by mental illness, trauma, multiple co-morbid conditions, psychological fragility, age-related illness and substance abuse.

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; (d) got a cell phone from the state domestic violence program and now is able to make her own medical appointments; or (e) 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, even though the client is poor, desperate, distracted and needy in so many dimensions, she wants to get better or has learned how to move herself 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, for example. 

Program Success Monitored By 
Ongoing Performance Measures:
Performance indicators include numbers of visits, case notes, clinical metrics and behavioral measures or 'milestone' events that are recorded in HCWW's client database by clinicians following each encounter. In Summer 2016, HCWW is upgrading to an Open MRS client database management system. 
 
Multi-year Evaluation of Clients, Services, Processes and Outcomes:
HCWW completed the initial phase of an intensive study of our target population to better understand their characteristics, needs and barriers to well-being. Data collection included a meta-analysis of patient, clincian, and collaborator surveys, charts, interviews, longitudinal medical records, key informant observations. This study was funded by the Robert Wood Johnson Foundation. (A summary of preliminary results presented to the American Public Health Association 2012 Annual Conference have been uploaded to this profile).
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.


Specialized Care for Families

HCWW’s Family Shelter Clinic Program serves homeless families (primarily single mothers with children) at two transitional housing sites in Waltham: Mary’s House and Home Suites Inn. And starting in June, HCWW will pilot an expansion of this program at Danvers Hotel Extended Stay to 100 families. HCWW provides immediate medical care, advocacy and health education to connect these marginally housed families who are 'below the health care radar screen' to existing medical resources. Many of the mothers housed in these homeless motel shelter sites are struggling with depression as well as daily survival, and our HCWW clinical teams help them access the health care systems for themselves and their children.

Budget  $70,000.00
Category  Health Care, General/Other Health Care, General/Other
Population Served Homeless Families
Program Short-Term Success 
The immediate health care needs of homeless families (the majority of whom are headed by single women with young children) are met through walk-in visits to for cold/flu check ups, diagnostics for ear infection and pneumonia, asthma treatment, and flu shots.
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 
One evening at the Home Suites Inn Family Shelter Clinic in Waltham illustrates the walk-in care provided by HCWW. A new mom with a swaddled two month old daughter arrives with questions about feeding. Another mom brings her two active, yet coughing preschoolers in to be examined. The younger one sounds much better after a nebulizer treatment. A family of seven, who migrated from the Southeast U.S. for safety reasons, seek physicals for their youngest two. An expectant mom wants a blood pressure check and a few words about her recurrent depression. A dad arrives with concerns about his son's knee pain.
 
HCWW's team, a volunteer doctor and nurse care manager, conduct true 'gap' care, filling in where distant PCPs have left off. At times we translate complicated medical instructions and offer practical support. We also provide parent skills training as well as general health and wellness education.

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. 

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 Jewish Children and Family Services and Middlesex Human Services in Waltham and DHCD/Wellspring House at Danvers Hotel Extended Stay. 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. Finally, representatives from Hearth, Metropolitan Housing Partnership, Home Start, Dimock, the Mayor's Office and Boston Health Care for the Homeless served on a task force with HCWW, Rosie's Place and Women's Lunch Place to develop and implement what would become the Bridges to Elders program. These collaborations continue today as HCWW works with Commonwealth Community Care, an affiliate of Boston Medical Center to provide seamless health care to 50 aging homeless women in Boston.

CEO/Executive Director/Board Comments

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Foundation Comments

--

Staff Information

Number of Full Time Staff 2
Number of Part Time Staff 18
Number of Volunteers 17
Number of Contract Staff 4
Staff Retention Rate % 50%

Staff Demographics

Ethnicity African American/Black: 4
Asian American/Pacific Islander: 0
Caucasian: 34
Hispanic/Latino: 2
Native American/American Indian: 0
Other: 0
Other (if specified): 0
Gender Female: 38
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. Karen A. Matjucha Principal, 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
Ms. Susan Anderson Office of the Treasurer, MA Voting
Mr. Steve Biondolillo Biondolillo Associates NonVoting
Ms. Beth Boland Bingham McCutcheon, LLP --
Ms. Susie Brown Boston Center for Adult Education Voting
Ms. Jan Concannon Massachusetts General Hospital Voting
Ms. Christina Failma EMC Corporation NonVoting
Ms. Helen Gillcrist Liberty Mutual Insurance Voting
Ms. Paula Johnson MD Brigham and Women's Hospital Voting
Doug Johnston Business Consultant --
Mary Jones Retired --
Ms. Jann Leeming Little Family Foundation --
Mr. John McDonough Center for Health Policy and Management Voting
Ms. Angela Menino First Lady, City of Boston Voting
Mr. Joseph Morray EMC Corporation NonVoting
Mr. Sean Nabi Candidate for Juris Doctor, New England School of Law, Boston NonVoting
Ms. Abby Nguyen-Burke Eastern Bank Voting
Ms. Patricia Patricelli Special Events and PR Consultant Voting
Ms. Estie Rappaport Legal Consultant Voting
Mr. Rupal Shah MPH Community Volunteer NonVoting
Mr. John Strauss MD MA Behavioral Partnership Voting
Ms. Charlotte Trubiani RN Public Health Nurse (retired) NonVoting

Board Demographics

Ethnicity African American/Black: 0
Asian American/Pacific Islander: 0
Caucasian: 5
Hispanic/Latino: 0
Native American/American Indian: 0
Other: 0
Other (if specified): --
Gender Female: 5
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

--

Foundation Comments

--

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) -- --
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Financial Planning

Endowment Value $0.00
Spending Policy Income Only
Percentage(If selected) --
Credit Line No
Reserve Fund No
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.