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Organization received a competitive grant from the Boston Foundation in the past five years No

Summary

Mission StatementMORE »

Founded in 1985 as one of the first Health Care for the Homeless programs in the country, Boston Health Care for the Homeless Program(BHCHP) is committed to a singular, powerful mission—to provide and assure access to the highest quality health care for Boston’s homeless men, women and children.

Mission Statement

Founded in 1985 as one of the first Health Care for the Homeless programs in the country, Boston Health Care for the Homeless Program(BHCHP) is committed to a singular, powerful mission—to provide and assure access to the highest quality health care for Boston’s homeless men, women and children.


FinancialsMORE »

Fiscal Year July 01, 2016 to June 30, 2017
Projected Income $54,417,723.00
Projected Expense $54,959,705.00

ProgramsMORE »

  • Behavioral Health Services
  • Dental Care
  • Family Outreach Services
  • Medical Respite Care
  • Primary Care Clinics

Revenue vs. Expense ($000s)

Expense Breakdown 2015 (%)

Expense Breakdown 2014 (%)

Expense Breakdown 2013 (%)

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


Overview

Mission Statement

Founded in 1985 as one of the first Health Care for the Homeless programs in the country, Boston Health Care for the Homeless Program(BHCHP) is committed to a singular, powerful mission—to provide and assure access to the highest quality health care for Boston’s homeless men, women and children.


Background Statement

In 1984, a coalition of health care professionals, homeless service providers, and elected officials came together to address the vast unmet medical needs of a growing homeless population. From their collective vision, BHCHP emerged as a new model of health services designed to meet the needs of homeless patients, one of 19 Health Care for the Homeless Projects across the nation. The following are key achievements and milestones that BHCHP has accomplished in its 30-year history:

• 1985: BHCHP began providing comprehensive primary care and dental services at multiple hospital and homeless sites, including a 25-bed medical respite unit at the Shattuck Shelter.

• 1987: BHCHP created the country’s first multidisciplinary HIV Team caring for homeless people.

• 1988: BHCHP was designated as a Federally Qualified Health Center and a 501(c)(3), enabling it to become the first Health Care for the Homeless project in the nation to receive reimbursement for services from Medicaid and Medicare.

• 1993: BHCHP purchased a former nursing home in Jamaica Plain and moved our in-patient medical respite unit to the 52-bed Barbara McInnis House. The first facility of its kind in the country, the Barbara McInnis House faced unrelenting demand, leading to an expansion to 72 beds in 1996 and to 90 beds in 2003.

• 1994: BHCHP responded to the growing number of deaths on the streets by creating a dedicated

Street Team, extending health services to people who avoid shelter and hospital clinics.

• 1995: BHCHP created a Behavioral Health Team to address the growing need for mental health services.

• 1996: BHCHP, in collaboration with the Laboratory of Computer Science at Massachusetts

General Hospital, created the nation’s first Electronic Medical Record for a homeless program.

• 2003: BHCHP dramatically expanded outpatient primary care services, assuming responsibility for the clinics at three of Boston’s largest homeless shelters: Pine Street Inn, Long Island Shelter, and Woods-Mullen Shelter.

• 2008: BHCHP opened the doors to Jean Yawkey Place, an integrated health facility serving homeless and recently housed men and women that unites medical, behavioral health, oral health and medical respite care to under one roof for the first time in the program’s history. Since then, BHCHP has been able to extend services to more patients in need of care, expand our medical respite program to 104 beds, and improve the quality of care that patients receive.


Impact Statement

BHCHP began in 1985 as a small program tucked within the walls of shelters, pioneering efforts to address the unmet medical needs and premature mortality of Boston's homeless patients. Today, BHCHP:

· Contributes a unique and critical level of services by providing comprehensive health care services to approximately 12,000 homeless men, women, and children over the course of a year;

· Delivers accessible health care at over 60 locations throughout the Boston area, operating clinics within shelters, homeless service organizations and soup kitchens, as well as hospital-based clinics on the campuses of Massachusetts General Hospital and Boston Medical Center;

· Provides medical, dental and behavioral health care, as well as case management services to the most vulnerable members of our community through the skills, talent and dedication of over 300 full-time and part-time employees, and over 100 volunteers;

· Plays an active role in strategies designed to end chronic homelessness by serving the complex health needs of newly--and often tenuously-- housed men and women through Housing First initiatives and permanent supportive housing programs; and

· Strives to eliminate the striking health disparities that homeless individuals and families endure by continuously evaluating the quality of care we provide and the health outcomes of the patients we serve, and adapting our care model to meet their needs.

 

Needs Statement

Each year, Boston Health Care for the Homeless Program provides high quality, comprehensive health care to approximately 12,000 homeless men, women and children across greater Boston by delivering care wherever they may be—in shelters, on the street, under bridges or in motels. To realize our mission, BHCHP relies upon on the generous contributions of time and treasure from members of our community who share our commitment to caring for those in need.

To assure that our patients are able to access the breadth of services they need to survive and be well, BHCHP strives to connect them with the health coverage for which they are eligible. Despite these efforts, many patients we serve do not have health coverage and many services we provide—such as case management and basic resources like undergarments and medications—remain unsupported despite their importance to our patients’ health. For this reason, BHCHP seeks the philanthropic support of individuals, foundations and corporations who believe in our mission and are dedicated to uplifting our community’s most vulnerable citizens.

BHCHP would not be able to provide the quality and scope of care that homeless patients need without the dedication of volunteers who generously donate their time and energy to improving the lives and health of the patients we serve. Whether as individuals or in groups, through activities with patients or administrative support, the work of our more than 100 volunteers has a lasting impact upon the lives of our patients.

When living in shelters, on the streets or in temporary housing, acquiring basic items—such as socks, toiletries, and season-appropriate clothing—can be a tremendous challenge for our patients, one that can further threaten their health and ability to access care. We invite corporations, schools and community groups to organize donation drives to meet these needs. The items that are gathered are distributed by doctors, nurses and case managers at our more than 60 clinics, and these contributions both improve the quality of care that patients receive, while helping our clinicians to develop and maintain the trusting relationships that are such an essential part of their work.


CEO Statement

Homelessness magnifies poor health, exposes those in crowded shelters to communicable illnesses such as tuberculosis and influenza, complicates the management of chronic diseases such as diabetes and AIDS, makes health care harder to access, and presents vexing obstacles that confound delivery systems. The lives of homeless people, fraught with fragmentation and loss, become overwhelmed by the relentless struggle for survival and unravel as tenuous connections to families and friends fray. Despite increased exposure to illness and trauma, health care easily becomes a distant priority, succumbing to the daily search for the food, clothing, and shelter. For nearly three decades, Boston Health Care for the Homeless Program (BHCHP) has been committed to providing health care that is comprehensive, compassionate, accessible, and of the highest quality to Boston’s homeless men, women and children. By maintaining a consistent presence in places that where homeless people are—in hospitals, shelters, motels, soup kitchens, and on the street—we now care for approximately 12,000 patients each year.

With strong levels of collaboration with virtually every shelter, hospital and homeless service organization in Boston, BHCHP delivers health care services at over 60 locations, ensuring that homeless individuals and families are able to access all of the services they need to improve their health and navigate a path out of homelessness. Our care model is designed to respond to the complex needs of our patients, integrating primary, behavioral health, and oral health care, along with the supportive services and resources they need to remain engaged in care, follow treatment plans and protect their health. BHCHP’s nationally-recognized medical respite program adds a unique and critical dimension of services for homeless men and women, providing 124 beds of round-the clock care and a safe place for patients to recuperate from surgeries, receive care while enduring rigorous treatments like chemotherapy or radiation, heal from trauma like bone fractures, or stabilize chronic illnesses such as diabetes. This program bridges the gap between costly and intensive inpatient hospital care and the health hazards that await in shelters or on the street.

Each day, BHCHP’s mission is brought to life by our clinical staff who are dedicated to bringing hope and healing to the most vulnerable people in our community. The cornerstones of BHCHP’s care are the trusting relationships formed between patients and health care providers, which assure continuity and consistency of care. We believe that this has been and will continue to be medicine that matters.


Board Chair Statement

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Geographic Area Served

In a specific U.S. city, cities, state(s) and/or region.
GREATER BOSTON REGION, MA

Boston Health Care for the Homeless Program (BHCHP) serves metropolitan Boston and Cambridge, a densely urban area that is home to more than 4million people. Though Boston is a city of distinct neighborhoods, homelessness knows no such bounds. It is a city wide problem, as is evidenced by the more than 60 homeless service locations scattered across greater Boston at which BHCHP provides care.

Organization Categories

  1. Health Care - Community Clinics
  2. Human Services - Homeless Services/Centers
  3. Mental Health & Crisis Intervention - Mental Health Treatment

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

Yes

Programs

Behavioral Health Services

While national estimates put the incidence of mental illness at 20-25%, BHCHP is acutely aware that the burden of mental illness among individuals experiencing homelessness is even higher. When homeless, each day brings tremendous obstacles to meet basic needs of food, shelter and clothing—obstacles that become seemingly insurmountable when compounded by behavioral health conditions. BHCHP’s Behavioral Health Team includes psychiatrists, psychologists, clinical social workers, behavioral health counselors and community support workers, and their work is increasing integrated with the primary care that our program provides, which helps to assure seamless access to much-needed services and improved quality of care. The core services provided by this team include psychiatry, individual and group counseling, child and family therapy, counseling and medication assisted therapies for substance use disorders, and referrals to recovery and rehabilitation programs.

Budget  $1,800,691.00
Category  Mental Health, Substance Abuse Programs, General/other Mental Health Treatment
Population Served Homeless Adults Poor,Economically Disadvantaged,Indigent
Program Short-Term Success 

BHCHP’s Behavioral Health Team develops strategies to identify the behavioral health conditions—including mental illness and substance use disorder--that homeless patients experience and improve access to and the quality of care.

As a crisis of opioid use disorder and overdoses has gripped our community, the need for action is clear. BHCHP’s health care teams see the devastating impact that opioid use disorder has upon the lives and health of people within its grip, particularly in the immediate vicinity of our main site, which has become the epicenter of the overdose crisis. As we strive to provide care that responds to the needs of homeless patients, our program is now undertaking several new and innovative initiatives to improve access to treatment for patients with substance use disorders and contribute to a decrease in the fatal and non-fatal overdoses that have come to characterize our community.

Program Long-Term Success 

BHCHP provides behavioral health services to families and adults in need by integrating behavioral health care with our delivery of primary care to patients across our program. The psychiatrists, licensed clinical social workers, licensed mental health clinicians and mental health interns on our Behavioral Health Team are present in our various clinical settings—alongside our outreach Family Team and Street Team, within Barbara McInnis House our 104-bed medical respite program, and embedded within our largest primary care clinic. Through this integration of medical and behavioral health care, BHCHP assures access to this important level of care, as well as cross-discipline collaboration amongst health care providers. Our new multi-service health care facility, Jean Yawkey Place, has presented an exciting opportunity to locate our core services under one roof and to enhance the integration of our behavioral and medical services.

Program Success Monitored By 

By BHCHP’s Electronic Medical Record, which tracks patient visits and contact, is crucial in program evaluation, data collection and reporting, allowing our program to assess the reach and effectiveness of the services we provide. This holds true for the Behavioral Health Team, as we are able to assess the rate of screenings for behavioral health conditions such as depression and anxiety, the utilization of behavioral health services, and the need to adapt our services to meet an unmet need amongst our patients. In assessing the integration of behavioral health and primary care for adults, BHCHP has also solicited the feedback of primary care providers and behavioral health providers to measure satisfaction and collect feedback.

Examples of Program Success 

Treating patients who are experiencing homelessness often requires flexibility, tenacity and the ability to adapt traditional models to meet each client’s individual needs. For example, the traditional 50-minute hour may be modified to a different length to better suit a patient’s capacity to sustain connection. Sometimes basic life needs--like accessing food, clothing and shelter--must be addressed before therapeutic work can begin, and only then can the work of setting personal therapeutic goals be implemented and successfully achieved. If substance abuse is an issue, it is addressed in partnership with the patients around his or her treatment goals.


Dental Care

Comprehensive oral health care is at once vital to the patients we serve, and yet too often overlooked amid the chaos of homelessness. Particularly for those who suffer from chronic illnesses such as HIV/AIDS and diabetes, small dental problems can rapidly escalate and bring about chronic mouth pain and disfigurement, which can impede their ability to eat properly, speak or seek employment. However, experiences of trauma, fear of being unable to afford dental care, and competing priorities of food and shelter often overshadow their ability to access care. Driven by our commitment to assuring access to much-needed health care for homeless men and women, BHCHP’s Dental Team provides a range of oral health services including preventive, restorative and emergency care at its two dental clinics—a full-time, five chair clinic located within Jean Yawkey Place, BHCHP’s multi-service health care facility, and a part-time, two-chair clinic located within Pine Street Inn.

Budget  $1,690,009.00
Category  Health Care, General/Other Dental Health Care
Population Served Homeless Adults Poor,Economically Disadvantaged,Indigent
Program Short-Term Success 

Now comprised of three full-time and one part-time dentist, a dental hygienist and five full-time dental assistants, the Dental Team performs approximately 10,000 dental visits each year serving nearly 3,000 patients. Over the upcoming year, BHCHP’s Dental Team will target specific measures to assess its progress in improving access to oral health care for homeless men and women and elevating the quality of care that they receive. Specifically, the Dental Team will strive:

· to engage more patients in oral health care through increased integration of oral health services with the primary care provided within our clinics, particularly targeting those living with chronic illnesses such as diabetes and HIV/AIDS;

· to increase the percentage of encounters that include an oral cancer screening and preventive services; and

· to increase the number of visits that include a screening for tobacco use and referrals to cessation support and resources.

 

Program Long-Term Success 

The overarching goal of BHCHP’s Oral Health Program is to assure that homeless men and women are able to access the high quality oral health services they need to address their immediate problems, engage in regular preventive care, identify undiagnosed health conditions and improve their overall health. By offering comprehensive oral health care in places that are accessible to homeless patients--under the same roof as our largest primary care clinic and 104-bed medical respite program and within New England's largest shelter--BHCHP:

· strives to ensure that patients are able to receive the breadth of services they need to identify and receive treatment for their health conditions,

· integrates oral health care with the delivery of primary care, and

· promotes engagement in preventative care, while also treating patients' immediate needs.

Program Success Monitored By 

The continually increasing volume of patients served by BHCHP’s Dental Team is a testament to the needs of homeless patients that have yet to be met. In 2014, over 2,800 patients received oral health care from BHCHP’s Dental Team through nearly 9,000 visits. BHCHP has seen a more than 110% increase in the number of patients able to access oral health services through our program since the opening of our new clinic at Jean Yawkey Place in 2008. The Dental Team will continue this growth over the upcoming year, delivering care to more patients in need. Using data captured in our Electronic Medical Record, BHCHP will monitor the number of patients served, the number and types of services provided, and our progress toward key quality health measures including regular cancer screenings.

Examples of Program Success 

The importance of oral health care is undeniable, as it supports a person’s systemic health and allows them to live healthy, productive lives. As we track our progress toward increasing access to care and quality health measures, the success of BHCHP’s Oral Health Program is also seen through our patients' experiences:

· from the patient who had pervasive painful periodontal disease and missing teeth who struggled to find employment due to her inability to speak properly until her condition was treated by our

· Dental Team and she was fitted for a new set of dentures;

· to the patient enduring painful infections and untreated dental conditions who finally was able to receive the care he needed and now regularly receives preventive care;
 
· to the patient undergoing radiation treatments for cancer who required many teeth to be removed and was able to undergo the extractions by a trusted dentist who then fitted him for dentures and restored his remaining teeth.

Family Outreach Services

Whether resulting from job loss, mounting medical debt, a home foreclosure, domestic violence or eviction, homelessness is a disorienting and traumatic experience. For over three years, the number of homeless families has overwhelmed the state family shelter system, causing hundreds to be placed in area motels as temporary homes, often far removed from their communities of origin and the resources they need to ensure their health and safety. As of October 2015, over 1,000 families are placed in widespread motels in addition to the more than 2,000 families living in shelters. Homelessness threatens the physical, emotional and mental health of families. BHCHP’s multidisciplinary Family Team mobilizes to ensure that families are able to access the services they need to survive and be healthy. The Family Team provides a trusted source of health care, supportive services and behavioral health care and is the medical presence in over 30 family shelters, domestic violence shelters and motels.

Budget  $1,352,221.00
Category  Health Care, General/Other Patient Care/Health Care Delivery
Population Served Homeless Families Poor,Economically Disadvantaged,Indigent
Program Short-Term Success 

In response to the extensive periods of homelessness that many families are experiencing—some for over two years—the Family Team is shifting its care model to provide shelter- and motel-based primary care. Over the coming year, BHCHP's Family Team will care for over 1,500 homeless parents and children through 7,000 outreach visits, responding to their complex health care and social needs, while providing them with the resources they need to remain healthy and engaged in care. Approximately 1,000 families will receive the care and support of Family Team case managers, who help them to overcome myriad social, economic and logistical hurdles on the path to improved health. Over 1,200 patients will receive direct care provided by Family Team physicians and nurses, including medical interventions to address conditions like asthma and diabetes; well child visits; public health interventions to prevent potential outbreaks of the flu and head lice; and evaluations of symptoms like rashes.

Program Long-Term Success 

BHCHP is committed to providing a source of medical care, behavioral health services, case management and material supports for families contending with the upheaval and isolation of homelessness. To this end, the Family Team targets the distinct needs of homeless families and mitigates the health disparities they experience. Delivering care at over 30 locations, the Family Team ensures that homeless families are able to access the health care and resources they need to manage their health and thrive as healthy people. Among its broad spectrum of services, the Family Team ensures that families receive:

· direct health care within shelters and motels delivered by physicians, nurse practitioners and nurses;

· referrals to prenatal, primary and pediatric care, as well as mental health and addiction services;

· on-site case management and connections to social services, food banks and food stamps; and

· assistance with applications for health insurance and housing.

Program Success Monitored By 

To track the Family Team’s progress over the upcoming year, BHCHP will utilize data captured within our Electronic Medical Record, which details the number of patients who receive care, the number of visits performed, the scope of services provided and key data pertaining to our patients’ health outcomes, such as Body Mass Index evaluations, tobacco cessation efforts, and routine cancer screenings. This information is used to assess our progress toward program goals, while also shining a light on the specific needs of the patients we serve and the ways in which our services may be adapted in order to effectively respond to these needs.

Examples of Program Success 

The success of the Family Team can be seen through the growing volume of patients that their services are able to reach, particularly as our community grapples with high rates of family homelessness. The Family Team is also assessing its impact by monitoring key patient information tracked in our EMR including the percentage of women up-to-date with cervical cancer screenings, childhood vaccinations, and BMI assessments and weight counseling when needed. However, the success of the Family Team is often best seen through the experiences of our patients:

*  the young, single mother who receives the guidance of a Family Team provider to understand the warning signs when her son needs medical attention for his asthma;

*  the homeless mother with a disabled child whose leg braces required special shoes that a Family Team nurse helped her to acquire; and

*  the pregnant woman who spoke little English and was unable to access food or prenatal care until she received the support of a Family Team case manager.


Medical Respite Care

A unique component of our care model, the Barbara McInnis House is a 104-bed medical respite program that provides round the- clock medical and nursing care to homeless men and women who are too fragile to return to shelters or the street, but do not need costly and intensive inpatient hospital care. Barbara McInnis House is designed to provide a safety net for homeless patients to recover from medical crises, surgeries and long-term illnesses under the care of exceptional teams of health care professionals. This program cares for patients who would otherwise have no place to go for pre- and post-operative care; for care while enduring radiation therapy; for recuperation from a broken limb; and even for end-of-life care. A stay at Barbara McInnis House is also, quite often, a unique opportunity for our patients to receive primary care, including physical exams and routine diagnostic tests.

Budget  $13,031,711.00
Category  Health Care, General/Other Patient Care/Health Care Delivery
Population Served Homeless Poor,Economically Disadvantaged,Indigent Adults
Program Short-Term Success 

Within this 104-bed medical respite facility, over the coming year, BHCHP plans to meet the following goals:

· To provide approximately 1,200 homeless men and women with 24-hour medical respite care provided by multidisciplinary health care teams with an approximate length of stay of 2 weeks;

· To respond to the referrals made by hospitals, clinicians, shelter and homeless service organizations seeking a safety net for their homeless clients who are too sick to return to shelters, but not sick enough to require a costly inpatient hospital stay; and

· In addition to medical, dental, and behavioral health care, to provide each patient with three balanced, healthy meals each day that are designed to meet their unique health needs, amounting to over 110,000 prepared meals each year, as well as daily opportunities for social interaction and creative expression through our Patient Activities Program.

Program Long-Term Success 

Barbara McInnis House improves quality of care and life for those less fortunate, while preventing needless expenses to the city, state and federal government. As lengths of hospital stays shorten, the need for respite care grows, bridging the gap between acute hospital care and the hazards of life in shelters or on the street. This program:

· Provides a safe environment in which homeless and newly housed patients may address a medical need under the care of multidisciplinary health teams;

· Responds to area hospitals as they strive to safely discharge patients who no longer need acute inpatient care but are too vulnerable to return to shelters or the street;

· Collaborates with shelters to prevent public health crises, providing a safe source of care for patients who may have communicable illnesses; and

· Provides a place of rest and care for homeless patients facing terminal diagnoses who may have fractured relationships and need a trusted source of end-of-life care.

Program Success Monitored By 

BHCHP’s Electronic Medical Record plays an integral role in evaluating the quality of services that we provide. For Barbara McInnis House, BHCHP monitors several measures including the number of patients served, number of admissions, average length of stay, sources of referrals, breadth of services provided, patient safety information and key health indicators. Despite continuously growing—most recently from 90 to 104 beds with the 2008 opening of Jean Yawkey Place—Barbara McInnis House continues to operate at full capacity, which is a testament to the demand for its unique level of care. Through an analysis of a sample of referrals from one area hospital over the course of a month, BHCHP found that of the referrals that could not be accommodated by Barbara McInnis House, 43% were declined due to the lack of an available bed. To increase access to this much-needed service, BHCHP is increasing its medical respite program by an additional 20 beds over the coming year.

 

Examples of Program Success  If not for Barbara McInnis House, Fernando and Mark would have needed prolonged, costly hospitalizations. Fernando, 72,only recently homeless, was too sick to work after an untreatable cancer metastasized. During this difficult time, he needed care and a place to live the remaining days of his life. Mark became Fernando’s roommate at McInnis House while recuperating after kidney stone surgery. Once a computer technician in one of Boston’s major law firms, Mark, 37, was in recovery after an addiction had left him with no home or income. Noticing a growth on his ear, Mark’s provider sent him for a biopsy, which showed that the growth was malignant and had invaded two lymph nodes. As he awaited surgery, the two roommates bonded over their shared experiences. Mark’s surgery and treatment were successful, and he soon moved into a residential recovery program. Fernando’s cancer progressed as expected, but he received the care and companionship to end his battle comfortably and with dignity.

Primary Care Clinics

As a nationally recognized model of innovative health care for homeless patients, BHCHP provides medical and primary care services at over 60 clinic sites across greater Boston through the work of its multidisciplinary health care teams. These teams engage homeless patients in places familiar to them: in family and emergency shelters, in area hospitals, under bridges, along back alleys, and countless other unconventional locations. The widespread locations where BHCHP operates primary care clinics include Massachusetts General Hospital, St. Francis House, New England Center for Homeless Veterans, Pine Street Inn, and Boston Medical Center.

While treating their immediate needs, BHCHP’s health care teams engage patients in preventive care, understanding that the early diagnosis and treatment of illness and assistance in adhering to treatment plans improves their lives and health while preventing minor symptoms from escalating into health crises.

Budget  $11,613,991.00
Category  Health Care, General/Other Ambulatory & Primary Health Care
Population Served Homeless Adults Other Health/Disability
Program Short-Term Success 

BHCHP’s largest primary care clinic—the BMC Campus Clinic—achieved Level Three recognition as a Patient Center Medical Home, and we are spreading this care model and seeking recognition for our busiest shelter-based clinics. This model emphasizes preventive care and improved integration and coordination of services. Through this model of care, BHCHP will strive to increase the percentage of diabetic patients who have an HgBa1c level of under 9, while also working to increase the percentage of hypertensive patients whose most recent blood pressure reading is under 140/90. BHCHP will emphasize preventive care such as increasing the percentage of women who receive regular Pap screenings and mammograms, growing the number of patients who receive key services such as flu shots, colon cancer screenings and depression screenings, and improving the number of patients who are assisted in tobacco cessation efforts.

Program Long-Term Success 

BHCHP is undertaking specific efforts to target gaps in care and unmet meets among the patients we serve. Continuing to make health care accessible to homeless patients and responsive to their unique needs, BHCHP is building upon its progress toward improved quality of care by providing services that respond to the unique barriers that homeless individuals and families face. To elevate the health outcomes of the patients we serve, BHCHP is committed to engaging patients in preventive care, allowing for early detection and treatment of illnesses, the prevention of avoidable or unnecessary use of emergency department care or inpatient hospital stays, and an overall improvement in their health and quality of life. Grounded in the knowledge that physical health and mental health are inextricably linked and that mental health conditions complicate medical care, BHCHP is increasing the integration of behavioral health and primary care and improving communication across disciplines.

Program Success Monitored By 

BHCHP’s early recognition that information technology is key in addressing the needs of transient patients seen at multiple locations has been integral to our success. In 1996, with the Laboratory of Computer Science at MGH, BHCHP created and implemented the first Electronic Medical Record (EMR) for a homeless program, dramatically improving our ability to provide and document care. Clinical information is stored in a centralized database, allowing for the input and retrieval from remote locations, which enables our staff to access medical records and communicate with one another from any of our more than 60 sites. The EMR improves continuity of care—essential to reducing health disparities and to diverting vulnerable patients from overburdened urgent care systems to ongoing primary care. Our information technology staff develops new forms to improve the management of clinical data, including recent efforts in the areas of diabetes management and women’s health screenings.

Examples of Program Success 

BHCHP has seen the impact that a coordinated and integrated level of care can have on patient engagement and health outcomes. For the year ending June 30, 2015, the quality health measures for BMC Campus Clinic patients represent rates of engagement and chronic disease management that are significantly higher than our program-wide measures:

• 72% of diabetic patients seen in the BMC Campus Clinic showed improved diabetes control, with A1C levels under 9,compared to 64% program-wide;

• 63% of eligible women seen in the BMC Campus Clinic were up-to-date with mammograms, compared to 47% program-wide;

• 64% of eligible women seen in the BMC Campus Clinic were up-to-date with cervical cancer screenings, compared to 54%program-wide; and

• 51% of patients between 50 and 75years old had received a colon cancer screening, compared to 33% program-wide.


CEO/Executive Director/Board Comments

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Management


CEO/Executive Director Mr. Barry Bock
CEO Term Start July 2013
CEO Email [email protected]
CEO Experience

Mr. Barry Bock has worked in the field of homeless health care since 1979. A registered nurse, in 1986, he was one of three nurses to develop the Morning Nurses' Clinic at Pine Street Inn in Boston. He then served as clinic administrator until 1990, when he joined Boston Health Care for the Homeless Program. When the Barbara McInnis House medical respite program was established, Mr. Bock served as the director, overseeing all aspects of the program, and was later appointed Boston Health Care for the Homeless Program's Chief Operating Officer. With his extensive experience and his leadership in pioneering new and effective services that meet the needs of homeless individuals and families, he has published and lectured on respite care, as well as on the management of communicable diseases in shelters. In 2012, Mr. Bock was named Chief Operating Officer for Boston Health Care for the Homeless Program.

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

Former CEOs and Terms

Name Start End
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Senior Staff

Name Title Experience/Biography
Pooja Bhalla MSN, RN Chief Operating Officer

Ms. Pooja Bhalla , RN, BSN, serves as the Chief Operating Officer of the program and has the overall responsibility for the clinical and program operations, developing and implementing policies and procedures that result in quality health care for homeless individuals and families. In conjunction with the Chief Medical Officer, Ms. Bhalla oversees quality improvement and utilization management for the program. Bhalla is a graduate of Simmons College of Nursing, where she received her BSN in 1997. She received her Master’s in, Leadership, Health Policy and Nursing Administration in 2014 from Northeastern University and now pursuing her Doctorate in Nursing Practice at Northeastern University and her research focus is on “Emerging Leaders and Homeless HealthCare”.

Ms. Bhalla joined BHCHP in 1997 and has worked with the homeless population since the beginning of her nursing career. In 2002, Ms. Bhalla along with the director of clinical operations led the efforts in establishing shelter clinics throughout the city to bring health care to homeless individuals. Today the program operates over 50 plus clinics throughout the city. Throughout her tenure, Ms. Bhalla has focused on bringing innovative practice models of care such as walk in access for behavioral health visits and access to preventive care measures during patient encounters. Ms. Bhalla is a member of the National Health Care for the Homeless Council and chair-elect for the steering committee of the clinicians network for the council.

Barry Bock RN Chief Executive Officer --
Dr. Denise De Las Nueces MD Medical Director

Dr. Denise De Las Nueces stepped directly into a leadership position at Boston Health Care for the Homeless Program in 2012, after completing her residency in Internal Medicine at Brigham and Women’s Hospital and her Masters of Public Health at the Harvard School of Public Health. As the Medical Director of the Barbara McInnis House, a 104-bed medical respite facility for over 1,000 homeless patients who are too sick for shelter or the streets, and a member of our Senior Management Team, Dr. De Las Nueces is responsible for clinical oversight of the care provided at this unique facility, including day-to-day bedside care, quality improvement, design of the care model, and the supervision of numerous clinicians.

In addition to her work at Boston Health Care for the Homeless Program, Dr. De Las Nueces also Co-Chairs BHCHP's Diversity and Inclusion Committee and has been appointed to the Steering Committee for the Boston Alliance for Community Health. She mentors young minority students at the high school and college level through the annual Biomedical Science Career Conference to encourage students interested in careers in biomedicine to pursue advanced studies and to provide advice, information and resources as they pursue their career paths in science-related fields. Dr. De Las Nueces also mentors minority students or students from economically disadvantaged backgrounds participating in the Poussaint Primary Care Scholars Program pre-matriculation program. In 2007, Dr. De Las Nueces served as a volunteer physician for Doctors for Global Health, providing general medical care in a rural clinic in Morazan, El Salvador for six months.

Dr. Jessie Gaeta MD Chief Medical Officer

Jessie M. Gaeta, MD, is the Chief Medical Officer of Boston Health Care for the Homeless Program, supervising the medical practice of BHCHP's physicians, nurse practitioners and physician assistants. She most recently served as the medical director for BHCHP’s Barbara McInnis House medical respite program from 2009-2011. Dr. Gaeta has strong clinical interests in respite care, medical education, and supportive housing. Her work in our respite program focused on designing systems that promote quality health care, collaborating with local hospitals, and improving end-of-life care for homeless persons.

 

Dr. Gaeta’s part time advocacy work for the Massachusetts Housing and Shelter Alliance since 2005 has focused on ending homelessness. She helped convince state lawmakers to appropriate resources in 2006 for a statewide Housing First model called Home & Healthy for Good, an innovative program designed to improve health and cost outcomes for newly housed tenants. Dr. Gaeta recently helped design a supportive housing program for the highest utilizers ofBostonMedicalCenter’s Emergency Room.

 

Dr. Gaeta earned her medical degree at University of Maryland School of Medicine.

Agnes Leung MHA Chief Financial Officer

Ms. Leung is responsible for planning, monitoring and reporting on the financial operations of the organization. She is also closely involved in long-term strategic program and financial planning.

 

Prior to receiving her Master of Health Care Administration and working in finance, Ms. Leung was a special education teacher in Hong Kong. She also holds degrees from York University, Toronto and the University of Massachusetts, Boston. Ms. Leung joined Boston Health Care for the Homeless Program in 1995.

Dr. Jim O'Connell MD President, Founding Physician, Street Physician

Dr. Jim O’Connell graduated summa cum laude from the University of Notre Dame in 1970 and received his master’s degree in theology from Cambridge University in 1972. After graduating from Harvard Medical School in 1982, he completed a residency in Internal Medicine at Massachusetts General Hospital. In 1985, Dr. O'Connell began fulltime clinical work with homeless individuals as the founding physician of the Boston Health Care for the Homeless Program, which now serves over 12,000 homeless persons each year in two hospital-based clinics (Boston Medical Center and MGH) and in more than 70 shelters and outreach sites in Boston. With his colleagues, Dr. O’Connell established the nation’s first medical respite program for homeless persons in 1985, with 25 beds nested within the Lemuel Shattuck Shelter. This innovative program now provides acute and sub-acute, pre- and post-operative, and palliative and end-of-life care in BHCHP’s 104-bed Barbara McInnis House. Working with the MGH Laboratory of Computer Science, Dr. O’Connell designed and implemented the nation’s first computerized medical record for a homeless program in 1995. From 1989 until 1996, Dr. O'Connell served as the National Program Director of the Homeless Families Program of the Robert Wood Johnson Foundation and the U.S. Department of Housing and Urban Development. Dr. O’Connell is the editor of The Health Care of Homeless Persons: A Manual of Communicable Diseases and Common Problems in Shelters and on the Streets. His articles have appeared in the New England Journal of Medicine, the Journal of the American Medical Association, Circulation, the American Journal of Public Health, the Journal of Clinical Ethics, and several other medical journals. Dr. O’Connell has been featured on ABC’s Nightline and in a feature-length documentary entitled “Give Me a Shot of Anything.” His first book, Stories from the Shadows: Reflections of a Street Doctor, was published in 2015 and featured on NPR’s Fresh Air with Terry Gross. He has received numerous awards, including the Albert Schweitzer Humanitarian Award in 2012 and The Trustees’ Medal at the bicentennial celebration of MGH in 2011. Dr. O’Connell is president of BHCHP and an assistant professor of medicine at Harvard Medical School.

Linda O'Connor Director of Development

As Director of Development, Ms. O’Connor guides the Development Department's efforts to secure private philanthropic support to advance the mission of BHCHP. As Capital Campaign Director, Ms. O’Connor led the organization’s first-ever capital campaign, raising $42 million for BHCHP’s new comprehensive medical facility atJean Yawkey Place.

 

Prior to joining the Development Department at BHCHP, Ms. O’Connor served as a volunteer on the program’s Development Advisory Board for five years, and held senior positions in development for the Jesuits of the New England Province, Pine Street Inn and the Orange County Community Development Council. 

Awards

Award Awarding Organization Year
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Affiliations

Affiliation Year
-- --
Member of state association of nonprofits? Yes
Name of state association Massachusetts League of Community Health Centers

External Assessments and Accreditations

External Assessment or Accreditation Year
-- --

Collaborations

In 1985, BHCHP became the first Health Care for the Homeless Program in the country to establish a medical practice of doctors, nurses, and physician assistants engaged full-time in direct care services to homeless people. Driven to meet the health care needs of Boston’s homeless individuals and families, we have developed strong relationships and extraordinary levels of collaboration with virtually every health care and homeless service agencies in Boston, including shelters, soup kitchens, hospitals, and community health centers located throughout the metropolitan area. These organizations include Pine Street Inn, Massachusetts General Hospital, St. Francis House, Latinas Y Ninos, New England Center for Homeless Veterans, Horizons for Homeless Children and Boston Medical Center. We cultivate a mutual relationship with these organizations that is grounded in the belief that homeless people need all of the resources and help possible, while reducing the likelihood of duplicated services. With a unique mission in the community, BHCHP cares for more homeless people than any other health care provider in Boston. The City of Boston relies upon BHCHP to be the health care provider for each shelter site, performing everything from primary care to public health interventions. 

CEO/Executive Director/Board Comments

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Foundation Comments

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Staff Information

Number of Full Time Staff 288
Number of Part Time Staff 59
Number of Volunteers 100
Number of Contract Staff 25
Staff Retention Rate % --

Staff Demographics

Ethnicity African American/Black: 129
Asian American/Pacific Islander: 28
Caucasian: 260
Hispanic/Latino: 52
Native American/American Indian: 0
Other: 6
Other (if specified): --
Gender Female: 372
Male: 103
Not Specified 0

Plans & Policies

Organization has Fundraising Plan? Yes
Organization has Strategic Plan? Yes
Years Strategic Plan Considers 5
Management Succession Plan --
Business Continuity of Operations Plan --
Organization Policies And Procedures Yes
Nondiscrimination Policy Under Development
Whistle Blower Policy Yes
Document Destruction Policy Yes
Directors and Officers Insurance Policy --
State Charitable Solicitations Permit --
State Registration --

Risk Management Provisions

--

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 Mr. Brett Painchaud
Board Chair Company Affiliation Vice President and Controller, Blue Cross Blue Shield of Massachusetts
Board Chair Term May 2011 -
Board Co-Chair Ms. Barbara Blakeney RN, MS
Board Co-Chair Company Affiliation Center for Innovations in Care Delivery, Massachusetts General Hospital
Board Co-Chair Term May 2011 -

Board Members

Name Company Affiliations Status
Mr. Larry Adams Consumer Voting
Ms. Sarah Anderson Esq. Greater Boston Legal Services Voting
Dr. Joe Avellone MD Executive Vice President, PARAXEL International Voting
Ms. Barbara Blakeney RN, MS Massachusetts General Hospital Voting
Mr. Scott Cronin Aerva, Inc. Voting
Mr. Tom Denher Health Management Associates Voting
Ms. Joanne Guarino Consumer Voting
Mr. Carlton Jones Resilient Systems, Inc. Voting
Mr. Kevin Leary VPNE Parking Solutions Voting
Mr. Steven Lipiner BNY Mellon Asset Management Voting
Mr. Brett Painchaud Blue Cross Blue Shield of MA Voting
Ms. Valeria Ramdin Massachusetts Promise Fellowship Voting
Ms. Sara Reid TransCEND/AIDS Action Committee, Consumer Voting
Dr. Lisa Rubinstein MD Psychiatry, Psychoanalysis and Mindfulness Training Voting
Mr. Leonard Simons Esq. Meyer, Connolly, Simons & Keuthen Voting
Dr. Brian J. Swann DDS, MPH Chief of Oral Health Services, Cambridge Health Alliance; Clinical Instructor, Harvard School of Dental Medicine and Havard School of Medicine Voting
Ms. Jean Tempel Retired Founder and Managing Director, First Light Capital, LLC Voting
Mr. Steve Tringale Chief Executive Officer, Tringale Health Strategies, LLC Voting
Mr. Steven M. Walsh Massachusetts Council of Community Hospitals Voting
Mr. Derek Winbush Community Volunteer Voting

Constituent Board Members

Name Company Affiliations Status
Larry Adams Consumer Advisory Board Co-Chair Voting
Raphael Garcia -- --
Joanne Guarino Consumer Advisory Board Member --
Richard Guido Consumer Advisory Board Member --
Warren Magee, Jr. Consumer Advisory Board Member --
Andrew Maier Consumer Advisory Board Member Voting
Shawnette Reed Consumer Advisory Board Member --
Sara Reid Consumer Advisory Board Member Voting
Caroline Smith Consumer Advisory Board Member --
Derek Winbush -- --

Youth Board Members

Name Company Affiliations Status
-- -- --

Advisory Board Members

Name Company Affiliations Status
Dr. Cary W. Akins MD Senior Cardiac Surgeon, Massachusetts General Hospital --
James Brett President and CEO, The New England Council --
James Champy Business Consultant & Author --
Eileen and Jack Connors Connors Family Office --
Jennifer and Dennis Eckersley Program Ambassadors --
Margaret Boles Fitzgerald Henry Luce Foundation --
Robin Glaser Vice President, The Kraft Group; Club Counsel, The New England Patriots NonVoting
Richard Grande Morgan Stanley Smith Barney --
Joanne Jaxtimer Senior Vice President, Director of Corporate Affairs, Mellon New England --
Richard C. Lord President and CEO, Associated Industries of Massachusetts, Inc. --
Daniel P. McQuade President, Tishman Construction of Massachusetts --
Jan Miller President and CEO, Wainwright Bank --
Alfred Minahan Partner, PretiMinahan Strategies --
Edmund F. Murphy III Empower Retirement --
Thomas P. O'Neill, III CEO, O'Neill and Associates --
Scott Rabshnuk Senior Vice President, Group Account Director, Hill Holliday --
Susan G. Reilly Program Ambassador --
Stephen Rosenfeld Esq. Rosenfeld & Rafik --
Paul Saperstein Paul E. Saperstein Co., Inc. --
Peter Smyth Chairman and CEO, Greater Media, Inc. --
John D. Spooner Managing Director/Wealth Management, Morgan Stanley Smith Barney --
Kirk A. Sykes President, New Boston Urban Strategy America Fund --
Suzy Welch Author, Television Commentator and Business Journalist --
Benaree Wiley Past President and CEO, The Partnership, Inc. --

Board Demographics

Ethnicity African American/Black: 5
Asian American/Pacific Islander: 0
Caucasian: 15
Hispanic/Latino: 0
Native American/American Indian: 0
Other: 0
Other (if specified): 0
Gender Female: 7
Male: 13
Not Specified 0

Board Information

Board Term Lengths --
Board Term Limits --
Board Meeting Attendance % --
Written Board Selection Criteria Under Development
Written Conflict Of Interest Policy Yes
Percentage of Monetary Contributions 72%
Percentage of In-Kind Contributions --
Constituency Includes Client Representation Yes

Standing Committees

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CEO/Executive Director/Board Comments

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Foundation Comments

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Financials


Revenue vs. Expense ($000s)

Expense Breakdown 2015 (%)

Expense Breakdown 2014 (%)

Expense Breakdown 2013 (%)

Prior Three Years Total Revenue and Expense Totals

Fiscal Year 2015 2014 2013
Total Revenue $49,476,332 $44,355,197 $40,171,473
Total Expenses $47,156,856 $43,358,066 $40,634,611

Prior Three Years Revenue Sources

Fiscal Year 2015 2014 2013
Foundation and
Corporation Contributions
-- $1,818,060 $1,533,033
Government Contributions $6,208,922 $6,993,008 $6,824,267
    Federal -- $3,262,069 $3,426,388
    State -- $3,188,125 $2,505,059
    Local -- $542,814 $751,346
    Unspecified $6,208,922 -- $141,474
Individual Contributions $4,689,336 $836,364 $1,161,485
Indirect Public Support -- -- --
Earned Revenue $37,126,211 $32,177,263 $29,277,781
Investment Income, Net of Losses $750,964 $1,819,170 $531,228
Membership Dues -- -- --
Special Events $455,900 $581,453 $446,603
Revenue In-Kind -- -- --
Other $244,999 $129,879 $397,076

Prior Three Years Expense Allocations

Fiscal Year 2015 2014 2013
Program Expense $38,308,406 $35,442,117 $32,674,632
Administration Expense $8,140,631 $6,980,959 $7,043,944
Fundraising Expense $707,819 $934,990 $916,035
Payments to Affiliates -- -- --
Total Revenue/Total Expenses 1.05 1.02 0.99
Program Expense/Total Expenses 81% 82% 80%
Fundraising Expense/Contributed Revenue 6% 9% 9%

Prior Three Years Assets and Liabilities

Fiscal Year 2015 2014 2013
Total Assets $69,858,209 $63,223,835 $58,478,858
Current Assets $14,445,405 $15,010,206 $14,980,299
Long-Term Liabilities $0 $0 $0
Current Liabilities $5,065,592 $4,262,628 $3,834,125
Total Net Assets $64,792,617 $58,961,207 $54,644,733

Prior Three Years Top Three Funding Sources

Fiscal Year 2015 2014 2013
1st (Source and Amount) -- --
-- --
-- --
2nd (Source and Amount) -- --
-- --
-- --
3rd (Source and Amount) -- --
-- --
-- --

Financial Planning

Endowment Value $6,705,827.00
Spending Policy --
Percentage(If selected) --
Credit Line No
Reserve Fund Yes
How many months does reserve cover? --

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 2015 2014 2013
Current Ratio: Current Assets/Current Liabilities 2.85 3.52 3.91

Long Term Solvency

Fiscal Year 2015 2014 2013
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 and corporations are listed under individuals when the breakout was not available.

Documents


Other Documents

No Other Documents currently available.

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?

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2. What are your strategies for making this happen?

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

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

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

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