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PART I, LINE 3C:
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FOR PATIENTS WHO FALL OUTSIDE COMMONWEALTH ASSISTANCE PROGRAMS, PATIENTS ARE CHARGED AT THE SAME LEVELS AS INSURERS ARE CHARGED; HOWEVER, THEY ARE OFFERED A PROMPT-PAY DISCOUNT (REGARDLESS OF INCOME LEVEL, ETC.) BASED ON THE UNCOMPENSATED CARE COST TO CHARGE RATIO IF THE PAYMENTS ARE MADE WITHIN THE FIRST 30 DAYS FROM THE AGREEMENT.INTRODUCTIONTHE STATUTE THAT CREATED BOSTON MEDICAL CENTER (BMC) REQUIRES IT TO SERVE ALL POPULATIONS. BMC IS A PRIVATE, NOT-FOR-PROFIT, 594-BED, URBAN ACADEMIC MEDICAL CENTER. IT EMPHASIZES COMMUNITY-BASED, ACCESSIBLE CARE AND IS GROUNDED BY ITS MISSION TO PROVIDE CONSISTENTLY ACCESSIBLE HEALTH SERVICESTO ALL IN NEED OF CARE, REGARDLESS OF STATUS AND ABILITY TO PAY. BMC IS THE LARGEST SAFETY-NET HOSPITAL IN NEW ENGLAND AND PROVIDES A FULL SPECTRUM OF PEDIATRIC AND ADULT CARE SERVICES FROM PRIMARY TO FAMILY MEDICINE TO ADVANCED SPECIALTY CARE. DRIVEN BY THE SOCIAL DETERMINANTS OF HEALTH THAT IMPACT HEALTH OUTCOMES AMONG OUR PATIENTS AND COMMUNITY, THE GOAL OF OUR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, OR COMMUNITY BENEFITS, IS TO IMPROVE COMMUNITY HEALTH.APPROXIMATELY 73% OF OUR INPATIENT DISCHARGES AND OUTPATIENT VISITS ARE FROM GROUPS THAT HAVE BEEN ECONOMICALLY AND SOCIALLY MARGINALIZED AND WHO RELY ON GOVERNMENT PAYERS, SUCH AS MEDICAID, THE HEALTH SAFETY NET, AND MEDICARE, FOR THEIR COVERAGE. ALMOST 30% OF OUR PATIENTS DO NOT SPEAK ENGLISH AS A PRIMARY LANGUAGE. TO ADDRESS THE HEALTH NEEDS OF ITS DIVERSE PATIENT POPULATION, BMC PROVIDES A WIDE RANGE OF SERVICES BEYOND THE TRADITIONAL MEDICAL MODEL. THESE PROGRAMS, INCLUDING BUT NOT LIMITED TO PATIENT NAVIGATION AND A FOOD PANTRY, HELP REDUCE BARRIERS TO ACCESSING HEALTH SERVICES AND ULTIMATELY ELIMINATE INEQUITIES IN HEALTHCARE AMONG THE PATIENT POPULATIONS BMC SERVES.WITH APPROXIMATELY 26,000 ADMISSIONS AND MORE THAN 1.1 MILLION PATIENT VISITS, BMC PROVIDES A COMPREHENSIVE RANGE OF INPATIENT, CLINICAL AND DIAGNOSTIC SERVICES IN MORE THAN 70 AREAS OF MEDICAL SPECIALTIES AND SUBSPECIALTIES. THE LARGEST 24-HOUR LEVEL I TRAUMA CENTER IN NEW ENGLAND, BMC'S EMERGENCY DEPARTMENT HAD APPROXIMATELY 122,000 PATIENT VISITS ANNUALLY.BMC SERVES THE URBAN COMMUNITY OF GREATER BOSTON. THE MAJORITY OF THE COMMUNITIES THAT BMC SERVES ARE LOCATED IN BOSTON CENSUS TRACTS THAT ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS/POPULATIONS. ALTHOUGH MASSACHUSETTS' UNIVERSAL CARE ENABLES INDIVIDUALS TO SEEK CARE AT ANY HOSPITAL, BMC REMAINS THE LARGEST SAFETY NET PROVIDER IN BOSTON AND NEW ENGLAND. AN ESTIMATED 17.5% OF BOSTON RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL. THE IMPLEMENTATION OF UNIVERSAL CARE DID NOT REDUCE THE REAL NUMBER OR PERCENT OF UNDERSERVED COMMUNITIES SERVED BY BMC. ACCORDING TO THE CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) MASSACHUSETTS HEALTH INSURANCE SURVEY'S 2023 RESEARCH BRIEF, AN ESTIMATE OF 1.7% OF RESIDENTS WERE UNINSURED DURING THE SURVEY OF WHICH 67.2% REPORTED EMPLOYER-SPONSORED INSURANCE (ESI) AND 31.9% REPORTED OTHER NON-ESI. STILL, INSURED RESIDENTS IN FAIR OR POOR HEALTH HAVE HIGH RATES OF AFFORDABILITY ISSUES WITH 14.8% REPORTING SPENDING A HIGH SHARE OF FAMILY INCOME ON OUT-OF-POCKET HEALTHCARE SPENDING. OF BMC'S PATIENTS IN 2023, MEDICAID MAKES UP 48.9%, MEDICARE IS 22.4%, UNINSURED IS 2.4%, PRIVATE COMMERCIAL IS 25.4%, WITH THE REMAINDER OF 0.9% ACCOUNTED FOR BY OTHER GOVERNMENT AND WORKERS COMP.PART I, LINE 5C:THE ORGANIZATION'S CHARITY CARE DID NOT EXCEED BUDGETED AMOUNTS. THE BUDGETED AMOUNTS ARE PREDICTED CHARITY CARE AMOUNTS. THE ORGANIZATION DID NOT HAVE ANY EXCESS FUNDS.
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PART I, LINE 7:
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FOR THE CALCULATION OF COSTS OF CHARITY CARE (LINE 7A) & MEDICAID COST (LINE 7B), AN OVERALL COST TO CHARGE RATIO WAS USED. A COST TO CHARGE RATIO IS DETERMINED BY DIVIDING THE TOTAL CHARGES FOR ALL SERVICES INTO THE TOTAL COST OF PROVIDING THE SERVICES. THE RATIO IS MULTIPLIED BY THE CHARGES FOR CHARITY CARE AND MEDICAID TO OBTAIN THEIR RESPECTIVE COSTS.FOR THE CALCULATION OF COMMUNITY HEALTH IMPROVEMENT SERVICES (LINE 7E) DISCRETE COSTING WAS USED. FOR THE CALCULATION OF HEALTH PROFESSIONS EDUCATION COST (LINE 7F) THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) COST ALLOCATION METHODOLOGY (CMS FORM 2552) WAS USED. CMS FORM 2552 IS A REQUIRED ANNUAL FILING TO THE FEDERAL GOVERNMENT.PART I, LINE 7, COLUMN F:THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE WAS $0.DURING FISCAL YEAR 2023, BMC RECOGNIZED NET FAVORABLE SETTLEMENTS FROM MEDICARE, MEDICAID, WELLSENSE, BLUE CROSS AND OTHER PAYORS RELATED TO PRIOR YEARS OF APPROXIMATELY $8,971,000.
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PART II, COMMUNITY BUILDING ACTIVITIES:
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BMC CONTRIBUTES TO THE COMMUNITY THROUGH ITS PAYMENT OF LINKAGE FEES TO THE CITY OF BOSTON. THOSE LINKAGE FEES FUND SUPPORT PROGRAMS FOR AFFORDABLE HOUSING AND NEIGHBORHOOD HEALTH CARE. BMC ALSO PROVIDES SUBSIDIES TO BOSTON HEALTHNET, WHICH SUPPORTS COMMUNITY-BASED SERVICES.PHYSICAL IMPROVEMENTS AND HOUSING:SOUTH BOSTON COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $600,000 FROM BOSTON MEDICAL CENTER DURING 2016 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JANUARY 26, 2016. COMMENCING JANUARY 26, 2017, BOSTON MEDICAL CENTER AGREED TO FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING COULD BE FORGIVEN IN TEN YEARS. IN FISCAL YEAR 2018, BOSTON MEDICAL CENTER INCURRED AN EXPENSE OF $540,000 TO FULLY RESERVE AGAINST THE NOTE RECEIVABLE AS IT WAS DETERMINED THAT NO FUTURE PAYMENTS WERE ANTICIPATED ON THE LOAN. THE LOAN AND RESPECTIVE RESERVE IS ACCOUNTED FOR ON THE BALANCE SHEET, ANNUALLY, EACH IS REDUCED BY THE FORGIVABLE AMOUNT.CAPITAL INVESTMENTS IN BOSTON HEALTHNET:WHILE THE NEED FOR COMMUNITY-BASED SERVICES CONTINUES TO GROW, IT HAS BECOME INCREASINGLY DIFFICULT FOR COMMUNITY HEALTH CENTERS TO MEET THE DEMAND. REIMBURSEMENT OFTEN DOES NOT COVER THE FULL COST OF CARING FOR THE COMPLEX NEEDS OF HEALTH CENTERS' DIVERSE PATIENT POPULATION. COMPOUNDING THIS PROBLEM, IN THE MID-LATE 1990S, MANY HEALTH CENTERS FOUND THEMSELVES OPERATING IN FACILITIES THAT WERE IN DESPERATE NEED OF RESTORATION OR EXPANSION. COSTLY INFORMATION TECHNOLOGY UPGRADES WERE ALSO REQUIRED TO ENHANCE MANAGEMENT EFFICIENCIES AND PATIENT CARE. IN RESPONSE TO THE HEALTH CENTERS' NEEDS, BMC PROVIDED APPROXIMATELY $16.9 MILLION IN DIRECT OPERATING SUPPORT TO THE BOSTON HEALTHNET HEALTH CENTERS IN FISCAL YEAR 2023 WITH $21.3 MILLION IN TOTAL SUPPORT FOR THE COMMUNITY HEALTH CENTERS FOR THAT SAME PERIOD. OTHER NET SUBSIDIES INCLUDE MOSTLY ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT.
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PART III, LINE 2:
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SCHEDULE H, PART III, LINE 3 REPORTS BAD DEBT EXPENSE AT COST. PATIENT PAYMENTS ON ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT ARE RECORDED AS A BAD DEBT RECOVERY, REDUCING THE GROSS BAD DEBT WRITE-OFF.
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PART III, LINE 3:
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THE ORGANIZATION ESTIMATED $0 OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) AS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY DUE TO THE MANNER IN WHICH THE DETAIL OF THE BAD DEBT EXPENSE IS PROCESSED IN ITS SYSTEM.
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PART III, LINE 4:
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THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED IN FOOTNOTES 2(S)(IV) AND 2(U) FOUND ON PAGES 16 AND 17 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS.
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PART III, LINE 8:
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MEDICARE ALLOWABLE COSTS OF $171,285,639 WERE CALCULATED USING THE CMS FORM 2552 METHODOLOGY OF DETERMINING MEDICARE COSTS. THIS USES THE STEP DOWN METHOD OF DETERMINING FULLY-ALLOCATED COSTS BY DISTINCT CLINICAL COST CENTERS AS DEFINED BY CMS. THESE FULLY-ALLOCATED COSTS ARE APPLIED AGAINST TOTAL CHARGES TO CALCULATE A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES BY DISTINCT CLINICAL COST CENTERS TO DETERMINE THE MEDICARE COSTS.
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PART III, LINE 9B:
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POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE HOSPITAL WILL NOT REQUIRE PRE-ADMISSION OR PRE-TREATMENT DEPOSITS FROM INDIVIDUALS REQUIRING EMERGENCY SERVICES OR DETERMINED TO BE LOW-INCOME. THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS:A. PATIENTS WITH MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN OF THE DISABLED, CHILDREN, AND FULL HEALTH SAFETY NET OR PATIENTS WITH COUNTY MEDICAL SERVICES PROGRAM OR PARTIAL HEPATOSPLENOMEGALY BELOW THE PROGRAM-DEFINED FEDERAL POVERTY LEVEL OR MODIFIED ADJUSTED GROSS INCOME GUIDELINE, OR OTHERS DETERMINED TO BE LOW-INCOME PATIENTS ARE EXEMPT FROM COLLECTION SUBJECT TO:1. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY LOW-INCOME PATIENT FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM.2. THE HOSPITAL MAY SEEK COLLECTION TO ALLOW A PATIENT TO MEET THE COMMONWEALTH ONE-TIME DEDUCTIBLE.3. THE HOSPITAL MAY ALSO INITIATE BILLING OR COLLECTION FOR A LOW-INCOME PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT WHO FAILS TO PROVIDE PROOF OF HIS OR HER PARTICIPATION AND WHOSE INSURANCE CANNOT BE VERIFIED IN THE HOSPITAL ELIGIBILITY SYSTEM. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, INCLUDING RECEIPT OR VERIFICATION FROM THE INSURANCE CARRIER, THE HOSPITAL SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES.4. THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON ANY LOW-INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW-INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW-INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL CEASE COLLECTION ACTIVITY FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THE PATIENT'S ELIGIBILITY.5. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.
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PART VI, LINE 2:
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IN 2022 AND FOR THE SECOND TIME, BMC CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COLLABORATION WITH COMMUNITY ORGANIZATIONS, BOSTON RESIDENTS, HEALTH CENTERS, HOSPITALS AND THE BOSTON PUBLIC HEALTH COMMISSION. THE BOSTON COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY HEALTH IMPROVEMENT PLAN COLLABORATIVE (THE COLLABORATIVE) FORMED IN 2019 TO UNDERTAKE THE FIRST BOSTON-WIDE CHNA AND CHIP. FOCUSING ON THE SOCIAL DETERMINANTS OF HEALTH AND USING A HEALTH EQUITY LENS, THE COLLABORATIVE EMPLOYED A PARTICIPATORY APPROACH THAT ENGAGED THE COMMUNITY IN EVERY STEP OF THE 2019 AND 2022 CHNAS.METHODSTHIS CHNA FOCUSES ON THE SOCIAL DETERMINANTS OF HEALTH AND IS GUIDED BY A HEALTH EQUITY LENS. IN THE U.S., SOCIAL, ECONOMIC, AND POLITICAL PROCESSES WORK TOGETHER TO ASSIGN SOCIAL STATUS BASED ON RACE AND ETHNICITY, WHICH MAY AFFECT ACCESS TO OPPORTUNITIES, SUCH AS EDUCATIONAL AND OCCUPATIONAL MOBILITY AND HOUSING OPTIONS, EACH OF WHICH ARE INTIMATELY LINKED WITHHEALTH. HISTORICAL OPPRESSION, INSTITUTIONAL RACISM, DISCRIMINATORY POLICIES, AND ECONOMIC INEQUALITY ARE SEVERAL ROOT FACTORS THAT SHAPE HEALTH INEQUITIES ACROSS THE U.S.REVIEW OF SECONDARY DATATHE 2022 BOSTON CHNA DATA GATHERING EFFORT INCLUDED A REVIEW OF EXISTING SECONDARY DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS. THESE INDICATORS PROVIDE INSIGHTS INTO PATTERNS ACROSS BOSTON, BY BOSTON NEIGHBORHOOD, AND BY POPULATION GROUPS WITHIN BOSTON. SECONDARY DATA SOURCES INCLUDED U.S. CENSUS/AMERICAN COMMUNITY SURVEY, VITAL STATISTICS (BIRTH/DEATH RECORDS), HOSPITAL CASE MIX DATA, BOSTON BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BBRFSS), BBRFSS COVID-19 HEALTH EQUITY SURVEY, YOUTH RISK BEHAVIOR SURVEY (YRBS), AND THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH BUREAU OF SUBSTANCE ADDICTION SERVICES TREATMENT DATA. THE SECONDARY DATA WORK GROUP OF THE COLLABORATIVE INCLUDED 16 MEMBERS REPRESENTING A RANGE OF ORGANIZATIONS, INCLUDING HOSPITALS, HEALTH CENTERS, AND LOCAL PUBLIC HEALTH. THE SECONDARY DATA WORK GROUP'S CHARGE WAS TO PROVIDE GUIDANCE ON SECONDARY DATA APPROACH AND INDICATORS AND FOSTER CONNECTIONS WITH KEY NETWORKS AND GROUPS TO PROVIDE RELEVANT DATA.TO IDENTIFY THE LIST OF SOCIAL, ECONOMIC, AND HEALTH INDICATORS, SECONDARY DATA WORK GROUP MEMBERS REVIEWED THE INDICATOR LIST FROM THE 2019 BOSTON CHNA AND PRIORITIZED WHICH INDICATORS SHOULD BE REVISITED FOR THE 2022 REPORT. THE SECONDARY DATA WORK GROUP ENGAGED IN MULTIPLE DISCUSSIONS AND PRIORITIZED THE SECONDARY DATA THAT ALIGNED WITH THE 2019 PRIORITY AREAS THAT COVID-19 HAD A DISPROPORTIONATE IMPACT ON, AND/OR WHERE THERE WERE THE GREATEST INEQUITIES BY RACE/ETHNICITY, NEIGHBORHOOD, OR OTHER CHARACTERISTICS.SECONDARY DATA IN THE 2022 CHNA REPRESENTS THE MOST RECENT DATA AVAILABLE, AND IN SEVERAL CASES OVERLAPS WITH DATA INCLUDED IN THE 2019 CHNA DUE TO THE NEED TO COMBINE DATA ACROSS YEARS TO LOOK AT PATTERNS BY NEIGHBORHOOD AND SOCIAL AND DEMOGRAPHIC FACTORS. QUALITATIVE DISCUSSIONS (DESCRIBED IN THE SECTION THAT FOLLOWS) BUILD UPON THE SECONDARY DATA BY SHEDDING LIGHT ON RESIDENTS' RECENT EXPERIENCES WITH AND PERSPECTIVES ON MANY FACTORS,INCLUDING THE SOCIAL DETERMINANTS OF HEALTH AND HOW THESE ISSUES HAVE BEEN AFFECTED BY THE COVID-19 PANDEMIC.QUALITATIVE DISCUSSIONS AND COMMUNITY ENGAGEMENT THE COMMUNITY ENGAGEMENT WORK GROUP INCLUDES 24 MEMBERS REPRESENTING A RANGE OF ORGANIZATIONS, INCLUDING HEALTH CENTERS, LOCAL PUBLIC HEALTH, COMMUNITY DEVELOPMENT, COMMUNITY-BASED ORGANIZATIONS, AND HOSPITALS. THE WORK GROUP'S CHARGE IS TO PROVIDE GUIDANCE ON THE APPROACH TO COMMUNITY ENGAGEMENT, INPUT ON PRIMARY DATA COLLECTIONS METHODS, AND SUPPORT WITH LOGISTICS FOR PRIMARY DATA COLLECTION. THE COLLABORATIVE'S COMMUNITY ENGAGEMENT WORK GROUP LED EFFORTS TO GAIN INSIGHT INTO COMMUNITY NEEDS AND STRENGTHS AS WELL AS PRIORITIES FROM COMMUNITY LEADERS AND RESIDENTS, ESPECIALLY AMONG THOSE WHERE THERE HAS BEEN A GAP IN REPRESENTATION IN PREVIOUS PROCESSES. ALTOGETHER, THEY FACILITATED 29 VIRTUAL AND IN-PERSON FOCUS GROUP DISCUSSIONS WITH A TOTAL OF 309 RESIDENTS WHO HAVE BEEN DISPROPORTIONATELY BURDENED BY SOCIAL, ECONOMIC, AND HEALTH CHALLENGES INCLUDING: YOUTH AND ADOLESCENTS, OLDER ADULTS, PERSONS WITH DISABILITIES, LOW-RESOURCED INDIVIDUALS AND FAMILIES, LGBTQIA+ POPULATIONS, RACIALLY/ETHNICALLY DIVERSE POPULATIONS (E.G., AFRICAN AMERICAN, LATINO,HAITIAN, CAPE VERDEAN, VIETNAMESE, CHINESE), LIMITED-ENGLISH SPEAKERS, IMMIGRANT AND ASYLEE COMMUNITIES, FAMILIES AFFECTED BY INCARCERATION AND/OR VIOLENCE, AND VETERANS. SOME FOCUS GROUPS WERE CONDUCTED IN LANGUAGES OTHER THAN ENGLISH, INCLUDING SPANISH, CHINESE, AND VIETNAMESE.COLLABORATIVE MEMBERS CONDUCTED KEY INFORMANT INTERVIEWS WITH 62 INDIVIDUALS. THESE REPRESENTED A CROSS-SECTION OF SECTORS TO IDENTIFY AREAS OF ACTION AND PERSPECTIVES ON THE COMMUNITY. THESE INTERVIEWEES INCLUDED LEADERS AND STAFF FROM PUBLIC HEALTH, HEALTH CARE, BEHAVIORAL HEALTH, THE FAITH COMMUNITY, IMMIGRANT SERVICES, HOUSING ORGANIZATIONS, ECONOMIC DEVELOPMENT, COMMUNITY DEVELOPMENT, RACIAL JUSTICE ORGANIZATIONS, SOCIAL SERVICE ORGANIZATIONS, EDUCATION, COMMUNITY COALITIONS, THE BUSINESS COMMUNITY, CHILDCARE CENTERS, ELECTED GOVERNMENT OFFICES, AND OTHERS.ADDITIONALLY, COLLABORATIVE MEMBERS CONDUCTED FOUR 90-MINUTE VIRTUAL COMMUNITY LISTENING SESSIONS IN JANUARY 2022. A TOTAL OF 122 COMMUNITY MEMBERS PARTICIPATED IN THESE FOUR SESSIONS. THESE SESSIONS OCCURRED MID-WAY INTO THE CHNA PROCESS AND PROVIDED AN OPPORTUNITY TO GATHER FEEDBACK AND INSIGHTS ON PRELIMINARY DATA FINDINGS AND POTENTIAL PRIORITIES AT THIS POINT IN TIME. DURING THESE SESSIONS, COLLABORATIVE MEMBERS SHARED PRELIMINARY THEMES FROM FOCUS GROUPS, INTERVIEWS, AND THE REVIEW OF SECONDARY DATA. THE PARTICIPANTS DISCUSSED THEIR REACTIONS AND FEEDBACK TO THESE PRELIMINARY FINDINGS IN SMALL GROUPS AND IDENTIFIED AREAS THAT WERE THEIR HIGHEST PRIORITY FOR ACTION.TO DEEPEN UNDERSTANDING OF ISSUES THAT WERE SALIENT TO RESPONDENTS, INTERVIEW, FOCUS GROUP, AND COMMUNITY LISTENING SESSION DISCUSSION GUIDES USED OPEN-ENDED QUESTIONS AND DID NOT ASK ABOUT SPECIFIC TOPICS. COMMUNITY ENGAGEMENT WORK GROUP MEMBERS AND THEIR PARTNERS CONDUCTED THE FOCUS GROUPS AND INTERVIEWS, AND THEN SUMMARIZED THE KEY THEMES FROM THE DISCUSSIONS THEY FACILITATED. THESE SUMMARIES WERE THEN ANALYZED TO IDENTIFY COMMON THEMES AND SUB-THEMES ACROSS POPULATION GROUPS AS WELL AS UNIQUE CHALLENGES AND PERSPECTIVES IDENTIFIED BY POPULATIONS AND SECTORS, WITH AN EMPHASIS ON DIVING DEEP INTO THE ROOT CAUSES OF INEQUITIES. FREQUENCY AND INTENSITY OF DISCUSSIONS ON A SPECIFIC TOPIC WERE KEY INDICATORS USED FOR EXTRACTING MAIN THEMES.KEY FINDINGS THAT EMERGED FROM THE CHNA INCLUDED HEALTH CARE ACCESS AND UTILIZATION, CHRONIC DISEASES AND RISK FACTORS, MENTAL HEALTH AND SUBSTANCE USE DISORDER, VIOLENCE, HOUSING AFFORDABILITY, AND ENVIRONMENTAL HEALTH.UNWAVERING IN OUR COMMITMENT TO ADDRESS THE HEALTH NEEDS OF OUR COMMUNITY, BMC PROVIDES A WIDE RANGE OF PROGRAMS BEYOND THE TRADITIONAL MEDICAL MODEL TO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. CORE TO FULFILLING OUR PUBLIC HEALTH MISSION AND CONSISTENT WITH THE CHNA FINDINGS, THE GOALS OF OUR COMMUNITY BENEFITS PROGRAM ARE TO IMPROVE ACCESS TO HEALTH SERVICES AND IMPROVE HEALTH OUTCOMES FOR UNDER-RESOURCED POPULATIONS IN OUR COMMUNITY.
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PART VI, LINE 3:
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THE HOSPITAL POSTS NOTICES OF AVAILABILITY OF FINANCIAL ASSISTANCE IN: I. INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT AND WAITING AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; IV. BUSINESS OFFICE AREAS THAT ARE OPEN TO PATIENTS. POSTED NOTICES ARE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. THE HOSPITAL ALSO INCLUDES A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL INITIAL BILLS. WHEN THE PATIENT CONTACTS THE HOSPITAL, THE PATIENT FINANCIAL SERVICES STAFF NOTIFIES THE PATIENT IF THEY QUALIFY FOR A PAYMENT PLAN. A PATIENT WHO IS ENROLLED IN A PUBLIC FINANCIAL ASSISTANCE PROGRAM (FOR EXAMPLE, MASSHEALTH, HEALTH SAFETY NET, OR FOR MEDICAL HARDSHIP) MAY QUALIFY FOR CERTAIN PLANS. PATIENTS MAY ALSO QUALIFY FOR ADDITIONAL ASSISTANCE BASED ON THE HOSPITAL'S OWN INTERNAL CRITERIA FOR FINANCIAL ASSISTANCE. FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL ASSISTS THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH CONNECTORCARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTH START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM. ALL SIGNS AND NOTICES ARE TRANSLATED INTO LANGUAGES OTHER THAN ENGLISH IF A LANGUAGE IS SPOKEN BY 5% OR MORE OF THE POPULATION RESIDING IN THE HOSPITAL SERVICE AREA. CURRENTLY, THE HOSPITAL TRANSLATES THE NOTICES INTO ENGLISH, PORTUGUESE, SPANISH, VIETNAMESE, AND HAITIAN CREOLE.
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PART VI, LINE 4:
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COMMUNITY INFORMATIONPLEASE SEE INTRODUCTION.
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PART VI, LINE 5:
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PROMOTION OF COMMUNITY HEALTHHEALTH CARE ACCESSBIRTH SISTERS: BIRTH SISTERS ARE COMMUNITY MEMBERS TRAINED BY BMC TO PROVIDE SUPPORT TO PREGNANT BMC PATIENTS FROM THEIR OWN COMMUNITIES DURING PREGNANCY, CHILDBIRTH AND EARLY PARENTHOOD. BIRTH SISTERS OFFER CHILDBIRTH AND PARENTING EDUCATION, CONNECT THEIR CLIENTS TO COMMUNITY AND HOSPITAL-BASED RESOURCES, PROVIDE CONTINUOUS LABOR SUPPORT, AND SUPPORT THEIR CLIENTS IN THE EARLY POSTPARTUM PERIOD. THE BIRTH SISTERS PROGRAM HAS BEEN LINKED TO SIGNIFICANTLY HIGHER BODY/BREASTFEEDING RATES AND FEWER CESAREAN BIRTHS. THE PANDEMIC REQUIRED SHIFTS IN SERVICE PROVISION, MOST NOTABLY, THROUGH THE UTILIZATION OF VIRTUAL SUPPORT STRATEGIES TO BUILD CONNECTION BEFORE AND AFTER BIRTH. DURING THE 2023 FISCAL YEAR, BIRTH SISTERS PROVIDED SUPPORT FOR 210 PATIENTS.CATALYST CLINIC: IN MAY 2016, BOSTON MEDICAL CENTER LAUNCHED THE CATALYST CLINIC (CENTER FOR ADDICTION TREATMENT FOR ADOLESCENT/YOUNG ADULTS WHO USE SUBSTANCES), A PROGRAM DESIGNED TO TREAT YOUNG PEOPLE AGED 25 AND UNDER WHO ARE STRUGGLING WITH SUBSTANCE USE, OR WHO HAVE EXPERIMENTED WITH DRUGS AND ALCOHOL AND MAY BE AT RISK FOR DEVELOPING AN ADDICTION.THE CATALYST CLINIC TEAM WORKS TO PROVIDE INTERDISCIPLINARY, TEAM-BASED CARE THAT INCLUDES PHYSICIANS, A NURSE, TWO SOCIAL WORKERS, A RECOVERY SUPPORT NAVIGATOR AND A PROGRAM MANAGER. THE CATALYST CLINIC TEAM WORKS TOGETHER TO OFFER ASSESSMENT, DIAGNOSIS, AND TREATMENT OF VARIOUS SUBSTANCE USE DISORDERS, AS WELL AS FACILITATES THE TRANSITION FROM ADOLESCENT TO ADULT CARE WHEN APPROPRIATE. IN FISCAL YEAR 2023, THE CATALYST CLINIC RECEIVED APPROXIMATELY 114 REFERRALS TO THE CLINIC; 839 REFERRALS HAVE BEEN RECEIVED SINCE THE PROGRAM'S INCEPTION.THE CENTER FOR THE URBAN CHILD AND HEALTHY FAMILY (THE CENTER): THE CENTER, LAUNCHED IN 2016, IS CATALYZING BMC'S VISION OF MAKING BOSTON ONE OF THE HEALTHIEST CITIES IN THE WORLD BY ENSURING EVERY CHILD HAS AN EQUAL OPPORTUNITY TO BE HEALTHY AND ACHIEVE THEIR FULL POTENTIAL. AS SUCH, THE CENTER IS CREATING A SYSTEM OF PEDIATRIC HEALTH CARE THAT ACTIVELY PROMOTES HEALTH EQUITY AND ERADICATES DISPARITIES. AS AN INNOVATION HUB WITHIN THE DEPARTMENT OF PEDIATRICS, THE CENTER CREATES AND TESTS INNOVATIVE HEALTH CARE DELIVERY MODELS, WORKING IN PARTNERSHIP WITH FAMILIES, COMMUNITIES AND OTHER CHILD- AND FAMILY-SERVING SECTORS.THE CENTER HAS SET A GOAL THAT BY 2028, ALL CHILDREN CARED FOR BY BMC PEDIATRICS WILL BE HEALTHY AND READY TO LEARN WITH ADEQUATE SUPPORTS TO THRIVE BY AGE FIVE. TO ACHIEVE THIS GOAL, THE CENTER CO-DEVELOPED A NEW MODEL OF PEDIATRIC PRIMARY CARE, THE PEDIATRIC PRACTICE OF THE FUTURE, WITH FAMILIES AND PEDIATRIC PROVIDERS. THIS MODEL SUPPORTS WHOLE FAMILY DEVELOPMENT WITH ATTENTION TO FACTORS INFLUENCING WELL-BEING AND BRINGING TOGETHER CARE IN A SYSTEMATIC, EQUITABLE WAY TO PROMOTE WELLNESS THROUGHOUT THE LIFE COURSE. THE CENTER IS PILOTING THE NEW MODEL INITIALLY AIMED AT FAMILIES WITH NEWBORNS, AND IS COLLECTING DATA TO UNDERSTAND ITS IMPACT. THE PILOT LAUNCHED IN JANUARY 2020 AND HAS SINCE ENROLLED 1100 PATIENTS. ULTIMATELY, A FINANCIALLY SUSTAINABLE MODEL WILL BE SCALED TO THE LARGER PRIMARY CARE PRACTICE. IN ADDITION, THE CENTER IS SUPPORTING AN INTEGRATED MEDICAL HOME FOR FAMILIES IMPACTED BY SUBSTANCE USE DISORDER AND AN INNOVATIVE ASTHMA CARE PROGRAM TARGETED AT OUR URBAN PEDIATRIC POPULATION.LIVING WELL AT HOME (LWAH, FORMERLY ELDERS LIVING AT HOME PROGRAM): THE GOAL OF LWAH IS TO HELP OLDER ADULTS AND PERSONS WITH DISABILITIES WHO ARE HOMELESS OR AT RISK FOR HOMELESSNESS SECURE AND MAINTAIN A PERMANENT RESIDENCE AND LIVE AS INDEPENDENTLY AS POSSIBLE. LWAH SERVED OVER 650 CLIENTS DURING FISCAL YEAR 2023 IN HOUSING HOUSING SEARCH AND PLACEMENT SERVICES. OF THESE CLIENTS, 355 WERE NEWLY ENROLLED DURING THE FISCAL YEAR, AND 189 WERE HOUSED OR HAD THEIR TENANCY PRESERVED. THE SUCCESS RATE OF LWAH'S STABILIZATION SERVICES IN OUR BOSTON HOUSING AUTHORITY SUPPORTIVE HOUSING PROGRAM IS 98%. IN 2023, AN ADDITIONAL 176 CLIENTS WERE SERVED THROUGH A COMMUNITY-BASED COMPLEX CARE MANAGEMENT PILOT DESIGNED TO IMPROVE HEALTH OUTCOMES FOR FRAIL RESIDENTS OF AN ELDERLY/DISABLED HOUSING COMPLEX IN ROXBURY AND ANOTHER IN CAMBRIDGE.GROW CLINIC: THE GROW CLINIC WAS FOUNDED IN 1984 WITHIN BMC'S DEPARTMENT OF PEDIATRICS. THE PRIMARY GOAL OF THE GROW CLINIC IS TO PROVIDE COMPREHENSIVE MULTIDISCIPLINARY MEDICAL, NUTRITIONAL, SOCIAL SERVICES AND DEVELOPMENTAL SUPPORT TO CHILDREN FROM THE GREATER BOSTON AREA DIAGNOSED WITH FAILURE TO THRIVE (FTT). CHILDREN WITH FTT HAVE SIGNIFICANT DIFFICULTY GROWING BECAUSE OF MALNUTRITION ASSOCIATED WITH ILLNESS, POVERTY, AND OTHER FAMILY STRESSORS. THE EFFECTS OF FTT INCLUDE SHORTENED ATTENTION SPANS, EMOTIONAL PROBLEMS, DELAYED COGNITIVE DEVELOPMENT, LASTING GROWTH FAILURE, AND FREQUENT SERIOUS ILLNESS, WHICH CAN RESULT IN HOSPITALIZATION. THE GROW CLINIC PROVIDES MEDICAL TREATMENT, NUTRITIONAL ASSESSMENT, HOME HEALTH EDUCATION, SOCIAL SERVICE ADVOCACY, DEVELOPMENTAL REFERRALS, AND ACCESS TO BMC'S THERAPEUTIC FOOD PANTRY, NUTRITIONAL SUPPLEMENTS, CHILDREN'S CLOTHES, DIAPERS, BOOKS AND EDUCATIONAL TOYS, AMONG OTHER SERVICES. APPROXIMATELY 200 FAMILIES ARE TREATED ANNUALLY BY THE GROW CLINIC. IN FY2023, THERE WERE 90 NEW PATIENTS. FORTY-FIVE PERCENT (45%) OF CLINIC PATIENTS WERE 12 MONTHS OF AGE OR YOUNGER; THE AVERAGE AGE AT REFERRAL WAS 22 MONTHS; AND THE AVERAGE LENGTH OF TREATMENT WAS 28 MONTHS. THERE WERE 818 TOTAL CLINIC VISITS DURING THIS PERIOD. APPROXIMATELY 12% OF PATIENT FAMILIES WERE HOMELESS AND LIVING IN SHELTERS. CLINICIANS MADE 20 HOME VISITS IN FY23. ALL PATIENTS DEMONSTRATED IMPROVED GROWTH, AND 80% DEMONSTRATED SIGNIFICANT WEIGHT IMPROVEMENT.
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BOSTON MEDICAL CENTER HEALTH PLAN, INC., DOING BUSINESS AS WELLSENSE HEALTH PLAN (WELLSENSE)WELLSENSE IS A NON-PROFIT HEALTH PLAN THAT PROVIDES HEALTH INSURANCE COVERAGE TO MASSACHUSETTS RESIDENTS, INCLUDING LOW INCOME, UNDERSERVED, DISABLED AND ELDERLY POPULATIONS. IT WAS ESTABLISHED IN 1997 BY BMC AND HAS MORE THAN 25 YEARS OF EXPERIENCE DELIVERING ACCESSIBLE CARE TO COMPLEX POPULATIONS. WELLSENSE SERVES OVER 639,000 MEMBERS ACROSS MASSACHUSETTS. IT ALSO PROVIDES HEALTH COVERAGE TO MEDICAID MEMBERS IN NEW HAMPSHIRE.BOSTON HEALTHNET (BHN)THE BOSTON HEALTHNET (BHN) HEALTH CENTER NETWORK REPRESENTS A FUNDAMENTAL PARTNERSHIP BETWEEN BOSTON MEDICAL CENTER AND THE COMMUNITY HEALTH CENTERS (CHCS) TO FULFILL A SHARED COMMITMENT TO THE MOST VULNERABLE AND DIVERSE PATIENTS SERVED. ESTABLISHED IN 1995, BHN IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMPRISED OF BMC, BOSTON UNIVERSITY'S CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE AND 12 COMMUNITY HEALTH CENTERS. THE PARTNERSHIP HAS BECOME A NATIONAL MODEL FOR COMMUNITY HEALTH CARE NETWORKS, ESPECIALLY THOSE SERVING URBAN, UNDERSERVED AND WORKING CLASS POPULATIONS BHN'S COMMUNITY HEALTH CENTER PARTNERS PROVIDE OUTREACH, PREVENTION, PRIMARY CARE, SPECIALTY CARE AND DENTAL SERVICES AT SITES LOCATED THROUGHOUT BOSTON'S COMMUNITIES AS WELL AS ATTLEBORO, QUINCY, TAUNTON, AND WINTHROP, THEREBY EXTENDING BMC'S PRESENCE INTO THESE NEIGHBORHOODS. PHYSICIANS WORKING IN THE HEALTH CENTERS ARE CREDENTIALED MEMBERS OF BMC'S MEDICAL STAFF. HEALTH CENTER PATIENTS HAVE ACCESS TO HIGHLY TRAINED SPECIALISTS AND CUTTING-EDGE TECHNOLOGY AT BMC WHILE PROVIDING INDIVIDUALIZED AND CULTURALLY SENSITIVE CARE IN THEIR OWN NEIGHBORHOODS.THE ACCOMPLISHMENTS OF THE NETWORK ARE EVIDENCED BY:NOTABLE SHARE OF BMC VOLUME ORIGINATING FROM THE HEALTH CENTERS;COLLABORATIVE DEVELOPMENT OF QUALITY IMPROVEMENT INITIATIVES, CLINICAL PROTOCOLS, AND STANDARDS OF PRACTICE;DEGREE OF FACILITATION AND COORDINATION OF HEALTH INFORMATION TECHNOLOGY TRAINING, COMMUNICATION AND OPTIMIZATION ACROSS THE HEALTH CENTER NETWORK WITH NINE OF THE BHN HEALTH CENTERS ON THE SAME ELECTRONIC HEALTH RECORD.IN ADDITION, THE COMMUNITY HEALTH CENTER PARTNERSHIP EXTENDS INTO CLINICIAN TRAINING AND JOINT HIRING WITH BU SCHOOL OF MEDICINE STUDENTS USING HEALTH CENTER EDUCATION PROGRAMS, RESIDENTS HAVING LONGITUDINAL AMBULATORY EXPERIENCE AT CHCS DURING 2023 AND PROVIDERS JOINTLY HIRED BY HEALTH CENTERS AND BU FAMILY MEDICINE ACROSS SIX HEALTH CENTERS.OTHER AREAS DEMONSTRATING THE LONGSTANDING AND DEEP PARTNERSHIP INCLUDE: GOVERNANCE: COMMUNITY HEALTH CENTERS ARE NOTABLY INVOLVED IN BMC GOVERNANCE WITH REPRESENTATION ON BMC'S BOARD OF TRUSTEES, TWO COMMITTEES OF THE BMC BOARD OF TRUSTEES AND THREE HOSPITAL COMMITTEES.RESEARCH: FOR OVER 15 YEARS, A RESEARCH COLLABORATIVE COMPRISED OF BHN, COMMUNITY HEALTH CENTERS AND BOSTON UNIVERSITY CLINICAL TRANSLATIONAL SCIENCE INSTITUTE HAS EXISTED IN ORDER TO ADVANCE HEALTH RELATED RESEARCH IN THE COMMUNITY, INCLUDE THE COMMUNITY VOICE IN RESEARCH PROJECTS AND FACILITATE CLINICIAN ENGAGEMENT IN THE RESEARCH PROCESS.ACO PARTICIPATION: CURRENTLY, 10 COMMUNITY HEALTH CENTERS AND FOUR HOSPITALS IN OUR MASSHEALTH ACO PROGRAM PARTICIPATE IN BACO. BACO'S PARTICIPANTS ARE COLLECTIVELY ACCOUNTABLE FOR THE QUALITY AND COST OF THE CARE THEY PROVIDE. BACO'S MOST SIGNIFICANT RISK ARRANGEMENT IS WITH THE MASSHEALTH ACO PROGRAM. WITH ITS PARTICIPATION IN THE MASSHEALTH ACO PROGRAM, BACO BECAME CLINICALLY AND FINANCIALLY INTEGRATED WITH BMC HEALTH SYSTEM, WHICH INCLUDES BMC, BOSTON UNIVERSITY MEDICAL GROUP, AND WELLSENSE.COVID-19 RESPONSE THE COVID-19 PANDEMIC REVEALED GROSS INEQUITIES IN THE UPTAKE OF VACCINATIONS BY BLACK AND LATINX PEOPLE ACROSS THE US, WITH DEADLY CONSEQUENCES. BMC LED LOCAL EFFORTS TO CLOSE THESE DISPARITIES IN BOSTON BY IMPLEMENTING COMMUNITY-BASED VACCINATION SITES IN CHURCHES AND COMMUNITY CENTERS, ORGANIZING MOBILE VACCINATION EVENTS AT SCHOOLS, GROCERY STORES AND COMMUNITY EVENTS, AND BY PROVIDING VACCINE ACCESS AS WELL AS HEALTH EDUCATION TO RESIDENTS OF THE CITY'S MOST IMPOVERISHED NEIGHBORHOODS.THESE EVENTS WERE CRITICAL IN PROVIDING ACCESS TO VACCINES IN LOCATIONS WITH THE HIGHEST SOCIAL VULNERABILITY INDEX (SVI), IDENTIFIED USING THE US CENSUS DATA INCLUDING SOCIOECONOMIC STATUS, HOUSEHOLD COMPOSITION AND DISABILITY, SOCIAL/ECONOMIC MINORITY STATUS, LANGUAGE, UNEMPLOYMENT, AND OTHER FACTORS AFFECTING COMMUNITY HEALTH. TO BUILD CONFIDENCE IN COVID-19 VACCINES AND IN THE HEALTHCARE SYSTEM, BMC PARTNERED WITH AFFILIATED HEALTH CENTERS, COMMUNITY PARTNERS, STATE AND LOCAL HEALTH DEPARTMENTS, AND THE COMMONWEALTH OF MASSACHUSETTS. AS FEATURED IN A SCHOLARLY ARTICLE IN MAY OF 2022 IN THE ANNALS OF INTERNAL MEDICINE, THE BMC VACCINATION INITIATIVE HAS SHOWN THE IMPORTANCE OF HAVING LEADERSHIP AND WORKFORCE COMMITMENT TO HEALTH EQUITY AND COMMUNITY ENGAGEMENT. AS A RESULT, BMC IS NOW PART OF THE COMMUNITY ENGAGED ALLIANCE OF THE NATIONAL INSTITUTES OF HEALTH, AIMED AT INCREASING VACCINE CONFIDENCE AND ENGAGEMENT IN RESEARCH.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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IMMIGRANT AND REFUGEE HEALTH CENTER (IHRC): THE IHRC CONNECTS ALL OF BMC'S EXISTING PROGRAMS AND EXPERTISE IN IMMIGRANT AND REFUGEE HEALTH CARE INTO ONE CENTRAL POINT OF ENTRY. THROUGH THE IHRC, ANY IMMIGRANT PATIENT CAN BE CONNECTED WITH ALL OF THE MEDICAL, MENTAL HEALTH AND SOCIAL SERVICES THAT THEY NEED TO HEAL, REBUILD, AND THRIVE. THIS INCLUDES SPECIALIZED PRIMARY CARE SERVICES FOR IMMIGRANT AND REFUGEE PATIENTS INCLUDING REGULAR CHECK-UPS, IMMUNIZATIONS AND SCREENINGS; SPECIALIZED, TRAUMA-INFORMED MENTAL HEALTH CARE FOR IMMIGRANT AND REFUGEE AND TAILORED OBSTETRICS AND GYNECOLOGICAL CARE FOR IMMIGRANT AND REFUGEE PATIENTS, INCLUDING PREGNANCY AND POSTPARTUM CARE, ANNUAL CHECK-UPS, GYNECOLOGIC CARE, CONTRACEPTION COUNSELING, SURGICAL CONSULTATION AND CONSULTATIONS REGARDING FEMALE GENITAL CIRCUMCISION. WE ALSO RECOGNIZE THAT NAVIGATING THE US HEALTHCARE SYSTEM CAN BE CHALLENGING. OUR CASE MANAGEMENT TEAM PARTNERS WITH OUR PATIENTS TO CONNECT THEM WITH THE MEDICAL AND SOCIAL SERVICES THEY NEED (FROM IMMIGRATION LEGAL NEEDS, TO CAREER DEVELOPMENT, TO FOOD AND HOUSING SUPPORT) IN A SUPPORTIVE ENVIRONMENT THAT IS SPECIFICALLY TAILORED TO MEET THE UNIQUE NEEDS OF OUR PATIENTS. FOREIGN AND SIGN LANGUAGE INTERPRETERS ARE AVAILABLE TO HELP PATIENTS COMMUNICATE WITH THE STAFF. THE PRACTICE PROVIDES ON-SITE INTERPRETERS AND PHONE-BASED INTERPRETERS FOR MORE THAN 250 LANGUAGES. IN THE PAST YEAR, THE IHRC SERVED FOR OVER 2,000 IMMIGRANT, REFUGEE, AND ASYLUM SEEKING PATIENTS, DELIVERING APPROXIMATELY 6,400 CLINICAL VISITS ANNUALLY.MARGARET M. SHEA RN ADULT DAY HEALTH PROGRAM: LICENSED UNDER THE DEPARTMENT OF PUBLIC HEALTH, BMC'S MARGARET M. SHEA RN ADULT DAY HEALTH PROGRAM IS AN INTERDISCLIPLANARY BASED PROGRAM THAT PROMOTES OUR CLIENT'S ACHIEVING AND MAINTAINING THEIR HIGHEST LEVEL OF FUNCTIONING WHILE PROVIDING SUPPORT TO THE CLIENTS AND THEIR CARE GIVERS TO ENABLE THEM TO REMAIN IN THE COMMUNITY. THIS IS ACHIEVED BY PROVIDING HOLISTIC CARE TO MEET THE INDIVIDUAL CLIENT'S PHYSICAL, COGNITIVE, SOCIAL AND EMOTIONAL NEEDS WTIHIN A GROUP SETTING. THE PROGRAM SERVED AN AVERAGE ROSTER OF 33 PARTICIPANTS DURING 2023 WITH AN AVERAGE OF APPROXIMATELY 20 CLIENTS PER DAY IN ATTENDANCE DURING THIS TIME PERIOD. ADDITIONALLY, THE PROGRAM ALSO WELCOMED A NEWLY CREATED CERTIFIED THERAPEUTIC RECREATION SPECIALIST POSITION TO EXPAND THE THERAPEUTIC ACTIVITY PROGRAMS THAT ARE OFFERED.PROGRAM FOR INTEGRATIVE MEDICINE AND HEALTH CARE DISPARITIES (INTEGRATIVE MEDICINE): STARTED IN 2004, THE PROGRAM FOR INTEGRATIVE MEDICINE AND HEALTH CARE DISPARITIES AT BMC COMBINES CONVENTIONAL MEDICAL TREATMENT, COMPLEMENTARY THERAPIES, AND LIFESTYLE CHANGES. THE CORE PURPOSE OF THIS PROGRAM IS TO PIONEER A WIDELY ACCESSIBLE, MULTICULTURAL, CROSS-DISCIPLINARY, NATIONAL MODEL OF INTEGRATIVE HEALTH FOR ALL THROUGH CLINICAL SERVICES, EDUCATION, RESEARCH AND ADVOCACY. COMPLEMENTARY THERAPIES INCLUDE YOGA, MASSAGE, ACUPUNCTURE, HERBAL THERAPY, DIETARY SUPPLEMENTS, MEDITATION, HYPNOSIS, CHI GUNG, TAI CHI, AND REIKI. THE PROGRAM OFFERS ALL CLINICAL SERVICES AND CLASSES AT LITTLE OR NO COST.CONVENTIONAL TREATMENTS MAY INCLUDE PRESCRIPTION MEDICATION, X-RAYS, SURGICAL PROCEDURES, PHYSICAL, AND OCCUPATIONAL THERAPY. HISTORICALLY, COMPLEMENTARY THERAPIES WERE NOT PART OF CONVENTIONAL MEDICINE; HOWEVER, CERTAIN THERAPIES ARE BECOMING MORE COMMON IN HEALTHCARE TODAY BECAUSE KNOWLEDGE AND RESEARCH ABOUT THEIR EFFECTIVENESS CONTINUES TO GROW.PEDIATRIC ASSESSMENT OF COMMUNICATION CLINIC (AUTISM PROGRAM): THE AUTISM PROGRAM AT BMC IS A MULTIDISCIPLINARY, MULTI-TIERED, COMPREHENSIVE AND CULTURALLY COMPETENT PROGRAM THAT IS UNIQUELY EQUIPPED TO MEET THE COMPLEX NEEDS OF PATIENTS AND FAMILIES. OUR TEAM, COMPRISED OF A PROGRAM DIRECTOR AND ASSOCIATE DIRECTOR, AUTISM RESOURCE SPECIALISTS, TRANSITION SPECIALIST, RESEARCH COORDINATOR AND AUTISM FRIENDLY HOSPITAL PROJECT COORDINATOR, OFFERS SPECIALIZED OUTREACH, TRAINING AND ADVOCACY SERVICES. IN ADDITION, THE TEAM FORMS EFFECTIVE PARTNERSHIPS WITH SCHOOLS, COLLABORATES WITH LOCAL SUPPORT ORGANIZATIONS AND DRAWS UPON A DEEP KNOWLEDGE BASE OF SOCIAL SERVICE AGENCIES TO FACILITATE LINKAGES TO RESOURCES AND SUPPORTS WHILE DEVELOPING AND SCALING UP NOVEL INTERVENTIONS TO MEET GAPS IN SERVICES. OUR AUTISM RESOURCE SPECIALISTS WORK INTENSELY WITH PATIENT FAMILIES TO HELP ENSURE TIMELY AND APPROPRIATE TREATMENT FOR CHILDREN, WHICH OFTEN INCLUDES PROVIDING SUPPORT FOR THOSE FACING FINANCIAL BARRIERS, LINGUISTIC NEEDS AND CULTURAL ISSUES; ENHANCING PATIENT-PROVIDER COMMUNICATION; NAVIGATING HEALTH CARE SYSTEM OBSTACLES; AS WELL AS ACCESSING STATE AND GOVERNMENTAL BENEFITS. ADDITIONALLY, STAFF PROVIDE INDIVIDUALIZED BEHAVIOR CONSULTATION AND PARENT TRAINING TO STRENGTHEN CHILDREN'S COMMUNICATION AND RELATED SKILL-BUILDING AND REDUCE CHALLENGING BEHAVIORS. OUR TRANSITION SPECIALIST PROVIDES TRANSITION-AGED YOUTH (14-22 YEARS OLD) AND THEIR FAMILIES WITH INFORMATION, GUIDANCE, AND RESOURCES REGARDING THE TRANSITION FROM SCHOOL SERVICES TO ADULT LIFE AND DISCUSSES TOPICS SUCH AS GOAL SETTING, SCHOOL IEP PLANNING, ADULT SERVICES, AND LIFE SKILLS DEVELOPMENT. OUR ADULT RESOURCE SPECIALIST PARTNERS WITH ADULT CLINICAL SETTINGS TO ASSIST ADULTS OF ALL AGES AND THEIR CARE PROVIDERS AND FAMILIES TO GAIN ACCESS TO RESOURCES AND SUPPORT SYSTEMS NEEDED TO CONTINE TO THRIVE THROUGHOUT ADULTHOOD.OUR AUTISM FRIENDLY INITIATIVE (AFI) IS RECOGNIZED AS A NATIONAL AND INTERNATIONAL LEADER IN IMPROVING THE HEALTHCARE EXPERIENCE FOR PATIENTS WITH AUTISM SPECTRUM DISORDER (ASD) AND THEIR FAMILIES. OUR AFI HAS SUCCESSFULLY DEVELOPED AND IMPLEMENTED A RANGE OF INTERVENTIONS ACROSS THE DOMAINS OF INDIVIDUALIZING PATIENT CARE, MODIFYING THE SENSORY ENVIRONMENT, STAFF TRAINING, AND PATIENT/FAMILY ACCOMMODATIONS. THE AUTISM PROGRAM ALSO HAS A WELL-ESTABLISHED SOCIAL MEDIA PRESENCE ON FACEBOOK AND INSTAGRAM-BOTH OF WHICH SERVE AS ADDITIONAL AVENUES TO PROVIDE RESOURCES, INFORMATION, AND GUIDANCE TO FAMILIES. THE AUTISM PROGRAM HAS SUPPORTED OVER 14,000 FAMILY REFERRALS SINCE ITS INCEPTION IN 2007 AND APPROXIMATELY 1,800 IN FY23. ADDITIONALLY, THE PROGRAM TRAINS OVER 1,500 INDIVIDUALS ANNUALLY.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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PEDIATRIC PAIN CLINIC: BMC'S PEDIATRIC PAIN CLINIC MANAGES ACUTE, COMPLEX, AND CHRONIC PAIN IN CHILDREN FROM INFANCY TO AGE 22. OUR INTERDISCIPLINARY TEAM OF EXPERTS WORKS CLOSELY WITH EACH PATIENT AND FAMILY STRIVING TO HELP CHILDREN REGAIN NORMAL LIVES AND PARTICIPATE IN TYPICAL AGE-APPROPRIATE ACTIVITIES. THE PEDIATRIC PAIN CLINIC IS ABLE TO TREAT A WIDE VARIETY OF CONDITIONS, AND OFFERS A VARIETY OF SPECIALIZED THERAPIES. EACH PATIENT IS GIVEN A PERSONALIZED PLAN TO BEST FIT THEIR NEEDS WHICH INCLUDES NON-PHARMACOLOGIC STRATEGIES AND PARENTING SUPPORT. THE TEAM REGULARLY COMMUNICATES WITH SCHOOLS AND OUTSIDE PROVIDERS TO ENSURE COMPREHENSIVE AND COLLABORATIVE CARE.NOURISHING OUR COMMUNITY: THE PREVENTIVE FOOD PANTRY AND TEACHING KITCHEN ADDRESS HUNGER-RELATED ILLNESS AND MALNUTRITION AMONG A LOW-INCOME, LARGELY UNDERSERVED PATIENT POPULATION WITHIN GREATER BOSTON. INDIVIDUALS AT RISK OF MALNUTRITION ARE REFERRED TO THE PROGRAM BY BMC OR BOSTON HEALTHNET PHYSICIANS OR NUTRITIONISTS WHO PROVIDE "PRESCRIPTIONS" FOR SUPPLEMENTAL FOOD THAT BEST PROMOTES PHYSICAL HEALTH, PREVENTS FUTURE ILLNESS, AND FACILITATES RECOVERY. THE PANTRY STAFF MEMBERS ARE FLUENT IN 4 LANGUAGES AND HAVE BEEN ESSENTIAL IN ASSISTING BMC'S MANY REFUGEE AND IMMIGRANT PATIENTS. THE FOOD PANTRY HAS CONTINUED TO PROVIDE NUTRITIONAL FOOD PRESCRIPTIONS TO APPROXIMATELY 6,134 PEOPLE EACH MONTH. IN FY23. WE PROVIDED FOOD TO 73,616 PEOPLE, AND DISPENSED APPROXIMATELY 11,000 POUNDS OF FOOD EACH WEEK. THIS EQUATES TO APPROXIMATELY 8 POUNDS OF GROCERIES PER PERSON. 50% OF THE FOOD DISPENSED ARE PERISHABLE ITEMS, WHICH ARE OFTEN LACKING IN THEIR DIET BECAUSE OF THE COST.THE TEACHING KITCHEN: OFFERS IN PERSON, VIRTUAL, AND HYBRID CLASSES TO PATIENTS, STAFF, STUDENTS, AND PARTNERING COMMUNITY ORGANIZATIONS. RE-CURRING CLASSES IN THE TEACHING KITCHEN INCLUDE HEALTHY HABITS, WELLNESS AND THE TEACHING KITCHEN, WEIGHT LOSS SURGERY PREPARATION, COOKING FOR RECOVERY, FOOD EXPLORERS, CUISINES OF THE WORLD AND MORE. NEW STRATEGIC PARTNERSHIPS HAVE BEEN MADE THROUGHOUT THE HOSPITAL TO FURTHER INTEGRATE INTO CLINICAL CARE. FOR EXAMPLE, AN INNOVATIVE CLASS WITH THE GROW CLINIC OFFERS NUTRITION AND CULINARY EDUCATION FOR PREGNANT AND POSTPARTUM PEOPLE TO SUPPORT PREGNANCY AND BABIES. PARTNERSHIPS WITH THE GRAYKEN CENTER'S START CLINIC AND CATALYST CLINIC SUPPORT FOLKS WITH SUBSTANCE USE DISORDER TO BUILD HEALTHY EATING HABITS AND GAIN CONFIDENCE IN FOOD PREPARATION USING ACCESSIBLE FOODS. THESE CLINICALLY INTEGRATED CLASSES ENHANCE CARE AND PROVIDE ADDITIONAL EDUCATION, SUPPORT, AND COMMUNITY TO ADDRESS THE NUTRITIONAL NEEDS OF OUR PATIENT POPULATION. RECIPES FEATURE STAPLE FOODS PROVIDED BY THE FOOD PANTRY, AND CULTURALLY COMPETENT FOODS FOR OUR DIVERSE COMMUNITY. RESEARCH EFFORTS CONTINUE TO GROW, INCLUDING A QUALITY IMPROVEMENT PROJECT ASSESSING PATIENTS' FOOD PREFERENCES AND ENVIRONMENT, THE FEASIBILITY OF TEACHING KITCHEN CLASSES IN CLINICAL CARE, AND RESEARCH ON HEALTH OUTCOMES. IN APRIL 2017, BMC OPENED ITS ROOFTOP FARM, TO MEET OUR PATIENTS' GROWING NEED FOR FRESH PRODUCE. THE ROOFTOP FARM HAS 2,400 SQUARE FEET OF GROWING SPACE, AND IS LOCATED ON TOP OF BMC'S ALBANY STREET POWER PLANT. THE FARM PRODUCES CROPS SUCH AS SPINACH, COLLARDS, BOK CHOY, RADISHES, SWISS CHARD, KALE, TOMATOES, AND MUCH MORE. IN ADDITION TO PRODUCE, THE FARM ALSO HAS 4 BEEHIVES WHICH PROVIDE 20-100 POUNDS OF HONEY TO THE HOSPITAL EACH SEASON. AS OF 2022 THE FARM HAS BEEN FULLY OPEN TO THE PUBLIC, HOSTING OVER 1000 VISITORS TO THE FARM LAST SEASON FOR TOURS, GARDENING CLASSES, YOGA, AND COOKING CLASSES. THE FARM CONTINUED TO HOST AN INTERNSHIP PROGRAM FOR PEOPLE LOOKING TO LEARN THE INS AND OUTS OF ROOFTOP FARMING AND GROWING FOOD FOR A HOSPITAL. IN FY2023, THE FARM GREW OVER 4,035 LBS OF FOOD VALUED AT $27,000 FOR THE HOSPITAL. MORE THAN HALF OF THE FOOD WENT TO THE FOOD PANTRY, WITH THE REST GOING TO THE HOSPITAL CAFETERIA AND WEEKLY FARMERS' MARKET. THE FARMERS MARKET, HOSTED EVERY TUESDAY IN THE SHAPIRO BUILDING, SERVES PATIENTS AND STAFF FRESH FARM PRODUCE AT A SUBSIDIZED RATE.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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PROJECT RECOVERY, EMPOWERMENT, SOCIAL SERVICES, PRENATAL CARE, EDUCATION, COMMUNITY AND TREATMENT (PROJECT RESPECT): PROJECT RESPECT IS A HIGH RISK OBSTETRICAL AND ADDICTION RECOVERY MEDICAL HOME AT BMC AND BOSTON UNIVERSITY'S CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE. PROJECT RESPECT PROVIDES A UNIQUE SERVICE OF COMPREHENSIVE OBSTETRIC AND SUBSTANCE USE DISORDER TREATMENT FOR BIRTHING PEOPLE AND THEIR NEWBORNS IN MASSACHUSETTS. PROJECT RESPECT SUPPORTS PATIENTS WITH ALL TYPES OF SUBSTANCE USE DISORDERS, AND THE MAJORITY OF PROJECT RESPECT'S PATIENTS ARE IN RECOVERY FROM OPIOID ADDICTION. IN-PATIENT, MONITORED, ACUTE SUBSTANCE WITHDRAWAL TREATMENT AND INDUCTION OF MEDICATIONS FOR OPIOID USE DISORDER FOR BIRTHING PEOPLE SEEKING ADDICTION TREATMENT ARE PROVIDED. INTENSIVE, INDIVIDUALIZED OUT-PATIENT TREATMENT PLANS ARE OUTLINED FOR EACH PATIENT TAILORED TO THE SEVERITY OF THEIR DISEASE AND THEIR RECOVERY PROGRESS. THE OUT-PATIENT MEDICAL HOME MODEL PROVIDES ON-SITE, COLLABORATIVE, AND MULTIDISCIPLINARY CARE FOR PREGNANT AND POST-PARTUM PATIENTS IN RECOVERY. PROJECT RESPECT TREATS AN AVERAGE OF 120-150 PATIENTS PER MONTH, WITH 6-10 NEW PATIENTS PER MONTH. IN FY23- PROJECT RESPECT SUPPORTED MORE THAN 300 MOTHER/CHILD DYADS.STREETCRED: BMC'S STREETCRED PROGRAM ADDRESSES FINANCIAL AND HEALTH INEQUITIES BY LINKING LOW- TO MODERATE-INCOME (LMI) PEDIATRIC PATIENT FAMILIES TO ANTI-POVERTY SAFE-NET PROGRAMS AND ASSET BUILDING TOOLS. STREETCRED PROVIDES AN ECONOMIC BUNDLE OF SERVICES DURING WELL CHILDVISITS IN THE FIRST YEAR OF LIFE, WHICH INCLUDES FREE TAX-PREPARATION SERVICES THROUGH WELL-TRAINED STAFF AND VOLUNTEERS WHO WORK WITH FAMILIES TO PREPARE THEIR TAXES AND ACCESS THE EITC. THE UNITED STATES FEDERAL EARNED INCOME TAX CREDIT (EITC) IS A REFUNDABLE TAX CREDIT FOR LMI WORKING INDIVIDUALS, PARTICULARLY THOSE WITH CHILDREN. UNDER OUR HEALTH BY WEALTH COLLECTIVE, STREETCRED HAS PREPARED OVER 8,000 TAX RETURNS, WHICH PROVIDED IN EXCESS OF $17 MILLION IN TAX REFUNDS. THESE TAX REFUNDS CAN HAVE A PROFOUND POSITIVE IMPACT ON A FAMILY'S HOUSEHOLD BUDGET AND, IN CASES OF FINANCIAL STRESS, ALLEVIATE SIGNIFICANT FINANCIAL BURDEN.SUPPORTING PARENTS AND RESILIENT KIDS CENTER (SPARK): THE SPARK CENTER HAS A LONG AND STORIED HISTORY OF PROVIDING INNOVATIVE CARE TO THOSE MOST IN NEED. THROUGH MARCH 2020, THE SPARK CENTER CARRIED OUT THIS MISSION THROUGH AN EDUCATION AND CARE PROGRAM FOR INFANTS AND TODDLERS WHOSE LIVES WERE AFFECTED BY COMPLEX OVERLAPPING HEALTH, EMOTIONAL, BEHAVIORAL, AND DEVELOPMENTAL CHALLENGES. AS A RESULT OF THE COVID-19 PANDEMIC, THE SPARK CENTER PIVOTED FROM CHILDCARE PROGRAMMING TOWARD EXPANDING CHILDHOOD OUTPATIENT BEHAVIORAL HEALTH SERVICES, A NEED THAT WAS ONLY AMPLIFIED THROUGH THE PANDEMIC. AS THESE CRITICAL BEHAVIORAL HEALTH SERVICES PROVIDED A SUPPORTIVE CONNECTION TO CARE FOR MANY FAMILIES, THE SPARK CENTER SIMULTANEOUSLY INITIATED A RE-ENVISIONING OF ITSELF AND ITS UNIQUE, COMMUNITY-BASED SETTING.IN AUGUST 2021, SPARK REOPENED AS THE HOME TO A NUMBER OF SPECIALTY PROGRAMS WITHIN BMC'S DEPARTMENT OF PEDIATRICS, ALL WITH THE OVERARCHING MISSION TO PROVIDE HIGH-QUALITY, EVIDENCED-BASED CARE. AT PRESENT, SPARK OFFERS NEURODEVELOPMENTAL ASSESSMENTS AND PSYCHOLOGICAL EVALUATIONS THROUGH THE DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS (DBP) TO IDENTIFY CHILDREN'S SPECIFIC EMOTIONAL, BEHAVIORAL, AND COGNITIVE CHALLENGES. MULTIDISCIPLINARY PROVIDERS, INCLUDING PEDIATRICIANS, ADVANCED PRACTICE CLINICIANS, PSYCHOLOGISTS, AND AUTISM RESOURCE SPECIALISTS, WORK COLLABORATIVELY WITH CAREGIVERS TO ACCESS SPECIAL EDUCATION SERVICES AND OTHER VITAL THERAPEUTIC SUPPORTS AS EARLY AS POSSIBLE TO IMPROVE CHILDHOOD OUTCOMES. ADDING TO THE CONTINUUM OF SPECIALIZED CHILDREN'S SERVICES, THE SPARK CENTER IS THE HOME OF THE EARLY CHILDHOOD BEHAVIOR THERAPY PROGRAM AND THE GOOD GRIEF PROGRAM AND IS A CLINICAL SITE FOR THE CHILD WITNESS TO VIOLENCE PROJECT. THESE PROGRAMS OFFER AN ARRAY OF TRAUMA-INFORMED, EVIDENCE-BASED THERAPY INTERVENTIONS FOR CHILDREN AND FAMILIES ROOTED IN TWO-GENERATION APPROACHES THAT UTILIZE THE CAREGIVER-CHILD RELATIONSHIP TO FOSTER HEALTHY CHILD DEVELOPMENT. THE SYNERGISTIC COLOCATION OF THESE SERVICES MAKES THE SPARK CENTER A FACILITY THAT PROVIDES BEST-PRACTICE CARE TO CHILDREN AND FAMILIES IMPACTED BY COMPLEX DEVELOPMENTAL AND BEHAVIORAL CHALLENGES, GRIEF AND LOSS, AND DOMESTIC VIOLENCE AND OTHER FORMS OF INTERPERSONAL VIOLENCE.IN ADDITION, SPARK SERVES AS AN OUTLET FOR PEDIATRIC INFECTIOUS DISEASE CASE MANAGEMENT AND CONCRETE RESOURCE SUPPORT, VIA THEIR INTEGRATED FOOD PANTRY. SPARK IS ALSO THE LOCATION OF A MONTHLY CLINIC, PROJECT POSITIVE HOPE, WHICH PROVIDES COORDINATED SERVICES FROM OBSTETRICS AND GYNECOLOGY, ADULT INFECTIOUS DISEASE AND PEDIATRIC INFECTIOUS DISEASE SPECIALISTS WITH ON-SITE CASE MANAGEMENT, PHARMACIST COUNSELING, AND PEER SUPPORT. WITH THE ABOVE ABUNDANCE OF INNOVATIVE CLINICAL SERVICES, THE SPARK CENTER HAS BECOME AN EXCEPTIONAL TRAINING SITE FOR MENTAL HEALTH CLINICIANS AND DBP TRAINEES. THE CLINICAL TRAINING OFFERED THROUGH THE SPARK CENTER WORKS TO ENHANCE THE SKILLS AND EXPERTISE OF THE FIELD OF PROVIDERS SUPPORTING CHILDREN AND FAMILIES WITH COMPLEX BEHAVIORAL AND DEVELOPMENTAL CHALLENGES AND PSYCHOSOCIAL SITUATIONS.TEAM UP: TEAM UP FOR CHILDREN TRANFORMING AND EXPANDING ACCESS TO MENTAL HEALTH CARE IN URAN PEDIATRICS IS A PEDIATRIC INTEGRATED BEHAVIORAL HEALTH INITIATIVE DESIGNED TO EQUIP PEDIATRIC PRIMARY CARE PRACTICES TO DELIVER EVIDENCE-INFORMED, TRAUMA-RESPONSIVE, INTEGRATED BEHAVIORAL HEALTHCARE IN STRUCTURALLY MARGINALIZED COMMUNITIES. THE TEAM UP CLINICAL MODEL FOCUSES ON PREVENTION, PROMOTION, EARLY IDENTIFICATION OF SOCIAL, DEVELOPMENTAL, AND BEHAVIORAL HEALTH ISSUES, AND PROMPT ACCESS TO CARE. WHILE THE MAJORITY OF MODELS ARE BASED ON INITIATING CARE AT THE POINT OF DIAGNOSIS, OUR GOAL THROUGH CONSISTENT SCREENING AND MONITORING FROM BIRTH TO YOUNG ADULTHOOD-IS TO ADDRESS EMERGING ISSUES BEFORE THEY REACH A CRISIS POINT. BMC'S TEAM UP SCALING AND SUSTAINABILITY CENTER PROVIDES PRIMARY CARE PRACTICES WITH EVERYTHING THEY NEED TO OVERCOME ROADBLOCKS AND IMPLEMENT THE TEAM UP CLINICAL MODEL. ACCESS TO THE TEAM UP LEARNING COMMUNITY GIVES HEALTH CENTERS IN-DEPTH, ONGOING CLINICAL TRAINING AND PRACTICE TRANSFORMATION SUPPORT, WITH DATA-DRIVEN TECHNICAL ASSISTANCE CUSTOMIZED TO THE PRACTICE. LEARNING COMMUNITY SUPPORT LASTS THROUGHOUT THE IMPLEMENTATION PERIOD AND BEYOND, WITH THE ENGAGEMENT INTENSITY HIGHEST AT THE BEGINNING OF THE PROJECT AND DECREASING AS SITES TRANSITION TOWARD SUSTAINING INDEPENDENT OPERATIONS. TEAM UP'S ROBUST EVALUATION ARM HAS PUBLISHED OVER TEN PEER-REVIEWED ARTICLES, DEMONSTRATING POSITIVE OUTCOMES FOR CHILDREN AND FAMILIES, THE HEALTH CARE WORKFORCE, AND SYSTEM-WIDE UTLIZIATION OF PRIMARY CARE SERVICES. GOOD GRIEF: THE GOOD GRIEF PROGRAM PROVIDES TRAUMA-INFORMED, CULTURALLY RESPONSIVE THERAPEUTIC SERVICES TO CHILDREN (AGE 0-18) IMPACTED BY DEATH AND ACUTE LOSS. AS ONE OF THE ONLY CHILDREN'S GRIEF AND LOSS PROGRAMS WITHIN THE CITY OF BOSTON, GOOD GRIEF WORKS TIRELESSLY TO BEST SERVE URBAN CHILDREN AND YOUTH WHO HAVE SUFFERED MULTIPLE, TRAUMATIC LOSSES. GOOD GRIEF SERVES CHILDREN AND THEIR FAMILIES IN A HOLISTIC WAY, RECOGNIZING THAT SIGNIFICANT LOSS IS ALWAYS ACCOMPANIED BY SECONDARY LOSSES THAT ARE DESTABILIZING, DISORIENTING, AND DAUNTING. OUR SMALL CLINICAL TEAM WORKS WITH FAMILIES TO SUPPORT THEIR MENTAL AND EMOTIONAL HEALTH NEEDS WHILE ALSO MITIGATING OTHER LOSS-RELATED STRESSORS AND STRUCTURAL DETERMINANTS OF HEALTH THEY MAY EXPERIENCE AND WHICH AFFECT OVERALL HEALTH (E.G., CHALLENGES AT SCHOOL, HOUSING/FOOD/FINANCIAL INSECURITY, IMMIGRATION-RELATED NEEDS, ETC.).IN 2017, THE GOOD GRIEF PROGRAM SHIFTED ITS PRIMARY FOCUS FROM TRAINING AND CONSULTATION WITH COMMUNITY-BASED ORGANIZATIONS TO PROVIDING DIRECT CLINICAL SERVICES TO CHILDREN IMPACTED BY SIGNIFICANT LOSS. IN THE SUBSEQUENT YEARS, THE NUMBER OF CHILDREN REFERRED TO AND SERVED BY THE PROGRAM HAS GROWN QUICKLY. WHEN CLINICAL SERVICES WERE OPENED IN AUGUST 2017, 26 CHILDREN WERE REFERRED IN A FIVE MONTH PERIOD. IN 2023, APPROXIMATELY 200 CHILDREN WERE REFERRED TO GOOD GRIEF. THE EXPONENTIAL GROWTH OF THE PROGRAM HAS BEEN FUELED BY MANY FACTORS INCLUDING THE DEARTH OF HIGH-QUALITY CHILDREN'S GRIEF SERVICES IN BOSTON AND GOOD GRIEF'S RELIABLE REPUTATION AMONG MEMBERS OF THE COMMUNITY AND OTHER SERVICE ORGANIZATIONS.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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HOUSING IN FISCAL YEAR 2018 BMC LAUNCHED A MULTI-YEAR INVESTMENT IN A SUPPORTIVE HOUSING STRATEGY AS PART OF OUR DETERMINATION OF NEED (DON) COMMUNITY HEALTH INITIATIVE (CHI). THIS PROJECT WAS DESIGNED WITH AS A MULTI-PRONGED APPROACH TO IMPACT AFFORDABLE HOUSING AND AFFORDABLE HOUSING WITH SUPPORTS IN BOSTON. THIS PORTFOLIO INCLUDES NEW FUNDING FOR INTERNAL HOUSING NAVIGATION SUPPORT IN THE PEDIATRIC AND COMPLEX CARE MANAGEMENT, EXPANSION OF THE LIVING WELL AT HOME PROGRAM (FORMERLY KNOWN AS THE ELDERS LIVING AT HOME PROGRAM) AND DEEPER COLLABORATION WITH BOSTON AND CAMBRIDGE HOUSING AUTHORITY ON SUPPORTIVE HOUSING PROGRAMS. THE FOLLOWING ADDRESSES THE SECOND OF THESE MULTI-YEAR COMMITMENTS. BMC INVESTED $1.35M IN A LOAN TO THE COMMUNITY ECONOMIC DEVELOPMENT ASSISTANCE CORPORATION (CEDAC). THE PURPOSE OF THIS LOAN IS TO PARTIALLY CAPITALIZE LOANS UNDER THE ACCELERATING INVESTMENTS IN HEALTH COMMUNITIES (AIHC) INITIATIVE. THROUGH THIS, CEDAC WILL PROVIDE SUBORDINATE LOANS TO THREE AFFORDABLE HOUSING DEVELOPMENTS. THIS INVESTMENT SERVES AS CRITICAL "GAP" FINANCING TO ALLOW ALL THE DIFFERENT FINANCING TO BE EXECUTED AT THE SAME TIME AND THEREFORE FOR CONSTRUCTION ON NEW AFFORDABLE HOUSING TO BEGIN BEFORE HOUSING COSTS INCREASE FURTHER. THE LOANS ARE LONG TERM, 20+ YEARS COMMITMENTS TO MATCH AND LEVERAGE THE CITY AND STATE INVESTMENTS IN THESE PROJECTS. BMC INVESTED $69,012 IN THE CAMBRIDGE HEALTH ALLIANCE (CHA) TOWARDS A COMMUNITY WELLNESS ADVOCATE AT THE MANNING APARTMENT COMPLEX. THE COMMUNITY WELLNESS ADVOCATE PROVIDED INDIVIDUALIZED CASE MANAGEMENT AND SUPPORT TO RESIDENTS OF MANNING HOUSE TO IMPROVE HEALTH OUTCOMES FOR THESE RESIDENTS. BMC ALSO INVESTED $65,219 IN A COMMUNITY WELLNESS REGISTERED NURSE (RN) AS PART OF THE LIVING WELL AT HOME PROGRAM. THE RN WORKED WITH THE CHA AND MANNING HOUSE STAFF TO IMPROVE RESIDENTS' ACCESS TO SERVICES AND SUPPORT, AND SERVED AS THE PRIMARY LIAISON BETWEEN BMC AND OTHER HEALTH CARE PROVIDERS. THIS PARTNERSHIP ENDED IN APRIL 2023, AND HAS BEEN SUSTAINED BY CAMBRIDGE HOUSING AUTHORITY. IN FISCAL YEAR 2022, BMC COMPLETED ITS LAST INVESTMENT OF $330,431 IN THE INNOVATIVE STABLE HOUSING INITIATIVE, BY HEALTH RESOURCES IN ACTION (HRIA). THROUGH THIS PARTNERSHIP, HRIA HAS CONTINUED TO SUCCESSFULLY FACILITATE A COMMUNITY ENGAGEMENT PROCESS THAT HAS BROUGHT TOGETHER HOUSING ADVOCATES, HEALTHCARE PROVIDERS, AND COMMUNITY RESIDENTS TO DESIGN AND IMPLEMENT A PARTICIPATORY GRANTMAKING PROCESS FOCUSED ON HOUSING STABILITY AND ECONOMIC MOBILITY. BMC INVESTED IN THE HEALTHY NEIGHBORHOOD EQUITY FUND, A $22.35 MILLION PRIVATE EQUITY FUND LED BY THE CONSERVATION LAW FOUNDATION AND THE MASSACHUSETTS HOUSING INVESTMENT CORPORATION. IT IS BASED ON A SOCIALLY RESPONSIBLE INVESTMENT MODEL THAT CONSIDERS THE COMMUNITY, ENVIRONMENTAL, AND HEALTH BENEFITS AS WELL AS THE FINANCIAL RISKS AND RETURNS. BOSTON PROJECTS INCLUDE TREADMARK, ASHMONT, DORCHESTER AND BARTLETT STATION, DUDLEY SQUARE, AND ROXBURY. BMC INVESTED IN THE BOSTON HOUSING AUTHORITY (BHA) TO SUPPORT THEIR REASONABLE ACCOMMODATIONS FUND, THROUGH WHICH BHA INVESTS FUNDS TO IMPROVE THE HEALTH, SAFETY, AND COMFORT OF THEIR RESIDENTS. FURTHER, BMC ALSO PROVIDED SUPPORT TO COVER SOME STAFFING TIME FOR ONE OF BHA'S STAFF MEMBERS. BMC ALSO INVESTED IN THE METROPOLITAN AREA PLANNING COUNCIL (MAPC), THE EVALUATOR FOR BMC'S DON. IN THIS ROLE, MAPC DEVELOPS AND IMPLEMENTS AN EVALUATION PLAN TO ASSESS THE IMPACTS AND EFFECTS OF BMC'S MULTI-YEAR DON FOCUSED ON IMPROVING HOUSING STABILITY. THE EVALUATION WILL SEEK TO ASCERTAIN HOW THE VARIOUS INVESTMENTS IN HOUSING STABILITY INDIVIDUALLY AND COLLECTIVELY ADDRESS CONDITIONS ASSOCIATED WITH HEALTH OUTCOMES AND WITH PERFORMANCE OF THE ORGANIZATIONS INVOLVED IN THE PROCESS. THE HOUSING TO HEALTH PROGRAM IN THE DEPARTMENT OF PEDIATRICS AT BOSTON MEDICAL CENTER HAS SUCCESSFULLY DEPLOYED A MULTIDIMENSIONAL STRATEGY FOR RESPONDING TO A RANGE OF HOUSING AND HOMELESSNESS ISSUES AMONG PATIENT FAMILIES. PEDIATRIC NAVIGATORS WORK CLOSELY WITH FAMILIES TO ENTER SHELTER, RESOLVE HOUSING QUALITY ISSUES, APPLY FOR RENTAL ASSISTANCE AND SUBSIDIZING HOUSING, AND CONNECT WITH LEGAL AND COMMUNITY-BASED SERVICES IN ADDITION TO OTHER WRAPAROUND SUPPORTS. THE WORK OF THE NAVIGATORS WAS BOLSTERED BY KEY EXTERNAL PARTNERSHIPS WITHIN HOUSING TO HEALTH. FOR EXAMPLE, MLPB PROVIDED REGULAR LEGAL PROBLEM-SOLVING TRAININGS TO FRONTLINE STAFF WORKING WITH FAMILIES AS WELL AS CASE-SPECIFIC LEGAL CONSULTATION.BMC HAS EMBARKED ON SUPPORTING SMALL BUSINESSES, PARTICULARLY BLACK, INDIGENOUS AND PEOPLE OF COLOR OWNED BUSINESSES IN THE BOSTON AREA. BMC PROVIDED A $1 MILLION DOLLAR ZERO INTEREST LONG TERM LOAN TO NUBIAN MARKETS, A $500,000 RECOVERABLE GRANT TO CITYFRESH FOODS AND A $40,300 INVESTMENT IN BOSTON IMPACT INITIATIVE.TO SUPPORT COMMUNITY OWNERSHIP, BMC DID CAPITAL GRANTS OF $200K TO BOSTON NEIGHBORHOOD COMMUNITY LAND TRUST, $300K FOR THE NEIGHBORHOOD BIRTHING CENTER AND $100K TO KIDDIE'S CORNER CHILDCARE CENTER EXPANSION IN THE MATTAPAN NEIGHBORHOOD OF BOSTON.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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CHRONIC DISEASES AND RISK FACTORSSUPPORT PROGRAMS FOR CANCER AND SICKLE CELL SUPPORT PROGRAMS: SUPPORT PROGRAM OFFERINGS INCLUDED AN ARRAY OF SIXTEEN (16) MONTHLY SUPPORT GROUPS BY CANCER TYPE (E.G., BREAST, GI, HEAD & NECK); POPULATION TYPE (E.G., MEN, SPANISH-SPEAKING); OTHER DISEASE (E.G., SICKLE CELL, AMYLOIDOSIS); AND RELATED SUPPORT (E.G., OSTOMY, CAREGIVER, BEREAVEMENT). ALSO PROVIDED TO ALL CLIENTS WERE SIX (6) ONGOING SUPPORT ACTIVITIES THAT MET WEEKLY TO MONTHLY (FOUR DIFFERENT BODY/MIND CLASSES AND ARTS & CRAFTS AND COOKING CLASSES). ALL OF THESE SUPPORT GROUPS AND ACTIVITIES WERE HELD VIA ZOOM. ADDITIONALLY, EACH QUARTER SAW A VARIETY OF FOUR TO SIX (4-6) FEATURED PROGRAMS IN ART-MAKING, WRITING, THEATER, OUTDOOR GAMES, COMEDY, MINDFUL HEALING, AND COMMUNICATION. SOME OF THESE MET IN PERSON AND SOME VIA ZOOM. NOW POST-PANDEMIC, HAVING THE CAPACITY FOR LARGER GROUPS TO MEET AGAIN IN PERSON, TWO LARGE CELEBRATORY ANNUAL EVENTS RETURNED: THE HOLIDAY PARTY AND THE (16TH ANNUAL) SURVIVORS CELEBRATION LUNCHEON. THE FREE WEEKLY ACUPUNCTURE CLINIC FOR PATIENTS CURRENTLY OR RECENTLY IN TREATMENT ALSO CONTINUED THROUGH THE YEAR.ALL PROGRAMS WERE MANAGED AND IMPLEMENTED BY THE PROGRAM MANAGER AND ONE PROGRAM ASSISTANT; TWO IN-HOUSE SOCIAL WORKERS WHO EACH FACILITATED ONE OF THE REGULAR MONTHLY GROUPS; A HIGHLY EXPERIENCED LICENSED ACUPUNCTURIST; BMC REGISTERED DIETITIANS FOR THE MONTHLY COOKING CLASS; AND SEVERAL OUTSIDE VENDORS CONTRACTED FOR THE FEATURED ART PROGRAMS. ONCE THE PROGRAMS TRANSITIONED TO ZOOM AT THE BEGINNING OF THE COVID PANDEMIC, COSTS SIGNIFICANTLY DECREASED, AS NEITHER FOOD NOR TRANSPORTATION NEEDED TO BE PROVIDED TO PARTICIPANTS. DURING THIS YEAR, SUCH COSTS INCREASED WITH MORE IN-PERSON MEETINGS AND ESPECIALLY WITH THE TWO LARGE EVENTS. HOWEVER, THESE COSTS STILL REMAINED SIGNIFICANTLY LOWER THAN PRE-PANDEMIC LEVELS.PATIENT NAVIGATION (PN): BMC'S PN PROGRAM WAS LAUNCHED IN 2005. THE MAIN FOCUS OF THIS PROGRAM IS TO IDENTIFY AND OVERCOME BARRIERS THAT PLAY A KEY ROLE IN A PATIENT'S TREATMENT COMPLIANCE AND COMPLETION. PATIENT NAVIGATORS DO THIS BY PROVIDING ADVOCACY AND CASE MANAGEMENT TO ONCOLOGY PATIENTS WHO HAVE AT LEAST ONE IDENTIFIED BARRIER TO CARE AND ARE UNDERGOING ACTIVE CANCER TREATMENT. PNS WORK TO EMPOWER PATIENTS BY LINKING THEM TO A BROAD RANGE OF SERVICES INCLUDING, BUT NOT LIMITED TO, ONCOLOGY SUPPORT SERVICES, TRANSPORTATION, FINANCIAL ASSISTANCE, AND APPROPRIATE COMMUNITY RESOURCES.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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VIOLENCECHILD WITNESS TO VIOLENCE PROJECT (CWVP): CWVP IS A NATIONALLY-RECOGNIZED AND AWARD-WINNING MENTAL HEALTH COUNSELING, OUTREACH, AND CONSULTATION PROGRAM. CWVP SPECIALIZES IN INTERVENTION WITH VERY YOUNG CHILDREN EXPOSED TO DOMESTIC OR COMMUNITY VIOLENCE. THE PROGRAM OFFERS BOTH SHORT- AND LONG-TERM EVIDENCE-BASED TREATMENTS THAT REPRESENT BEST PRACTICE IN SERVING THE NEEDS OF TRAUMATIZED CHILDREN AND THEIR FAMILIES. THE PROGRAM PROVIDES A FLEXIBLE COMBINATION OF SERVICES, INCLUDING RESOURCE ADVOCACY, AND IT LINKS FAMILIES TO BASIC SERVICES SUCH AS HEALTH CARE, CHILDCARE, HOUSING, AND AFTER-SCHOOL PROGRAMS. THE CWVP PROVIDED REFERRALS, ADVOCACY, ASSESSMENT, SHORT-TERM, AND/OR LONGER-TERM CLINICAL CARE TO APPROXIMATELY 325 FAMILIES IN FY23. IN ADDITION TO ITS CLINICAL SERVICES, CWVP IS ENGAGED IN EXTENSIVE LOCAL, STATEWIDE, AND NATIONAL TRAINING EFFORTS TO RAISE THE STANDARD OF CARE FOR YOUNG CHILDREN EXPERIENCING THE TRAUMATIC EFFECTS OF VIOLENCE. THE STAFF HAVE DELIVERED NUMEROUS TRAININGS ACROSS MULTIPLE STATES AND ABROAD TO MENTAL HEALTH AND OTHER PROVIDERS ACROSS SERVICE SECTORS AND SETTINGS.COMMUNITY VIOLENCE RESPONSE TEAM (CVRT): THE CVRT ADDRESSES THE GREAT NEED FOR SERVICES FOR VICTIMS OF COMMUNITY VIOLENCE AND THEIR FAMILIES, AS WELL AS FAMILY SURVIVORS OF HOMICIDE VICTIMS FROM THE GREATER BOSTON AREA. FREE, CULTURALLY SENSITIVE, FAMILY-FOCUSED CLINICAL SERVICES PROVIDED BY THE CVRT INCLUDE CRISIS INTERVENTION, ADVOCACY, CASE MANAGEMENT, AND TRAUMA-FOCUSED COUNSELING FOR ADULTS, ADOLESCENTS, AND CHILDREN (WITH A FOCUS ON AGE EIGHT AND OVER). CVRT SEEKS TO REDUCE THE EFFECTS OF TRAUMA BY PROVIDING THERAPEUTIC SUPPORT THROUGHOUT THE RECOVERY PROCESS AND ULTIMATELY MINIMIZING MENTAL HEALTH TRAUMA. CVRT STAFF REFLECTS THE DIVERSITY OF BMC'S PATIENT POPULATION. IN FY23 THE CVRT SERVED 653 PEOPLE.DOMESTIC VIOLENCE PROGRAM (DVP): THE DVP PROVIDES DIRECT ADVOCACY SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE, AS WELL AS TRAINING AND EDUCATION FOR STAFF, STUDENTS, AND COMMUNITY GROUPS INTERESTED IN LEARNING MORE ABOUT DOMESTIC VIOLENCE, ITS IMPACT ON HEALTH ACROSS THE LIFESPAN, AND THE ROLE WE ALL CAN PLAY IN ADDRESSING IT. IN FY23 THE MULTI-LINGUAL TEAM OF 4 SAFETY AND SUPPORT ADVOCATES ASSISTED 613 VICTIMS AND SURVIVORS WITH A RANGE OF SERVICES INCLUDING CRISIS INTERVENTION/COUNSELING; RISK ASSESSMENT AND SAFETY PLANNING; ASSISTANCE WITH ACCESSING PROTECTIVE ORDERS AND VICTIM COMPENSATION; ACCOMPANIMENT TO COURT, LEGAL, MEDICAL, HOUSING AND OTHER APPOINTMENTS; REFERRAL TO COMMUNITY-BASED DV ADVOCACY/RAPE CRISIS COUNSELING, MEDICAL/MENTAL HEALTH SERVICES; EMERGENCY FINANCIAL ASSISTANCE; AND OTHER SUPPORT AS NEEDED. OF THOSE SERVED, APPROXIMATELY 72% WERE PATIENTS REFERRED BY BMC PROVIDERS, 3% WERE BMC EMPLOYEES, AND 25% WERE SELF-REFERRALS OR REFERRED BY COMMUNITY AND GOVERNMENT PROGRAMS THAT ASSIST DV SURVIVORS AND THEIR CHILDREN.DURING FY23 THE DV PROGRAM ALSO OFFERED A SERIES OF 6 WEEK SUPPORT GROUPS IN BOTH ENGLISH AND SPANISH FOR WOMEN-IDENTIFIED SURVIVORS. THE PROGRAM MANAGER (WHO IS ALSO THE PROGRAM'S PRIMARY TRAINER/PRESENTER) PROVIDED 50 PRESENTATIONS AND OTHER TYPES OF TRAINING TO APPROXIMATELY 800 PARTICIPANTS, MOST OF WHOM WERE BMC STAFF AND PROVIDERS, AS WELL AS A FEW STUDENT AND COMMUNITY GROUPS. PRESENTATION TOPICS INCLUDED ORIENTATION TO THE DV PROGRAM, EDUCATION ABOUT THE DYNAMICS AND HEALTH IMPACT OF DOMESTIC VIOLENCE, AND FOCUSED SKILL BUILDING AND BEST PRACTICES FOR ASSESSING AND RESPONDING TO THOSE WHO HAVE EXPERIENCED DOMESTIC VIOLENCE.VIOLENCE INTERVENTION ADVOCACY PROGRAM (VIAP): CONCEIVED IN 2006 TO HELP STEM THE TIDE OF BOSTON'S GUN AND KNIFE VIOLENCE, VIAP HAS BECOME A VITAL COMPONENT OF VIOLENCE INTERVENTION IN THE CITY AND BEYOND. VIAP'S PURPOSE IS TO HELP VICTIMS HEAL SO THEY CAN AVOID FUTURE VIOLENCE AND BUILD A POSITIVE FUTURE. TO ACCOMPLISH THIS, PATIENT VICTIMS AND THEIR FAMILIES ARE PAIRED WITH A TEAM COMPRISED OF A CASE MANAGER, A MENTAL HEALTH CLINICIAN, AND A FAMILY SUPPORT ADVOCATE TO HELP THEM OVERCOME BARRIERS AND TURN THEIR LIVES AROUND. A POWERFUL VIAP INNOVATION IS THAT THE INTERVENTION WITH THE PATIENT BEGINS IN THE SAFETY OF THE HOSPITAL, WHERE THEY ARE VISITED BY A VIOLENCE INTERVENTION ADVOCATE IN REAL TIME, IN THE TRAUMA BAY, TO INITIATE CASE MANAGEMENT, TAKING ADVANTAGE OF THE "TEACHABLE MOMENT" ASSOCIATED WITH VIOLENT INJURY. AS THE VICTIM HEALS, THE VIAP TEAM CONTINUES A COMPREHENSIVE TREATMENT PROGRAM THAT INCLUDES SAFETY PLANNING, COUNSELING, JOB AND EDUCATIONAL TRAINING, MENTAL HEALTH, AND FAMILY SUPPORT SERVICES FOR BOTH THE VICTIM AND THEIR FAMILY MEMBERS.DURING FY23, VIAP PROVIDED ESSENTIAL SERVICES TO SURVIVORS OF GUNSHOTS AND STABBINGS, AND THEIR FAMILY MEMBERS. (IT IS SIGNIFICANT TO NOTE THAT IN FY23 BMC RECEIVED 65% OF THE CITY'S GUNSHOT AND STABBING VICTIMS.) DURING THIS PERIOD 271 NEW VICTIMS WERE SERVED, INCLUDING 101 GUNSHOT AND 170 STABBING VICTIMS. THERE WERE 247 FAMILY MEMBERS SERVED THROUGH OUR FAMILY SUPPORT COMPONENT, AS WELL AS 22 FAMILIES OF HOMICIDE VICTIMS. SURVIVORS RECEIVED A SPECTRUM OF SERVICES, INCLUDING EMPLOYMENT HELP (212 SERVICES PROVIDED AND 11 NEW JOBS OBTAINED); BEHAVIORAL AND MENTAL HEALTH CARE (60% IN SHORT-TERM THERAPY AND 20% IN LONG TERM); AND LEGAL ASSISTANCE. VIAP ASSISTED WITH HOUSING APPLICATIONS; EDUCATION (4 OBTAINED THEIR HISET AND 7 COMPLETED JOB TRAINING). MEDICAL ASSISTANCE INCLUDED ACCESSING PRIMARY CARE, PT, REHABILITATION, NURSING SERVICES, SUBSTANCE USE AND MEDICATION MANAGEMENT. ADDITIONAL ASSISTANCE INCLUDED HELP WITH FOOD INSECURITY, TRANSPORTATION, OBTAINING A DRIVER'S LICENSE, SOCIAL SECURITY CARD, AND REGISTERING TO VOTE. VIAP'S STAFF WELLNESS PROGRAM HAS INCLUDED TRAININGS, TEAM BUILDING, AND OTHER ESSENTIAL SUPPORTIVE RESOURCES.MENTAL HEALTH AND SUBSTANCE USE DISORDERMENTAL HEALTH DIVERSION INITIATIVE (MHDI) OR CRIMINAL JUSTICE DIVERSION PROGRAM (DMH): THROUGHOUT FY23 (NOTE THAT THIS ENCOMPASSES JULY 1-JUNE 30 FOR THESE PROGRAMS AS THEY ARE ON THE ACADEMIC YEAR) , BOSTON MEDICAL CENTER CONTINUED TO STAFF THE THREE BOSTON MUNICIPAL COURT MENTAL HEALTH COURT SESSIONS LOCATED WITHIN THE CENTRAL DIVISION, THE WEST ROXBURY DIVISION AND THE ROXBURY DIVISION. SESSIONS CONTINUE TO BE WELL UTILIZED WITH A TOTAL OF 219 CLIENTS BEING SERVED ACROSS ALL THREE COURTS OVER THE COURSE OF THE FISCAL YEAR.IN TOTAL, ALL THREE SESSIONS COMPLETED INTAKES FOR AND ACCEPTED 116 NEW CLIENTS. AT THE END OF THE FISCAL YEAR, THERE WERE 13 NEW REFERRALS PENDING THROUGHOUT ALL THREE SESSIONS. THE SESSION'S SUCCESS CAN BE DEMONSTRATED THROUGH A VARIETY OF MEANS, INCLUDING THE NUMBER OF PROGRAM GRADUATES (CLIENTS WHO HAVE MET ALL LEGAL AND PROGRAMMATIC EXPECTATIONS). DURING FY23 THE THREE SESSIONS GRADUATED A TOTAL OF 35 CLIENTS. BMC CENTRAL REMAINS THE LARGEST SESSION WITH 2-3 NEW REFERRALS PER WEEK; WEST ROXBURY AND ROXBURY AVERAGE 1-2 NEW REFERRALS PER WEEK.
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SCHEDULE H, PART VI, LINE 5 (CONTINUATION):
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FASTER PATHS: FASTER PATHS IS THE LOW-BARRIER SUBSTANCE USE DISORDER BRIDGE CLINIC AT BOSTON MEDICAL CENTER (BMC). OPEN SEVEN DAYS PER WEEK, FASTER PATHS OFFERS SAME-DAY, ON-DEMAND CARE BY ADDICTION MEDICINE AND NURSING SPECIALISTS, INCLUDING INITIATION AND CONTINUATION OF MEDICATIONS FOR OPIOID USE DISORDER (MOUD), MEDICATIONS FOR OTHER SUBSTANCE USE DISORDERS, OUTPATIENT MEDICALLY MANAGED WITHDRAWAL, REFERRAL TO INPATIENT MEDICALLY MANAGED WITHDRAWAL, INFECTION SCREENING, TREATMENT AND PREVENTION SERVICES, AND OVERDOSE PREVENTION. AFTER STABILIZATION, FASTER PATHS PATIENTS ARE REFERRED TO A COMPREHENSIVE NETWORK OF BMC AND COMMUNITY SERVICES FOR LONG-TERM CARE, INCLUDING PRIMARY AND BEHAVIORAL HEALTH CARE AND LONG-TERM MOUD. THE FASTER PATHS PROGRAM COLLABORATES CLOSELY WITH LICENSED ALCOHOL AND DRUG COUNSELORS FROM BMC'S PROJECT ASSERT, WHO PROVIDE PSYCHO-SOCIAL ASSESSMENTS AND REFERRALS TO AN ARRAY OF ADDICTION TREATMENT SERVICES AND SHELTERS, OVERDOSE PREVENTION EDUCATION AND NALOXONE, HARM REDUCTION SERVICES, AND TRANSPORTATION. THE RAPID ACCESS PROGRAM, WHICH INCLUDES A TEAM OF RECOVERY COACHES AND ADDICTION COUNSELORS, IS ALSO A CLOSE PARTNER. SPECIFIC MEDICATIONS AVAILABLE IN FASTER PATHS 7 DAYS/WEEK INCLUDE SUBLINGUAL BUPRENORPHINE/NALOXONE, MONTHLY INJECTABLE BUPRENORPHINE, MONTHLY INJECTABLE NALTREXONE, AND METHADONE ADMINISTRATION FOR OPIOID WITHDRAWAL FOR UP TO 72 HOURS WITH LINKAGE TO AN OPIOID TREATMENT PROGRAM. IN ADDITION TO THE INTERNAL COLLABORATIONS, FASTER PATHS PARTNERS CLOSELY WITH COMMUNITY PROGRAMS INCLUDING THE BOSTON PUBLIC HEALTH COMMISSION'S (BPHC) PROVIDING ACCESS TO ADDICTION TREATMENT, HOPE, AND SUPPORT (PAATHS) PROGRAM, TO FACILITATE CONNECTIONS TO COMMUNITY SERVICES. IN A TWELVE-MONTH PERIOD, FASTER PATHS SERVED APPROXIMATELY 1,100 UNIQUE PATIENTS FOR 4,180 VISITS. CARE INCLUDED APPROXIMATELY 1,122 SUBLINGUAL BUPRENORPHINE/NALOXONE PRESCRIPTIONS, 232 LONG-ACTING INJECTABLE BUPRENORPHINE ADMINISTRATIONS, 21 LONG-ACTING INJECTABLE NALTREXONE ADMINISTRATIONS, AND 2,221 METHADONE ADMINISTRATIONS. ADDITIONALLY, 138 NALOXONE KITS WERE PRESCRIBED AND 334 NALOXONE KITS DIRECTLY DISTRIBUTED IN CLINIC. INFECTION SCREENING, TREATMENT, AND PREVENTION SERVICES INCLUDED 612 HIV TESTS AND 1,152 SYPHILIS, CHLAMYDIA, AND GONORRHEA TESTS; 25 PATIENTS WITH HIV WERE TREATED WITH ANTIRETROVIRAL THERAPY AND 98 PATIENTS RECEIVED HIV PRE- OR POST-EXPOSURE PROPHYLAXIS FOR HIV PREVENTION. ADDITIONALLY, FASTER PATHS CONTINUES TO OFFER HARM REDUCTION SUPPLIES AND LONG-ACTING REVERSIBLE CONTRACEPTION (E.G., CONTRACEPTION IMPLANTS). THE SUCCESS OF THE FASTER PATHS MODEL HAS INSPIRED REPLICATION IN OTHER BRIDGE CLINICS.ALCOHOL & SUBSTANCE ABUSE SERVICES, EDUCATION, AND REFERRAL TO TREATMENT (PROJECT ASSERT): PROJECT ASSERT WAS ESTABLISHED IN 1994 TO PROVIDE GREATER ACCESS TO SUBSTANCE USE TREATMENT IN THE EMERGENCY DEPARTMENT (ED) SETTING AND HAS EXPANDED TO INCLUDE A VARIETY OF SOCIAL AND COMMUNITY HEALTHCARE SUPPORT SERVICES. BASED IN THE ED, PROJECT ASSERT COUNSELS PATIENTS WHOSE ALCOHOL AND/OR DRUG USE WAS DIRECTLY AND INDIRECTLY IMPLICATED IN THEIR NEED FOR EMERGENCY SERVICES. LICENSED ALCOHOL AND DRUG COUNSELORS (LADCS) CONSULT AND COLLABORATE WITH HOSPITAL STAFF TO OFFER ED PATIENTS ALCOHOL AND DRUG SCREENING, BRIEF INTERVENTION, COUNSELING ON TREATMENT OPTIONS AND REFERRALS TO HEALTH AND SOCIAL RESOURCES SUCH AS SUD TREATMENT AND PRIMARY CARE SERVICES. IN FY23, 1,270 PATIENTS HAD 2,268 ENCOUNTERS WITH RECOVERY SUPPORT NAVIGATORS AT PROJECT ASSERT. OF THOSE ENCOUNTERS, 30% OF THE PATIENTS IDENTIFIED AS BLACK, 20% IDENTIFIED AS HISPANIC, AND 50% IDENTIFIED AS WHITE. 700 PATIENTS WERE DEEMED AT HIGH RISK FOR SUBSTANCE USE BASED ON RESULTS FROM THE TAPS SCREENER ASSESSMENT. 1,154 ENCOUNTERS HAVE DOCUMENTED REFERRALS TO RECOVERY COACH SERVICES, FASTER PATHS (MAT), DETOX/WITHDRAWAL MANAGEMENT, AND CLINICAL STABILIZATION SERVICES (CSS). 536 UBER RIDES WERE BOOKED FOR TRANSPORTATION TO EXTERNAL SERVICES SUCH AS CSS AND DETOX. PROJECT ASSERT MIRRORS THE SAME POPULATION SEEN IN THE ED FOR SUDS TREATMENT. SUPPORTING OUR FAMILIES THROUGH ADDICTION AND RECOVERY (SOFAR): THE GOAL OF SOFAR IS TO CREATE A MEDICAL HOME IN THE PEDIATRIC PRIMARY CARE CLINIC FOR MOTHERS IN RECOVERY AND THEIR CHILDREN. SOFAR HOUSES A MULTIDISCIPLINARY TEAM OF PHYSICIANS, SOCIAL WORKERS, PATIENT NAVIGATORS, NURSE PRACTITIONERS, AND COORDINATORS WHO PROVIDE HIGH-QUALITY, COORDINATED MEDICAL AND PSYCHOSOCIAL CARE FOR FAMILIES TO MAXIMIZE THEIR ABILITY TO SUCCESSFULLY NAVIGATE PARENTING AND SUBSTANCE USE RECOVERY. SOFAR PROVIDES ONGOING SUPPORT FOR FAMILIES TO ENHANCE CHILD DEVELOPMENT AS WELL AS ONGOING SUPPORT FOR RECOVERY, WITH ACCESS TO SPECIALTY CARE AND SOCIAL SERVICES. IN FY23, SOFAR HAD APPROXIMATELY 325 PATIENTS ENROLLED IN THE CLINIC.
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PART VI, LINE 7
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BMC DOES NOT FILE A COMMUNITY BENEFITS REPORT WITH THE COMMONWEALTH OF MASSACHUSETTS.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.