HCH Directory - Massachusetts

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729 Massachusetts Avenue
Boston, MA 02118
Phone: (857) 654-1000
Fax: (617) 414-7776
Email: bblock@bhchp.org
Web: www.bhchp.org
Director: Robert Taube, PhD
HCH Coordinator: Barry Bock, RN
Medical Director: Greg Wagoner, MD
UDS Number: 011210

The Boston Health Care for the Homeless Program (BHCHP) provides health care and psychosocial services at 83 sites, including shelters, motels, soup kitchens, day centers, street outreach, detoxification units, transitional programs, and clinics of four major teaching hospitals.

BHCHP provides primary and episodic care at more than 70 sites in greater Boston. These sites include hospitals, CHCs, and adult, family and domestic violence shelters, as well as the streets of Boston. In addition, BHCHP provides dental and behavioral health care. BHCHP operates the McInnis House, a 90-bed inpatient medical respite facility.

Linkages include Boston Public Health Commission, Massachusetts Housing and Shelter Alliance, Homes for Families, Massachusetts Coalition for the Homeless, Boston's Emergency Shelter Commission, Boston Health Net, Massachusetts League of CHC, and the State Departments of Transitional Assistance and Mental Health.

Statistics

Estimated homeless population: 11,000 Patients served: 10,836

Cambridge Hospital, City of Cambridge
HCH Program
1493 Cambridge Street
Cambridge, MA 02139
Contact: Mark McGovern
Phone: (617) 498-1000
Fax: (617) 498-1682
Email: MMcGovern@CHAlliance.org

Mass General Hospital
Wang 108, Medical Walk In Unit
Boston, MA
Phone: (617) 726-2707
Fax: (617) 724-0189

South End Community Health Center
1601 Washington Street
Boston, MA 02118
Contact: Tristram Blake
Phone: (617) 424-8724
Fax: (617) 425-2043

Duffy Health Center

105 Park Street
Hyannis, MA 02601
Phone: (508) 771-9599
Fax: (508) 771-1986
Email: jdegroot@duffycenter.cc
Director: Claire F. Goyer
HCH Coordinator: Claire F. Goyer
Medical Director: Lisa Zandonella-Huhta, MD
UDS Number: 011720

Project Description

The Duffy Health Center is a 330(h) health center for homeless adults and those at risk for homelessness. Duffy offers best practice homeless health care through an interdisciplinary team approach, integrating primary and preventive care with on-site behavioral health services, case management, benefits enrollment, and other social services. Care is provided at two clinics, and at its modified therapeutic community site, Pilot House. Staff provide outreach on the street and at camps, motels, and other locales. Duffy oversees health services for two "housing with support" programs: Pilot House, and a Housing First demonstration project, as well as seasonal housing programs.

Duffy Health Center's integrated health services model includes the following: outreach and on-site primary, preventive, and episodic health care; in-depth assessment and risk reduction education; individual and group mental health counseling; psychiatric services; substance abuse treatment (including buprenorphine treatment and services for opioid addiction), education and support; intensive case management; health insurance and disability benefits enrollment and coordination; Representative Payee services; chiropractic services; nutritional education and counseling; laboratory work and medications; HIV/hepatitis C prevention and education; on-site specialty clinics (surgery consult, neurology, ENT); assistance with daily needs; medical transportation; and housing support through community partnerships. Duffy has formal referral arrangements for pediatric care and for concurrent obstetrics care for its pregnant clients and refers to a nearby CHC for dental services.

Key linkages focus on transition to housing. Duffy links with the Social Security Administration to provide outreach and SSI/SSDI benefits enrollment to eligible adults. State partners include the MA Department of Public Health and the MA Department of Transitional Assistance, as well as the MassHealth Behavioral Health Partnership that funds Duffy’s Housing First demonstration program. Local partnerships resulted in "Operation in From the Cold," which provided motel vouchers to homeless clients in winter, 2005, as well as Pilot House, developed to shelter chronically homeless adults banned from other shelters. Pilot House offers a modified therapeutic community with a step-up to Pilot II housing with support. Strengthening the health care continuum underlies other critical linkages. Duffy works with the VNA to provide men's and women's preventive health screenings, the local hospital system for follow-up care, with transitional housing programs to offer healthcare, with local agencies to coordinate outreach, and provides pre-and/or post-discharge services for the correctional facility and domestic violence, detox, and other agencies. Duffy is also part of a regional Cape Cod CHC network. In 2006-07, Duffy began overseeing the planning of a regional CHC behavioral health network.

Estimated homeless population: 4,000 Patients served: 1,718

Greater Lawrence Family Health Center, Inc.

34 Haverhill Street
Lawrence, MA 01841-2884
Phone: (978) 725-7400
Fax: (978) 687-3726
Email: lpatton@glfhc.org
Web: www.glfhc.org
Director: Robert J. Ingala
HCH Coordinator: Ann Marie Isaac-Tsewole
Medical Director: Glennon O'Grady, MD
UDS Number: 012160

Project Description

The Greater Lawrence Family Health Center (GLFHC) provides medical care at 14 sites in Lawrence, Haverhill, and Tewksbury to individuals and families who are homeless. A primary objective of GLFHC is to ease the transition into an already existing health care system which includes outreach, health education, and case management.

GLFHC's Health Care for the Homeless model is a comprehensive care model which includes primary care assessment and treatment, referral, disease prevention and health education, client-centered case management, substance abuse counseling, outreach assistance, and transportation for clients needing referral to/linkage with other support services. Mental health counseling is provided through a network of local programs, including CAB Health and Recovery Services. Those clients needing extensive assistance with substance abuse are linked to prevention, education, and counseling services offered locally. A small network of specialty care providers --podiatrists, dermatologists, ophthalmologists, dentists -- see homeless clients on a pro bono basis. Access to emergency room and inpatient care is available through off-site resources.

GLFHC's HCH program networks with local and State agencies that provide services for individuals who are homeless living in the Merrimack Valley. The Massachusetts State Departments of Mental Health, Public Health, Social Services, and Transitional Assistance. Local agencies include shelters, drop-in centers, soup kitchens, detoxification sites, AIDS coalitions, community action councils, family social service agencies, mental health providers, boards of health, violence prevention programs, and community hospitals. Homeless services are also coordinated with GLFHC-sponsored programs, including Northeast Center for Healthy Communities, which provides consultation on health needs and interventions in 53 communities north of Boston. Expansion of GLFHC's services has led to a collaborative initiative with CAB Health and Recovery Services, which provides a continuum of substance abuse prevention and treatment services outside the traditional health care system.

Estimated homeless population: 4,500 Patients served: 835

Homeless Outreach and Advocacy Project

72 Jaques Avenue
Worcester, MA 01610-2480
Phone: (508) 860-1057
Fax: (508) 860-1046
Email: lgottlieb@communityhealthlink.org
Web: www.communityhealthlink.org
Director: Deborah Ekstrom
HCH Coordinator: Larry Gottlieb, MSW, MPA
Medical Director: Erik Garcia, MD
UDS Number: 010180

Project Description

The Homeless Outreach and Advocacy Project (HOAP) is a comprehensive community based program that provides an array of primary care, mental health, and support services to people who are homeless in Worcester, and a Tenancy Preservation Program.

HOAP's services include primary medical care, psychiatric and mental health services, case management, substance abuse, supportive housing, transitional housing services for single adult men and women, homeless intervention services, and emergency assessment and response to homeless crisis.

HOAP has linkages with Salvation Army, Abby's House (shelter), Mustard Seed (soup kitchen), Youville Shelter, Salvation Army Adult Rehabilitation Center, and Daybreak Shelter for Women (domestic violence).

Estimated homeless population: 2,500 Patients served: 2,292

Family Health Center of Worcester
26 Queen Street
Worcester, MA 01610
Contact: Frances Anthes
Phone: (508) 860-7700
Fax: (508) 860-7990

Great Brook Valley Health Center
19 Tacoma Street
Worcester, MA 01605
Contact: Zoila Torres Feldman
Phone: (508) 852-1805
Fax: (508) 853-8593

The Worcester People in Peril Shelter
701 Main Street
Worcester, MA 01610
Contact: David McCloskey
Phone: (508) 757-0103
Fax: (508) 753-2271

Springfield Health and Human Services Department

95 State Street, Suite 201
Springfield, MA 01103
Phone: (413) 787-6737
Fax: (412) 787-6458
Email: hcaulton@springfieldcityhall.com
Web: www.springfieldcityhall.com
Director: Helen R. Caulton-Harris
Medical Director: Judy Mealey, RN, NP
UDS Number: 010120

Project Description

The Springfield Health and Human Services Department participates in an interagency program to deliver health care and social services in settings covering more than 1,800 miles. The main agencies are Springfield Health and Human Services Department, Mercy Medical Center/HCH, and Open Pantry Community Services.

Health Services for the Homeless provides health care, social services, and advocacy at 46 sites. An extensive referral network augments these services. Services are provided at soup kitchens, shelters, recovery programs, an education and job training program, and through street outreach. Mercy Medical Center/HCH uses a nursing model to provide primary care, substance abuse/mental health assessment, and referral. Assistance with medication, developmental screening, immunizations, health education, and health-related support to shelter staff is also provided. Health care services are provided by the City of Springfield, Health and Human Services Department staff, and Mercy Medical Center/HCH through a medical director, 4 nurse practitioners, 7 RNs, and 4.5 case managers. Additional services are provided by Open Pantry Community Services/Open Door program staff.

Mercy Medical Center/HCH provides emergency, lab, x-ray, and inpatient medical/surgical services. Extensive social services are available through service providers in the community who provide advocacy/outreach for entitlement benefits, housing placement, case management, bilingual services, mental health/substance abuse assessment and referral, and counseling.

Estimated homeless population: 1,728 Patients served: 3,729

City of Springfield, Worthington House, Dental Clinic
769 Worthington Street
Springfield, MA 01103
Contact: Barbara Stanley
Phone: (413) 787-6737
Fax: (413) 787-6458
Email: bstanley@springfieldcityhall.com

Health Care for the Homeless / Mercy Medical Center
271 Carew Street
Springfield, MA 01102
Contact: Doreen Fadus
Phone: (413) 748-9064
Fax: (413) 748-9049
Email: doreen.fadus@sphs.com

Open Pantry Community Services, Inc.
287 State Street, PO Box 5127
Springfield, MA 01101
Contact: Theresa O'Connor
Phone: (413) 737-4167
Fax: (413) 737-6811
Email: toconnor@openpantry.org