Harvard Street Neighborhood Health Center Inc

HEALTH CENTER PROGRAM

HEALTH CENTER PROGRAM

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

FY 2021 ENDING THE HIV EPIDEMIC - PRIMARY CARE HIV PREVENTION

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - THIS INITIATIVE, EXPANSION OF BH & SUD SERVICES FOR BOSTON'S UNDERSERVED COMMUNITIES, WILL SIGNIFICANTLY INCREASE HARVARD STREET’S BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER PROGRAMMING AND ITS CAPACITY TO MEET THE NEEDS OF THE LOW-INCOME, RACIALLY AND ETHNICALLY DIVERSE, AND SOCIOECONOMICALLY DISADVANTAGED POPULATIONS WE SERVE. LOCATED IN THE HEART OF BOSTON’S MOST UNDERSERVED NEIGHBORHOODS OF DORCHESTER, ROXBURY AND MATTAPAN, HARVARD STREET SERVES A POPULATION THAT IS PREDOMINANTLY BIPOC (BLACK, INDIGENOUS, PEOPLE OF COLOR) WITH MORE THAN 40% IDENTIFYING AS ETHNICALLY LATINX AND HALF PREFERRING A LANGUAGE OTHER THAN ENGLISH. MANY ARE NEW IMMIGRANTS, REFUGEES, SINGLE-MOTHER FAMILIES, AT-RISK YOUTH, MEMBERS OF THE LGBTQI+ COMMUNITY, ELDERLY, DISABLED AND OTHER VULNERABLE POPULATIONS SUCH AS UNHOUSED INDIVIDUALS, VETERANS, FORMERLY INCARCERATED, AS WELL AS THOSE ENGAGING IN HIGH-RISK DRUG ACTIVITIES OR SUFFERING FROM SUBSTANCE USE DISORDER. THE RATES OF SUBSTANCE USE DISORDER AND OPIOID OVERDOSES HAVE BEEN RISING DRAMATICALLY IN OUR COMMUNITY SINCE 2017, WITH BOSTON EXPERIENCING A 40+% INCREASE IN OPIOID-RELATED DEATHS – THE MAJORITY OF WHICH ARE FENTANYL-ASSOCIATED. THE MOST DRAMATIC INCREASES IN OVERDOSES HAVE OCCURRED IN BOSTON’S BLACK AND LATINX COMMUNITIES, WITH ANNUAL OPIOID MORTALITY RATES 66% AND 31% HIGHER THAN THEIR WHITE COUNTERPARTS, RESPECTIVELY. YOUNG ADULTS ARE PARTICULARLY VULNERABLE. LACK OF EDUCATION, ALONG WITH LACK OF ACCESS TO HARM REDUCTION, MOUD (MEDICATIONS FOR OPIOID USE DISORDER), SUD COUNSELING, PEER SUPPORT, AND INPATIENT REFERRALS ALL CONTRIBUTE TO THE CONTINUED RISE IN THE DEATHS. LIKEWISE, WE’VE WITNESSED THE ONSET OF A MENTAL HEALTH CRISIS IN BIPOC POPULATIONS, ESPECIALLY AMONG YOUTH – PARTICULARLY CONCERNING FOR TRANSGENDER YOUTH (22% ATTEMPTING SUICIDE). ALL AGES IN OUR COMMUNITY ARE AFFECTED BY DEPRESSION, ANXIETY, SELF-HARMING BEHAVIORS, OBSESSIVE-COMPULSIVE DISORDER, POST-TRAUMATIC STRESS DISORDER , SUBSTANCE USE DISORDER OR OTHER CONCERNS. MANY OF THESE DISORDERS MAY BE LINKED WITH TRAUMA, SYSTEMIC RACISM, DOMESTIC ABUSE, OR NEIGHBORHOOD VIOLENCE AND LOSS. THE NEED FOR INCREASED BH/SUD SERVICES IN BOSTON’S LOW-INCOME, COMMUNITIES OF COLOR IS CLEAR, AND YET MANY DO NOT SEEK TREATMENT DUE TO SHAME, STIGMA, LACK OF TRUST IN HEALTHCARE, INABILITY TO PAY AND CULTURAL BELIEFS. FURTHERMORE, THE SOCIAL DETERMINANTS OF HEALTH (SDOH) BARRIERS FACED BY THOSE WE SERVE ARE VAST AND INCLUDE LANGUAGE AND CULTURAL BARRIERS, ECONOMIC BARRIERS, LACK OF TRANSPORTATION OR CHILDCARE, FOOD INSECURITY, LACK OF ADEQUATE HOUSING OR DIGITAL DIVIDE. THOSE WHO ARE STRUGGLING WITH BASIC NEEDS, LIKE FOOD OR HOUSING, ARE UNLIKELY TO SEEK NEEDED CARE FOR ADDICTION OR PRIORITIZE THEIR MENTAL HEALTH. THE STRESS OF THEIR STRUGGLES ONLY DRIVES THEM FURTHER FROM TREATMENT AND RECOVERY. WE WILL ENGAGE THOSE HARDEST TO REACH WITH A CULTURALLY COMPETENT AND UNBIASED APPROACH – BOTH WITHIN THE HEALTH CENTER AND ACROSS THE COMMUNITY – THROUGH PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS AND VIA OUR MOBILE INFECTIOUS DISEASE TEAM. WE WILL INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH AND SUD SERVICES, INCLUDING THOSE RECEIVING MOUD, BY ENCOURAGING REFERRALS FROM PARTNERS, BEGINNING MOUD, TRAINING STAFF, AND ADDING RECOVERY COACHING, PEER YOUTH SUPPORT, EDUCATIONAL OUTREACH, AND NALOXONE DISTRIBUTION. BY INTEGRATING BH/SUD WITH PRIMARY CARE, DENTISTRY, AND OTHER DEPARTMENTS, WE WILL BETTER SCREEN AND IDENTIFY PATIENTS IN NEED. AS AN AFFILIATE OF BOSTON MEDICAL CENTER (BMC), WE WILL REFER THOSE IN NEED OF URGENT OR RESIDENTIAL TREATMENT TO BMC’S FASTER PATHS TO TREATMENT PROGRAM AND WILL PROVIDE FOLLOW-UP RE-ENTRY SUPPORT. WE WILL HELP PATIENTS OVERCOME STIGMA, PROVIDE HARM REDUCTION MATERIALS, AND GAIN TRUST BY OFFERING NEEDED SDOH SUPPORT (FOOD PANTRY, COMPUTER LAB, TRAVEL VOUCHERS ETC.). ADDED STAFF WILL INCLUDE 3.5 SUD & BH SOCIAL WORKERS, 1 YOUTH-FOCUSED CHW, 1 RECOVERY COACH, AND A .5 FTE PSYCH NP. H80CS2900

HEALTH CENTER INFRASTRUCTURE SUPPORT

FISCAL YEAR 2025 EXPANDED HOURS. - EXPANDED HOURS AND ACCESS FOR UNDERSERVED POPULATIONS H80CS29009 HARVARD STREET SERVES A RACIALLY, ETHNICALLY, AND SOCIOECONOMICALLY DIVERSE PATIENT POPULATION IN THE LOW-INCOME BOSTON NEIGHBORHOODS OF DORCHESTER, ROXBURY AND MATTAPAN. 97% OF THOSE WE SERVE ARE LOW-INCOME (BELOW 200% OF THE FPL) WITH 72% BEING VERY LOW-INCOME (BELOW 100% OF THE FPL). THE ZIP CODES SERVICED BY HARVARD STREET HAVE BEEN IDENTIFIED AS AREAS OF HIGH UNMET NEEDS BY HRSA’S SERVICE AREA NEEDS ASSESSMENT. NEW PATIENT NUMBERS ARE RISING SIGNIFICANTLY, AS THE HEALTH CENTER WELCOMES AND CARES FOR NEWLY ARRIVING IMMIGRANT FAMILIES FROM COUNTRIES SUCH AS HAITI, DOMINICAN REPUBLIC, BRAZIL, AND CAPE VERDE. ADDITIONALLY, OUR HEALTH LITERACY OUTREACH EFFORTS – AIMED AT OVERCOMING RACIAL AND ETHNIC HEALTH DISPARITIES AND INCREASING ACCESS FOR COMMUNITIES OF COLOR – HAVE RESULTED IN POSITIVELY ENGAGING MANY NEW PATIENTS IN CARE. MEANWHILE, WE’VE SUCCESSFULLY RE-ESTABLISHED CARE FOR MANY EXISTING PATIENTS WHOSE HEALTHCARE HAD LAPSED DURING THE COVID-19 PANDEMIC. THESE ARE ALL VERY POSITIVE DEVELOPMENTS, BUT HARVARD STREET IS NOW STRUGGLING TO MEET THE GROWING DEMAND FOR APPOINTMENTS WITHIN ITS CURRENT STAFFING STRUCTURE AND OPERATING HOURS IN PART DUE TO A HIGH “NO SHOW” RATE. OUR WAITING LIST FOR NEW PATIENT APPOINTMENTS AND ANNUAL PHYSICALS IS GROWING – WITH SOME WAITING TWO MONTHS TO BE SEEN. MANY OF OUR PATIENTS AND THEIR FAMILIES STRUGGLE WITH SCHEDULING VISITS TO THE CLINIC AND, AT TIMES, POSTPONE NEEDED CARE WHICH CAN LEAD TO PREVENTABLE EMERGENCY ROOM VISITS, AS THEIR CONDITION WORSENS WITHOUT THE NECESSARY PREVENTATIVE TREATMENT. OTHERS VISIT THE ER UNNECESSARILY, SIMPLY BECAUSE IT IS OPEN LATE AND ON WEEKENDS OR BECAUSE THEY ARE UNABLE TO SCHEDULE A VISIT WITH US IN A TIMELY MANNER. STILL OTHERS SCHEDULE A CLINIC VISIT, BUT THEN CANCEL OR “NO SHOW” AS THEY ENCOUNTER INSURMOUNTABLE BARRIERS SUCH AS LACK OF WORKPLACE FLEXIBILITY OR DIFFICULTY ACCESSING TRANSPORTATION DURING A BUSY WORK/SCHOOL DAY. EXPANDED EVENING AND WEEKEND CLINIC HOURS WOULD ADDRESS THESE CHALLENGES, PROVIDE BETTER SCHEDULING OPTIONS, DECREASE NO SHOWS, AND INCREASE APPOINTMENT AVAILABILITY, THEREBY IMPROVING QUALITY OF CARE AND EFFICIENCY. HARVARD STREET PROPOSES EXPANDING ITS HOURS BY 3.5 HOURS ON THURSDAY AND FRIDAY EVENINGS, FROM 4:30–8PM, AND ADDING 2 HOURS ON SATURDAYS, FROM 3-5PM. THIS COMBINED ADDITIONAL NINE HOURS FOR PRIMARY CARE, PEDIATRIC, NUTRITION, MENTAL HEALTH AND DENTAL SERVICES WILL ENABLE PATIENTS TO MORE EASILY SCHEDULE AND KEEP APPOINTMENTS. THIS WILL PROVIDE HARVARD STREET WITH THE ADDITIONAL TIME AND CAPACITY NEEDED TO CATCH UP ON ITS WAITING LIST AND REDUCE WAIT TIMES, THEREBY IMPROVING ACCESSIBILITY AND QUALITY OF CARE FOR PATIENTS. IN ADDITION TO IN-PERSON SERVICES, WE WILL ALSO OFFER TELEHEALTH VISITS DURING THESE EXPANDED HOURS – FOR THOSE WHO PREFER AND QUALIFY FOR TELEMEDICINE. FOR SOME, TELEHEALTH CAN BE VERY HELPFUL IN ADDRESSING AND OVERCOMING OBSTACLES, SUCH AS LACK OF TRANSPORTATION AND CHILDCARE. IT HAS ALSO BEEN SHOWN TO REDUCE “NO SHOW” RATES WHEN A PATIENT IS UNABLE TO MAKE IT INTO THE HEALTH CENTER IN PERSON. AS PART OF THIS INITIATIVE, WE WILL INCREASE STAFFING FOR 1 MD, 2 NPS, 1 RN, 1 NUTRITIONIST, 1 LISCW, 2 MAS, 2 CS, 1 REFERRAL COORDINATOR, 1 DENTIST, 2 DAS, AND I HYGIENIST.

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM