Lowell Community Health Center Inc.

Transcription

1 Lowell Community Health Center Inc. General Information 161 Jackson Street Lowell, MA (978) Website Organization Contact Karen Myers Year of Incorporation

2 Statements & Search Criteria Mission Statement Lowell Community Health Center seeks to provide caring, quality, and culturally appropriate health services to the people of Greater Lowell, regardless of their financial status; to reduce health disparities and enhance the health of our community; and to empower each individual to maximize overall well being. Background Statement Founded in 1970, Lowell Community Health Center (Lowell CHC) provides primary care and behavioral health services, targeting individuals and families who are low-income, medically underserved, uninsured, and limited English proficient. Because of the disproportionately high levels of poverty and unemployment in the City of Lowell, the health center touches the lives of more than 50,000 community members each year--or nearly half of all Lowell residents. Our Metta Health Center is a state-designated Refugee Health Assessment site. In its early years, Lowell CHC operated as an affiliate of Lowell General Hospital and provided nursing visits to local public housing residents in need of services. In 1985, Lowell CHC was separately incorporated, with its own Board of Directors comprised of patient and community representatives. One in every five Lowell residents is foreign-born, and the health center is committed to providing culturally competent care to reduce a wide range of health disparities, particularly among lowincome, underserved immigrant and refugee communities (primarily Southeast Asians, Africans, and Latinos). Despite the success of health care reform in Massachusetts, 6% of our patients remain uninsured. Almost 90% of Lowell CHC s patients lives at or below 200% of the federal poverty level, and over 70% uses a publicly funded form of health insurance to pay for their care. (FY2015 data) Our patients reflect Lowell s rich cultural diversity. In 2015, approximately 70% of our patients identified as Non-Hispanic/Latino, with 30% Hispanic/Latino. Racially, 38% of our patients identified as White; 27% as Asian; 12% as Black/African Immigrants, and 23% reported as Multiracial or did not indicate a race. Our Metta Health Center is a Massachusetts-designated Refugee Health Assessment Site, and we also serve many individuals whose complex health care needs are complicated by multiple conditions, cultural and linguistic barriers, and histories of torture and trauma. Almost half (46%) of our patients are best served in a language other than English. In 2015 the health center employed a staff of 384 individuals. Over half of our employees are bilingual/bicultural, and provide interpretation or direct services in 28 different languages. As a result of Lowell CHC's patient-centered, cross-cultural model of care, the U.S. Department of Health and Human Services has recognized our health center as one of the Top Five Culturally Competent Health Agencies in the nation. Expansion of dental and specialty services is a key organizational Strategic Plan goal. In 2015 the health center received federal approval to expand access to affordable oral health services, marking Lowell CHC s ongoing commitment to our community and the initiation of a project to renovate 65,000 sf of the undeveloped portion of our former mill complex. Fundraising is underway for the projected $25.5 million expansion project, with a capital campaign goal of $2.5 million. 2

3 Impact Statement Accomplishments in FY16: * Provided high-quality health care services, community health screenings and education to more than 50,000 low-income individuals living in and around Lowell, MA almost half the population of the city of Lowell * Provided health benefits assistance to help submit 26,028 patient applications for the Commonwealth's array of subsidized health plans * Received $1m award from Health Resources and Services Administration (HRSA) to build a new Dental Clinic * Received $419,998 award from MA Executive Office of Health and Human Services (EOHHS) Infrastructure and Capacity Building project to Design and Implement a Practice Support Center * Received $352,083 award from Health Resources and Services Administration (HRSA) to expand Substance Use Disorder services * Received $100,000 grant from MA Department of Public Health for expanded Office Based Opioid Treatment (OBOT) services * Received major grant support from the Theodore Parker Edson Foundation; the Ludcke Foundation, and the Abbot and Dorothy Stevens Foundation Goals for FY 2017: * Complete $2.5 m capital campaign to fund 65,000 s.f. expansion project, to include new Dental Clinic, Vision Clinic, expanded adult medicine services, and expanded youth programming *Expand Lowell CHC as the health care home for the underserved by further integrating behavioral health services with primary care * Continue to seek funding for essential "Wraparound services including medical interpretation in multiple languages, case management, community health programs, and chronic disease selfmanagement groups. 3

4 Needs Statement Current and Ongoing Needs * Raise $2.5m towards costs to renovate 65,000 sf of undeveloped space in our former mill complex with new Dental and Vision clinics, and expanded access to primary health care services for low-income populations. As of October 2017 we have raised $2.6 M in gifts and pledges; goal has been extended to $3 M in line with plans to renovate all 280 Italianate windows in our historic building. As of October 2017, 237 staff members - more than half of all Lowell CHC employees - have donated $140,687 toward a $150,000 Employee Giving campaign goal. We are honored to have this level of support from our staff, many of whom are from our local community. * Raise $350,000 for the WrapAround Fund, to support essential programs and services needed for patient health and wellbeing that are not covered by health insurance reimbursements like interpreter services (in 2016, we provided services in 61 languages); bilingual health insurance counseling and enrollment; community health education and screening; Teen BLOCK, our youth development afterschool program; home visits by certified Community Health Workers); case management, and referrals and linkages to local agencies and organizations) * Garner philanthropic contributions for our Teen BLOCK (Building Leadership Opportunities in the Community and providing Knowledge) Youth Development after school program, which is 100%- funded through grant support. Teen BLOCK's evidence-based programs focus on academic skills development; leadership training, and fostering artistic expression, to help teens make healthy choices and avoid teen pregnancy and STDs, gang violence, and substance abuse. The University of Massachusetts-Lowell Center for Community Research and Engagement has provided annual evaluations of Teen BLOCK * In early 2018, open new Eye Care and Dental Clinics, with access to Lowell CHC's full range of primary care, behavioral health, and support services. CEO/Executive Director Statement Lowell Community Health Center s three-pronged approach to improving the health of the Greater Lowell community includes primary medical care for all ages, behavioral health (mental health and substance abuse) treatment, and community health promotion through outreach and education with youth, refugees and immigrants. Each of these approaches is critical to community health, particularly for Lowell's low income, refugee/immigrant, and limited English speaking communities. Services are designed to be culturally competent; over 50% of the health center's employees are bilingual, bicultural, with 28 languages spoken. Our Board of Directors represent the cultural diversity of Lowell, and more than 50% of board members are Lowell CHC consumers. These factors contributed to recognition, in 2004, by the federal Office of Minority Health as one of the top five culturally competent health organizations in the United States. Examples of successful approaches at the health center are its nationally recognized Metta Health Center. Metta integrates Eastern and Western approaches to primary medical care and mental health services, and utilizes many gateways to care such as acupuncture, massage therapy, meditation, and faith-based partnerships, in addition to medical and mental health services. Lowell CHC is committed to holistic, culturally competent care, and to the concept that health care is one component of a global approach to keeping people and communities healthy. Addressing social determinants of health is a key part of the work that health center staff provide for each and every patient. 4

5 Board Chair Statement I have served as a Lowell Community Health Center board member for the past 8 years, and it is my privilege now to serve as Board Chair at this pivotal moment in our organization s history. For many years I worked closely with former Lowell CHC CEO Dorcas Grigg-Saito, who retired in April During her 18-year tenure, Dorcas oversaw the health center during a period of phenomenal growth that has helped shape the organization s future. During this time we undertook our first capital project to merge six separate healthcare sites into one consolidated location in downtown Lowell, which has since achieved the highest ranking as a Patient Centered Medical Home from the National Committee for Quality Assurance. In 2000 the health center established the Metta Health Center, which has been recognized by the federal Office of Minority Health as a model of culturally competent care delivery. Most importantly, since its founding in 1970 Lowell Community Health Center s budget has grown from $9 million to $39 million, with capacity to serve close to 50,000 individuals annually through clinical services and community outreach programs. This spring we hired our 400 th employee, and the health center s economic impact on the City of Lowell now tops $46 million. We ve come a long way! But our message hasn t changed over the years to continue to meet the needs of our patients, we need to get bigger, not smaller. We know that since opening our facility at 161 Jackson Street in December 2012, 15,100 new patients have turned to Lowell Community Health Center for quality, patient-focused care. We also know from public health evidence and a study by Harvard School of Dental Medicine Residents that low-income patients in our region need more affordable services to improve health and wellbeing, like dental and vision care. To meet these and other healthcare needs of low-income, immigrant and refugee populations, we are now embarking on a new expansion project to renovate approximately 65,000 s.f. of the remaining portion of our mill complex, to include our area s first affordable Dental and Vision clinics, and expanded access to primary care. Philanthropy will be vital to our ability to meet the $2.5 million campaign goal for a projected $25.5 million capital project. Along with my board colleagues and health center staff, I look forward to a seamless leadership transition as Susan West Levine, MPH, takes the helm as Lowell Community Health Center s new Chief Executive Officer in summer We are excited to welcome Susan to the health center and the community. At Lowell Community Health Center, patients come first. Our leadership and our vision for the future ensure that low-income patients and families will continue to receive the compassionate care that they have come to rely on, for generations to come. Bruce Robinson Service Categories Community Clinics Mental Health Treatment Youth Development Programs Geographic Areas Served 5

6 Greater Lowell area, Massachusetts Please review online profile for full list of selected areas served. 6

7 Programs Health Care Navigation for Refugees and Immigrants Description Lowell CHC provides primary medical and behavioral health care, as well as health education and health promotion programs to almost half of Lowell s population of 105,000. More than one in five Lowell residents is foreign-born, and there is a tremendous need for assistance in learning how to effectively enter and utilize the U.S. health care system. The main refugee and immigrant groups in Lowell are Cambodians, Lao, Africans from a dozen countries, Brazilians, Latinos from several origins, and newer communities of Burmese, Bhutanese, and Iraqi refugees. Our bilingual, bicultural Community Health Workers (CHWs) and medical interpreters assist refugees and immigrants in navigating the often complex and confusing U.S. health care system, and provide many gateways to care. They meet, engage, and educate people in familiar gathering places such as faith-based organizations or English as a Second or Other Language (ESOL) classes. They provide community--based screenings for conditions including diabetes, hypertension, cholesterol, HIV, and depression. They assist with scheduling appointments for medical and mental health care, as well as insurance counseling. Metta Health Center is a MA-state designated Refugee Health Assessment site, and when refugee and limited English proficient patients seek care at the health center, they are likely to have a CHW as their medical interpreter. The CHW also will follow up with phone calls and/or home visits to help with referrals, proper use of medication, and linkages to resources such as transportation, clothing, housing, food, and employment. CHWs help individuals with complex medical, mental health, and social challenges learn to manage their conditions and connect with available social service resources. Budget In 2015, Lowell CHC Health Promotion Department Community Health Workers delivered a range of support for our diverse patient population, including: 15 Health Screening Events throughout the Lowell community, reaching 801 individuals 294 Community Outreach Events, reaching close to 6,000 individuals 1,094 Interpreting Sessions at Lowell CHC 780 individuals assisted with Patient Navigation at the health center. Category Population Served Employment, General/Other Immigrant, Newcomers, Refugees, Unemployed, Underemployed, Dislocated, At-Risk Populations 7

8 Program Short Term Success Program Long term Success Program Success Monitored By Short-term success will focus on teaching individuals from diverse refugee and immigrant communities in Lowell, MA how to navigate the health care system and linking those individuals to health care, health information, and skills for managing their own health. Success of the Navigation Program will be measured by the numbers of refugees and immigrants who are engaged through community screenings and then obtain health insurance and receive care at the health center. In our community health screenings conducted throughout the City of Lowell in 2011, 31% of the 865 individuals screened did not have a primary care provider and 29% had no health insurance. The Navigation Program will increase the number of people screened and the number connected to health care and health insurance. Overall, Lowell Community Health Center served 47,000 people in 2012 with primary medical care, behavioral health (mental health and substance abuse) treatment, community health promotion, and youth development programs. We helped 12,000 people sign up for, or renew, health insurance coverage. With the addition of additional Community Health Workers In the coming year, these numbers will increase and more of Lowell s medically underserved will receive the quality, culturally competent health care services they need. Long-term success will focus on promoting individual, family, and community health and well-being. It will be evident through improvements in clinical measures and outcomes for the refugees and immigrants connected to care by the program s Community Health Workers. Of the 865 individuals screened in community settings in 2011, 10% self-reported diabetes and 25% had hypertension, illustrating the importance of linking these folks to on-going health care. In addition, success will also involve the number and percent of individuals who retain health insurance and continue their connections with health care, both important factors for ensuring good health. Program success will be measured by the number of individuals screened in the community, number and percent without health insurance and without a primary care provider, and the number and percent of individuals who are linked with health insurance and health care following implantation of the Navigation Program. For those with conditions such as diabetes and hypertension, their clinical measures will include HbA1C (blood sugar level) and blood pressure. 8

9 Examples of Program Success After years of extreme poverty and repression in Burma, Mr. Thawngmung left his family behind to start a new life in Lowell. The Health Center s team of Community Health Workers met Mr. Thawngmung while they were conducting a health screening and info session at a local ESOL class. They learned that Mr. Thawngmung had not seen a doctor in years because he didn t have money to pay for his care. So, he had his blood pressure, blood sugar, and cholesterol tested and was screened for depression and HIV. Thanks to this important connection with one of our caring and capable Community Health Workers, Mr. Thawngmung learned he needed to see a doctor, found out his blood pressure was high, learned what he needed to bring to apply for health insurance coverage, and was registered for an appointment with a doctor at the health center the very next week. At that appointment, he had an opportunity to talk about how lonely he felt without his family so we also connected him to our Behavioral Health services. 9

10 Wrap-Around Fund for Needed Services not covered by Health Insurance Reimbursements Description The Lowell CHC Wrap-Around Fund is inspired by the World Health Organization definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Close to 90% of Lowell CHC patients live below 200% of the Federal Poverty Level and face tremendous challenges including inadequate housing and limited access to healthy food. The majority of our patients present with complex medical and behavioral health needs. The WrapAround Fund covers the cost of vital health-related services that are not covered by insurance but are needed to improve and enhance individual, family, and community health. Nearly 75% of all Lowell CHC patients require the non-reimbursable services covered by our WrapAround Fund. Budget One example of fundraising efforts to support the WrapAround Fund is ArtUp. The premise of Art Up reflects the healing power of art, which can soothe, transport, or offer a distraction, especially for patients who come to the health center during times of stress and concern over health issues. A juried collection of 249 artworks by Lowell artists was selected in 2015, and patrons purchase artwork that is placed on permanent display at the health center. One-half of the purchase price is given to the artist; the remaining funds are donated to the Wrap-Around Fund. For more information about ArtUp, please see: ArtUp website (artuplowell.com/) ArtUp Facebook page (facebook.com/artuplowell/) With 'Art Up,' Lowell Community Health Center, creative community join forces to bring local artwork to public eye. Article in the Lowell Sun (March 2015) NECN coverage on 9/10/2015 (necn.com/entertainment/thescene/artup-lowell html) Art for All: The Lowell Community Health Center s ArtUp Program is a Win-Win for Patients, Staff, Artists and Community. Merrimack Valley Magazine (2015) Category Population Served Health Care, General/Other Public Health Poor,Economically Disadvantaged,Indigent, Immigrant, Newcomers, Refugees, Minorities 10

11 Program Short Term Success Program Long term Success Objective 1.1: By the end of CY2016, create a permanent art collection throughout the facility Objective 1.2: Involve the volunteer ArtUp Committee in decision-making and as ambassadors for the project, to increase visibility for Lowell CHC and the local arts community Objective 1.3: Set the stage for future ArtUp activities, including periodic calls for work by local artists and programming that highlights the links between health and well-being, while creating a model that is replicable in other communities Objective 2.1: Donate 50% of proceeds from the sale of ArtUp artworks to the Lowell CHC WrapAround Fund Objective 2.2: Through ArtUp publicity and outreach activities, continue to engage new audiences in the work of Lowell CHC Objective 2.3: Through ArtUp promotional activities, increase awareness of the connection between art and healing Objective 3.1: Provide 50% of proceeds from the sale of 249 ArtUp artworks as payment to contributing Lowell artists Goal 1: Reduce patient stress and anxiety through creation of a healing canvas at Lowell Community Health Center Goal 2: Ensure access to needed community services for patients through the WrapAround Fund Goal 3: Continue to demonstrate Lowell CHC s commitment to the creative growth of Lowell Program Success Monitored By With guidance from the project curator and ArtUp committee, we created a website and project database specific to the ArtUp project. Data including artwork purchase price, medium, subject matter, etc., are logged in the database for each ArtUp purchase, allowing us to assess price points and trends in audience interest. The database also allows us to track sales figures and signup numbers. We will monitor the number of ArtUp patrons who continue to be engaged in the work of the health center through event attendance, annual giving, and/or interest in receiving our quarterly electronic newsletter. To gauge overall project impact on our patient and donor base, we may create and deploy a public survey tool once the collection is mounted in its entirety. Our goal is to sell all pieces in the catalogue by December 2016, with half of the purchase price paid to artists and the other half donated to the WrapAround Fund. We anticipate future calls for art work, potentially in conjunction with Lowell CHC's plans to renovate adjacent space at 101 Jackson Street a capital project that has been approved by the health center's board of directors as the future site of a dental clinic and mixed-use development. Examples of Program Success Purchased art continues to be hung throughout the health center, and we have received wonderful feedback from patients, their families, staff and visitors. In 2015 the health center also received a generous $75,000 grant from the Theodore Edson Parker Foundation to more than double the amount of artwork in the collection. 11

12 Teen BLOCK Youth Development Program 12

13 Description The Teen BLOCK (Building Leadership Opportunities in the Community and providing Knowledge) program supports the healthy development of Lowell s teens, many of whom are from immigrant and refugee families, empower ing them to become community leaders through civic engagement; experiential learning; support groups; academic preparation; and healthy behaviors education. Since 1998, Lowell CHC s Teen BLOCK teen pregnancy, substance use, HIV/STIs, violence prevention and cultural programs have supported the healthy develop ment of more than 8,000 teens and young adults. Teen BLOCK s evidence-based after school programs promote strong and resilient youth who are able to overcome environmental obstacle by developing academic, leadership and coping skills necessary for future success. Teen BLOCK partners with the Lowell Public Schools. Our onsite program at Lowell Community Health Center offers a safe environment for teens, with behavioral health, primary care, and family planning services and expertise close at hand. Teen BLOCK staff are certified Community Health Workers, trained in substance use prevention, mental health, violence prevention, sexual health, and nutrition. Teen BLOCK staff members are role models. They reflect the ethnic diversity of our teens, and provide mentoring and links to community-based organizations. Teen BLOCK youth provide leadership in the community, and as Peer Leaders, co-facilitate programs and mentor other youth. Daily during the school year, as many as 70 high school youth participate in an on-site or school-based Teen BLOCK activity. 100% of Teen BLOCK participants graduate from high school. Programs include: Environmental Strategies Working Group/Substance Use and Prevention Task force Regional Dance-4-Peace Planning Committee A.D.A.M. (Awareness and Development of Adolescent Minds) academic and career readiness AfroFusion, celebrating the African diaspora through cultural enrichment activities Journey to Healing, helping Southeast Asian youth develop coping skills for dealing with trauma and building healthier relationships with family Lyrical Expression, a spoken-word arts program Health & Wellness workshops on physical and mental health, nutrition and stress management Healthy Teens, Healthy Relationships workshops on teen pregnancy, sexually transmitted infections (STIs), HIV/AIDS prevention, and Making Proud Choices, an evidence-based curriculum providing sexual health education and discussions related to the social and emotional transition from adolescence to adulthood. 100% of Teen BLOCK programming is supported through grants 13

14 and donations. Budget Category Population Served Program Short Term Success Youth Development, General/Other Youth Leadership Adolescents Only (13-19 years), Immigrant, Newcomers, Refugees, Minorities Short Term Success 100% of teens report being proud of their heritage 95% of teens complete the TeenBLOCK program of their choice 90% of teens report a grade average of B or better 85% of teens meet regularly with their staff mentor to discuss goals 100% of teens graduate high school Program Long term Success Program Success Monitored By Long Term Success: 100% of teens believe they can make a difference in their community 100% of teens feel confident that they can protect themselves or a partner from pregnancy and STIs 100% of teens feel confident that they can educate peers on a health topic 100% of teens intend to attend college 100% of teens know how and when to apply for financial aid for college The evaluation team from the University of Massachusetts, Lowell Center for Community Research and Engagement (CCRE) collaborates with Teen BLOCK program facilitators to analyze data from surveys given to youth participants at the beginning and at the end of programming. Outcome data are gathered as a crucial measure of the Teen BLOCK youth development programming. The intent of the survey is to measure whether participants feel empowered that they should and can make a difference in their community by taking action and discussing important issues with others. This evaluation is conducted annually, and the formal report is used to make decisions about future directions of Teen BLOCK programming. Examples of Program Success From the FY14 Teen Block Alumni Evaluation (youth who have graduated from programming within the past 6 years): 78% of alumni volunteer in their communities 97 % agree that they feel comfortable expressing their opinions with others 83% agree that they can create a plan to address a community issue 78% are enrolleed in higher education and plan to graduate on time 100% receive financial assistance for higher education 83% attend University of Massachusetts, Lowell Program Comments CEO Comments In April 2016, Dorcas Grigg-Saito, MSPH, retired after 18 years as Lowell CHC Chief Executive Officer (CEO). The Board of Directors has since approved the appointment of Susan West Levine, MPH, as Lowell CHC s new CEO. Ms. Levine joined the staff in summer 2016 and reports directly to 14

15 the Board. 15

16 Management CEO/Executive Director Executive Director Term Start June Ms. Susan West Levine Experience Formerly a top adviser and chief of staff to the Johns Hopkins University Provost, Susan West Levine brings more than 25 years of leadership experience in health care, public health, and higher education to her new role as CEO of Lowell Community Health Center. Prior to joining Johns Hopkins in 2014, Ms. Levine served as chief executive of UHealthSolutions, a nonprofit affiliate of the University of Massachusetts Medical School. Earlier in her career, she held executive-level roles at UMass Medical School s consulting division, Commonwealth Medicine, and worked for the Massachusetts Department of Public Health for nearly a decade. Susan Levine holds a master s in public health focusing on health service, and says it was her early experience working in clinical, administrative, and ambulatory care programs for Lemuel Shattuck Hospital in Jamaica Plain, Massachusetts, that set her on this trajectory. Working at the Lemuel Shattuck Hospital as a young professional further shaped my value system, she says, and fostered my commitment to work in public health. Ms. Levine returned to Massachusetts in summer 2016, eager to take on her new role. " I am thrilled to join the Lowell Community Health Center to continue the center s great tradition of delivering culturally competent health care and enhancing the overall health and well-being of the community of Lowell. Former CEOs Name Term Ms. Dorcas Grigg-Saito June Senior Staff Dr. Kumble Rajesh Title Chief Medical Officer Experience/Biography Henry Och Title Chief Operations Officer Experience/Biography 16

17 Rubin Williams Title Chief of Human Resources Experience/Biography Robert J Ebersole Title Chief Financial Officer-Interim CEO Experience/Biography Sheila Och Title Chief of Community Health and Policy Experience/Biography Clare Gunther Title Chief of Development and Communications Experience/Biography Staff Information Full Time Staff Part Time Staff Volunteers Contractors Retention Rate % Staff Demographics - Ethnicity African American/Black 0 Asian American/Pacific Islander 0 Caucasian 0 Hispanic/Latino 0 Native American/American Indian 0 Other 389 Staff Demographics - Gender Male Female Unspecified Formal Evaluations 17

18 CEO Formal Evaluation CEO/Executive Formal Evaluation Frequency Senior Management Formal Evaluation Senior Management Formal Evaluation Frequency NonManagement Formal Evaluation Non Management Formal Evaluation Frequency Annually Annually Quarterly Plans & Policies Organization has a Fundraising Plan? Organization has a Strategic Plan? Years Strategic Plan Considers Under Development Date Strategic Plan Adopted Oct 2014 Does your organization have a Business Continuity of Operations Plan? Management Succession Plan? Organization Policy and Procedures Nondiscrimination Policy Whistleblower Policy Is your organization licensed by the Government? Permit? 2 Awards Awards Award/Recognition Organization Year National Model for Culturally Competent Care Top Five Culturally Competent Health Centers Outstanding MA Community Health Center Director Award to CEO Dorcas Grigg-Saito Premier Cares Award to Metta Health Center Premier Cares Award to Metta Health Center Level III Patient-Centered Medical Home Recognition Federal Office for Minority Health, U.S. Department of Health and Human Services U.S. Department of Health and Human Services Massachusetts League of Community Health Centers Monroe E. Trout Premier Cares Award Monroe E. Trout Premier Cares Award National Committee for Quality Assurance (NCQA)

19 Board & Governance Board Chair Board Chair Mr. Bruce Robinson Company Affiliation Fredchurch Insurance Term Apr 2013 to Apr Board CoChair Board CoChair Sophy Theam Company Affiliation Enterprise Bancorp Term Apr 2013 to Apr 2018 Board Members Name Affiliation Status Mariatou Allie-Dumbuya MA Department of Children and Families Maureen Andricopoulos Paralegal Voting Susanne Beaton Sheryl Bourbeau Phyllis and Paul Fireman Foundation Gallagher & Cavanaugh, LLP Sokhm Chun Community Volunteer Voting Maria Cunha Richard Dionne Susan Green Ivy Ho PhD Dr. Terry Howard MD Vanna Howard Stephen Laput Middlesex Community College Anstiss & Co Lowell General Hospital University of Massachusetts, Lowell OB/GYN Aide to Congresswoman Nikki Tsongas Architectural Resources Cambridge Voting Yolanda Mauricio Community Volunteer Voting Mayte Ramos Bruce Robinson Leo Sheridan Patty Sullivan-Talty Doris Ummuna Mayte Ramos Law Offices Fred C. Church, Inc. Forsythe Technology Talty & Talty Nursing Elizabeth Wando Community Volunteer Voting Board Demographics - Ethnicity African American/Black 3 19

20 Asian American/Pacific Islander 3 Caucasian 10 Hispanic/Latino 3 Native American/American Indian 0 Other 0 Board Demographics - Gender Male Female Unspecified Board Information Board Term Lengths Number of Full Board Meetings Annually Written Board Selection Criteria? Written Conflict of Interest Policy? Percentage Making Monetary Contributions Constituency Includes Client Representation 3 12 Under Development 90% Standing Committees Executive Finance Human Resources / Personnel Nominating Patient Care Strategic Planning / Strategic Direction 20

21 Impact Goals Strategic Plan Goals: Goal 1. Expand Lowell Community Health Center as the health care home for the underserved by increasing access to high quality health care and integrating the delivery of health care Objective 1.1: Achieve and maintain Patient Centered Medical Home status. Expand walk-in access for new and established Lowell Community Health Center patients. Objective 1.2: Integrate behavioral health services with primary care. Objective 1.3: Integrate community health workers with primary care. Objective 1.4: Develop business plans for specialty services and oral health services. Goal II. Reduce health disparities and enhance the overall health of Greater Lowell Objective 2.1: Develop and implement a targeted strategy to reach the medically underserved in Greater Lowell. Objective 2.2: Expand health promotion programs in the community. Objective 2.3: Strengthen and expand community partnerships. Goal III. Invest in our people to become the workplace of choice, and to ensure the ongoing and consistent delivery of high quality health care Objective 3.1: Cultivate leaders and leadership at all levels of the organization. Objective 3.2: Design and implement a career ladders program. Objective 3.3: Develop a comprehensive succession plan. Objective 3.4: Foster a culture within the organization of continuous learning and improvement by enhancing and expanding management training; and ensuring timely and appropriate reporting of information. Objective 3.4: Develop and implement a clear, consistent process of collaboration, communication, decision making and accountability. 21

22 Strategies Rationale for 101 Jackson Street Expansion Project: Renovation of 65,000 sf of undeveloped space in our existing mill complex, to improve access to care, reduce health disparities, and provide opportunities for workforce development When Lowell CHC opened the doors to its consolidated location at 161 Jackson Street in December 2012, neither the board nor our leadership could have predicted that by 2015, an additional 15,100 new patients would have turned to Lowell CHC for a range of primary and behavioral health concerns outstripping our capacity to deliver the highest quality care to patients. By 2015, Lowell CHC was one of only three health centers in MA without a dental program. A screening survey conducted at Lowell CHC in 2014 by Harvard School of Dental Medicine (HSDM) Residents revealed that 71% of participating adult patients aged years had untreated dental decay. Most disturbing, a full 82% of screened children 6-9 years had untreated cavities a rate that is 382% higher than the nationwide prevalence of 17%. The HSDM study presented compelling evidence that our patients are in desperate need of affordable dental care. Only 55% of patients surveyed by HSDM had seen a dentist in the past year (statewide average 76%) and almost half (49%) did not have a dental provider. Patients also identified linguistic challenges that likewise limit options for dental care: "I don't know how to find treatment, and I can't find a dentist who speaks my language." Vision care is another unmet need for low-income patients in our area. Unmet eye and vision care needs impact learning, job performance, employment opportunities, and home safety, and if left untreated, eye problems can impact a child s overall physical, mental health, social development and educational advancement opportunities. Diabetes prevalence in Lowell is higher than the statewide rate (9.9% as compared with 7.5%), and vision care is vital for diabetics since diabetic retinopathy, a common cause of vision loss in people with diabetes, can go unnoticed until vision loss occurs. Early detection of eye problems, timely treatment, and appropriate follow-up care are needed to help adults and children improve quality of life and protect against vision loss. To reduce these and other health disparities, in summer 2016 Lowell CHC will undertake a major capital project to renovate 65,000 s.f. of our adjacent mill building (101 Jackson Street). Despite ongoing investments in staffing and technology, patient need has outstripped our capacity to meet demand. In addition to new dental and vision services, technology enhancements are needed to improve operational efficiencies especially at points of entry such as the Patient Access Center and the Call Center, which handles more than 1,000 inquiries daily. Our project will have a major impact on our patients and our community. Renovation of 101 Jackson Street will allow the health center to deliver new dental and vision services, and expand access to behavioral health and primary care services. It will improve wait times for patients by strengthening our technology and systems infrastructure. In addition, through new opportunities for employment and indirect economic benefits from operations (estimated at $98 million by 2019), this project will contribute to Lowell CHC s ongoing commitment to the revitalization of a once-neglected downtown Lowell neighborhood. 22

23 Capabilities Lowell CHC is housed in the former Hamilton Mill Complex ( Jackson Street, Lowell). We purchased the complex in 2009, and in 2012 opened our facility at 161 Jackson Street, which occupies roughly half of the 200,000 sf complex. We now seek support to expand access to care by renovating another 65,000 sf of the unfinished portion of our building complex (101 Jackson Street), to include a new Dental Clinic and new Vision Clinic; expansion of adult, family medicine, behavioral health, and specialty care; strengthened infrastructure projects, and related renovations at 161 Jackson Street. To assist the health center in planning and development, Lowell CHC has retained the services of Steve Joncas (Joncas Associates, Lowell MA). Mr. Joncas was project manager for the 161 Jackson Street project, and has experience in private real estate development including site location services, project feasibility, and project management. Durkee Brown Viveiros Werenfels Architects (Providence RI), has extensive experience converting historic structures for new use, including the successful completion of our 161 Jackson Street facility. JM Coull, Inc., will provide construction management and general contractor services, and is a certified Green Building contractor. Rebeca Polan, Capital Link, is project financing consultant. Rita Schwantes, Klein Hornig LLP, serves as Borrower Counsel, and Christine Beard, Tremont Preservation, is our historic tax credit consultant. Ms. Polan and Ms. Schwantes served as consultants on the health center s 2012, $42 million expansion project. Additional project implementation support will be provided by R.W. Sullivan, MEP Engineers; Jody Trunfio, The Engineering Corporation; Yoder Tidwell, structural engineer, and Hancock Associates, surveyors. We anticipate a capital project start date of July 2016, and a 14-month construction period, with occupancy scheduled for late August We estimate capital project costs totaling $25.5 million, of which $2.5 million must be raised through philanthropy. The remaining costs will be met through a combination of New Market Tax Credits, Historic Tax Credits, and leveraged debt. 23

24 Indicators Our timeline and anticipated outcomes are as follows: The 101 Jackson Street expansion project was approved by the Lowell CHC Board of Trustees in We have completed the design phase, with a project start date scheduled for July We anticipate occupancy beginning in late August By the end of CY2019, the Lowell CHC Expansion Project will result in an addition of 100 new staff, for a total of 500 full-time equivalents a 20% increase over current staffing levels. This is a multi-phase project, planned over three years. Our current overall design for 101 Jackson Street is as follows: Floor 1: Vision Clinic, Retail Optical Services, Access expansion Floor 2: Dental Clinic, Call Center, Referrals and Informatics work areas; Community Room; Teen Block expansion Floor 3: Adult Medicine, Behavioral Health Services, HIV-AIDS (Carino), and Office Based Opioid Treatment (OBOT) Floor 4: Rehabilitation Services Floor 5: Future Use Floor 6: Future Use Patients will have easy access to 101 Jackson Street services by means of throughways connecting our 161 Jackson Street building. Expansion efforts also will improve Lowell CHC operations overall through the relocation and/or expansion of other departments (Family Medicine; Health Promotion; Human Resources: Specialty Services) within our flagship location. Our financing confirms that patient revenue from new exam rooms, the addition of dental, vision and specialty services, and income from a retail Optical Shop, will generate adequate revenue to offset any new operating costs while also covering the related capital debt obligations. Additional exam rooms will allow Lowell CHC to hire more providers, which also will improve operating efficiencies through improvements in patient flow. The retail Optical Shop, to be located at street level, will be available to walk-in clients who may subsequently become Lowell CHC primary care patients. Progress Capital Expansion Project (101 Jackson Street): An external project team has been assembled to assist in project implementation and completion. Our financial plan was completed in February 2016 by Capital Link, a nationally recognized consulting firm specializing in technical assistance and financing advice for community health centers. 24

25 Financials Fiscal Year Fiscal Year Start Oct 01, 2016 Fiscal Year End Sept 30, 2017 Projected Revenue $41,511, Projected Expenses $41,484, Endowment? No Credit Line? Reserve Fund? Months Reserve Fund Covers 0 Detailed Financials Revenue and Expenses Fiscal Year Total Revenue $39,069,632 $33,817,973 $32,536,014 Total Expenses $38,867,207 $33,808,100 $29,382,011 Revenue Sources Fiscal Year Foundation and Corporation Contributions Government Contributions $6,534,006 $5,963,224 $5,142,783 Federal State Local Unspecified $6,534,006 $5,963,224 $5,142,783 Individual Contributions $4,383,661 $2,513,196 $3,772,899 Indirect Public Support -- $0 -- Earned Revenue $27,219,812 $23,952,137 $21,039,825 Investment Income, Net of Losses $795,772 $786,981 $2,213,690 Membership Dues -- $0 -- Special Events $112,289 $0 -- Revenue In-Kind Other $24,092 $602,435 $366,817 25

26 Expense Allocation Fiscal Year Program Expense $33,681,316 $29,169,845 $25,579,956 Administration Expense $4,858,734 $4,510,720 $3,723,274 Fundraising Expense $327,157 $127,535 $78,781 Payments to Affiliates Total Revenue/Total Expenses Program Expense/Total Expenses 87% 86% 87% Fundraising Expense/Contributed Revenue 3% 2% 1% Assets and Liabilities Fiscal Year Total Assets $56,959,070 $39,810,990 $39,831,966 Current Assets $49,212,887 $33,738,250 $31,305,754 Long-Term Liabilities $25,589,738 $9,465,660 $9,776,924 Current Liabilities $7,623,109 $5,959,428 $5,679,013 Total Net Assets $23,746,223 $24,385,902 $24,376,029 Short Term Solvency Fiscal Year Current Ratio: Current Assets/Current Liabilities Long Term Solvency Fiscal Year Long-Term Liabilities/Total Assets 45% 24% 25% Top Funding Sources Fiscal Year Top Funding Source & Dollar Amount Second Highest Funding Source & Dollar Amount Third Highest Funding Source & Dollar Amount Capital Campaign Currently in a Capital Campaign? Campaign Purpose To renovate undeveloped space in our historic mill complex to include new Dental and Vision Clinics, and expand access to primary care and youth programming Goal $ Dates Jan 2014 to Dec 2017 Amount Raised To Date $ as of Oct 0 Capital Campaign Anticipated in Next 5 Years? No Comments CEO Comments The Health Center is rapidly responding to the current health care environment that is changing due to both state and federal health care reform and health care payment reform. As we approach the future of global payments and accountable care organizations, we are working to implement the 26

27 standards of the Patient Centered Medical Home to continuously improve the quality of our care and the ability of patients to manage their own care. The expense of preparing for these reforms is significant. While global payments may cover some of the cost of services provided by community health workers and nurse case management, a significant portion of these costs is not recouped through insurance reimbursements and must be covered by the organization. The majority of our patients are medically complex and face numerous challenges to health access. These "wrap around" services are vital to our patients' wellbeing and ability to engage in their own care. We also face additional challenges in the form of insufficient reimbursement rates for medical and behavioral health services, and the extra costs of serving a high number of limited-english-proficient patients. Foundation Staff Comments Financial summary data in charts and graphs are per the organization's IRS 990s. Contributions from foundations and corporations are listed under individuals when the breakout was not available. Created Copyright 2018 The Boston Foundation 27