Harvard Street Neighborhood Health Center, Inc.

Harvard Street Neighborhood Health Center, Inc. General Information 632 Blue Hill Avenue Dorchester, MA 2121 3213 (617) 825-34 Website www.harvardstreet.org Organization Contact Kenya Baudouin kenya.baudouin@harvardstreet.org Year of Incorporation 1976 1

Statements & Search Criteria Mission Statement The mission of the Harvard Street Neighborhood Health Center (HSNHC) is to serve as a primary health care provider without regard to race, sex, color, political philosophy, religious belief or ability to pay. HSNHC promotes the physical and behavioral health of families and children of the Dorchester, Mattapan, and Roxbury communities of Boston, in particular, and the city of Boston and adjoining areas in general. It serves as a primary source for health education and works with the community to analyze and implement health services and policies. HSNHC also initiates and participates in research to promote the well being of the communities served. It is HSNHC s philosophy that high quality health care should be made available, accessible, and acceptable to all people, rendered in a dignified manner as a right rather than a privilege. Background Statement Harvard Street Neighborhood Health Center was established in 1969 as an offshoot of the Boston Department of Health and Hospitals. It became an independent, non-profit corporation in 1976. Its mission is to provide high quality health care to the communities it serves. The underlying principles guiding its mission are that people can best improve their quality of health and life by developing goals of self-health, by being producers of health rather than consumers of health care and by being dedicated participants in health education and preventive medicine. Today, HSNHC provides a full range of physical and behavioral health services, including pediatrics, family and internal medicine, adolescent clinic, women s center with obstetrics and gynecological services, men s center, behavioral health department, dental clinic, as well as a wide range of support services from WIC to an on-site pharmacy, a food pantry, chronic illness care, STD testing and counseling, and assistance with transitional housing. Impact Statement Accomplishments Since 1969, HSNHC has promoted the health and welfare of an average 8, patients per year. Increased current behavioral health capacity and offerings by providing a continuum of care linking primary care to a range of therapeutic services that include multiple models of clinical intervention. Services also entail case management to address patients psycho-social needs and care coordination with internal and external providers. Launched partnership with Steward Network to increase clinical capacities and expand services offered by all clinics. Expanded outreach and enrollment staff, raising awareness about health center services, sharing information about MassHealth insurance and enrolling uninsured area residents. Started process towards Joint Commission on Accreditation of Healthcare Organizations (JCAHO) certification to receive the recognition as a facility that meets the highest standards in quality and safety in care delivery. Goals for Fiscal Years 214-216 Become a primary care medical home facility certified by the National Committee for Quality Assurance. Achieve readiness level for JCAHO accreditation. Upgrade the electronic health system to be meaningful use certified, meeting certain measurement thresholds such as recording patient information as structured data and exchanging summary care records. The system will then capture data that will allow for better tracking of patient outcomes and chronic disease management. As a Massachusetts Department of Public Health Prevention and Wellness Fund recipient, concentrate greater efforts on reducing rates of the most prevalent and preventable health conditions, increasing healthy behaviors, and addressing health disparities. 2

Needs Statement In the next months, HSNHC will work to meet the following pressing needs: Expand capacity for walk-in visits to improve access and continuity of care and treat patients who would otherwise require care at a hospital emergency room. Improve continuity of care and strengthen risk management strategies by adding a dedicated community outreach worker/patient advocates targeting high risk patients and increasing clinical service. Acquire digital/electronic health records and new x-ray machines for the dental department. Expand dental services and space by adding two new operatories to respond to increasing demand for both routine and comprehensive care. Begin capital improvements in the facility by replacing aging bricks on facade. Make necessary repairs to the medical records room converting all paper files into electronic. Service Categories Community Health Systems Emergency Assistance (Food, Clothing, Cash) Mental Health & Crisis Intervention NEC Geographic Areas Served Located on Blue Hill Avenue in Dorchester, HSNHC's primary service areas are Roxbury, Dorchester and Mattapan. Our patients are mostly low-income people, many newly arrived immigrants from the Caribbean, Latin America and various countries in Africa. Because of our history and cultural capacity, many patients also travel to Harvard Street from other neighborhoods of greater Boston and surrounding communities. Please review online profile for full list of selected areas served. 3

Programs Dental Clinic Description The oral health department has created healthy smiles for patients of all ages and from all walks of life. Its team of caring and experienced dental professionals takes time to know and understand patients unique needs. Dentists and staff work together with patients to develop a treatment plan that results in the beautiful and healthy smile they want. At the dental clinic, staff utilizes the latest in digital radiography, digital imaging and computerized medical record technologies for improving patients quality of care. The clinic is also a training site for various dental schools in the greater Boston area and beyond including Harvard University, Boston University, Tufts University Schools of Dentistry as well as Lutheran Medical Center in New York. Budget 1325585 Category Population Served Program Short Term Success Health Care, General/Other Dental Health Care General/Unspecified, Adults, Families In the short-term, we hope to make appointments in such a way that we see more walk-in patients throughout the day simultaneously with scheduled clients. When patients are suffering from dental pain, they want to be seen right away, and we want to respond to such urgent needs more immediately. Program Long term Success Program Success Monitored By Long-term success for the clinic is reflected in the number of patients without cavities or patients not requiring extensive dental work. These patients show consistently in visits that they are following a good at-home regimen maintaining their teeth, and all they require during new visits is cleanings and routine care. HSNHC uses several tools to measure the dental department's success, ranging from patient satisfaction surveys and staff meetings for discussions about patient progress and improvements to patient care and work flow. In the next months, HSNHC will transition to Dentrix as our dental electronic health record system. Dentrix aggregates data associated with key metrics into easy-to-understand reports, delivering valuable information about patient outcome patterns. Examples of Program Success An example of program success is the dental department's service expansion from two to seven operatories due to need. We hope to expand the department, again, in the long-term but cannot do so at the moment due to a lack of clinical space. 4

Family and Internal Medicine Description HSNHC s service delivery model is effective and responsive to the community s needs in several fundamental ways as a comprehensive primary care health center. The core of services is the internal and family medicine department; these are complemented by an array of services offered on-site that ensure comprehensive care for all patients, and specialized care for particular sub-populations and medical conditions. Since the enactment of the 26 Massachusetts health law, the primary care supply does not meet the patient care delivery demand and has become progressively more restrictive in recent years, especially for persons insured by Medicaid and other state programs. Further complicating this matter is that many consumers continue to utilize hospital emergency rooms for their care. Thus, community health centers such as HSNHC remain critically important as they fill the primary care vacuum. Budget 1328426 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Examples of Program Success Health Care, General/Other Health Diagnostic, Intervention & Treatment Services General/Unspecified, Families, Children and Youth ( - 19 years) In the near term, markers of success include Improvements in the health outcomes of patients with nutritionrelated illnesses Patients get immediate and timely appointments to access primary care The number of medical patients utilizing all services steadily rise More of our patients have insurance coverage due to our intensive outreach efforts to educate them about the Affordable Care Act and their insurance options Patient surveys reflect satisfaction with services Long-term success for HSNHC primary care delivery services is that we strengthen our capacity to meet service demands, and patients become more deeply involved in their care. Program success is monitored by a staff of providers, clinicians and administrators. In the next year, we plan to redesign our website, which we will use to administer patient satisfaction surveys, which are currently also provided to patients on-site after consultations and service delivery. Answers are used to adjust care delivery and gauge patient needs. An example of program success is HSNHC's fruitful partnerships with area hospitals that has resulted in improved patient care. As a founding member of Boston HealthNet, the Center can electronically refer patients to Boston Medical Center, and incorporate their inpatient and outpatient hospital care into the primary care electronic medical record system. HSNHC also has contractual and referral arrangements with Carney Medical Center for OB/GYN and Tufts Medical Center for oral surgery, periodontal care and other dental specialties. 5

Behavioral Health Description HSNHC recently expanded its behavioral health capacity to five clinicians including three licensed psychologists and two social workers as well as retained its one psychiatrist on staff for 17 years. The department staff treats patients adults and children with a great variety of concerns: depression, anxiety, trauma, behavioral challenges, substance abuse, post traumatic stress disorder and are providing individual and family therapy and psychological testing. In the near future, group therapy will be added to our menu of services. Budget 4743 Category Population Served Program Short Term Success Program Long term Success Mental Health, Substance Abuse Programs, General/other Mental Health Treatment General/Unspecified, Adults, Children and Youth ( - 19 years) As part of a recent decision to integrate behavioral health and medical services, HSNHC staff works with patients to ensure greater compliance with appointments, thereby significantly increasing behavioral health patients' show rates. Long-term success for the department is tied to it increasing services to two key but under-served populations within our community, veterans and children. Funding permitting, it will Increase the number of veterans among its client pool by 4%. Expand outreach to 5% more Boston youths most underserved in schools to offer psychological testing that identify appropriate interventions and resources for young patients. Program Success Monitored By Examples of Program Success Clinicians monitor program success by administering the patient checklist on a monthly or quarterly basis, depending on treatment lengths. The checklist gauges for self reported patient progress such as greater interaction with loved ones, engagements in community life and avoidance of negative behavior. It is used as an addendum to clinician observations and reporting. The Massachusetts Executive Office of Health and Human Services awarded funding to HSNHC that allowed us to grow our staff and services this year. We regard the award as a recognition of the crucial services we deliver to the community. 6

Pediatrics Description Originally established as a well baby vaccination program in the early 7 s, the Pediatrics Clinic at HSNHC is committed to the well-being of all children. Its physicians and staff provide quality care to youths in the greater Boston neighborhoods of Dorchester, Roxbury, Mattapan, and surrounding areas. The clinic offers a wide range of services to infants, children, adolescents and prospective parents. Its pediatricians are affiliated with Children s Hospital Boston, Boston Medical Center, New England Medical Center, and Brigham and Women s Hospital. Budget 8799 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Health Care, General/Other Ambulatory & Primary Health Care Children and Youth ( - 19 years), Children Only (5-14 years), Families Experience a 6% increase in the number of asthmatic children controlling their symptoms throughout the year but especially during the winter and summer seasons when flare-ups occur the most. The clinic s goal is to offer services to infants, children and adolescents. Examples of long-term success include Increasing the number of overweight children shedding weight and adopting better eating habits and healthy lifestyles Increasing the number of immunizations to children visiting the clinic Program success is monitored by patient outcomes and during initial and follow-up visits. For newborns, the department tracks healthy growth and development during well-child checks-- physicals, which are recommended at regular intervals through age three. After age three, patients are seen at least yearly for physicals or as needed for booster shots or other health concerns. Examples of Program Success HSNHC participates in the Harvard Youth Violence Prevention Center and Striving To Reduce Youth Violence Everywhere (STRYVE) program, supported by the U.S. Centers for Disease Control, in collaboration with many other health centers and community organizations to develop community-level interventions to address youth violence. This initiative has greatly benefited youth patients of the pediatric department, teaching them about positive interactions with peers and strategies for properly diffusing tense situations. 7

Food Pantry and Women, Infant and Children (WIC) Program Description In addition to specialized clinics, HSNHC offers extensive support services including a Food Pantry, which we have operated for 3 years. The pantry provides nutritious meals to approximately 5 families every year. We also operate our Women, Infants and Children (WIC) program out of three sites in the Boston area serving 35 recipients in fiscal year 212. Budget 2311175 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Food, Agriculture & Nutrition, General/Other Nutrition Families, General/Unspecified, Adults Immediate short-term is reflected in significant reductions in body weight and/or composition, lipids, HgA1c, blood pressure. Our primary long-term success measure is to see significant reduction in incidence of nutrition-related diseases such as obesity, diabetes, heart disease, hyper-lipidemia, hypertension; increased understanding of the direct relationship between diet, exercise, and health; and low no-show rate. We monitor laboratory test results, recommend regular follow-up appointments, and speak to patient's primary care or other providers as means of collaborating with patient on their care. In addition, when clients use the pantry, we help them select the most nutritious items for their families by providing them with a list arranged in order of food groups and their recommended serving size. This list ensures clients are selecting a balance of items to prepare nutritious meals at home. The program director also monitors pantry use to ensure that the maximum number of families needing the service have access to it. At the same time, the WIC program is part of a Massachusetts Department of Public Health-run system that must meet certain measures and benchmarks in order to remain operational. Examples of Program Success Examples of program success range from patients who have managed to prevent diabetes through early intervention, lower cholesterol with or without medication through lifestyle change, and lose weight gradually to a more desirable weight, thereby increasing confidence increasing knowledge on nutrition-related topics (e.g. how to read a food label, healthy vs. unhealthy fats, healthy cooking methods, etc.). 8

Management CEO/Executive Director Executive Director Term Start Dec 213 Email Mr. Charles Murphy charley.murphy@harvardstreet.org Experience Charles Murphy joined HSNHC in December 213. He brings to the position eight terms of service in the Massachusetts legislature, where he served in a variety of leadership positions that include two years as Chairman of the House Committee on Ways and Means and one year as the House Majority Whip. Additionally, he served on the senior management team at Arcadia Solutions, a healthcare data analytics firm, as vice president of public policy and government affairs. Mr. Murphy has worked as a Massachusetts attorney since 1994. Prior to that he served on active duty with the United States Marine Corps as a Judge Advocate in a variety of positions including Staff Judge Advocate for the 22d Marine Expeditionary Unit (Special Operations Capable) that deployed to the Mediterranean Ocean and Mogadishu, Somalia. He remains active in the community serving on the board of directors of Mil Milagros, a Boston based non-profit that provides nutritional and educational opportunities for over 1 children that live in Guatemala and is the elected Town Moderator for the Town of Burlington. He is a graduate of Villanova University, Vermont Law School, Naval Justice School and the Kennedy School of Government at Harvard University where he earned a Master of Arts in Public Administration. Former CEOs Name Term Dr. Chidi Achebe June 28 - May 213 Mr. Joseph Evering June 1983 - Apr 28 Senior Staff Ms. Claudia Liranzo Title Director of Operations Experience/Biography Mr. Tayo Banjo Title Director of Information Technology Experience/Biography Mr. Melesse Gobena Title Director of Finance Experience/Biography 9

Dr. Wha-Ja Woo Title Chief of Pediatrics Experience/Biography Dr. Uduak Okereke Title Dental Director Experience/Biography Staff Information Full Time Staff Part Time Staff Volunteers Contractors Retention Rate 72 1 92% Staff Demographics - Ethnicity African American/Black 5 Asian American/Pacific Islander 4 Caucasian 1 Hispanic/Latino 18 Native American/American Indian Other Staff Demographics - Gender Male Female Unspecified 14 68 Formal Evaluations 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 Annually 1

Plans & Policies Organization has a Fundraising Plan? Organization has a Strategic Plan? Years Strategic Plan Considers Under Development Under Development Date Strategic Plan Adopted Sept 214 Does your organization have a Business Continuity of Operations Plan? Management Succession Plan? Organization Policy and Procedures Nondiscrimination Policy Whistleblower Policy Document Destruction Policy Directors and Officers Insurance Policy 3 No No Under Development Collaborations HSNHC is a founding member of BostonHealthNet, a consortium of Boston Medical Center, Boston University Medical School and 15 community health centers. By sharing technology and other tools, members work together to improve the overall health of the city of Boston and surrounding communities. HSNHC is in a collaborative relationship with Carney Hospital. Since 21, medical providers from Carney have delivered more than 1,5 Ob/Gyn patient encounters on-site at HSNHC. The Healthy Baby/Healthy Child Programis a community-based program designed to promote infant survival, positive birth outcomes, oral health, and family unity. Collaborators include Boston Medical Center, Brigham and Women s Hospital, Children s Hospital and eight community health centers. In collaboration with the Massachusetts Department of Public Health, HSNHC provides WICservices to the communities of Dorchester, Roxbury, Hyde Park and Mattapan. The service provides assistance to over 3,5 clients a year. HSNHC WIC services are provided to both HSNHC and non-hsnhc patients. With assistance from the City of Boston and Project Bread, HSNHC has provided emergency food rations to over 37 people. The Center on a daily basis receives faxes from various community organizations who have identified individuals and families who are in need of emergency food assistance and responds with food assistance. HSNHC works with the Boston Asthma Initiative to integrate clinical care with environmental mitigation and home visiting for families affected by chronic asthma. 11

Board & Governance Board Chair Board Chair Ms. Bonnie Brathwaite Company Affiliation US Department of Agriculture Term Jan 212 to Email bonnie.brathwaite@hotmail.com Board CoChair Board CoChair Mr. Brian Shelly Company Affiliation AthenaHealth Term Feb 214 to Email brian.shelly@verizon.net Board Members Name Affiliation Status Mr. Michael Bergan Beacon Strategies Group Voting Ms. Bonnie Brathwaite US Department of Agriculture Voting Dr. Jocelyn Carter Massachusetts General Hospital Voting Mr. Jim Cote MetLife Voting Ms. Jamiese Martin Ms. Velda McRae-Yates Franklin Field, Franklin Hill Dorchester/Healthy Boston University of Massachusetts, Boston Voting Voting Mr. Brian Shelly AthenaHealth Voting Board Demographics - Ethnicity African American/Black 4 Asian American/Pacific Islander Caucasian 3 Hispanic/Latino Native American/American Indian Other Board Demographics - Gender Male Female Unspecified 3 4 12

Board Information Board Term Lengths Board Term Limits Number of Full Board Meetings Annually Board Meeting Attendance % Written Board Selection Criteria? Written Conflict of Interest Policy? Percentage Making Monetary Contributions Percentage Making In-Kind Contributions Constituency Includes Client Representation 3 2 12 8% 5% 5% 13

Impact Goals HSNHC's ultimate goals are to improve access to care and increase prevention, thereby fostering a healthier community whose members take charge of their health. Strategies Our strategy for accomplishing our goal is to expand services, so that all required patient care is available on site by transitioning to a medical home model. In the medical home model, patients never leave the HSNHC premises for required services. All tests and medical services are delivered on site as patients are never referred out for additional care. Capabilities To serve as an effective medical home for patients, HSNHC currently offers a comprehensive range of clinical services, including Ob/Gyn, adult medicine, pediatrics, diabetes clinic, dentistry, orthopedics, nutrition, behavioral health services, adolescent center, women s center and men s center, as well as pharmacy, laboratory, three WIC sites, and a food pantry serving approximately 4 families per month. We also leverage partnerships to enhance the care that patients receive on our premises. Our arrangement with Carney Hospital has allowed us to enhance on-site gynecological services. Since 21, medical providers from Carney Hospital on HSNHC premises have provided more than 1,5 OB/GYN patient encounters on-site. The relationship has allowed HSNHC to provide advanced level medical care to its OB/GYN patients. As a founding member of Boston Health Net, HSNHC is in a consortium comprising of 15 community health centers, Boston Medical Center, and Boston University Medical Center. As an integrated health delivery system, the consortium is able to deploy and standardize health delivery technology to improve overall quality of care to the residents of Boston and surrounding communities. As a member of the consortium, HSNHC is able to receive free and or discounted tools such as electronic medical records and various other health information technology tools. Indicators All HSNHC departments abide by a quality improvement/quality assurance plan. The purpose of the plan is to provide a mechanism for the continuous, prospective and retrospective monitoring of the quality of primary care as well as institutional operations in order to determine current performance levels, assess the need for interventions that are aimed at reducing or eliminating undesirable outcomes and/or identify opportunities for refining existing processes. The aim of the plan is to assure HSNHC achieves the following specific goals: Objectively identify, measure and evaluate the appropriateness, timeliness, efficiency and effectiveness of patient care, treatment and outcomes; Ensure that patients are respected and care/treatment is based on individual needs; Identify opportunities for continuous improvement in patient care and ensure that actions are implemented to improve care; Coordinate the communication of quality improvement activities seamlessly between all departments that care for Harvard Street Health Center patients; Ensure a continuing level of professional performance by patient care providers; Monitor compliance with standards set by external review agencies; Improve HSNHC's physical infrastructure. 14

Progress As a thriving community health center working to respond to our patients' health needs, we meet the care delivery components of our quality improvement plan. Our next major goal is to acquire stateof-the art equipment that will improve clinical quality, enhance our ability to recruit and retain physicians and add revenue-generating services. As the Health Center s market area continues to grow, so will the demand and need for a new expanded clinical space and new technology. Feasibility studies will be conducted during the next fiscal year and technologies added throughout FY14-FY16 so that we meet these goals. 15

Financials Fiscal Year Fiscal Year Start July 1, 213 Fiscal Year End June 3, 214 Projected Revenue $9,27,552. Projected Expenses $8,418,458. Endowment? No Credit Line? No Reserve Fund? No Months Reserve Fund Covers Detailed Financials Revenue and Expenses Fiscal Year 214 213 212 Total Revenue $8,428,749 $7,323,5 $7,578,965 Total Expenses $7,577,733 $7,76,633 $7,255,17 Revenue Sources Fiscal Year 214 213 212 Foundation and Corporation -- -- -- Contributions Government Contributions $3,97,468 $3,557,728 $3,362,65 Federal -- -- -- State -- -- -- Local -- -- -- Unspecified $3,97,468 $3,557,728 $3,362,65 Individual Contributions $12,72 $153,348 $116,388 Indirect Public Support -- -- -- Earned Revenue $4,63,69 $3,275,6 $3,392,956 Investment Income, Net of Losses -- $9,939 $13,243 Membership Dues -- -- -- Special Events -- -- -- Revenue In-Kind -- -- $13,495 Other $354,871 $326,93 $563,818 16

Expense Allocation Fiscal Year 214 213 212 Program Expense $5,619,629 $5,868,578 $5,71,26 Administration Expense $1,86,972 $1,774,449 $1,461,484 Fundraising Expense $97,132 $63,66 $92,48 Payments to Affiliates -- -- -- Total Revenue/Total Expenses 1.11.95 1.4 Program Expense/Total Expenses 74% 76% 79% Fundraising Expense/Contributed Revenue 2% 2% 3% Assets and Liabilities Fiscal Year 214 213 212 Total Assets $2,314,434 $1,911,426 $1,988,53 Current Assets $1,559,932 $1,225,317 $1,283,516 Long-Term Liabilities $238,845 $359,219 $373,822 Current Liabilities $934,851 $1,262,485 $94,881 Total Net Assets $1,14,738 $289,722 $673,35 Short Term Solvency Fiscal Year 214 213 212 Current Ratio: Current Assets/Current Liabilities 1.67.97 1.36 Long Term Solvency Fiscal Year 214 213 212 Long-Term Liabilities/Total Assets 1% 19% 19% Top Funding Sources Fiscal Year 214 213 212 Top Funding Source & Dollar Amount -- -- -- Second Highest Funding Source & Dollar -- -- -- Amount Third Highest Funding Source & Dollar Amount -- -- -- Capital Campaign Currently in a Capital Campaign? No Comments Foundation Staff Comments Financial summary data in charts and graphs are per the organization's audited financials. Contributions from foundations and corporations are listed under individuals when the breakout was not available. Created 11.3.217. Copyright 217 The Boston Foundation 17