Dorchester House Multi-Service Center Inc General Information 1353 Dorchester Avenue Dorchester, MA 02122 (617) 288-3230 Website www.dorchesterhouse.org Organization Contact Michelle Nadow ducluu@dorchesterhouse.org Year of Incorporation 1971 1
Statements & Search Criteria Mission Statement The mission of Dorchester House Multi-Service Center (Dorchester House) is to provide affordable, accessible, and exceptional health care and other essential services in an environment that respects our consumers, staff and diverse community, to be a leading force for change in the health, economic, and social well being of our community, and to be an essential resource for our community in its efforts to achieve the highest levels of health, well being and quality of life for residents. Background Statement Founded in 1887 as a settlement house, Dorchester House evolved into a community health center in the 1970s to meet the needs of a continually changing and growing population. Before our evolution, we provided a range of services to the Fields Corner neighborhood where the health center is located. This holistic settlement house tradition continues, as our staff examines the core challenges that affect our patients health outcomes, such as chronic disease, health disparities, or lack of wellness in our racially diverse, underserved populations. Our providers take steps outside of the medical visit to tackle our patients most pressing needs. Ninety-four percent (94%) of our patients live at or below 200% of the federal poverty line; 31% Asian (predominantly Vietnamese), 29% African American, 31% White, and 14% Hispanic/Latino, with 8% not reporting their status. Over 7000 patients indicate that they are best served in a language other than English. Consequently, we have made reducing health disparities due to race, socioeconomic status, or nationality a key priority of our health care approach; it is now a part of our five-year strategic plan. Our efforts are three-pronged. First, we try to remove barriers to access for our minority populations by hosting certain services on-site, such as radiology and mammography. We also maintain highquality dental and behavioral health departments in-house services that minority populations typically struggle to obtain. Second, we reach up the causal chain to create programs that address the social determinants of health (e.g., education, income level, social capital), which we know are a major contributing factor in poor health outcomes in minority groups. Examples include our Fiscal Health Vital Signs program (administered by DotWell our partner organization), which seeks to diagnose and treat finance disparities as well as reduce overall fiscal stress; and our unparalleled case management department, whose partnership-oriented approach links our patients to social services that are instrumental to addressing the social determinants of health. Finally, we maintain a robust foreign language capacity, and implement hiring practices that are carefully calibrated to ensure that our staff population reflects our patient population. In this way, we promote culturally competent care and ensure that every patient who walks in our building is treated fairly, competently, and appropriately. 2
Impact Statement In November 2012, Dorchester House welcomed a Walter Ramos as the new CEO. He replaced our previous CEO who retired after 26 years of service. Mr. Ramos brings with him a wealth of knowledge in the Health Care field as well as exceptional leadership, public relations and legislative capabilities. Additionally, Dorchester House launched CenteringPregnancy, a program that prepares young pregnant women for motherhood and was also nationally recognized as a Patient Centered Medical Home (PCMH). With the addition of a 9 exam room Walk-In/Urgent Care clinic, and another 9 exam rooms for Primary Care in 2011, Dorchester House can now accommodate over 26,000 more patient visits annually. We developed Healthy Weight for Life (HWFL) a multi-disciplinary group-based family centered program targeting children, ages 6-12 meeting monthly as a large group with both parents and children as each learn separate nutrition messages in a facilitated discussion. Children also learn simple ways to play, engaging in beneficial exercise in an hour with an exercise specialist. The evening concludes with a healthy meal. The success of the program has us planning for expansion in the coming year. Our Farmer's Market increases access to healthy foods for the community..we were one of the first Farmers Market to participate in the Boston Bounty Bucks Program, which provides low-income people access to locally grown, produce 50% off market prices. The goal of our Food Pantry in particular is to provide high quality, nutritious meals to area residents who lack sufficient resources to feed themselves and their families. Our Food Pantry serves nearly 40,000 people annually, distributing 15,435 bags of groceries each year, providing 385, 875 meals per year. Needs Statement Our most pressing needs include: 1) financial support for the non-reimbursable clinic staff functions such as Case Managers, Translators and Financial Counselors, all of whom are essential for better health outcomes; 2) support for recreation activities including the onsite pool in particular, renovations to the pool area and locker rooms as well as memberships which contribute to healthy lifestyles; 3) additional staff, specifically primary care providers who are culturally and linguistically aligned with our community; as well as 4) funding to add Community Health Workers to our enhanced patient-centered medical home (PCMH) teams to provide outreach to patients helping them to engage in better self care and in-reach as a bridge between medical teams and patients; and; 5) finally as a PCMH and to increase patient access to medical records, including making appointments, funds to implement a patient portal, a secure internet connection that ensures confidentiality. The technology updates are implemented through DotWell, our partnership organization with Codman Square Health Center which handles all crossite technology needs and enhancements and 6) support for our capital needs to upgrade our wellness, recreation and teen center facilities within the physical plant, as well as to expand physical space for our dental clinic 3
Board Chair Statement It has been said that a House is not a Home. Fortunately, this is not true about Dorchester House (Dot House). Dot House is a Medical Home to many people, young, middle age, elderly, white, black, Asian and all other ethnicities one can think of. Our challenge as a Governing Board is to ensure that the excellent quality of care that Dot House has come to be known for is maintained. It is the Governing Board s responsibility to ensure that the best people are hired, from maintenance to CEO. In these economic times, an additional challenge, but equally if not more important, is to keep Dot House fiscally sound. Our success in meeting these challenges is accomplished because of the hard work and commitment of our employees. Our employees have proven time and time again, their dedication to providing the best service possible to all who come through our doors and to making sound management decisions. Twelve years ago, I became a consumer based upon the recommendation of an employee. I have never regretted the decision to transfer my health care to Dot House. When I saw that Dot House was recruiting for Board members there was no hesitation on my part to submit my application. It has been my privilege to be the Governing Board President for the past year. The members of the Board, like staff, are committed to fulfilling the duties of the Governing Board and in making decisions, sometimes difficult ones, that are in the best interest of Dorchester House. CDC Caring, Dedication, Commitment, makes Dorchester House a Home. We welcome you to our Home. Service Categories Community Clinics Geographic Areas Served 02122, 02125, 02121 02124, 02126,02127 and 02169. In addition, we serve smaller numbers of patients from area codes 02119, 02131, 02136, 02301 and 02368. We also have a number of longtime patients who, although they've moved to South Shore committees including Quincy, they continue to travel to Dorchester House for their primary care. Please review online profile for full list of selected areas served. 4
Programs Healthy Weight for Life Description The Healthy Weight for Life Clinic (HWFLC) is a clinical pediatric obesity intervention. The program is designed to educate and assist families to help their child achieve a healthy weight by establishing healthy eating and physical activity habits. We do this by addressing the issue of healthy weight in the context of the family. This multi-component program emphasizes parent education and children s physical activity, and includes weekly swim lessons for the children. We work with our families to create change in the food environments at home, through change in attitudes and behaviors of the children s caretakers as well as change in the child's index and habits. These short-term changes, combined with improved knowledge, result in the desired longterm outcome of reduced body mass index (BMI) in the child. Our goal, by 2013 is to develop an adult weight management group modeled after the pediatric HWFL. The new program also will combine nutrition education and physical activity. Budget 7000 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Examples of Program Success Health Care, General/Other Preventive Health Children Only (5-14 years), Families, Poor,Economically Disadvantaged,Indigent Short term success will be reflected by an increase in parental knowledge regarding nutrition and exercise. In children, it will be reflected by an increase in their physical activity including an increase in their swim skills. Change parent attitudes Improve BMI of the children The number of families who complete the program The changes in BMI in the children The reported changes of cooking habits of families Examples of program success will include a decrease consumption of sugar sweetened beverages by the children as well as a decrease in the time they spend being sedentary, sitting in front of the television or playing video games. 5
Farmers' Market Description Our health center has hosted a seasonal Farmers' Market for the past 5 years, from June to early October. The goals of the Farmers' Market are to increase access to healthy foods for our patients, staff, and community; increase redemption of WIC Farmers' Market coupons as well as other Farmers Market Coupons; and increase EBT sales at the Farmers' Market through participation in the Boston Bounty Bucks program. Our Farmers' Market was one of the first to participate in the Boston Bounty Bucks Program, which provides low-income people access to locally grown, produce 50% off market prices. In addition, our growers and project partners, are two local farms with social missions as well as agricultural missions. A female farmer leads each of our farms, one farm trains Boston s homeless, and grows foods for the homeless shelter kitchen, the second farm runs in tandem with a womens' shelter, and its dual mission is to provide women with life skills while they are residents of the shelter. Budget 20,000 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Examples of Program Success Food, Agriculture & Nutrition, General/Other Food, Agriculture & Nutrition, General/Other Poor,Economically Disadvantaged,Indigent, Families, General/Unspecified Short term success will be measured by an increase in the number of patients and residents who shop at the Farmers' Market as well as an increase in the number of people who use Bounty Bucks and EBT cards at the Farmers' Market. Long-term success will will include brexpansion in the days or hours that the Farmers' Market operates as it will be based on need and ability for farmers to successfully sell their wares. Also extending the Farmers' Market season to include a winter Farmers' Market in a potential partnership arrangement. Program success will be monitored by the number of people who attend and purchase from the Farmers' Market as well as an increase in the number of farmers seeking to set up stands at the weekly markets. Again program success will be monitored by the demand for expanding hours, days or seasons/ PLEASE ADD AN EXAMPLE OF PROGRAM SUCCESS 6
Community Health Workers Description We are in the process of becoming a Patient-Centered Medical Home (PCMH), a proven model of primary care that provides a team approach to patient care. We are enhancing our model (E- PCMH) to assess and treat social determinants of health by adding a Community Health Worker (CHW) on each care team to conduct universal screening for social determinants of health and to provide healthcare system navigation. The E-PCMH also incorporates an innovative Social Determinants Vital Signs assessment which diagnoses a patient s fiscal and social health and is used to create an individualized treatment plan. The E- PCMH CHW and case manager provide support and follow-up to patients as they work towards their treatment plan goals. Budget 75000 Category Population Served Program Short Term Success Program Long term Success Program Success Monitored By Examples of Program Success Health Care, General/Other Health Care Reform Poor,Economically Disadvantaged,Indigent, Families, Unemployed, Underemployed, Dislocated Our short term success will be measured by 1) our ability to build our workforce capacity to coordinate care and address social determinants of health; and 2) operationalizing the E-PCMH model and implementation of social determinants screening and assessment; Our long term objectives include overall improvement in patient care; Improvement in patient health, including capacity for wellness and self-management; and realizing cost savings by creating an actionable risk-sharing model that incorporates social determinants of health. Success is monitored by how many patients complete the assessments and from there have individualized treatment plans created. Success is further monitored by the number of patients who achieve the benchmarks identified in their treatment plan. This social determinants assessment was first tested in a more traditional community setting with 181 residents of a lower-income public housing development in Dorchester. Residents completed the 20-question assessment upon enrollment into the program and worked with a fiscal health case manager to develop a financial treatment plan. After six-month follow-up assessments, 77% of program participants demonstrated improvement in at least one aspect of fiscal health. Areas of greatest improvement among participants included obtaining a bank account (n=60 participants), viewing their credit report (n=72), being able to make minimum credit card payments on time (n=38), having $500 available for emergencies (n=30), and being able to name at least one community resource for income support (n=68). 7
CenteringPregnancy Description CenteringPregnancy, a model of group prenatal care offered that integrates three major components of care: health assessment, education, and support into a group setting, will launch at Dorchester House in the fall of 2012. Women with similar gestational ages meet together and participate in facilitated discussions throughout their pregnancy while learning self-care skills and developing a support network with other soon-to-be moms. A medical provider facilitates this module and also performs medical assessments required during each prenatal visit. They meet throughout pregnancy and for six weeks post-partum. Some groups have a nutritionist as the co-leader of the group who addresses prenatal and pediatric nutrition and activity. Compared to women in individual care, women in CenteringPregnancy had significantly more prenatal visits, increased healthy weight gain during their pregnancy, increased breast feeding rates, and higher overall satisfaction with their prenatal care. Budget 35000 Category Health Care, General/Other Family Planning Population Served Females, Families, Infants to Preschool (under age 5) Program Short Term Success As we launch Centering Pregnancy at Dorchester House our initial short-term success will be measured by how many of our prenatal patients select Centering as their choice of prenatal care delivery. After one year of offering Centering we estimate that 25% of our prenatal population will be involved with Centering Pregnancy. In addition, 100% of Centering patients will be offered the support of prenatal case manager. Finally a short-term success of Centering will be the creation and implementation of a monthly reporting system related to pregnancy and birth outcome that will serve as a dashboard in our electronic medical record that will include the following data: number of new pregnancies, number of current pregnancies, number of babies delivered, number of low birthweight and macrosomia (overweight) babies, % of women still breastfeeding at postpartum visit, number of babies stillborn. 8
Program Long term Success The long-term success for Centering is that it will enable our providers and support staff will be able to spend more time with each patient, allowing us to address their individual needs and explain concepts more fully with patients. The group care model also helps patients develop a peer support system and a community of learning. Centering will help eliminate waiting times experienced by patients and will enable us to improve practice management flow for this our prenatal patients involved in this program. The addition of a Centering Program through the Centering HealthCare Institute will require us to implement pre and post surveys with our patients that assess increased knowledge and skills as a result of their participation and also measures their satisfaction with this program. These measures will indicate our progress in achieving a more patient-centered prenatal care experience along qualitative perspectives. In terms of quantitative data we anticipate the following long term outcomes 95% of Women who are Centering patients completed 100% of their prenatal visits 95% of Centering patients will deliver healthy birthweight babies 95% of Centering patients will complete their postpartum visit schedule Program Success Monitored By Program success will be monitiored by the aforementioned monthly reporting system that will feature a dashboard of pregnancy and birth outcome data. This data will be retrieved from our electronic medical record which includes patient visit data and relevant hospital and delivery records. In addition the Centering HealthCare Institute who will help us implement Centering Pregnancy will supply as with qualitative surveys to distribute to patients to assess their knowledge, skills and satisfaction with the program at Dorchester House. These quantitative and qualitative measures be enable us to monitor short and long term success for the Centering Program at Dorchester House. 9
Examples of Program Success An example of success we anticipate with the program is that Centering Pregnancy will evolve into the way we deliver prenatal care at Dorchester House and that a significant percentage of our prenatal population will select Centering as their choice for prenatal care because of the benefits of the group model; no wait times for the provider, building a community of peer education and support and improved maternal and child health outcomes. If Centering Pregnancy is successful we could then also implementcenteringparenting (c), a continuation program that was created to assure family success as parents begin their parenting journey. CenteringParenting takes place for the first 12 months of the child s life with group well-child visits at which both the infant and the mother s health is assessed and education about healthy lifestyle offered. We hope to implement CenteringParenting(c) at Dorchester House within the next three years. 10
Management CEO/Executive Director Executive Director Mr. Walter Ramos Term Start Nov 2012 Email walter.ramos@dorchesterhouse.org Experience Prior to joining Dorchester House, Mr. Ramos held Executive Leadership positions at the Boston Public Health Commission, BMC HealthNet Plan and the Massachusetts Hospital Association. Former CEOs Name Term Joel Abrams Sept 1986 - Aug 2012 Senior Staff Patrick Egan MD Title Chief Medical Officer Experience/Biography Mary Irwin Title Director of Human Resources Experience/Biography John Chambers Title Chief Financial Officer Experience/Biography Danny MacNeil Title Chief Information Officer Experience/Biography Michelle Nadow Title Chief Administrative Officer Experience/Biography Noel Moreno Title Chief of Staff Experience/Biography 11
Julita Mir Title Medical Director Experience/Biography Staff Information Full Time Staff Part Time Staff Volunteers Contractors Retention Rate 222 39 25 71 100% Staff Demographics - Ethnicity African American/Black 68 Asian American/Pacific Islander 75 Caucasian 127 Hispanic/Latino 42 Native American/American Indian 0 Other 20 0 Staff Demographics - Gender Male Female Unspecified 112 220 0 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 Plans & Policies Organization has a Fundraising Plan? Organization has a Strategic Plan? Under Development 12
Years Strategic Plan Considers Date Strategic Plan Adopted Nov 2007 Does your organization have a Business Continuity of Operations Plan? Organization Policy and Procedures Nondiscrimination Policy Whistleblower Policy Document Destruction Policy Directors and Officers Insurance Policy Is your organization licensed by the Government? Permit? 5 Risk Management Provisions Boiler and Machinery Commercial General Liability and Medical Malpractice Directors and Officers Policy Professional Liability Workers Compensation and Employers' Liability Disability Insurance Automobile Insurance Computer Equipment and Software General Property Coverage Life Insurance Medical Health Insurance Umbrella or Excess Insurance Collaborations Our most significant collaboration is with Codman Square Health Center (CSHC) which resulted in the creation of DotWell. Incorporated in 1998 as Health Services Partnership of Dorchester d/b/a DotWell, the entity operates with a mission to realize the two health centers visions by providing management services, and integrating clinical and community services that address health disparities, build social capital, and meet the complex needs of the centers target communities. DotWell extends our capability and enables both health centers to sustain programs and staff we would be unlikely to do independent of each other. DotWell employs the Chief Information Officer for both CSHC and Dorchester House. External Assessments and Accreditations Assessment/Accreditation Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - Ambulatory Care Accreditation Year 0 13
Affiliations Affiliation National Association of Community Health Centers (NACHC) Massachusetts Nonprofit Network 0 Year 0 14
Board & Governance Board Chair Board Chair Rev Arthur Lavoie Company Affiliation Dorchester House Patient Term Sept 2013 to 0 Email fathaatha@verizon.net Board Members Name Affiliation Status Gloria Coulter Retired Educator Voting Mr. Paulo A. De Barros Community Volunteer Voting Son H. Dinh Pharmacist Voting Rosemary Gallagher Community Volunteer Voting Annissa George Stitch House Voting Arthur Lavoie First Parish Church Voting Niurka LeBron Community Volunteer Voting Kevin McDermott Mass. Bay Transportation Authority Voting Dorice Y. Nelson M.Ed Educator Voting Ellen Nyepon Community Volunteer Voting Mr. Nathan Pham Community Volunteer Voting Judi D. Smith Citizens Bank Voting Lucinda Williams Community Volunteer Voting Board Demographics - Ethnicity African American/Black 6 Asian American/Pacific Islander 2 Caucasian 4 Hispanic/Latino 1 Native American/American Indian 0 Other 0 0 Board Demographics - Gender Male Female Unspecified 5 8 0 Board Information 15
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 Constituency Includes Client Representation 3 3 12 85% 80% Standing Committees Executive Finance Nominating Strategic Planning / Strategic Direction 16
Financials Fiscal Year Fiscal Year Start Oct 01, 2011 Fiscal Year End Sept 30, 2012 Projected Revenue $24,513,000.00 Projected Expenses $26,615,500.00 Endowment? No Spending Policy N/A Credit Line? No Reserve Fund? Months Reserve Fund Covers 3 Detailed Financials Revenue and Expenses Fiscal Year 2012 2011 2010 Total Revenue $18,357,467 $31,008,781 $24,559,429 Total Expenses $27,040,602 $25,227,589 $24,676,260 Revenue Sources Fiscal Year 2012 2011 2010 Foundation and Corporation $2,731,822 $1,509,786 $1,664,837 Contributions Government Contributions $0 $7,965,925 $1,813,910 Federal -- $7,542,966 $1,323,951 State -- $94,554 $142,793 Local -- $328,405 $347,166 Unspecified -- -- -- Individual Contributions -- -- -- Indirect Public Support -- -- -- Earned Revenue $20,776,609 $21,256,312 $20,413,785 Investment Income, Net of Losses $884,615 $147,650 $537,040 Membership Dues -- -- -- Special Events -- -- -- Revenue In-Kind -- -- -- Other ($6,035,579) $129,108 $129,857 17
Expense Allocation Fiscal Year 2012 2011 2010 Program Expense $20,341,193 $19,175,368 $19,303,995 Administration Expense $6,699,409 $6,052,221 $5,372,265 Fundraising Expense -- -- -- Payments to Affiliates -- -- -- Total Revenue/Total Expenses 0.68 1.23 1.00 Program Expense/Total Expenses 75% 76% 78% Fundraising Expense/Contributed Revenue 0% 0% 0% Assets and Liabilities Fiscal Year 2012 2011 2010 Total Assets $26,083,346 $36,598,485 $26,550,563 Current Assets $9,137,984 $12,272,919 $10,638,353 Long-Term Liabilities $1,044,036 $2,952,352 $0 Current Liabilities $3,836,033 $3,644,789 $2,330,411 Total Net Assets $21,203,277 $30,001,344 $24,220,152 Short Term Solvency Fiscal Year 2012 2011 2010 Current Ratio: Current Assets/Current Liabilities 2.38 3.37 4.57 Long Term Solvency Fiscal Year 2012 2011 2010 Long-Term Liabilities/Total Assets 4% 8% 0% Top Funding Sources Fiscal Year 2012 2011 2010 Top Funding Source & Dollar Amount -- -- -- Second Highest Funding Source & Dollar -- -- -- Amount Third Highest Funding Source & Dollar Amount -- -- -- Capital Campaign Currently in a Capital Campaign? Capital Campaign Anticipated in Next 5 Years? No Comments Foundation Staff Comments Financial summary data in the charts and graphs above are per the organization's audited financials, for Dorchester House only and not the affiliates. Please note, 2011 revenues include Facility Improvement Project funds from the American Recovery and Reinvestment Act. Created 04.09.2018. Copyright 2018 The Boston Foundation 18