Unwavering in our long-standing commitment to address the health needs of our community, Boston Medical Center (BMC) provides a wide range of programs beyond the traditional medical model. Core to fulfilling our public health mission and consistent with the findings of our recent Community Health Needs Assessment, the goals of our Community Benefits Programs are to improve access to and utilization of health services, and to improve health outcomes for underserved populations in our community.
As the largest safety net hospital in New England, BMC serves a significantly disproportionate number of disadvantaged patients who live in our community. Approximately 59% of our patients are from underserved populations, such as the low-income and elderly, who rely on government payers such as Medicaid, the Health Safety Net and Medicare for their coverage.
In 2016 BMC conducted a comprehensive Community Health Needs Assessment (PDF) which included reviewing existing social, economic, and health data about residents of our community and those who are traditionally underserved; conducting focus groups with community members; and conducting key informant interviews with health care providers and community leaders. Key findings that emerged from the Needs Assessment included health care access, chronic diseases and risk factors, violence, and mental health and substance abuse. These key findings informed our Implementation Strategy, which was approved by BMC's Board of Trustees in August 2016 and serves as our roadmap for providing community benefits for the next three years.
Community Benefits Programs Highlights
In 2017 Boston Medical Center (BMC) committed its entire $6.5 million Determination of Need contribution to a single social determinant of health: housing. The goal of this first of its kind housing partnership in Boston among a healthcare system, community organizations and government agencies, is to improve the health of some of the most vulnerable children and families, individuals and elders in our community.
We are dedicated to the Boston neighborhoods that are most disadvantaged and also home to the majority of patients who receive care at BMC. Our investment in a singular social determinant of health emerged from engagement with community stakeholders and discussions of pain points. These conversations showed us that housing was an opportunity for deepened partnership and reinforced our understanding that supportive affordable housing is an urgent need for our patients. The result has been a community informed initiative we hope will catalyze investments at the intersection of housing and health.
The core of these investments are supportive housing and wraparound services that foster housing stability. When integrated with behavioral health and substance use disorder services and medical care, stable housing can transform population health. To that end, we have invested in projects that enhance existing units and support the development of healthy local retail to increase access to amenities like food markets and gyms; the development of a next generation of housing support services that emphasize housing stabilization; projects that re-imagine healthcare for housing instable people by integrating the housing and healthcare systems; community engagement in order to understand and respond to the challenges, barriers, and opportunities facing Boston residents facing displacement and rising costs; and transformative multisectoral equity investments in transit-oriented developments that prioritize community, environment, and health. These investments signify BMC’s commitment as an anchor institution to making a healthier Boston.
Since 2001, the Preventive Food Pantry (the Pantry) and The Teaching Kitchen have addressed hunger-related illness and malnutrition among a low-income, largely underserved and vulnerable patient population. Individuals at risk of malnutrition are referred to the Pantry by BMC, Boston HealthNet physicians, or nutritionists who provide “prescriptions” for supplemental food that best promotes physical health, prevents future illness, and facilitates recovery. Fourteen years after it first opened, the Pantry now provides nutritional food prescriptions to approximately 7,000 patients and family members each month, for a total of more than 74,500 Greater Boston residents per year. Nearly 12,000 pounds of food supplies are required weekly to stock the Pantry shelves at BMC. In July 2016, the Pantry moved into a new 1,500 square foot space that is significantly larger than the former location and features a walk-in refrigerator and freezer, and added storage space, allowing the Food Pantry to accept larger donations. The Teaching Kitchen complements the work of the Pantry by educating patients about nutrition through cooking methods that are compatible with their medical and dietary needs, as prescribed by their physicians. Following its relocation to the Yawkey Ambulatory Care Center's new cafeteria in July 2016, The Teaching Kitchen is able to serve more patients in a larger, more accessible and highly visible space.
The Patient Navigation Program is designed for patients with cancer and chronic diseases who need special assistance in navigating the health care system. Patient Navigators are individuals from the communities served by BMC who have special language skills, training in scheduling, and refined compassion/communication skills. Patient Navigators contact our most vulnerable patients and help them to efficiently access the doctor visits and treatments that they need. They arrange transportation for patients, remind them about the appointments they helped schedule, and connect patients to community resources, such as BMC's Food Pantry.
The Violence Intervention Advocacy Program (VIAP) was founded in 2006 and provides specialized services to victims of violence, using two Violence Intervention Advocates (community health workers) who provide individual counseling, triage and referral services for victims of violence brought to the BMC Emergency Department. VIAP staff collaborate with public and private agencies to offer a broad spectrum of services to patients recovering from violent injury. VIAP provides services to a total of more than 400 victims a year, with a nearly equal distribution of gunshot and stabbing victims. VIAP provides victims and their families with direct services and referrals to outside services, including crisis intervention and stabilization, housing and transportation, legal assistance, education, vocational and life skills development, mental health, employment, and health and wellness. In addition to its presence at BMC, the VIAP model has been disseminated to two other hospitals in Massachusetts.
Project ASSERT (Alcohol & Substance Abuse Services, Education, and Referral to Treatment) was established in 1998 and has been an ongoing component of safety-net services in BMC's Emergency Department (ED). As members of the Project ASSERT team, Health Promotion Advocates consult and collaborate with hospital staff to offer ED patients alcohol and drug screening, brief intervention, and referrals to health and social resources, such as substance abuse treatment and primary care services. Project ASSERT also educates patients at risk for opioid overdoses and distributes over 200 naloxone rescue kits to ED patients, family and friends per year. Project ASSERT has more than 4,000 ED and 225 inpatient consults annually, and each year, more than 1,200 patients receive referrals to outpatient Narcotics Anonymous/Alcoholics Anonymous, behavioral health services, and shelters. Finally, more than 200 patients receive a primary care appointment through Project ASSERT every year.
If you have any questions or comments or would like a paper copy of the Community Health Needs Assessment or Implementation Strategy, please contact:
Jennifer M. Fleming
Director of Community Benefits
Boston Medical Center
801 Massachusetts Avenue, 1st Floor
Boston, MA 02118