Grant Partners

The Massachusetts Public Health Association (MPHA) will support collaborative efforts to integrate public health and prevention into health care payment reform discussions.  MPHA is a statewide membership organization that undertakes advocacy, education, coalition-building and organized action to improve the public's health.

Whittier Street Health Center will provide enrollment and redetermination assistance through 'Virtual Enrollment Sites' and make referrals to services at Whittier and partner organizations. A yearly redetermination education campaign will include educational workshops and fliers/brochures based on MassHealth's guidelines.

The Boston Center for Independent Living (BCIL) will support advocacy on behalf of those living with disabilities.  BCIL is a frontline civil rights organization led by people with disabilities that advocates for supports and services that enhance the independence of people with disabilities.

The Disability Policy Consortium (DPC) will unify the voice of disability groups as a leader in the Disability Advocates Advancing our Healthcare Rights (DAAHR) coalition, and focus the work of that coalition on the “dual eligibles” initiative, an effort to improve services for those dually eligible for Medicaid and Medicare. DPC will also address barriers to access such as underinsurance and advocate for the needs of those with disabilities who do not meet the federal definition of disabled.

The Massachusetts Immigrant and Refugee Advocacy Coalition will develop its organizing framework by engaging a statewide coalition to monitor the continued implementation of health reform and its effect on immigrant communities. The program will promote positive policy change for greater immigrant access to affordable health care and educate communities to advocate for access to health care coverage including defense of the Health Safety Net.

Healthy Lives:  Brookline Community Mental Health Center will serve 200 low-income adults living in Brookline or Boston who present with serious mental illness (schizophrenia, bipolar disorder, major depression, severe anxiety, or PTSD) and at least two chronic medical conditions (including diabetes, cardiovascular disease, or COPD).  The health center will engage patients in their care, help them coordinate the services they receive, provide wellness interventions, offer disease management programs, home visits, and individual and group counseling. The intent of the project is to help patients move from passive recipients to active participants in their health care and by doing so, reduce cost and improve quality.

Health Law Advocates will use funds to provide legal representation to low-income residents experiencing difficulty accessing or paying for needed medical services.

Steppingstone, Inc. will partner with Stanley Street Treatment and Resources (SSTAR) to create a new program called MyCare, an effort to promote a more pro-active approach to health care for those in Steppingstone’s residential recovery programs. The target population for MyCare is persons in early recovery from chronic substance abuse and mental health disorders.  Over 70% of this population has recent histories of homelessness and more than 70% have chronic conditions, in addition to their substance abuse or mental health disorders. The project will begin with residents of its Fall River women’s program in year one and will incorporate the Fall River men’s program in the second year, and its Stone Residence for chronically homeless individuals in the third year. The program projects to serve 465 clients over the three years with one-on-one assistance and intervention. 

Brockton Neighborhood Health Center will provide traditional outreach and individual assistance with applications, referrals to primary care providers, education on health plans, and assistance with annual renewals. The program will focus on local food pantries and the Plymouth House of Corrections.

The Joint Committee for Children's Health Care in Everett will provide outreach, interpretation, application assistance, and scheduling support for children and their parents, particularly in Latino and Haitian immigrant populations.

MyLink:  Community Healthlink and its hospital partners will identify 300 “high user” patients and provide them with a MyLink community support worker who will meet them in the emergency room, maintain regular telephone and in-home contact, provide assistance in meeting basic needs, help anticipate crises, and connect the patient with the appropriate level of care (primary care, home health services, or behavioral healthcare). The project expects to expand to Health Alliance Hospital in Leominster and St. Vincent Hospital in Worcester, and collaborate with dispatchers and EMTs to provide additional insight into the needs of the patients they treat and transport.

Lynn Community Health Center will develop and evaluate its Integrated Care Project, an effort that integrates primary care and behavioral health care.  It will also develop a universal care plan supported by an electronic health record.  The project will create new models of care management and coordination for the health center’s highest-risk patients.  The health center believes that more appropriate services and increased treatment compliance will result in fewer emergency room visits and inpatient hospital care, reducing overall health care costs.  Over the three-year project, the health center will target 1,000 patients who have the highest rates of emergency room visits and inpatient hospital care.  To serve these patients, Lynn will develop an intensive care management team in which primary and behavioral health providers will work together. 

Enhancing Patient Access to Primary Care:  Greater Lawrence Family Health Center will target “super-utilizers” of the emergency departments of Holy Family Hospital, Lawrence General Hospital and Merrimack Hospital.  “Super-utilizers” are identified as those who have visited the emergency department during clinical hours of operations, could have waited at least 12 hours to be seen, and have been seen at least four times within a 12-month period at one of the hospitals.  A team consisting of a family physician, a behavioral health psychologist, a nurse care manager, and bilingual and bicultural health care coaches will develop care plans for these patients.