Evaluation of the Collaborative Care Management Program, East
Boston Neighborhood Health Center
The Collaborative Care Management Program (CCMP) is a HRSA-funded SPNS project
located at the East Boston Neighborhood Health Center (EBNHC) in Boston,
Massachusetts.
The East Boston Neighborhood Health Center was established in 1975 as a
community-owned and operated health center. EBNHC serves the low income
and working class communities of Chelsea, Revere, East Boston and Winthrop,
communities that are geographically isolated from the city of Boston proper
by congested tunnels and bridges. The EBNHC service area includes immigrant
communities; populated initially by Italians, and since the 1980’s
by Central Americans, Brazilians and Asians. Many residents are undocumented,
and thus uninsured, while others have private health insurance, Medicaid,
or Medicare. The health center provides a full complement of primary care
services and is the largest community health center in New England.
The Collaborative Care Management Program operates in the context of the
demographics of the area served by EBNHC as well as in the context of a
city that is highly medicalized. It also operates in the context of a previous
SPNS project at EBNHC. In 1994, the East Boston Neighborhood Health Center
(EBNHC) received a grant from the Health Resources Services Administration
(HRSA) under the Special Projects of National Significance (SPNS) program
to develop an integrated model of care for individuals with HIV/AIDS. Project
SHINE (Support, Healthcare, Intervention and Education) was designed as
a community-based program that uses a multi-disciplinary team approach to
caring for people with HIV/AIDS. CCMP was developed to complement Project
SHINE, with a goal of extensive integration and coordination between the
two programs.
CCMP’s mission is to provide intensive care management as well as
coordinated and linked medical, mental health, substance abuse and support
services to HIV-positive EBNHC primary care patients with the greatest needs.
Approximately 80% of EBNHC’s HIV infected patients suffer from complex,
persistent mental health and substance abuse disorders. Their need for services
exceeds those that a primary care organization can reasonably provide and
frequently requires referrals to outside agencies for substance abuse treatment,
detoxification, and/or psychiatric and inpatient services. Prior to the
develop of CCMP, coordinated, comprehensive care was compromised by poor
communication and inadequate linkage to primary care, lack of immediate
access to critically needed services, and the varying degrees of quality
and capacity to deliver culturally and linguistically sensitive services
among affiliating agencies. Thus, the focus of the program is to improve
access to and quality of substance abuse and mental health services for
EBNHC’s high-risk patients by securing a more reliable service bridge
between primary care and these critically needed services.
Federal funding for this program will end in October 2001, but the structure
of the care model and lessons learned from the intervention have been incorporated
into the Health Center as lasting, effective changes to the health care
delivery system for patients with HIV/AIDS.
The HDWG served as the evaluator of the CCMP program. Key evaluation staff
included Mari-Lynn Drainoni, Ph.D., Senior Evaluator, and Karin Haberlin,
M.A., Project Manager.
National Evaluation and Program Support Center to conduct a multi-site evaluation of outreach activities designed to engage and retain individuals with HIV in medical care. Funded by Health Resources and Services Administration
A national evaluation of peer education training programs for people living with HIV.
A National Center working to advance the Healthy People 2010 objective that all children with special health care needs have access to adequate health insurance and financing for their care.
A cross-disciplinary training curriculum in HIV and substance abuse, designed for health care providers, support service providers and substance abuse treatment providers.