Community Outreach and Education Services:

Whittier has developed a system that utilizes enabling services and ensures continuity and a continuum of care to help the community access care, navigate the health care system and remain engaged in care. Whittier has developed an organizational structure designed to provide a comprehensive range of treatment and prevention services to low income minority and immigrant populations. Whittier Street Health Center utilizes enabling services on-site and off-site to help patients overcome these barriers to care. Some of these include:

 Free transportation to and from the health center through the use of the Whittier van (see below).

• Targeted community outreach and education.
• Translation services.
• Health benefits advising to enroll individuals in health insurance and free (or sliding scale) health care for those who are uninsured.
• Patient navigation and case management.
• Community screenings.
• Referrals to social services including housing, education, jobs, daycare, food and clothing.

For deeper outreach to target population Whittier St. engages in:

• Development of systems to improve diagnosis and connection to primary care through pervasive screening/testing in community venues with a focus on communities of color and undocumented populations at risk.
• Strengthening of Whittier’s efforts to increase patient engagement and retention in primary care.
• Raising of community-wide awareness of chronic diseases related to lifestyle factors and infectious diseases related to risk behaviors.
• Enhancement of the coordination with CBOs.
• Promotion of wellness and health maintenance with a focus on higher levels of health literacy.
• Focus on access to primary care and subspecialty care for all medical conditions.
• Use of social media to promote primary care and wellness resources. Social media represent an underused opportunity to reach and engage with communities on health issues.

Use of telehealth systems to increase access and ease of use for patients

Mobile Health Van:

Whittier Street Health Center launched its new Mobile Van in late 2018, designed to provide health education, screenings and linkage to care to the un-housed members of their community, including those on Melnea Cass Blvd and Mass Ave (a need area referred to as “Methadone Mile”). The goal of the Mobile Van is to screen and connect clients to immediate medical treatment and address challenges associated with access to medical, mental, and substance abuse treatment. Community Outreach workers and Navigators provide  HIV, Hepatitis C, sexually transmitted infections screenings, substance abuse assessments, prevention counseling, condom and safe kit distribution, referrals, and linkage to comprehensive care from the van. Community health workers staffing the Mobile Van are out in the community five days a week at various high risk locations, offering a range of services to those most in need, including linkage to appropriate treatment and services. In addition, the clinical team provides oral health services, diabetic retinopathy screenings, medical screenings and referral to social services including housing, employment and our food pantry.

 Building Vibrant Communities in Public Housing Program:

We established our Wellness Institute  to provide access to safe and affordable fitness center and access to fresh fruits and vegetables through our community garden. Residents were involved in the planning and implementation of a high quality, safe and affordable fitness center and community garden and the garden is managed by representatives from the public housing developments.

Access is one of the main barriers to primary care delivery. We seek to address this by increasing community participation and engagement in the public housing developments. We also want to increase referrals to health services and other community resources to help reduce disparities in access to health services and obesity prevention programs. We have retained the five Social Health Coordinators and would like to train more Social Health Coordinators so they can contribute to health education and capacity building within the community. Having more coordinators will help us with another major barrier: the lack of insurance information. The coordinators will work with our Financial Counselors to explain benefits, answer patient questions, and enroll them in the insurance plans of their choice.

Men’s Health: To address the disparities in the health of minority and low income men, Whittier embarked on a strategic campaign to increase access to men. Due to WSHC’s commitment and effort, men now comprise nearly half of our patient population. Since men are less likely than women to seek out a primary care provider, we offer innovative and comprehensive outreach, screenings, and referrals to link men to our primary care and support services.

Once men are enrolled at Whittier, we offer programs such as our Men’s Health Clinic for case management, outreach, education, family planning, and screening; an all-day Men’s Health Summit; and our Wellness Institute to encourage an annual physical, three days of physical activity each week, and five servings of fruit and vegetables a day. Program objectives are to:

• Save men’s lives by reducing premature mortality of men and boys.
• Provide men’s health education to the general population with a particular emphasis on African American and Latino men.
• Employ a multifaceted approach to community outreach.
• Foster community organizing among men.
• Conduct a variety of health screenings for men.
• Conduct a unique outreach effort and case management services to incarcerated men -pre-release from jails and prisons.
• Provide case management and follow-up to men receiving services at the Health Center.
• Identify and enroll uninsured men for health care coverage.
• Referral and retention at Whittier’s Men’s Health Clinic.
• In 2004 we created a Men’s Health Clinic that is open during hours convenient for men. The department is staffed by four male staff (case management, outreach, education, family planning and screening) and male providers (internists and NPs).
• For the last nineteen years, we have hosted an all-day Men’s health Summit, which attracts 300 – 400 men during National Men’s Health Day.
• Focus on violence prevention.
• Developed 12 weeks’ peer leadership program for men to serve as Health Ambassadors.
• Health Ambassadors help with recruiting men into our program and serve as role models.
• Weekly “Men’s Health Group visits” sessions for men recently released from jails and in halfway houses. Health topics include depression, diabetes, cancer, CVD, stroke and wellness.
• Developed men’s health curriculum to educate men about preventable diseases.
• Post-prison programs support patients with re-entry and reducing recidivism rates.
• Focus on family and parenting.

 Post-Prison Program: Whittier has operated an extremely successful Post Prison Release Program since 2003. This world-class reentry program has supported more than 12,000 men to safely return to their communities within the Commonwealth of Massachusetts over the last 15 years. Over 12,000 men have been linked to health insurance and primary care. Whittier Street Health Center PTL (Prison to Life) model has been effective in lowering the recidivism rate to below 15% (state average is 40%). In 2010, Whittier added a Post Prison Release program for women and this program has served more than 3,000 women and has experienced similar results in lowering recidivism rates, connecting patients to medical and behavioral health and social support services.