Community Oriented Primary Care A Practical Assessment, Vol. 2: Case Studies (1984) / Chapter Skim
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East Boston Neighborhood health Center
East Boston Neighborhood health Center
Pages 71-92
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From page 71... ...
One was the East Boston Health Committee, a group of local residents concerned about health issues but not yet incorporated, and the other -~-a_ _ em ~_~~ ILL OU~L ~ office, ~oca~ea an Castle square, staffed with community organizers who were there to help develop the health center. AS with several other health centers in the city, tension grew between the health committee and the central support office over control of leadership of the health center.
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From page 72... ...
In 1975, the East Boston Health Committee developed a proposal for a Hill-Burton grant for 2 million dollars in order to build a health center. At that time, the health center was operating out of an aging city-owned building, and consisted of a hodge-podge of programs funded with federal, state and, private foundation money.
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From page 73... ...
to 9 :00 p.m. The health center services include adult medicine, pediatrics, adolescent medicine, obstetrics and gynecology, home care, dental care, social services, nutrition services, public health nursing, optometry and opthalmologoy, and laboratory and X-ray services.
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From page 74... ...
1 1 - 1 15 1 165 1 t ~ 1 al 1 l 1~1 ~ 1 ~ 1 851 M! i i 1~1 ~1 ~ 1 1~ law FIGURE 1 Organization Chart of East Boston Neighborhood Health Center.
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From page 75... ...
It was at this time the medical staff looked into another way of organizing the medical care and it was then they went to the team approach. Medical Records In general, the medical record system at East Boston is organized by family; each nuclear family is given a number that is assigned to the medical records for that family.
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From page 76... ...
The emphasis for this new management information system will be on billing and will not include or attempt the computerization of the medical records. The new management information system will, however, result in the development of a new encounter form.
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From page 77... ...
that came as fees for services from private insurance and Medicare. It should also be noted here that East Boston because of its ties to Boston City Hospital {BCH)
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From page 78... ...
East Boston seems to have been relatively unaffected by the various fluctuations in public funding over the last 10 years. ILS financial situation seems to be marked by steady and rapid growth due primarily to the innovation of some sound f inancial management techniques in 1978 that marked a signif icant increase in revenues for the health center.
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From page 79... ...
Another example of cooperation is something called the Elderly Services Network, wherein the social service department at the health center works closely with the community mental health center to coordinate services for the elderly. There has also been considerable contact between the medical director and various community groups in relation to the community surveys and epidemiologic research that has been part of East Boston activities.
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From page 80... ...
Although the board is primarily concerned with issues such as acceptability and accessibility of East Boston's services, they nonetheless are involved in identifying subsets of the community whose health needs are not being met. There are fewer examples in which the board was able to specifically identify a health need to which health center services should be directed.
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From page 81... ...
mere are a number of advantages in having the community involved in administration of a health center like East Boston, not the leant of which is the continual reminder of the patient perspective. However, community involvement does not occur without some costs.
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From page 82... ...
In addition, the survey confirmed that there are a large number of dependent elderly in East Boston, a community that has strong extended family ties and that resists institutionalization of elderly. In response to the identif fed needs of these dependent elderly and sens itive to the cultural res istance to institutionalization, ache community board tried to obtain funding to convert an old school near the health center to congregate housing for the dependent elderly in the community.
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From page 83... ...
The case load of prenatal patients at the East Boston doubled in the year following the change in admitting privileges. The birth certificate data were reviewed following the change to Beth Israel and they confirmed that more East Boston women were getting prenatal care at the health center.
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From page 84... ...
A nurse educator from East Boston has worked with teachers in planning and developing a health education curriculum including growth and development, reproduction, alcohol and substance abuse. The nurse educator and other staff members have also taught classes at the school and coord inated introductory programs and tours at the health center .
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From page 85... ...
Certainly the health center operates at stage IV for thi s f unction. Identifying Community Health Needs The health needs of the population of East Boston have been identif fed in a var iety of ways -- through the community board, outside data sou roes, and surveys conducted by East Boston.
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From page 86... ...
In general, the health center identif ies and characterizes health problmes of the community with problem-specific epidemiologic studies. These are well designed and place East Boston at stage III in the development of this function, for the majority of their COPC efforts.
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From page 87... ...
The plan to assess the effect of efforts to address a wide range of issues in adolescent health is based on an anticipated increase in the number of adolescents using the health center, and thus is at stage O of development. In contrast, the ef feet of improving the prenatal care for the community was based on a repeat review of the marital statistics for East Boston and clearly demonstrates stage III development.
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From page 88... ...
evolution as a COPC. Organization of Financ ing Ability to generate revenue f ram a variety of sources has been important to East Boston's ability not only to grow as a health center but also to support many of the COK: activities it has engaged in over the last ten year a.
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From page 89... ...
The brochure that descr ibes the health center state. that, Tour purpose is to provide personalized high quality health services easily accessible to all residents of East Boston.
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From page 90... ...
TABLE 5. 2 Comparison of the Level of Development of the Ma jor Functional Elements of COPC in the East Boston Ne ighborhood Health Center Identify Modify De f ine and Commun i ty the Mon i to r Characterize Health Health Impact of the Cononunitv Problems Program Modif ications .
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From page 91... ...
Jean Nesbitt, Director, Home Health Care Linda Riesenberg, Director of Social Services Howard Rivenson, Chief Financial Of f icer Pete r Str ingham, M D., clinician
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From page 92... ...
East Boston Senior Health Pro ject . Good Health -- Community Outreach and Preventive Program of East Boston Ne ighborhood Health Center ~ b rochure ~ .
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