Back to Projects Home – HDWG Home

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.