Lynn Community Health Center (LCHC) is a freestanding, nonprofit, federally qualified community health center that has served as the primary source of health care services in one of the most severely underserved communities in Massachusetts since its beginnings as a storefront mental health counseling center in 1971. LCHC has experienced significant growth and is now the largest provider of primary health care and behavioral health services in Lynn. The health center has a budget of $80 million with 182 full-time equivalent health care providers. In CY 2016, LCHC provided 283,281 medical, behavioral health and dental visits to 40,009 patients – more than 40% of Lynn residents and more than 40% of all Lynn children 19 and under. Our Obstetrics and Gynecology team delivered 507 babies at Salem Hospital during CY 2016.
Our mission is to provide Comprehensive Health Care of the Highest Quality for everyone in the Greater Lynn community regardless of ability to pay. Access to quality and comprehensive health care allows children to focus on success in school and adults to raise healthy families, pursue gainful employment, and become productive members of our society; ultimately resulting in a stronger, more vibrant community. Our target populations are those who experience the greatest barriers to care: children and their families, the poor, minorities, non-English speaking, teens, and the frail elderly. Nearly 90% of the health center’s patients live at or below 200% of the federal poverty level, over 80% are minorities, and nearly 60% are best served in a language other than English.
We accomplish our mission by providing a comprehensive array of high quality health care services, including: pediatric, family medicine, adult medicine, and OB/Gyn primary care services; specialty medical services; behavioral health and social services; health education; comprehensive HIV/AIDS services; nutrition services; a dental clinic; pharmacy; radiology; and eye care services. In addition to our main site in downtown Lynn, the health center operates two comprehensive primary care practices and behavioral health services in the West Lynn/Market Square area. The health center also manages eight School Based Health Centers in the Lynn Public Schools that provide integrated primary care and behavioral health services in three high schools, two middle schools and three elementary schools. We provide behavioral health services in six additional elementary schools. We administer the Women, Infants, and Children (WIC) nutrition program for ten North Shore cities and towns.
We believe that by developing our people to solve problems each and every day, we can achieve our clear purpose for our patients: Exceptional Care, Our Commitment, Every Day. Our improvement efforts are focused on four key areas: the Patient, our Team, Quality, and Financial Stewardship. We aim to create a culture at the health center that will allow everyone to work together to deliver an exceptional patient experience consistently, a supportive workplace and learning environment for all staff, and a positive and measurable impact on the health of our patients and the Lynn Community.
LCHC has been recognized by the National Committee for Quality Assurance (NCQA) as a Patient-Centered Medical Home Level 3. The Patient-Centered Medical Home model emphasizes enhanced access to care, patient engagement in care, coordinated care across the health system, integrated team-based care among physicians, nurses and behavioral health providers, and robust clinical information systems. LCHC is also accredited by the Joint Commission for both primary care and behavioral health since 2000, and was certified by the Joint Commission as a Primary Care Medical Home again in June 2015. In 2016, we became one of the first organizations to receive PCMH PRIME Certification, a joint program by the NCQA and Massachusetts Health Policy Commission to recognize practices that reach the highest criteria for integrating behavioral health into primary care. LCHC is one of the founding members of the Community Care Cooperative (C3), a new Accountable Care Organization (ACO) participating in MassHealth’s pilot program to test a new model of delivering and paying for health care.
The Need in our Community
LCHC has continued to grow significantly and is now the largest provider of primary health care in Lynn. From 1994 to 2017, LCHC experienced dramatic growth in the number of total health center patient visits from 62,000 to 291,000 visits. Since 2006, LCHC has consistently seen an average of 450 new patients every month. LCHC believes that this unabated demand for services is due to a combination of economic conditions in our area and the significant increase in the number of individuals with health insurance through Massachusetts Health Reform and the Affordable Care Act. Lynn is a federally designated Medically Underserved Area and a Health Professional Shortage Area. In our community, providing access to primary care, behavioral health services and dental care has been a continuing challenge. Community needs assessments completed in October 2015 in collaboration with the North Shore Medical Center and in 2016 in collaboration with 1199SEIU and Next Shift Collaborative, LLC documented a critical need to increase primary care, substance use disorder, and mental health services in Lynn.
The need for affordable community-based health services is made more acute by the continuing growth in underserved minority, immigrant, and low-income families. Lynn is an aging, densely populated former factory town, with a population of 94,459 according to 2015 Census data. Lynn’s minority population continues to grow and today comprises 61.0% of the population, compared to 27.0% statewide. Immigrant and refugee populations are also growing, with 32.3% of residents born outside the US compared to 16.1% statewide. Lynn’s per capita income is $24,126, compared to $38,130 statewide, and 19.6% of the total Lynn population lives at or below the federal poverty level, compared to 11.5% statewide.
Lynn also experiences significant health disparities. The rate of births to teens is almost three times that of the state at 29.2 per 1,000 females aged 15-19 for Lynn compared to 10.6 for the state (2014). Chronic disease presents a challenge for the community, with a diabetes prevalence of 14.2% for Lynn compared to 9.7% for Massachusetts, a hypertension prevalence of 37.0% for Lynn compared to 27.8% for Massachusetts, and a current asthma prevalence of 14.4% for Lynn compared to 12.0% for Massachusetts (2014). Lynn residents experience poor outcomes related to substance use and mental health disorders, with one of the highest rates of overdose deaths in the state at 44.5 per 100,000 in 2015, almost double the state rate of 22.6; and a suicide rate of 12.2 compared to 9.0 for the state (per 100,000, 2010). Source: Massachusetts Department of Public Health.
To meet the urgent health needs in our community, the Lynn Community Health Center continues to innovate and expand programming and services that are culturally and cognitively appropriate, and designed for immigrant, minority, and low literacy populations. To accomplish this, we have significantly increased our physical space in the past four years.
In 2012, the Lynn Community Health Center completed construction on an $18.8 million, 55,300 square foot addition to our main site at 269 Union Street. The resulting Stephen D. Hayes Building includes a large Urgent Care Center on the first floor. The second floor was designed to support an innovative Integrated Health Care Team of medical and behavioral health providers. The second floor also houses a Dental Clinic with twelve dental operatories. The lower level includes additional office space as well as a teaching kitchen and multi-purpose room for health education programs promoting prevention, wellness, nutrition, and physical activity. We have expanded our space for specialty Behavioral Health and Eye Care Services in a building near our main site. These efforts have significantly increased our ability to carry out the health center’s mission by providing the space we need to meet the most pressing primary medical, dental, behavioral health, and health education needs of a severely underserved community.
In September 2016, we opened a new Integrated Primary Care Team in rental space at 280 Union Street. We built out an additional 13,000 square feet in the previously vacant 3rd floor of the Hayes building, which opened in March 2017. We have upgraded clinic space on the 2nd floor of the original Mantzoukas building at 269 Union Street, which will open in September 2017. These projects will allow for the development of an additional integrated primary care and behavioral health team and expansion of two existing teams. The renovation project for the Hayes and Mantzoukas buildings were financed by the North Shore Medical Center, as part of their state approved plan for addressing the needs of the community in the wake of the closure of the Union Hospital in Lynn.
The 2012 construction of the additional space at 269 Union Street allowed for the development and implementation of a fully Integrated Primary Care and Behavioral Health model with (1) co-location of primary care and behavioral health services, (2) co-management of patients by medical and behavioral health providers through a “Shared Care” model, and (3) utilization of a shared electronic health record (EHR). LCHC’s Integrated Health Care model has improved access to needed behavioral health care, reduced stigma, and greatly increased demand for additional behavioral health services. In 2016, LCHC provided 84,324 behavioral health visits for 7,877 patients, more than doubling our visit volume since 2010.
LCHC’s fully Integrated Primary Health Care Teams each have five to nine Primary Care Providers (family medicine, internal medicine and pediatric physicians, nurse practitioners, and physician assistants) and two to three licensed Behavioral Health Therapists (psychologists, social workers, mental health counselors). The integrated teams also include a psychiatrist or an advanced practice psychiatric nurse practitioner, nurses, clinical assistants, community health workers, and nurse care managers. LCHC has designed our integrated model to align with our target populations, with eight of our school based health centers (SBHC) staffed by integrated provider teams. LCHC has developed an Integrated Addictions Team to provide primary care and behavioral health for patients with substance abuse disorders, including medication-assisted therapy to treat opiate addiction. LCHC has also co-located primary care within our specialty Behavioral Health Department to reach out to patients with serious mental illness who are not receiving optimal primary care.
Board of Directors and Leadership
LCHC is a nonprofit 501(c) (3) organization, with a 22-member Board of Directors, representing a cross-section of the population served by the health center. Over 50% of the board members are active patients of the health center. Board members have a diversity of experience and expertise. We have, for example, members with expertise in banking, law, finance, long term care, public health, employees of other community agencies, a Lynn Episcopal priest, two high school students (patients of our SBHC at Classical High School), and several retirees. 13 of the current 22 members are Latino, African American, or Asian. 13 are women.
The Board of Directors has responsibility for setting the policies of the corporation, managing and controlling all property of the corporation, and assuring the financial viability of the organization and the quality of its services. The Board has the responsibility for recruiting, hiring, and regularly evaluating the Chief Executive Officer, who is responsible to the Board for carrying out strategic and operational goals. The Senior Management team reports to the Chief Executive Officer. Kiame Mahaniah MD, a licensed family medicine physician will become the Chief Executive Officer in October 2017 upon Lori Abrams Berry’s retirement. Dr. Mahaniah has over two decades of community health center clinical and leadership experience. Mark Alexakos, MD, MPP, is a licensed psychiatrist board-certified in both child/adolescent psychiatry and adult psychiatry, and serves as our Chief Behavioral Health Officer. Our Chief Operating Officer is Bernadette Thomas, APRN, DNP, MPH, who has many years of health center clinical and operational experience. Our medical staff members are all board eligible or board certified in their specialty areas and we have extensive credentialing and privileging procedures for all licensed clinical staff.
LCHC makes every effort to meet the diverse multicultural needs of its target populations with significant numbers of bilingual and bicultural staff. Of current employees, 59% are non-white. Staff members who are bilingual or multilingual make up 56% of our staff. Languages spoken at the health center include Akoin, Amharic, Arabic, Chinese, Creole, French, German, Hebrew, Hindi, Hungarian, Igbo (Nigeria), Italian, Khmer, Korean, Laotian, Pashto (Pashtun), Portuguese, Russian, Spanish, Tigrigna (Eritrea), Vietnamese, Yoruba (Nigeria)The health center serves many Latino, Cambodian and Russian families and individuals. As the Massachusetts Refugee and Immigrant Health Program’s health assessment service for the North Shore, LCHC has also attracted patients from Somalia, Iraq, Eritrea, Afghanistan, Burma, Congo and many other countries.
The health center has made an ongoing commitment to improve organizational cultural competence and to assure the delivery of effective care that incorporates the cultural values and beliefs of the patients that are served. The health center has developed a variety of organizational systems to improve cultural and linguistic competency, including the addition of cultural sensitivity and awareness expectations to job descriptions and annual performance evaluations for all staff.