The addition of an optical shop on the ground floor of 1601 Washington Street was but one measure to increase the public visibility of the South End Community Health Center (SECHC). Established in 1968 by Dr. Gerald Hass and businessman turned activist Mel Scovell, SECHC has in recent years expanded its client base, increased its footprint with additional service sites and is poised to reach further into the community with its recent certification as a Federally Qualified Health Center (FQHC) and receipt of a large federal grant to fund expansion of services to the public housing population. A new medical director, Dr. Beth Mazyck, and additional medical and outreach hiring will aid SECHC in meeting its goals.

The Center's annual board meeting on January 28th reported significant growth, dramatic challenges met, new health-care and development initiatives, and ambitious goals for expansion. In his opening remarks, Robert Johnson, President and CEO of SECHC, noted that the Center's service has grown from 52,000 visits in 2009 to nearly 80,000 visits in 2013, an increase of 57% which has been met with new hires and resulting growing pains. Johnson pointed out that the recent relocation of Pathways to Wellness, which previously rented SECHC's third floor, freed desperately needed staff and treatment space.

Johnson spoke with excitement of the Dr. Gerald Hass Center, which offers medical and dental services at 400 Shawmut Avenue, next door to the Blackstone Elementary School. "It has been a fabulous success by any measure," Johnson said. The center provided 8,000 visits last year, including 4,000 from students and the remainder from patients around the neighborhood. The school-based center, which celebrated its first anniversary in May 2013, received a grant from the Department of Public Health in the amount of $100,000 per year for ten years.

Contacted last week for follow-up information, Vice President for Marketing and Development Monika Montrymowicz was helpful but harried as she toiled against a tight deadline to submit a grant proposal, the lifeblood of the Center. As Johnson explained at the board meeting, SECHC's insurance reimbursements have not risen in three years, and as a result the Center's visits are being reimbursed at 70% of cost, with the remainder covered by grant dollars. In FY 2013, SECHC received only one grant rather than the usual three or four, sustaining a $1 million loss in its annual budget of $14-15 million. Johnson referred to the combination of stagnant reimbursements and lack of new grant money as "a perfect storm." As FY 2014 began, the fiscal crisis reversed with the receipt of six new grants from various sources. "The state of our center is once again strong and prepared for the future," Johnson said.

As another means of ensuring the Center's financial stability, Montrymowicz launched a Board of Ambassadors to educate the public at large as well as businesspersons and philanthropists about SECHC's services. Montrymowicz recruited former colleague and longtime friend Mark Lippolt, a Senior Vice President at Hammond Residential Real Estate who has been active with organizations such as the Women's Lunch Place, Community Servings and the Haitian Multi-Service Center, as co-chair of the Board of Ambassadors. Explaining his new role, Lippolt wrote in an e-mail, "Given the wonderful complexity of the services provided by the South End Community Health Center, the Board of Ambassadors was started in August 2013 to help promote the work of SECHC and to engage our friends and neighbors in the mission." SECHC also acknowledged donors who make significant contributions of supplies and other resources. The program of the recent board meeting lists Toro, AnitaKurl Salon and the American Repertory Theater as donors who provide items and services that are "outside of budget constraints." The program also thanks Evelyn Berde, an artist whose work graces the Center's walls. A most striking piece hangs on the third floor, a small portrait of two girls with haunting, dark eyes. "We've been very fortunate to get wonderful pieces from her. She is a lovely person," Montrymowicz said.

The Center's FQHC status is accompanied by a federal grant of approximately $800,000 per year indefinitely, in contrast to most grants that must be replenished annually or every three or four years. The grant will fund SECHC's outreach to more than 3,000 new patients from South End public housing complexes over the next two years, with some services to be provided on-site and public health workers recruited from public housing. With the new status and funding come new regulations, standards and periodic inspections. To lead the Center's medical staff through the changes, Johnson turned to Dr. Beth Mazyck, a former colleague from his days as President and CEO of the U. Mass.-affiliated Community Health Connections in Fitchburg, to lead the providers as the Center's new Chief Medical Officer. Mazyck, who started at SECHC part-time in December and went full-time in January, said, "It's been a wonderful ride since the first of the year, and it's a fantastic group of people. The providers here, the nursing staff, medical assistants, the administrative people, are all excellent. Not all community health centers can say that." She continued, "What I have discovered here, however, is that some of the systems need work in quality, privileging and credentialing."

Both Johnson and Mazyck see the federal standards as an advantage, a call to quality control and consistency of service that will result in better care and increased efficiency. In a follow-up interview, Mazyck said, "We just became a FQHC a few months ago, so I am working on bringing required procedures up to standard. We have to ensure good safety and quality of care for when we get inspected." Johnson chimed in, "For new grantees, there are inspections within the first 10 months and regular reporting of everything we do every year: quality of care, financial. We were trying to do all those things but until we got the grant and became part of HRSA (the federal Health Resources and Services Administration), you don't have money to do what they require. There are specific goals on all kinds of things. It's a good thing because it's like a quality certification."

For the public-housing outreach program, SECHC will send medical and dental practitioners into South End public housing sites to provide screenings and basic care as well as employing new and existing public health workers to introduce SECHC's services to public housing residents and encourage them to join the Center. Rosette Martinez, Vice President for Community Programs, will be directing the public housing campaign. According to Johnson, Martinez will meet with representatives from South End public housing sites and from the Boston Housing Authority, and public housing residents will be surveyed to determine their health care needs and concerns. Johnson also pointed out that the initiative will deliver employment opportunities as well as health services to public housing residents. "We are going to hire four community health workers from public housing in the first year and another four in the second year, so those eight people will have access to great jobs right in their neighborhood," Johnson said, adding, "The people who will be in these jobs will be certified community health workers. They are trained to provide medical information and have knowledge of the medical system and getting people referred to resources. The good part is that public housing has trained a number of people to do this. They had people working through state funding but that was cut. I think it has been the goal since we started this health center 46 years ago, to hire people from within this neighborhood." Mazyck added that the economic improvement angle makes community health care funding popular on both sides of the political aisle. "Community health centers (CHCs) supported by HRSA are well supported by both Republicans and Democrats, and HRSA's role has increased in the past 10 years," Mazyck observed. "Republicans like CHCs because it's been shown many times that CHCs help reduce health care costs overall by providing preventive care. Democrats like it because we improve economies of neighborhoods and improve lives by providing a source of hiring. CHCs are supposed to hire within the neighborhood as much as possible." Johnson reported that the Center recently hired a new pediatrician, Dr. Alice Abrahamian, who moved to the neighborhood when she took the job. SECHC is also recruiting a new family medicine physician and a dentist to visit public housing to do screenings, and down the road, a new nurse practitioner will also be sought.

SECHC's behavioral health department is offering a new program to the Center's medical patients in response to the uptick in violence by young women and girls in recent years. SECHC nurse/psychologist Laurie Goldman developed a series of workshops on relaxation and coping with stress that will run weekly through February, with sessions on sleep hygiene, nutrition and other strategies to promote mindfulness and impulse control. "These sessions are for our medical patients who don't want to come for mental health services because of the stigma. We are trying to have a better connection between medicine and mental health. When they learn these skills they can put them to use in the future. We are trying to focus on wellness," nurse/psychologist Clare O'Callaghan said.

While over half of SECHC's patients are covered by Medicaid and Medicare versus about one-quarter of patients who have coverage through their employers or The Connector, Montrymowicz points out, "We serve the diversity of the South End population. We have retirees who choose to come here for their services because they moved to the South End for everything it has to offer. We are not just for the poor but for the diversity of the South End."