Boston Health Care for the Homeless Program

In 1984, the city of Boston received funding for a homeless healthcare pilot program, one of nineteen funded across the country by The Robert Wood Johnson Foundation and the Pew Charitable Trust.{{Cite journal |last1=Zlotnick |first1=Cheryl |last2=Zerger |first2=Suzanne |last3=Wolfe |first3=Phyllis B. |date=2013 |title=Health Care for the Homeless: What We Have Learned in the Past 30 Years and What's Next |journal=American Journal of Public Health |volume=103 |issue=S2 |pages=S199–S205 |doi=10.2105/AJPH.2013.301586 |pmc=3969140 |pmid=24148056 }}

In 1987, Congress passed the Stewart B. McKinney Homeless Assistance Act, making BHCHP a federally qualified health center funded by the Health Resources and Services Administration’s Bureau of Primary Health Care.{{Cite web |date=2012 |title=Linking Housing and Health Care Works for Chronically Homeless Persons |url=https://www.huduser.gov/portal/periodicals/em/summer12/highlight3.html |archive-url=https://web.archive.org/web/20230525221303/https://www.huduser.gov/portal/periodicals/em/summer12/highlight3.html |archive-date=2023-05-25 |access-date=2023-04-20 |website=United States Department of Housing and Urban Development |language=en}}

In 1985, seven individuals{{Who|date=April 2024}} worked together to initiate a program of coordinated clinical services for homeless people. This group created health care centers based in homeless shelters and hospitals. They utilized a team of medical staff that worked in a rotation of multiple settings.{{Cite web |last= |date=14 March 2022 |title=Telling the Story Part One: About Boston Health Care for the Homeless Project |url=https://sjspwellesley.org/2022/03/part-one-about-boston-health-care-for-the-homeless-project/ |archive-url=https://web.archive.org/web/20230710201904/https://sjspwellesley.org/2022/03/part-one-about-boston-health-care-for-the-homeless-project/ |archive-date=2023-07-10 |access-date=2023-04-21 |website=St. Paul Catholic Collaborative |language=en-US}}

Dr. Jim O'Connell is the founding physician and president of Boston Health Care for the Homeless.Tracy Kidder, Rough Sleepers: Dr Jim O’Connell’s Urgent Mission to Bring Healing to Homeless People (New York: Random House, 2023): 28 He agreed to the role of founding physician as a temporary favor to the City of Boston, but stayed with BHCHP for over forty years.{{Cite web |date=2023-03-02 |title=This Boston doctor has cared for the homeless for 40 years. Here's what he's learned |url=https://www.wgbh.org/news/local-news/2023/03/02/this-boston-doctor-has-cared-for-the-homeless-for-40-years-heres-what-hes-learned |archive-url=https://web.archive.org/web/20230710202058/https://www.wgbh.org/news/local-news/2023/03/02/this-boston-doctor-has-cared-for-the-homeless-for-40-years-heres-what-hes-learned |archive-date=2023-07-10 |access-date=2023-04-18 |website=WGBH |language=en}}{{Cite web |date=2022-10-05 |title=Jim O'Connell |url=https://www.irishamerica.com/honoree/jim-oconnell/ |archive-url=https://web.archive.org/web/20230710202303/https://www.irishamerica.com/honoree/jim-oconnell/ |archive-date=2023-07-10 |access-date=2023-04-18 |website=Irish America |language=en-US}}{{Cite news |title='Just give love': One man's tireless care for homeless people |work=Christian Science Monitor |url=https://www.csmonitor.com/Books/Book-Reviews/2023/0116/Just-give-love-One-man-s-tireless-care-for-homeless-people |access-date=2023-04-20 |archive-url=https://web.archive.org/web/20230710202503/https://www.csmonitor.com/Books/Book-Reviews/2023/0116/Just-give-love-One-man-s-tireless-care-for-homeless-people |archive-date=2023-07-10 }}

O'Connell was trained in patient engagement by Barbara McInnis, a nurse at the Pine Street Inn clinic. McInnis taught O'Connell how to build rapport with homeless patients by soaking their feet. Foot-soaking is still offered to homeless patients at the BHCHP clinic at St. Francis House, the largest day shelter in Massachusetts.{{cite news |last1=Kidder |first1=Tracy |title='You Have to Learn to Listen': How a Doctor Cares for Boston's Homeless |url=https://www.nytimes.com/2023/01/05/magazine/boston-homeless-dr-jim-oconnell.html |work=The New York Times |date=5 January 2023 |archive-url=https://web.archive.org/web/20230710183309/https://www.nytimes.com/2023/01/05/magazine/boston-homeless-dr-jim-oconnell.html |archive-date=2023-07-10 }}{{Cite web |last=Gotbaum |first=Rachel |title=Boston Foot-Care Clinic Treats Feet of the Homeless. |url=https://www.npr.org/templates/story/story.php?storyId=5293169 |archive-url=https://web.archive.org/web/20230710202712/https://www.npr.org/templates/story/story.php?storyId=5293169 |archive-date=2023-07-10 |website=NPR}}{{Cite web |date=2021-12-20 |title=A time for charity: St. Francis House in Boston provides refuge, clothes and a path to stability |url=https://www.wgbh.org/news/local-news/2021/12/20/a-time-for-charity-st-francis-house-in-boston-provides-refuge-clothes-and-a-path-to-stability |archive-url=https://web.archive.org/web/20230712013655/https://www.wgbh.org/news/local-news/2021/12/20/a-time-for-charity-st-francis-house-in-boston-provides-refuge-clothes-and-a-path-to-stability |archive-date=2023-07-12 |access-date=2023-04-20 |website=WGBH |language=en}}{{Cite web |title=Street Doctor |url=https://www.harvardmagazine.com/2016/01/street-doctor |archive-url=https://web.archive.org/web/20230712013925/https://www.harvardmagazine.com/2016/01/street-doctor |archive-date=2023-07-12 |website=Harvard Magazine|date=9 December 2015 }}

When BHCHP was founded, it was composed of multidisciplinary teams of physicians, caseworkers, and nurses. The teams worked in over forty shelters and outreach clinics, collaborating with Boston City Hospital and Massachusetts General Hospital, two major teaching facilities in the city.{{cite journal |last1=O'Connell |first1=James |last2=Lebow |first2=Joan |title=AIDS and the Homeless of Boston |journal=New England Journal of Public Policy |date=23 March 1992 |volume=8 |issue=1 |url=https://scholarworks.umb.edu/nejpp/vol8/iss1/49/ }} Primary care clinics were held across these two facilities multiple days a week, with BHCHP staff visiting and supporting homeless patients in their treatment, discharge and follow-up.

BHCHP serves homeless communities in the Greater Boston area, providing services to nearly 10,000 individuals every year.{{cite news |id={{ProQuest|405068224}} |last1=Lebovits |first1=Susan Chaityn |title=PUTTING MEDICAL RELIEF ON TRACK; Doctor holds hours at Suffolk Downs |website=The Boston Globe |date=29 July 2007 |page=8 }} BHCHP now offers services at more than 80 sites throughout the Boston area, and is the “largest and most comprehensive” program of its type in the nation, including a patient-tracking system, shelter-based clinics, counselling, detox programs and HIV teams.{{cite news |last1=Zezima |first1=Katie |title=In Boston, House Calls for the Homeless |id={{ProQuest|433976044}} |url=https://www.nytimes.com/2008/11/11/giving/11boston.html |work=The New York Times |date=11 November 2008 }} Many of BHCHP services are now housed in the Jean Yawkey Place complex, a $35 million renovation of the city’s old morgue repurposed in 2008.

BHCHP responded to the crisis by ramping up its partnerships with the major hospitals, conducting weekly sessions in the Boston City Hospital AIDS clinic, reinforcing resources for its drug treatment programs, providing pneumonia and influenza vaccinations throughout shelters and clinics, supporting AZT drug routines,{{cite news |last1=Rosenthal |first1=Elisabeth |title=HEALTH; Health Care for the Homeless: Treating the Byproducts of Life on the Street |id={{ProQuest|427527871}} |url=https://www.nytimes.com/1990/02/22/us/health-health-care-for-homeless-treating-byproducts-life-street.html |work=The New York Times |date=22 February 1990 }} providing care in AIDS ‘health care stations’ across the city, giving out drugs against tuberculous and pneumonia – which killed 10% of Boston’s homeless population between 1985 and 1989.

In 1992, Healthcare for the Homeless opened a medical clinic at the Suffolk Downs Thoroughbred racetrack to treat hundreds of uninsured backstretch workers who would otherwise be without medical care. The majority of patients at this clinic were traveling migrant workers who came from Spanish-speaking countries such as Guatemala, Mexico, and El Salvador. Providers at the clinic noted that due to a lack of health care, patients were known previously to medicate themselves with drugs meant for the horses. The presence of BHCHP helped workers on the track recover from addiction, especially from alcoholism.{{Cite web |title=Putting medical relief on track |url=http://archive.boston.com/news/local/articles/2007/07/29/putting_medical_relief_on_track/ |archive-url=https://web.archive.org/web/20230530052134/http://archive.boston.com/news/local/articles/2007/07/29/putting_medical_relief_on_track/ |archive-date=2023-05-30 |access-date=2023-04-18 |website=The Boston Globe |language=en}}{{Cite web |title=Aiding former backstretch workers, The Eighth Pole perseveres in New England {{!}} Topics: New England, Suffolk Downs, The Eighth Pole, Rockingham Park |url=https://www.thoroughbredracing.com/articles/2173/aiding-former-backstretch-workers-eighth-pole-perseveres-new-england/ |archive-url=https://web.archive.org/web/20230530052300/https://www.thoroughbredracing.com/articles/2173/aiding-former-backstretch-workers-eighth-pole-perseveres-new-england/ |archive-date=2023-05-30 |access-date=2023-04-18 |website=Thoroughbred Racing Commentary}}

In 1996, BHCHP became the first homeless organization in the United States to implement a computerized electronic medical record (EMR) system, which was designed and built by the Laboratory of Computer Science at Massachusetts General Hospital.{{Cite journal |last1=Blewett |first1=D. R. |last2=Barnett |first2=G. O. |last3=Chueh |first3=H. C. |date=1999 |title=Experience with an electronic health record for a homeless population |journal=Proceedings. AMIA Symposium |pages=481–485 |pmc=2232624 |pmid=10566405}}{{cite journal |last1=Angoff |first1=Gerald H |last2=O’Connell |first2=James J |last3=Gaeta |first3=Jessie M |last4=De Las Nueces |first4=Denise |last5=Lawrence |first5=Michael |last6=Nembang |first6=Sanju |last7=Baggett |first7=Travis P |title=Electronic medical record implementation for a healthcare system caring for homeless people |journal=JAMIA Open |date=April 2019 |volume=2 |issue=1 |pages=89–98 |doi=10.1093/jamiaopen/ooy046 |pmc=6951900 |pmid=31984348 }}

In 2019, the organization announced a partnership with Netsmart to implement a new electronic medical record specifically designed for tracking and coordinating addiction treatment.{{Cite web |date=8 November 2019 |title=Boston Health Care for the Homeless Program Partners with Netsmart to Address the Opioid Crisis |url=https://www.argentum.org/news/boston-health-care-for-the-homeless-program-partners-with-netsmart-to-address-the-opioid-crisis/ |archive-url=https://web.archive.org/web/20230712014044/https://www.argentum.org/boston-health-care-for-the-homeless-program-partners-with-netsmart-to-address-the-opioid-crisis/ |archive-date=2023-07-12 |access-date=2023-04-18 |website=Argentum |language=en-US}}{{Cite web |date=2019-11-05 |title=Boston Health Care for the Homeless Program Partners with Netsmart to Address the Opioid Crisis |url=https://www.businesswire.com/news/home/20191105005198/en/Boston-Health-Care-for-the-Homeless-Program-Partners-with-Netsmart-to-Address-the-Opioid-Crisis |archive-url=https://web.archive.org/web/20230712014200/https://www.businesswire.com/news/home/20191105005198/en/Boston-Health-Care-for-the-Homeless-Program-Partners-with-Netsmart-to-Address-the-Opioid-Crisis |archive-date=2023-07-12 |access-date=2023-04-18 |website=Business Wire |language=en}}{{Cite web |title=Boston organization to use new EHR to reduce opioid-related deaths |url=https://www.healthdatamanagement.com/articles/[object%20Object |archive-url=https://web.archive.org/web/20230712014335/https://www.healthdatamanagement.com/articles/%5Bobject%20Object |archive-date=2023-07-12 |access-date=2023-04-18 |website=Health Data Management}}

In 1994, just under a decade after its founding, BHCHP began to offer behavioral health services to address a ‘growing, unmet need’.{{Cite web |title=Our History |url=https://www.bhchp.org/about/our-history/ |access-date=2023-12-06 |website=Boston Health Care for the Homeless Program |language=en-US}} In 2003, BHCHP’s street team integrated medical and behavioral health care by employing a clinical social worker and part time psychiatrist; by 2007, there was program-wide integration of behavioral health with primary care services.

In 2016, Healthcare for the Homeless opened SPOT, a medical observation and stabilization space for intoxicated patients. SPOT was a response to the growing opioid epidemic, with overdose from fentanyl being the leading cause of death among BHCHP patients.{{Cite web |title=Supportive Place for Observation and Treatment (SPOT) |url=https://www.bhchp.org/services/spot/ |access-date=2023-12-06 |website=Boston Health Care for the Homeless Program |language=en-US}} Within just two months of SPOT's opening, nurses logged 447 visits from 129 patients. Monitoring and communication established between providers and patients help providers better understand current street drugs and their impacts on people who use them. SPOT focuses on giving patients oxygen, rather than giving every person naloxone and potentially making them sick or damaging rapport. SPOT workers only give naloxone to patients if it's completely necessary to their survival. Patients have expressed appreciation for the space to move through their highs without fearing being hit by cars in the high-traffic neighborhood of Mass and Cass and for not having to hide their drug use in bathrooms and alleyways, which creates a high risk of fatal overdose.{{Cite web |title=In A Safe Space, Medical Professionals Monitor What's Really Happening During A Drug High |url=https://www.wbur.org/news/2016/06/15/spot-drug-users |archive-url=https://web.archive.org/web/20230710233624/https://www.wbur.org/news/2016/06/15/spot-drug-users |archive-date=2023-07-10 |access-date=2023-04-19 |website=WBUR |date=15 June 2016 |language=en}} Due to SPOT, the average number of over-sedated individuals observed in public significantly decreased by 28% in two years.{{cite journal |last1=León |first1=Casey |last2=Cardoso |first2=Lena J.P. |last3=Johnston |first3=Salem |last4=Mackin |first4=Sarah |last5=Bock |first5=Barry |last6=Gaeta |first6=Jessie M. |title=Changes in public order after the opening of an overdose monitoring facility for people who inject drugs |journal=International Journal of Drug Policy |date=March 2018 |volume=53 |pages=90–95 |doi=10.1016/j.drugpo.2017.12.009 |pmid=29294417 }}{{cite news |title=Providing A Safe Space And Medical Monitoring To Prevent Overdose Deaths |date=31 August 2016 |work=Health Affairs Blog |doi=10.1377/forefront.20160831.056280 }}{{cite thesis |last1=Leung |first1=Brandon |title=Describing connections to substance use disorder treatment from a medical monitoring program servicing the homeless |date=2020 |hdl=2144/41287 |hdl-access=free }}

BHCHP has demonstrated the effectiveness of the medical respite model for homeless people.{{Cite journal |last1=Shetler |first1=Dan |last2=Shepard |first2=Donald S. |date=2018 |title=Medical Respite for People Experiencing Homelessness: Financial Impacts with Alternative Levels of Medicaid Coverage |journal=Journal of Health Care for the Poor and Underserved |language=en |volume=29 |issue=2 |pages=801–813 |id={{Project MUSE|694367}} |doi=10.1353/hpu.2018.0059 |pmid=29805141 |s2cid=44069562 }} Respite centers allow people who are homeless to recuperate and heal in a safe, clean place after major hospital treatments, rather than discharging them to the streets. Respite centers within the organization have helped stabilize clients in a less traumatic environment than hospitals,{{Cite web |last=Wood |first=Lisa |date=13 November 2018 |title=Hospital discharges to 'no fixed address' – here's a much better way |url=http://theconversation.com/hospital-discharges-to-no-fixed-address-heres-a-much-better-way-106602 |archive-url=https://web.archive.org/web/20230710233852/https://theconversation.com/hospital-discharges-to-no-fixed-address-heres-a-much-better-way-106602 |archive-date=2023-07-10 |access-date=2023-04-18 |website=The Conversation |language=en}} reduce readmissions and over-utilization of emergency rooms,{{Cite web |title=How respite care for homeless reduces readmissions |url=https://www.athenahealth.com/knowledge-hub/practice-management/3-minute-case-study-extensive-care-team-reduces-readmissions |archive-url=https://web.archive.org/web/20230710234124/https://www.athenahealth.com/knowledge-hub/practice-management/3-minute-case-study-extensive-care-team-reduces-readmissions |archive-date=2023-07-10 |access-date=2023-04-18 |website=Athena Health}} and improve overall health outcomes for homeless and formerly homeless individuals.{{cite journal |last1=Robinson |first1=Tyler D. |last2=Oliveira |first2=Thiago M. |last3=Timmes |first3=Theresa R. |last4=Mills |first4=Jacqueline M. |last5=Starr |first5=Nichole |last6=Fleming |first6=Matthew |last7=Janeway |first7=Megan |last8=Haddad |first8=Diane |last9=Sidhwa |first9=Feroze |last10=Macht |first10=Ryan D. |last11=Kauffman |first11=Douglas F. |last12=Dechert |first12=Tracey A. |title=Socially Responsible Surgery: Building Recognition and Coalition |journal=Frontiers in Surgery |date=5 April 2017 |volume=4 |page=11 |doi=10.3389/fsurg.2017.00011 |pmc=5380666 |pmid=28424776 |doi-access=free }}

In 1985, Boston Health Care for the Homeless Program, led by Dr. Jim O'Connell opened the first medical respite for homeless individuals in the United States at the Lemuel Shattuck Shelter, beginning with five beds and expanding to 25 beds.{{Cite web |last=McMurray-Avila |first=Marsha |date=1999 |title=Medical Respite Services for Homeless People: Practical Models |url=https://www.ncceh.org/media/files/article/VF_MedicalRespiteServices.pdf |archive-url=https://web.archive.org/web/20230710234302/https://www.ncceh.org/media/files/article/VF_MedicalRespiteServices.pdf |archive-date=2023-07-10 |website=National Health Care for the Homeless Council}}{{Cite web |last=Stamatis |first=Renee |date=2019-03-27 |title=White Mass talk to focus on homeless |url=https://www.bridgeportdiocese.org/white-mass-talk-to-focus-on-homeless/ |archive-url=https://web.archive.org/web/20230710234431/https://www.bridgeportdiocese.org/white-mass-talk-to-focus-on-homeless/ |archive-date=2023-07-10 |access-date=2023-04-18 |website=Diocese of Bridgeport |language=en-US}}

In 1993, Boston Healthcare for the Homeless program opened the Barbara McInnis House respite center, named in honor of Barbara McInnis, a veteran nurse and tuberculosis specialist who pioneered providing treatment for people living in shelters.{{Cite web |last=Zagastizábal |first=Andy |date=2008-04-04 |title=McInnis House will move out |url=http://jamaicaplaingazette.com/2008/04/04/mcinnis_house_will_move_out/ |access-date=2023-04-18 |website=Jamaica Plain Gazette |language=en-US}}{{Cite web |date=2018 |title=The Birth of Consumer Advisory Boards at Health Care for the Homeless Programs: A Case Study from Boston |url=https://nhchc.org/wp-content/uploads/2019/08/boston-cab-case-study_final.pdf |website=National Healthcare for the Homeless Council}} The facility helps over 2,200 patients a year stay off the street and out of congregate settings while they recover from acute illnesses and medical procedures. McInnis House also serves undocumented, terminally ill, homeless people with dignified end-of-life care.{{Cite web |title=McInnis House Provides End-Of-Life Care For The Undocumented And Homeless |url=https://www.wbur.org/news/2014/06/10/undocumented-health-care-mcinnis-house |access-date=2023-04-18 |website=WBUR |date=11 June 2014 |language=en}} In 2008, McInnis House expanded, moving from a former nursing home in Jamaica Plain to the Jean Yawkey Place clinic in the South End.{{Cite web |title=Boston Health Care for the Homeless Program to dedicate new health care facility |url=https://www.bizjournals.com/boston/stories/2008/05/26/daily12.html |access-date=2023-04-18 |website=Business Journals}}

In 2016, BHCHP opened the Stacy Kirkpatrick House, a 20-bed medical respite in the former location of Barbara McInnis House.{{Cite web |last=Marino |first=Maryann |date=May 2016 |title=Community Welcomes 30 Men and Women, No Longer Homeless |url=https://www.jamaicaplainnews.com/2016/05/01/community-welcomes-30-men-and-women-no-longer-homeless/19021 |access-date=2023-04-18 |website=Jamaica Plain News |language=en-US}} It was named in honor of Stacy Kirkpatrick, a BHCHP nurse of 16 years who died of ovarian cancer.{{Cite web |last=Marquard |first=Bryan |title=Stacy Kirkpatrick, 52; caregiver to the neediest |url=https://www.bostonglobe.com/metro/2016/04/27/stacy-kirkpatrick-nurse-practitioner-boston-health-care-for-homeless-dies/ZzVJJaYOlnYPyofQF3Iy3L/story.html |access-date=2023-04-18 |website=The Boston Globe |language=en-US}} The building is also home to Francis Grady Apartments, 30 studio units for formerly homeless men and women, along with onsite case management and behavioral health services.{{Cite web |date=2016-05-02 |title=Jamaica Plain Apartments House 30 Formerly Homeless Men and Women |url=https://patch.com/massachusetts/jamaicaplain/jamaica-plain-apartments-house-30-formerly-homeless-men-women |access-date=2023-04-18 |website=Jamaica Plain, MA Patch |language=en}}

In 1985, Dr. Jim O'Connell recognized that the majority of deaths of homeless people were occurring among "rough sleepers", people who sleep outside rather than in shelters. At the time, there was a tuberculosis outbreak that could only be treated by a structured medical regimen, unrealistic to be adhered to by rough sleepers. These factors drove O’Connell and fellow medical workers at the Pine Street Inn and the former Boston City Hospital to practice street medicine, traveling to where clients resided outside to treat them.{{Cite web |last=Dillon |first=Katie |date=22 November 2022 |title=What Is a Street Doctor? |url=https://healthcity.bmc.org/policy-and-industry/what-street-doctor |archive-url=https://web.archive.org/web/20230710183710/https://healthcity.bmc.org/policy-and-industry/what-street-doctor |archive-date=2023-07-10 |access-date=2023-04-18 |website=HealthCity |language=en}}{{Cite book |last=Kidder |first=Tracy |title=Rough sleepers |date=2023 |isbn=978-1-9848-0143-2 |location=New York |publisher=Random House Publishing Group |oclc=1312653408 }}

In 1986, the Massachusetts government funded the first outreach van for homeless people in the state, dubbed "The Overnight Rescue Van" which street doctors would ride around Boston at night, checking up on people during the three coldest winter months. The doctors quickly determined that their approach was intrusive based on feedback from patients so they began using food, survival supplies, humor, and patience to build rapport with the community. RN Barbara McInnis proposed that the workers on the van should keep track of deaths among rough sleepers to determine what seasons averaged the highest deaths. In that year, the staff documented 56 deaths among rough sleepers and found that they died an equal amount in all four seasons. McInnis and O'Connell reported this data to the Massachusetts State House, which led to the legislature's public health committee financing the van year-round.

In 2010, an earthquake in Haiti caused 300,000 people to become injured, and 1.5 million people to become homeless. In response, BHCHP staggered staffing of its Massachusetts facilities, so that 41 of its providers could go to Haiti to treat patients medically impacted by the earthquake.{{Cite web |date=2022-01-12 |title=UN marks anniversary of devastating 2010 Haiti earthquake |url=https://news.un.org/en/story/2022/01/1109632 |archive-url=https://web.archive.org/web/20230712014440/https://news.un.org/en/story/2022/01/1109632 |archive-date=2023-07-12 |access-date=2023-04-19 |website=United Nations News |language=en}}{{Cite web |last=Metzger |first=Andy |title=Maintaining a connection to Haiti |url=https://www.wickedlocal.com/story/arlington-advocate/2010/03/27/maintaining-connection-to-haiti/40818286007/ |archive-url=https://web.archive.org/web/20230712014619/https://www.wickedlocal.com/story/arlington-advocate/2010/03/27/maintaining-connection-to-haiti/40818286007/ |archive-date=2023-07-12 |access-date=2023-04-19 |website=Wicked Local |language=en-US}}

In 2016, an outbreak of fatal bacterial meningitis occurred amongst the City of Boston's homeless population, especially in shelters. Centers for Disease Control and Prevention (CDC) investigated the outbreak and found close contact over a series of hours to be a risk factor. Close contact is difficult to avoid in congregate settings, such as shelters. Healthcare for the Homeless responded to the crisis by vaccinating 2,400 people in two weeks and providing antibiotics to infected and high-risk patients. Healthcare for the Homeless in collaboration with the Boston Public Health Commission and the CDC implemented contact tracing and provided preventative antibiotics to people who had close contact with diagnosed patients for extended periods of time.{{Cite web |title=CDC in Boston to investigate illness striking homeless |url=https://www.bostonglobe.com/metro/2016/03/16/cdc-disease-detectives-arrive-boston-investigate-illness-striking-boston-homeless/eH5kuTMbgSkhL2DGJlFonI/story.html |archive-url=https://web.archive.org/web/20230710202904/https://www.bostonglobe.com/metro/2016/03/16/cdc-disease-detectives-arrive-boston-investigate-illness-striking-boston-homeless/eH5kuTMbgSkhL2DGJlFonI/story.html |archive-date=2023-07-10 |access-date=2023-04-20 |website=The Boston Globe |language=en-US}}{{Cite web |date=21 March 2016 |title=CDC investigates infection affecting Boston's homeless population |url=https://dailyfreepress.com/2016/03/21/centers-for-disease-control-investigates-infection-plaguing-bostons-homeless-population/ |archive-url=https://web.archive.org/web/20230710203055/https://dailyfreepress.com/2016/03/21/centers-for-disease-control-investigates-infection-plaguing-bostons-homeless-population/ |archive-date=2023-07-10 |access-date=2023-04-20 |website=The Daily Free Press |language=en-US}}{{Cite web |last=Adams |first=Katie |date=2023-03-13 |title=How Providers Across the US Are Caring For the Country's 580,000+ Homeless People |url=https://medcitynews.com/2023/03/how-providers-across-the-us-are-caring-for-the-countrys-580000-homeless-people/ |archive-url=https://web.archive.org/web/20230710203255/https://medcitynews.com/2023/03/how-providers-across-the-us-are-caring-for-the-countrys-580000-homeless-people/ |archive-date=2023-07-10 |access-date=2023-04-20 |website=MedCity News |language=en-US}}{{Cite web |last=Freyer |first=Felice J. |title=Death of homeless man from bacterial infection sparks vaccination drive |url=https://www.bostonglobe.com/metro/2016/02/19/death-homeless-man-from-bacterial-infection-sparks-vaccination-drive/cYFreOHhyxa7HY0OxyRR2J/story.html |archive-url=https://web.archive.org/web/20230710203448/https://www.bostonglobe.com/metro/2016/02/19/death-homeless-man-from-bacterial-infection-sparks-vaccination-drive/cYFreOHhyxa7HY0OxyRR2J/story.html |archive-date=2023-07-10 |access-date=2023-04-20 |website=The Boston Globe}}

Category:Homeless shelters in the United States

Category:1985 establishments in Massachusetts

Category:Clinics in the United States

Category:Types of health care facilities

Category:Health centers