Children’s Health
The network provides a collaborative program with Children’s Hospital of Boston entitled “Advocating Success for Kids.” The Advocating Success for Kids (ASK) Program improves the healthy development of low-income Boston children, ages three to nine, who have mental health, behavioral, developmental and/or educational needs. ASK brings experts in these areas directly to families in their neighborhoods. The team screens children with signs of behavioral and learning issues, develops a list of recommendations for school and home adaptations and medical treatment, if necessary, and supports the family in applying the recommended treatment. In addition, the program educates pediatricians, parents, and local school departments about developmental issues, and provides a vital link between parents, schools, and health care providers.

Continuous Quality Improvement (CQI)
CCA’s continuous quality improvement efforts build on the strong foundation laid during CCA’s initial years that includes a well-functioning Medical Directors Committee, network-wide IS improvements and the development of a health center quality improvement strategy. CCA is now developing a network-wide framework for continuous quality improvement (CQI) goals. In addition to recasting member health center quality improvement goals into this new framework, CCA implemented a CQI project to improve the specialty referral process. CCA will eventually develop a common measurement dashboard to allow for a “report card” that reflects measurement across the network for agreed upon dimensions as well as individualization of health center-specific quality improvement projects.

Human Resources
Health center staff is its lifeblood. The lack of qualified, highly skilled, and bilingual/bicultural support staff impinges upon access to care and health center performance. However, the labor pool of linguistically and clinically competent staff is very limited—a problem compounded by Boston’s highly competitive employment market where eleven academic medical centers are seeking those very same skilled staff. CCA works with its member centers to address their human resource needs by convening a Human Resource Work Group. This group works to create new opportunities for supporting and mentoring existing staff to decrease turnover and increase productivity. The work group also focuses on other Human Resource concerns such as adhering to compliance standards, and credentialing medical professionals.

Pharmacy
Access to medications is a pressing concern for most of our patients. With the escalating costs of medications and increasing numbers of Massachusetts’s residents without health insurance, CCA patients are confronted with the unconscionable decision of “heat, eat, or treat.” In addition to limited or no insurance coverage, CCA patients on Lower Cape Cod face a lack of retail pharmacies. Even those with insurance experience significant barriers in filling prescriptions. CCA has responded with the grant-funded Comprehensive Pharmacy Program. The program includes a web-based Patient Assistance Program (PAP), medicine closet/samples management, and more access to medications.

Patient Assistance Program: Helping the uninsured obtain free and low-cost prescription medications
CCA has implemented a Patient Assistance Program (PAP) to improve access to free prescription medication for uninsured patients and increased efficiency and effectiveness of health center PAP programs. The web-based program provides current information and forms needed to apply for over 100 major pharmaceutical manufacturers’ indigent patient programs. Staff receive reminder reports to process renewals and refills. CCA also assists its members in streamlining the management of their drug samples closet and provides technical assistance on a range of pharmacy issues through our partnership with the Massachusetts College of Pharmacy and Health Sciences (MCPHS).

Enhanced Pharmaceutical Care
Working collaboratively with the Massachusetts College of Pharmacy and Health Sciences (MCPHS), CCA is improving patient outcomes through enhanced pharmaceutical care. MCPHS utilizes CCA health centers as a practical training site for sixth-year pharmacy students. Under the guidance of a licensed pharmacist, students educate patients on drug adherence, conduct research for providers, assist with accessing drugs for uninsured and underinsured patients, and provide disease management workshops.

Resource Development
CCA partners with its members to explore new means of creating a sustainable pool of community health center funding. This effort includes both seeking
philanthropic contributions from private foundations, individual donors, and institutional partners to support CCA initiatives such as the Advocating Success for Kids program, but also exploring the feasibility of a Community Health Center Endowment Fund. CCA has also supported its members in their individual fundraising efforts by purchasing a web-based fund raising software subscription for each health center.

Utilization Management/Utilization Review (UM/UR)
CCA Medical Directors meet monthly to share issues of common concern and review UM/UR data to improve medical practice and productivity. CCA providers are members of Beth Israel Deaconess Physicians Organization (BIDPO), which ensures all CCA physicians are qualified to practice through a centralized application and credentialing process. BIDPO provides a wealth of information and support including the latest pharmaceutical updates from the active Pharmacy & Therapeutics committee. Two pharmacists attend the monthly CCA Medical Directors’ meeting, providing valuable education as well as data on CCA and individual provider’s performance on quality and cost savings measures. These data are analyzed monthly by the CCA and are used to enhance the organization’s productivity and efficiency.