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    Collaborative focuses on wellness

    Seniors participate in a fitness class at Framingham’s MetroWest YMCA, which is a part of a regional effort to boost preventive health care.
    Aram Boghosian for The Boston Globe
    Seniors participate in a fitness class at Framingham’s MetroWest YMCA, which is a part of a regional effort to boost preventive health care.

    A partnership involving community organizations, health care providers, and municipal agencies in Framingham, Hudson, Marlborough, and Northborough is one of nine collaborations across Massachusetts that will receive up to $1.7 million a year for three years from the state’s Prevention and Wellness Trust Fund.

    Some have described the program, administered by the Department of Public Health, as the second phase of the Massachusetts health care law, and say it could become a national model much the way its Health Connector, the nation’s first medical insurance exchange, did in 2006.

    The wellness program’s aim is to quantify how preventive care can keep people healthy and lower treatment costs, with its focus on four problem areas: tobacco use, pediatric asthma, hypertension, and falls among the elderly. The results will be used to help persuade insurers to cover new wellness programs.

    Aram Boghosian for The Boston Globe
    From left: Harold Kams 72, Electra Theodore 83, Bobbi Starr 80, and Pushpa Lele 74, participated in a senior fitness class at the MetroWest YMCA in Framingham.


    The local grant is being matched by the MetroWest Health Foundation, which has committed to providing 10 percent of the state’s contributions.

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    The participants in the area collaboration, which was organized by Hudson officials and is being led by the town’s director of public and community health services, Sam Wong, are in the planning stages of a campaign aimed at reducing disease, disability, and costs associated with the four targeted health issues.

    What distinguishes this effort is the emphasis on collaboration among health care providers, social service agencies, YMCAs, and other community organizations to ensure that no patient slips through the cracks.

    “As a clinical site, we see a patient three or four times a year, for 20 minutes, and another team member like a nurse or community health worker might refer them to a food pantry, help with housing issues,” said Paula Kaminow, vice president for operations at the Edward M. Kennedy Community Health Center’s facility in Framingham. “We don’t really have connections with them the other 360 days of the year.”

    A close working relationship, she said, is the key.


    “The emphasis is on building clinical-community partnerships,” Kaminow said. “We’ve always paid attention to treating people’s medical concerns in context,’’ looking at the social environment, or any impediments to a healthy lifestyle, she said, “but this brings it to a new level.”

    The wellness effort is part of a $60 million, four-year program that was established by the Legislature in 2012. The funds were raised through a one-time assessment on the state’s large health insurers and hospitals, and not a single taxpayer dollar is involved, according to the program’s report.

    Grant recipients are allowed between six and 10 months for planning, and invited to participate in Web seminars and share information available in the workplace, said Kaminow.

    Wong said the health officials in Hudson are excited about the grant.

    “We jumped at it right away,” said Wong. “This is the very first time the state has put together a competitive program to reduce health care costs and improve outcomes.”


    During a recent phone interview, Wong said that three of the group’s communities — Hudson, Framingham, and Marlborough — are among the unhealthiest in the state. Hudson, for example, has the highest adult smoking rate, and the highest number of lung cancer deaths, and all three are ranked at the bottom in other “major health conditions,” he said.

    The application for the grant was developed with particular segments of the communities in mind, particularly immigrants, the uninsured, and families and individuals with low incomes.

    When it created the trust fund, public health professionals say, the Legislature recognized that it would take money and time to transform a system based on “sick care” into one that emphasized prevention. There were also concerns about sustaining the effort once it was up and running.

    But some observers, including Alexandra DePalo, Hudson’s program manager for the local Prevention and Wellness Trust Fund collaboration, say it’s not a leap to envision meetings with health insurance companies to discuss funding for preventive efforts. Others, including Framingham’s Health Department director, Steven Ward, predict the campaign’s results will be convincing.

    “Breaking down the clinical and community health silos to address chronic health issues in a systematic and cost- efficient manner is probably the most important benefit,” Ward wrote in an e-mail.

    Kaminow, the Kennedy Community Health Center executive in Framingham, said new practices could become best practices. Electronic medical records, she noted, have already raised health care to a higher level.

    “We can make referrals out to our partners electronically, have a good exchange of information, communication, back and forth,” she said.

    Ward said the grant will support efforts to reduce health risks in public housing, starting with smoking and air quality. One idea is to check public housing stock when apartments become vacant, and before a new family moves in.

    “We’re being proactive. Usually, we react to a complaint,” added Roberto Santamaria, Framingham’s deputy health director, during a conference call with Ward and public health nurse Kitty Mahoney. “This is good for everybody, and it’s just the start.”

    Hattie Bernstein can be reached at hbernstein1@hotmail.com.