Massachusetts: Trained Community Health Workers From Local Program Help Homeless HIV Patients Overcome a Variety of Issues

Around 80 HIV patients in Greater Boston participate in the Prevention and Access to Care and Treatment program. It is operated by the nonprofit Partners in Health, which is best known for its global work. Started in 1997, PACT assigns trained community health workers to help patients who have failed to thrive in spite of medical intervention.

"Almost all of the people who are referred to us are people of color, are poor, and often have a lot of psychosocial issues," said Dr. Heidi Behforouz, PACT's founder. "We're not supplanting the medical services they're getting. We're basically enhancing or complementing them."

PACT's six staffers are not trained medical professionals; rather, they work to motivate and guide patients, providing practical solutions to help them take good care of their health. Organizers aim for clients to graduate from the program after 1.5-2 years. PACT's costs -- about $6,000 per patient per year -- are funded by the state, foundations, and private donors.

A 2009 analysis of Medicaid billings found that inpatient hospital expenditures for PACT patients declined by 62 percent, while their use of outpatient and pharmacy services increased. PACT and another community health worker program at Boston's Fenway Institute hope to expand to serve other patients, including those at risk of HIV and those battling other chronic diseases.

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