Looking at Boston’s Fenway Health today it’s difficult to imagine the community health center’s humble beginnings. What started as a drop-in center located in an apartment basement has developed into one of the world’s leading institutions for LGBT care and HIV research. “It speaks to the need,” President and CEO Dr. Stephen Boswell says. “HIV sparked it, but I think [Fenway Health’s] growth is because of our work in LGBT health and our focus in really trying to provide the highest-quality care you can provide in a national setting – and using cutting-edge technology to do it.”

Serving the LGBT community has been an integral part of Fenway Health’s mission since its beginning. The drop-in clinic opened near Fenway Park in 1971 to serve people without health insurance. The opening occurred around the same time as the Stonewall riots in New York City, considered to be the starting point of the gay liberation movement in the United States, and Fenway Health provided care to many of the LGBT residents who lived in the neighborhood. The volunteer staff was comprised of politically-minded volunteers from Northeastern University who cared for patients regardless of their ability to pay. 

Fenway Health’s importance in the LGBT community rose in the 1980s when the first cases of HIV were discovered in the Boston area. At the time, most major health institutions in the city were not interested in caring for LGBT people, Boswell says, so Fenway Health provided those patients with a safe place to seek treatment. “It became pretty clear in the early ’80s that Fenway needed to build a full-time staff,” Boswell says. By the middle of the decade, Fenway Health was caring for 300 people with HIV infection, making it one of the largest providers of HIV care in New England. It also meant the clinic was running out of space. The health center soon embarked on an 18-month capital campaign to build a $4 million facility across the street.

Fenway Health’s work with HIV and AIDS led to new opportunities. The health center received a National Institutes of Health grant to study HIV, a key moment in Fenway Health’s development as a research institution. “Today, we’re one of the premier institutions in the world studying transmission and prevention of HIV infection,” Boswell says. 

Fenway Health has been involved in a number of breakthroughs in HIV and AIDS treatment. The health center was instrumental in developing the “cocktail,” a combination of therapy drugs that control the virus. When the cocktail was first introduced, there was a debate within the medical community about when patients should start treatment because the toxic medications in the cocktail were considered dangerous. Research from Fenway Health showed that early treatment was effective and helped patients to gain back weight and fight symptoms. “It helped to not only influence what we did, but helped set the guidelines,” Boswell says of the HIV treatment studies.

By the mid-1990s, the cocktail had become more commonly used, marking the end of the beginning of the AIDS scare. At that point, Boswell says Fenway Health took a step back and realized it had built a significant research structure and was caring for a large number of people in the LGBT community. The fledgling community health center had built a global reputation and began to think about how it could use its facilities and influence to further the medical interests of the LGBT community. “Since then, we’ve been focusing on expanding our work to understand the health needs of LGBT folk,” Boswell explains.

Fenway Health has continued its HIV research but has also expanded its other programs. By the end of the 1990s, the health center laid out plans to build a 100,000-square-foot, $60 million facility in Boston. Through a combination of new market tax credits, public bond financing and a $19 million capital campaign, Fenway Health realized that vision and completed its main health center building in 2009.

Fenway Health Today

The journey from basement clinic to a national leader in LGBT healthcare has turned Fenway Health into an operation with an annual budget of more than $90 million. Today, the health center cares for almost 30,000 patients annually and is growing its patient base by 8 to 10 percent each year. Of that patient population, about 50 percent identifies as LGBT and just under 10 percent is living with HIV.

Fenway Health is a magnet health center with four facilities in the Boston area. Although it still primarily serves Bostonians, the organization has patients from as far away as Italy and China. The U.S. Department of Health and Human Services has designated the health center as a training institution for LGBT health around the country.

Because Fenway Health was founded on the principle that healthcare is a right and not a privilege, it’s not surprising that the organization was an advocate of the Affordable Care Act (ACA). “Early on, we embraced health reform and are helping to lead the charge for moving the healthcare system to an improved quality with a careful eye to trying to be more efficient,” Boswell says. 

As part of that leadership, Boswell sits on the board of a local Accountable Care Organization.

The $60 million clinic built in 2009 is the hub of Fenway’s structure, but the health center is looking to build more spokes so it can reach as many as 60,000 patients within the next six years. As it grows the hospital and patient base, Boswell says Fenway Health’s advocacy efforts will continue to play a large role in its future. 

Already, the health center has pushed for policies that will make it a requirement for healthcare providers to be able to collect data on sexual orientation by 2017. The group has also worked with organizations such as the Human Rights Campaign and the Center for American Progress to develop policy. “To have those kinds of effects that will really make a difference is something to be proud of,” Boswell says. 

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