A Year of Reproductive Health Wins

What a year it has been! Covid-19 has continued to be a big part of everyone’s lives in 2021, including an impact on patients’ access to reproductive care. Amidst that challenge, we have seen what our partners and their communities have done to provide best-in-class contraceptive care in the face of uncertainty, and we feel immensely encouraged by it.

Through dedicated work and a tireless commitment to patient care, we have seen 5 health centers in Massachusetts move through our program implementation to graduation. We are excited to share with you spotlights of two of our newly graduated partners, Harvard Street Neighborhood Health Center, and Holyoke Health! ???? These health centers, along with their peers, Community Health Center of Franklin County, Family Health Center of Worcester, and Fenway Health, have worked hard to bring best-in-class contraceptive care to their communities, and we are thrilled to be able to celebrate them today.

We also look back on some other great successes from 2021, and we hope you will take a few minutes with us to reflect on some reproductive health wins this year. We are heartened by the dedicated work of our partners and friends to ensure that all patients in the Commonwealth have access to patient-centered contraceptive care.

We at Upstream wish you Happy Holidays and a joyous New Year. We look forward to continuing our work with you in 2022!

Harvard Street Neighborhood Health Center

Founded in 1969 as part of the Boston Department of Health and Hospitals, Harvard Street Neighborhood Health Center is now an independent nonprofit and a Federally Qualified Health Center (FQHC) that serves the community in and around Dorchester, MA. Their mission is to provide equitable, exemplary, high-quality, and timely care to the community at every opportunity through rigorous, multifaceted, and patient-centered health care services and programs.

In January 2020, Upstream worked with HSNHC to integrate a pregnancy intention screening question (PISQ) field in the EHR. Since integrating a PISQ and training staff on contraceptive care workflows, Harvard Street’s annual PISQ documentation rate has continued to increase. While most health centers were not able to increase PISQ rates during the pandemic, Harvard Street consistently increased their PISQ reporting. Now, 93% of Harvard Street’s patients have a documented response to the PISQ at least once in the past 12 months.

The patient experience can be awkward when they are being asked intimate and ‘probing’ questions. It can be awkward for the MAs and Nurses as well. With the Upstream training, everyone is more comfortable with initiating the conversation and better equipped to handle those uncomfortable conversations with care.”

— Dr. Alice Lin, Interim Medical Director at Harvard Street Neighborhood Health Center

Holyoke Health

 Holyoke Health Center has been providing low cost medical, dental, and pharmaceutical services in both
English and Spanish to the Holyoke, Chicopee, and the surrounding communities for over 40 years. Their mission is to “Improve the health of their patients through affordable, quality health care and comprehensive community-based programs to create a healthy community.”

Over the course of the Upstream partnership, HH has undergone a practice change in how it provides contraceptive care to its patients. This includes changes in the ways pregnancy intention is screened (PISQ), delivering patient-centered counseling, information sharing among support staff and providers, and measuring capacity to deliver same-day access to the full range of methods.

“I’ve been very lucky with the group of individuals I get to work with on this initiative at the health center, and then to have Upstream continuously support the efforts to make our work even that much better has been really great.”

— Glorimar Irizarry, Project Coordinator, Holyoke Health

New Partner!

We are pleased to welcome Manet Community Health Center, Inc. (Manet) as our newest Upstream partner in Massachusetts!

Founded in 1979, Manet is a not-for-profit Federally Qualified Health Center (FQHC) dedicated to providing preventive, primary and non-emergent urgent care to all, regardless of financial circumstance or health insurance coverage status. Manet provides services that are reflective of the languages and cultures of the communities it serves and offers a full array of services and programs for infants, children, adolescents, adults, and seniors.

We are excited to begin program work with Manet in 2022, helping to ensure best-in-class contraceptive care for all patients.

Upstream MA — A Year in Review:

We signed 4 new partners — Hilltown Community Health Center, Outer Cape Health Services, HealthFirst Family Care Center, and Manet Community Health Center.

We added 3 new members to our Council of Advisors — Anne d’Avenas (She/Her), OB/GYN Women’s Health Program Director at Fenway Health; Jessica Aguilera-Steinert, Director, Health Services, ABCD; Tara Kumaraswami, Obstetrics and Gynecology Residency Program Director at UMass Memorial.

We celebrated our first 5 graduates in Massachusetts — Community Health Center of Franklin County, Family Health Center of Worcester, Fenway Health, Harvard Street Neighborhood Health Center, and Holyoke Health! ????
You can find the other three graduation spotlights here!

Upstream formalized a clinical training partnership with Planned Parenthood League of Massachusetts! Through this program, providers from Upstream’s health center partners are able to attend precepting clinics at PPLM’s Boston location following Upstream’s training, where they are able to practice the necessary skills for IUD and Implant placement and removal.

Our health center partners received their new Patient Education Materials and started using them for contraceptive counseling!

Left: Irvin at Fenway Health with the new Patient Education materials. Right: Our health center partners received their PEM along with some sweet Upstream swag.

Upstream partners who have completed training can access free, digital versions of the materials online at our Partner Portal website. Connect with your Upstream Team to discuss stocking printed versions or send us an email at info@upstream.org.

Creative use of PEM

Check out this creative use for the Upstream Patient Education Materials (PEM), set up by one of our sustainability coaches at Boston Health Care for the Homeless Program, Enid Ramos Pitcher! To make the board, Enid downloaded and printed the PDF one-pagers from Upstream’s “learn about birth control” page! (also available in Spanish)


Telemedicine Bill Signed
On January 1st, 2021, Governor Baker signed comprehensive health care legislation (S.B. 2984, An Act Promoting a Resilient Healthcare System that Puts Patients First), which put into law several provisions that make telehealth more accessible and affordable for people across the Commonwealth. Upstream was an active member of the Massachusetts Telemedicine Coalition (tMED), which has advocated for and signed on in support of this legislation.

More info here.

Access Law Advocacy
The Massachusetts Department of Public Health earmarked $500,000 of the 2022 budget for a public awareness campaign regarding 12-month dispensing of hormonal contraceptives. This campaign came about as a direct result of the advocacy by Upstream, NARAL MA, and other reproductive health champions during the pandemic to raise awareness about the Contraceptive ACCESS Law and to ensure that it was being properly implemented among healthcare providers and insurers across the state. More info here.

Additionally, as a result of media coverage of the ACCESS Law garnered by Upstream, the Massachusetts Association of Health Plans committed to launching a public campaign to increase awareness and uptake of the Contraceptive ACCESS law!


Transgender Day of Visibility
On this year’s Transgender Day of Visibility (March 31), we celebrated one of our exemplary Upstream MA partners, Fenway Health, in a Partner Spotlight blog on our website. Fenway Health is a leader in LGBTQIA+ care, and has been for decades. We are honored to work with and learn from this stellar health center.

Successful Partnerships

I want to thank Upstream so much for all the help that they have given our health center in getting our sexual and reproductive health services off the ground. I really don’t think we could do it without them.”

— Alyssa Valbona, Sexual & Reproductive Health Program Manager

It has been a pleasure working with Upstream. Everyone we came across or had the opportunity to work with has been very helpful, patient, supportive, and understanding of the challenges the health center faces while we work to increase contraceptive awareness in patients and staff.”

— Dr. Alice Lin, Interim Medical Director, Harvard Street Neighborhood Health Center

Upstream’s focus on an anatomy-based approach to contraceptive care has allowed this program to seamlessly incorporate into Fenway’s reproductive health management and improve our care…Basing questions and care on an individual’s anatomy, reproductive potential, and goals provides a clearer path to communication, education, and understanding of a patient’s needs and desires.

— Julie Thompson, PA‑C, Medical Director of Trans Health at Fenway

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