The evolution of the Fenway Community Health model

Fenway Community Health was founded by community activists in 1971 in the F enway neighborhood of Boston, Mass, and within a decade had rapidly expande d its medical services for gay men in response to the AIDS epidemic. Increa sed expertise and cultural competence in lesbian, gay, bisexual, and transg ender (LGBT) care led to expansion of medical services to address broader c ommunity concerns, ranging from substance use to parenting issues to domest ic and homophobic violence, as well as specialized programs for lesbians, b isexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recor ded 5000 patient care visits; in 2000, Fenway's clinical departments record ed 50 850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff peopl e responsible for clinical programs, community education, research, adminis tration, planning, and development. Over the past few years, Fenway's annua l budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGB T health issues for other health providers and has developed programs to ed ucate the general community about specific LGBT health concerns. This healt h center may provide a model of comprehensive LGBT health services that hav e a local impact.