For more than 15 years, the Lynn Health Task Force has worked on issues of public health access for low income residents of Lynn and surrounding communities. These efforts began in earnest in 1985 when, after the merger of Lynn’s two community hospitals, the merged entity elected to close its downtown location and consolidate operations at its other facility. The Task Force, utilizing a mix of direct action and legal maneuvering sought and secured a commitment to maintain walk-in and urgent care capabilities at the downtown location. Some 10 years later the hospital unceremoniously closed the walk-in facility and slowly the remaining services at the downtown location. The final insult came when in 1996 the building was demolished and in its place rose a Stop & Shop. The Task Force vowed to restore those services. Shortly after a new opportunity arose.

In 1997, faced with escalating losses the now sole community hospital in Lynn put its facility on the market, seeking a larger health care institution to acquire and maintain the hospital. The Task Force, represented by Neighborhood Legal Services and Health Law Advocates, demanded a public process for selection of this new provider of health care services in Lynn and demanded a major role in the process. What resulted was an unprecedented open process which has been cited as a national model for appropriate community involvement in hospital mergers and acquisitions. The Task Force demanded and received authority to ask each bidder to provide detailed written answers to extensive written questions drafted by the Task Force concerning the bidder’s public health commitments and commitments to the uninsured. Then each was required to appear at an open public forum (see photo) with the Task Force provided half of the forum to ask its own follow up questions and offer the assembled community residents its views.

Of the four bidders, half were large Massachusetts non-profit hospital organizations and half were national for-profits. In addition to its public role, the Task Force and its counsel also negotiated privately with each bidder, seeking firm commitments that could later be enforced. Ultimately, after reviewing all of the proposals and completing negotiations with the bidders, the Task Force reached an agreement with Partners Health Care, the operators of Mass. General and Brigham and Women’s Hospitals to support their application in exchange for a written commitment to "invest $50 million in new facilities, equipment, programs and services over the next five years (throughout the North Shore), of which at least $15 to 20 million with be required for facilities, programs and services in the Lynn community alone." In addition to this general commitment, the agreement provided for specific commitments based on Task Force recommendations concerning primary care enhancements, infectious disease services, transportation services, translation and interpreter services, enhancements to primary care availability, teen pregnancy prevention activities, domestic violence services, free care for the uninsured, substance abuse and mental health treatment alternatives, community health outreach services and an increased consumer voice in governance for the facility. Ultimately the Task Force’s selected bidder was selected to operate the hospital. The Task Force then established a 10 taxpayer group to serve as a party in the Public Health Council proceedings necessary for the transfer of the hospital’s license to Partners. With Partners ultimate agreement the Public Health Council attached all of these agreement as conditions to the hospital’s new operating license.

As part of this licensure system, the Task Force is now a party to all license reviews and the Public Health Council holds a public hearing each year to review Partners’ compliance with the conditions at which the Task Force reports in writing and orally at the hearing on compliance to date. Below is a summary of the new health care resources and initiatives that have sprung up since this agreement was forged.

During the first year of the agreement, the parties focused on the most specific and in some instances narrowest commitments - those easiest to make progress on as the relationship between the parties developed. Ironing out the specifics of these commitments occurred and continues to occur through regular monthly meetings between Task Force volunteers, hospital staff and Partners representatives, together with smaller working groups on specific conditions. During the first year, 1998, Community health programming was established in collaboration with several Task Force partner organizations. In connection with the Lynn Teen Pregnancy Prevention Coalition (now called the Lynn Youth Neighborhood Coalition) the hospital provided funds and staffing for weekly counseling sessions for boys and girls and a health educator was provided at their center. Working with the North Shore AIDS Collaborative, the hospital began contracting for the delivery of health care education programming and a health counselor at the Collaborative’s site, Cornerstone for. The hospital also provided funding to Help for Abused Women and Children to employ domestic violence outreach and response staff to be housed in the hospital’s emergency rooms in both Lynn and Salem.

Two new community health outreach workers were hired - one Cambodian and the other Latino. Three new certified interpreters were employed by the hospital. Interpreter capacity was established in Spanish, Russian, Khmer, Creole and French with 24 hour access to on-call or on-site interpreter services for Spanish, Russian and Khmer, the three biggest non-English speaking populations in the community. For the first time the hospital began tracking the primary language of its patients and began maintaining logs of use of its interpreter resources which are regularly shared with the Task Force for future monitoring. A new school based health center was established and staffed at Lynn’s Breed Middle School. A new primary care practice was established as a hospital-based clinic able to take free care patients, facilities for it constructed and a new primary care physician recruited and hired. A new mental health treatment facility was opened with three new clinicians, one of whom was, for the first time, a Spanish speaker. The hospital purchased a mobile health services van (really an 18 wheel truck) capable of providing both a base for outreach activities but large and well equipped enough to also provide direct medical treatment and other services.