Boston is home to one of the most respected and pioneering homeless healthcare programs in the entire United States. The Boston Health Care for the Homeless Program — known widely as BHCHP — has been serving people experiencing homelessness for four decades, operating a network of clinics, street teams, and medical respite facilities that together reach over 10,000 individuals every year. But the program is now navigating one of its most financially precarious moments, even as the need for its services has never been greater.
Here is everything you need to know about how BHCHP works, what services it provides, who it serves, and the serious challenges threatening its future.
What Is the Boston Health Care for the Homeless Program (BHCHP)?
The mission of the Boston Health Care for the Homeless Program is to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in the community.
Founded in 1985, BHCHP marked its 40th anniversary in 2025 as one of the longest-running and most comprehensive homeless healthcare programs in the country. It is an integrated team of over 600 medical and behavioral health staff, social service providers, and support staff committed to providing comprehensive, high-quality health care for individuals and families experiencing homelessness in Boston and beyond. At its 30-plus clinic sites in shelters and hospitals, its medical respite program, and on the streets, it provides medical care, behavioral health care, youth and family services, and case management to nearly 10,000 individuals — adults and children — every year.
The program grew out of a 1984 Robert Wood Johnson Foundation initiative that provided grants to 19 U.S. cities to address healthcare for homeless populations. Boston’s response was shaped from the beginning by a coalition insisting that healthcare for homeless people be treated as a matter of social justice, not charity — a founding principle that still defines BHCHP’s approach today. (Source: PMC/American Journal of Public Health)
| Key Facts | Details |
|---|---|
| Founded | 1985 |
| Staff | 600+ medical, behavioral health, and support staff |
| Patients served annually | ~10,000 individuals and families |
| Clinic locations | 30+ sites (shelters, hospitals, streets) |
| Annual budget | ~$50 million |
| Primary funding source | ~75% from MassHealth, Medicare, Health Safety Net |
| Headquarters | Jean Yawkey Place, 780 Albany Street, Boston (South End) |
(Source: BHCHP Press Kit, bhchp.org)
The Scope of Homelessness in Boston
To understand BHCHP’s scale, you need to understand the problem it is addressing.
In 2025, Boston’s homelessness census showed meaningful progress in efforts to prevent and reduce homelessness. Overall, homelessness declined by 4.3 percent, reversing several years of post-pandemic increases. More than 2,800 people exited homelessness to permanent housing in 2024 — up 41 percent from the prior year. Boston continues to have one of the lowest rates of unsheltered homelessness among major U.S. cities, with just 2.4 percent of people experiencing homelessness living on the street.
Still, the 2024 census had counted approximately 6,000 individuals experiencing homelessness in the city, with the area known as “Mass and Cass” — the intersection of Massachusetts Avenue and Melnea Cass Boulevard — serving as a visible epicenter of the city’s homelessness and substance use crisis. (Source: Gardner Magazine)
The health consequences of homelessness are severe and well-documented. Research shows that people experiencing homelessness face heightened risk for chronic conditions like hypertension and diabetes, communicable diseases like tuberculosis, and mental health disorders including depression, anxiety, and schizophrenia. (Source: PMC/NIH) A landmark Boston survey found that unhoused individuals in the city reported significantly higher rates of poor general health, tobacco use, tooth decay, and poor sleep compared to housed residents. (Source: Boston University School of Public Health)
Factors usually associated with homelessness include substance use, mental health challenges, poverty, and a history of incarceration. While these factors increase the risk of homelessness at the individual level, they cannot explain population-level trends. Greater Boston has similar — and often lower — rates of these individual factors than many other U.S. regions, yet still experiences high rates of homelessness. What is different is the region’s severe shortage of affordable housing, limiting the ability of people of modest means to find decent housing without public support.
The Full Range of BHCHP Services
BHCHP is not a single clinic. It is a network of care that meets people where they are — whether that is in a shelter, a hospital, or under a bridge.
Primary Care
Primary care is the backbone of what BHCHP does. The program delivers medical care at more than 30 clinic sites embedded in shelters, hospitals, community health centers, and drop-in locations across greater Boston. Patients can access primary care, urgent care, chronic disease management, preventive care, immunizations, lab work, pharmacy services, and referrals to specialty care. The main walk-in clinic at Jean Yawkey Place, 780 Albany Street in the South End, is open to homeless patients and allows same-day walk-in appointments.
For anyone wishing to become a patient, BHCHP can be reached at 857-654-1605, or visited directly at Jean Yawkey Place. For existing patients needing after-hours care, the number is 781-221-6565. (Source: bhchp.org)
The Street Team: Care Without Walls
One of BHCHP’s most distinctive programs is its Street Team. The Street Team, based out of Mass General, provides direct care in a variety of unconventional settings: under bridges, down back alleys, in abandoned cars, on park benches and street corners, and in community meals programs, overnight drop-in centers, emergency departments, detoxification units, and nursing homes. These dedicated professionals are a consistent presence on the streets, providing a continuum of care that brings people from the street corner, to the intensive care unit, to respite care, and ideally, to secure housing.
This model — known as street medicine — is increasingly recognized nationwide as the most effective way to reach people who would otherwise never enter a healthcare setting. BHCHP’s Street Team helped pioneer this approach, and Boston’s model has been studied and replicated in cities across the country.
Medical Respite: The Barbara McInnis House
Perhaps BHCHP’s most celebrated innovation is the Barbara McInnis House — the first medical respite facility ever created in the United States. In 1985, BHCHP opened the first medical respite facility in the nation — a safe place for patients experiencing homelessness to recover from short-term injuries, illnesses, and hospital stays. This flagship 103-bed medical respite facility at Jean Yawkey Place, called the Barbara McInnis House, provides 24/7 care for patients who are too sick for life in shelters or the street, but not sick enough to occupy a hospital bed. The medical respite program has since inspired dozens more nationwide.
The Barbara McInnis House offers short-term medical care to more than 1,000 unique patients every year. The average stay is about two weeks. During their stay, patients have access to 24/7 care and three nutritious meals per day. They also receive behavioral health services, dental care, benefits management, case management and discharge planning support, patient support groups, and access to laundry facilities.
BHCHP provides medical respite care — short-term medical and recuperative services — for homeless people who are far too sick for life in shelters but not sick enough to occupy a costly acute care hospital bed. This fills a critical gap in the healthcare system that would otherwise result in patients cycling repeatedly through emergency rooms at enormous cost to the healthcare system.
Dental Care
For people experiencing homelessness, the prevalence of oral disease is high — one study showed that 72% of homeless patients had a history of tooth loss, compared with 54% of the general population — and the ability to access treatment is low. The myriad concerns of daily survival often take priority over oral health, until the need is urgent.
For decades, BHCHP has been a trusted source of oral health care for people experiencing homelessness, as well as a trainer of dental students passionate about social justice. The state-of-the-art six-chair dental clinic at Jean Yawkey Place provides both scheduled and walk-in appointments every day for patients in need of urgent care and those who could not schedule in advance.
Dental care goes beyond comfort. Untreated dental issues are directly linked to serious systemic health conditions including diabetes, heart disease, and stroke — conditions that are already prevalent in the homeless population. (Source: BHCHP)
Behavioral Health and Substance Use Services
Mental illness and substance use disorders are disproportionately common among people experiencing homelessness, and BHCHP treats them as primary medical concerns rather than secondary add-ons. The program offers therapy, psychiatric medication management, counseling, support groups, and a Mobile Addiction Program. BHCHP also provides Hepatitis C treatment and HIV care — two conditions closely linked to substance use and unhoused populations. In 2024, BHCHP provided substance use disorder treatment to more than 1,500 unique patients. (Source: Boston Globe)
Youth and Family Services
Unaccompanied youth experience homelessness at alarming rates. A 2015–2016 national survey found that one in 10 young adults aged 18 to 25 had been homeless within the last year. These experiences are often linked to substance use disorder, behavioral health problems, and trauma.
Since 1985, BHCHP has delivered multilingual, trauma-informed care to youth and families, serving as the primary health care presence in family and domestic violence shelters, hotels, and motels across Boston. The program provides primary and urgent medical care, including family planning and Hepatitis C treatment, as well as treatment for substance use disorders and behavioral health care, including therapy, support groups, and medication.
How BHCHP’s Care Model Works
What sets BHCHP apart from a standard clinic is its philosophy of care: meet patients where they are, build trust before demanding compliance, and treat the whole person rather than just the presenting complaint.
The program operates on principles of Harm Reduction and Trauma-Informed Care. This means providers understand that addiction, mental illness, and repeated trauma shape how patients engage with healthcare — and design their approach accordingly. Rather than requiring patients to meet a set of preconditions to receive care, BHCHP offers unconditional access.
A critical structural element is the horizontal and vertical integration of care. Horizontally, BHCHP operates across shelters, soup kitchens, day programs, detox units, and housing programs — no matter where a patient is in their life, a point of care is reachable. Vertically, a patient can move from a street encounter with the Street Team, to a primary care appointment, to a hospital stay, to the Barbara McInnis House for recovery, and then to supported housing — with the same team of providers following them through each stage. (Source: PMC/American Journal of Public Health)
In 1996, BHCHP implemented the nation’s first electronic medical record system for homeless programs, helping ensure continuity of care across its many settings.
The Crisis: Medicaid Cuts and Financial Pressure
Despite four decades of success, BHCHP is facing what its leadership has called one of the most difficult financial periods in its history.
BHCHP’s annual budget is approximately $50 million: about 75% of that comes from third-party reimbursements from MassHealth, Medicare, and Health Safety Net. The remainder comes from grants and philanthropy. That heavy reliance on Medicaid makes BHCHP acutely vulnerable to federal and state policy changes.
In September 2025, BHCHP announced it was laying off 25 staff members — roughly 4% of its workforce — and closing the Stacy Kirkpatrick House, a medical respite facility in Jamaica Plain. “BHCHP is confronting one of the most difficult financial periods in our 40-year history,” a spokesperson for the nonprofit said. “For the first time, we have had to make the painful decision to eliminate some positions.” The flagship Barbara McInnis House remained open with its 103 respite beds.
The cuts came in anticipation of sweeping changes to Medicaid under federal legislation. That legislation instituted new work requirements that mean Medicaid recipients must demonstrate they work 80 hours per month to be eligible for benefits. Recipients must also go through recertification every six months instead of the previous one-year timeline.
The projected impact on Massachusetts is steep. In Massachusetts alone, approximately 326,000 residents — nearly 5% of the entire state population — are expected to lose insurance coverage under the new Medicaid restrictions. Under one projection, the Boston Health Care for the Homeless Program could lose $30 million to $40 million in Medicaid revenue over a four-year period.
The nonpartisan Congressional Budget Office says the law will cut federal Medicaid spending by nearly $1 trillion over ten years and cause millions to lose health coverage. For homeless patients specifically — people who already struggle to meet bureaucratic requirements because they lack stable addresses, phones, and documentation — work requirements and more frequent recertifications pose enormous barriers to maintaining coverage.
In January 2026, BHCHP’s CEO Stan McLaren resigned amid these financial pressures, marking the third leadership change at the organization since 2022. (Source: Boston Globe)
The consequences of reduced services reach far beyond BHCHP’s walls. When homeless patients cannot access primary care, they end up in emergency rooms — at a far higher cost to the healthcare system overall.
How to Access BHCHP Services
BHCHP accepts patients experiencing homelessness or housing instability, regardless of immigration status or ability to pay.
| Service | How to Access |
|---|---|
| Become a new patient | Call 857-654-1605 or walk in to Jean Yawkey Place, 780 Albany Street, Boston |
| After-hours care (existing patients) | Call 781-221-6565 |
| Walk-in clinic | Jean Yawkey Place — walk-in slots available daily |
| Dental walk-in | Six-chair dental clinic at Jean Yawkey Place, daily appointments |
| Street Team | Proactive outreach — no action needed; teams approach individuals |
| Medical respite (Barbara McInnis House) | Provider referral or through BHCHP clinical staff |
(Source: bhchp.org)
Other Boston Organizations Supporting Homeless Health
BHCHP is the largest and most comprehensive homeless health program in Boston, but it operates alongside other organizations:
Pine Street Inn — One of New England’s largest homeless service providers, offering shelter, housing, and supportive services to adults experiencing homelessness. Pine Street Inn is also a partner in the City of Boston’s broader homelessness response strategy.
Boston Medical Center (BMC) — The safety-net hospital for Boston, located on the same campus as BHCHP’s Jean Yawkey Place. BMC serves a high volume of unhoused patients and coordinates closely with BHCHP for inpatient and post-discharge care.
Boston Public Health Commission (BPHC) — The city’s public health agency operates shelters and coordinates the annual homeless census, while partnering with BHCHP on public health outreach.
St. Francis House — A day resource center in downtown Boston offering meals, clothing, employment support, and connections to health services for homeless individuals.
Frequently Asked Questions
Do I need insurance to receive care at BHCHP?
No. BHCHP provides care regardless of insurance status. Staff can also help patients apply for MassHealth (Massachusetts Medicaid) and other health coverage programs.
Does BHCHP serve families, or only individuals?
Both. BHCHP has dedicated youth and family services and has been the primary healthcare presence in Boston’s family and domestic violence shelters since 1985.
Is the Street Team available 24/7?
The Street Team operates regular schedules and is a consistent presence in Boston’s homeless communities, but it is not a 24-hour emergency service. For medical emergencies, call 911. For after-hours care as an existing patient, call 781-221-6565.
What is medical respite care, and how is it different from a hospital?
Medical respite is short-term recuperative care for people who are too ill to safely recover in a shelter or on the street, but do not require the intensity of an acute hospital stay. The Barbara McInnis House provides this care with 24/7 nursing and medical support, behavioral health services, dental care, and case management — all under one roof.
How is BHCHP funded?
About 75% of BHCHP’s approximately $50 million annual budget comes from Medicaid (MassHealth), Medicare, and the Health Safety Net program. The remaining 25% comes from private grants and philanthropy. This funding structure makes the program highly sensitive to any changes in federal or state Medicaid policy.
Key Contacts and Resources
| Resource | Contact |
|---|---|
| BHCHP Main (new patients) | 857-654-1605 |
| BHCHP After-Hours (existing patients) | 781-221-6565 |
| BHCHP Headquarters | 780 Albany Street, Boston, MA 02118 |
| BHCHP Website | bhchp.org |
| Boston Public Health Commission | boston.gov |
| Pine Street Inn | pinestreetinn.org |
| Boston Medical Center | bmc.org |
Sources: Boston Health Care for the Homeless Program (bhchp.org), Massachusetts General Hospital, American Journal of Public Health / PMC, Boston Globe, GBH News, Boston.com, Boston.gov, Boston Indicators, Bay State Banner, National Health Care for the Homeless Council (nhchc.org).