A History of Fenway Health’s First Forty Years
As a younger man living in Boston in the 1970s, I became involved with what was then the Fenway Community Health Center, operating out of the basement at 16 Haviland Street. I volunteered for the Board of Directors, even serving as Board chair at a time when someone in his 20s could do that sort of thing. The idea that “health care is a right, not a privilege” was the mission that motivated us. Students and neighborhood activists had collaborated to create a health care facility that was welcoming to all. Those were exciting, and sometimes exhausting, times.
In the late 1970’s, Fenway wrestled with a growing disparity between its original mission and health care model—free care for all, and provision of this care by volunteers—with increasing government regulations and requirements. If providers were licensed, Fenway could become eligible for third-party payments that would allow free care to continue in a different, perhaps more limited form. Intense debates split Fenway’s original ideological founders from other leaders who believed that integration with Boston’s established health care system would provide more opportunities for growth and success.
Decisions in the late 1970s and early 1980s set Fenway on a path toward full licensure as a community health center, making it eligible for support from Boston’s health care establishment and multiple government agencies—support that would prove essential in establishing Fenway’s national leadership in the AIDS crisis since 1981. In those last innocent years before HIV, our board was encouraged to eliminate volunteer providers and replace them with board-certified doctors and nurses. The Women’s Health Collective was the last holdout against this change, believing that self-educated women’s health advocates were better equipped to care for Fenway’s women patients and clients than a largely male medical establishment.
The moment in this process that holds so much meaning for me personally is the night when we made our most difficult choice during my term as Fenway’s Board Chair—one that was most likely correct, but still filled me with regret. As we worked with the state to become a fully licensed health center, we were faced with the knowledge that the Women’s Health Collective—the last bastion of free care by volunteer providers—was standing between our organization and its eligibility for state licensure, third-party insurance and Medicare/Medicaid payments. Seeking those credentials, reliable sources of revenue, and increased participation in Boston’s health care system, I presided over our vote to eliminate volunteer reproductive and health counseling by Fenway’s Women’s Health Collective. Good, dedicated people, many of whom had been volunteering tirelessly for a decade, watched as we decided that they would be replaced by paid professionals, all in the name of progress. It was an event we all believed had great importance, and we feared it might cost Fenway as much in alienation from our original mission and community as it might help us gain in increased organizational security and stature.
Luckily, our fears were unwarranted. Within two years, new Executive Director Sally Deane and Board Chairman Dan Cirelli had rebuilt the bridges we thought had been burned, and people dedicated to the provision of women’s health care were back at Fenway, working within the center’s new “professional” system almost as if nothing had happened. The fact that so few of us remember this story is testimony to how short-lived a crisis it really was. Rightfully, is only one story in four decades of stories, one night in almost 15,000 nights when something happened at Fenway Health. Many other stories, many other days and nights, and many other individuals have far more to do with where the organization is today.
But it was that story that was in the back of my head as I met with members of Fenway Health’s Development and Communications Departments in their modern new offices at 1340 Boylston Street in early 2010. At the time, we were nearing Fenway’s fortieth anniversary and I had the idea for a book that would chronicle the story of so many people who have been involved with Fenway Health over the years. Putting my story down on paper felt like the right thing to do not only for posterity’s sake, but also as way for me to find some measure of peace with the decision that night, so long ago.
I spent almost two years interviewing historic and current Fenway leaders and patients, tracking down historical documents and photos, combing through Fenway’s archives, and recording my own experiences on the health center’s Board of Directors in the 1970s. The result is For People, Not For Profit: A History of Fenway Health’s First Forty Years, a real-life history covering the evolution of the community health center movement, the founding and growth of Fenway Health, the empowerment of Boston’s LGBT community and our response to the HIV/AIDS epidemic, and the evolving field of LGBT health. The book is chock full of photos, historical documents and personal reflections.
It’s remarkable that so many of Fenway’s leaders, men and women who were in their 20’s forty years ago, are still here today, fighting the same fight in different ways, with different resources, but still here. It says something about the stamina of good ideas and good causes over time, and about the relentless contributions of good people. It’s inspirational. For People, Not for Profit is a book that must be read by those who lived through the times it describes, and – even more so – by those who did not. We can all learn from the memories of those who shaped these remarkable times – whether they are with us today, or live on only through the contributions they made as part of organizations like Fenway Health.
For People, Not For Profit: A History of Fenway Health’s First Forty Years is available from Amazon.com, Barnesandnoble.com and Apple’s iBook store.