
Boston Health Care for the Homeless Program receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.
Home > Behavioral Health > Community Care in Reach (CCiR) Mobile Addiction Program
The people served by the Community Care in Reach (CCiR) Mobile Addiction Program are among BHCHP’s patients who are most vulnerable to structural inequities. Some 99% suffer from a substance use disorder, mostly commonly opioid use disorder and cocaine use disorder. Many live in hidden outdoor encampments, are food insecure, have histories of severe trauma, and are disconnected from the health care system. Overdose and infectious complications from drug use are common. Every patient has been affected by the stigmatization and criminalization of drug use, limiting access to housing, education, and employment.
In the face of these layered injustices, the CCiR team—flexible and armed with a mobile health clinic—offers lowest-barrier substance use disorder care. Meeting patients where they are—literally deep within neighborhoods and metaphorically wherever they are in their addiction journeys—the team delivers services that mitigate the risk of fatal overdose, and in so doing saves lives and offers a model for similar programs across the state.
In 2018, the Kraft Center for Community Health partnered with BHCHP, the Boston Public Health Commission and the GE foundation to launch CCiR as a mobile health program to bring life-saving addiction services directly to historically stigmatized populations in Boston.
Since 2021, the CCiR team is also supported by the Massachusetts Department of Public Health. The CCiR team, equipped with a health clinic on wheels, is able to offer readily accessible medications to treat opioid use disorder, harm reduction services and supplies, and much more, directly to people on the streets. It operates consistently and according to peoples’ common whereabouts. The van parks in some of Boston’s overdose hot spots, including the West End, Nubian Square, and near Massachusetts Avenue and Melnea Cass Boulevard, for eight four-hour sessions each week, two of which are focused specifically on young adults. Addiction medicine clinicians on the CCiR van work hard to form lasting relationships with patients founded on mutual respect, and partner with the Boston Public Health Commission’s Access, Harm Reduction, Overdose Prevention, Education (AHOPE) program to leverage the pre-existing relationships AHOPE staff have developed through their harm reduction work.
Harm reduction is the cornerstone of CCiR’s work, as staff offer people various evidence-based tools to prevent overdose and infectious complications of drug use. These tools include education about safer drug use and supplies such as syringes, fentanyl test strips, syringe disposal containers, and naloxone to reverse overdoses. The program also offers:
In providing these services, and a safe place to access them, the team saves lives not only in the immediate, but also in the long-term, by acting as a connector between patients and the broader health care system.
To broaden the impact of the CCiR program, researchers have collected qualitative and quantitative data from the program and published findings in journals such as Frontiers in Public Health and Journal of Health Care for the Poor and Underserved. Staff also advocate on the city, state, and federal levels in support of the expansion of harm reduction services including supervised consumption sites and offering CCiR as a replicable model. The Commonwealth of Massachusetts has already taken note: the Department of Public Health is now funding three additional mobile addiction programs across the state.
“The staff is pleasant, helpful, and compassionate. It shows people do care. When you are hopeless and down and out and you feel like no one cares, you can come here and realize people do care.”
Carlos, patient
Boston Health Care for the Homeless Program receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.