Scaling Network Lead Entities Grantee Profile 

Network Name: Massachusetts Association of Home Care Programs and Area Agencies on Aging 

Grant Goal: 

Massachusetts Association of Home Care Programs (MHC), in partnership with twenty-eight Aging Services Access Points (ASAPs) 

and Area Agencies Aging (AAAs) will, in the course of this two-year project, lead a community integrated health network (CIHN) 

that will coordinate accessibility and delivery of services to address (SDOH) in historically underserved Massachusetts communities. 

The goal is to provide greater access to sustainable, universal, high-quality, integrated care for older adults and individuals with 

disabilities across Massachusetts, by establishing a single network lead entity (NLE) that allows health care entities to access 

services that address inequities and SDOH. 

Grant Partners: 

• 28 Community-based organizations (CBOs), 

ASAPs, and AAAs 

• Commonwealth Care Alliance 

• Massachusetts Executive Office of Elder Affairs 

• Senior Whole Health 

Award: $283,792 

Target Population: 

Older adults, persons with disabilities, people of 

color, and underserved and marginalized 

Grant Objectives: 

1) Create an administrative structure that improves 

access to long-term services and supports (LTSS). 

2) Implement a health information exchange to 

improve administrative efficiency and 

effectiveness. 

3) Adopt an evidence-based quality improvement 

program to measure health and social impact. 

4) Develop products to address SDOH within a 

competitive pricing structure. 

Anticipated outcomes include: 

1) Access to long-terms services and supports (LTSS). 

2) Improve coordination of care and customer 

service through increased capacity for health 

information exchange. 

3) Create no less than 6 performance measures for 

SDOH and health equity. 

4) Develop no less than 5 products/services to 

address SDOH and health equity. 

Grant Summary: 

MHC’s role as the NLE is to drive evidence-based quality improvement, 

ensure continual analysis of consumer needs and deliverables, and 

coordinate the policies and procedures that guide the collection, 

analysis, and bidirectional sharing of consumer and program data, with 

the primary focus on improving consumer, caregiver, and community 

health outcomes. The ASAP/AAA network, serving in line with the No 

Wrong Door (NWD) System foundation, has incorporated into 

Administrative Services Unit LLC. (ASU) and delivers centralized and 

seamless LTSS based on solidified contract infrastructure. Through the 

NLE model, MHC/ASU will offer services and supports available though 

the network to contracted entities and will act as the fiscal agent to 

centralize network efforts. Their CIHN includes board members and 

officers with roles and responsibilities, staffing structure, detailed 

clinical integration and quality improvement plan, and identified needs 

to advance the business model. 

ASU delivers a broad spectrum of the state’s NWD access functions, 

based on a consumer-centered approach. Additionally, each 

ASAP/AAA brings extensive experience working with local health care 

systems. 

As part of business development, MHC will use this grant to work with 

Health Management Associates and Ball Consulting to increase their 

capacity in operations, management of external markets, and 

partnership development. 

This project will expand geographic coverage of the CIHN to a 

statewide level. The CIHN member agencies all have extensive 

experience as ASAPs and AAAs within their designated program 

services areas. Additional SDOH needs will be assessed through the 

Health-Related Social Needs (HSRN) Screening Tool, which will allow 

member agencies to meet the needs of individuals experiencing high 

levels of healthcare utilization, and/or have SDOH needs. 

Planned activities for NLE enhancement will focus on: 

☒Leadership 

☒Finance 

☒Business Development 

☒Network Development and Support 

☒Network Administration 

Grant Contact: 

Lisa Gurgone, Massachusetts Association of Home Care Programs and AAAs, lgurgone@springwell.com