Reegan Mair knows how much good has been done by the Colorado Coalition for the Homeless's mobile medical clinic, aka the Stout Street van. She's a volunteer for Denver's Harm Reduction Action Center, which educates injection drug users to prevent the spread of infectious diseases like HIV and hepatitis-C, and numerous clients have told her how much the van has helped them. She quotes one homeless woman as saying, "The Stout Street van treated me like a human."
Which only makes it more unfortunate that it's about to go away.
Earlier this month, CCH announced that it was eliminating the van as of February 8 -- one of many cuts precipitated by a more than $3.4 million reduction in funding from the State of Colorado; get more details by clicking here. John Parvensky, CCH's president, understands why advocates like Mair are frustrated. As he concedes, "I'm upset about it as well."
The Stout Street van was a long time coming, Parvensky notes. "Almost eight years ago, we started with a converted recreational vehicle that we used to take health-care services out to shelters and other places in the community," he says. "Then, two years ago, we were able to get a dedicated mobile health clinic with two exam rooms to go to locations throughout the community, in order to bring health care to where people were -- and particularly to people who weren't able to come to the Stout Street Clinic," at 2100 Broadway.
According to Parvensky, this expansion, which cost about $200,000 per annum, was made possible by "state funding through the tobacco tax, and the tobacco settlement fund," among other things. But the money train hasn't left the station for quite some time, leading to funding cuts that were made retroactive to July 1, 2009. "We lost almost a third of our health-care budget," Parvensky allows. "We had to make some decisions about how to prioritize programs, so that we could go into this year with a balanced budget."
Ultimately, Parvensky goes on, "we decided we needed to concentrate our funding on those programs serving the greatest number of individuals and having the greatest impact -- and we felt that because it's more inefficient and costly to run the mobile clinic, we would be better off taking the docs and nurses, the medical providers that were being used in the mobile clinic, and put them in the Stout Street Clinic, so they could see more people there, as well as work through our street outreach efforts to identify other people who were having problems reaching Stout Street."
Parvensky backs up this conclusion with numbers. Last year, he says, "we served about 2,200 people using the mobile health clinic. And we served about 12,000 individuals medically at the Stout Street Clinic." He expects this last number to grow in 2010 given the lingering economic downturn, making it all the more important to stretch the dwindling resources available. Already, he says, approximately 700 people are on the waiting list for mental-health services.
Mair fears even more patients may fall through the cracks once the van stops running. "A lot of people east and west of the city can't even afford bus fare, and the lines at Stout Street are really long," she says. "People can wait for hours and hours there," in contrast to the much speedier service provided by the van crew. As a result, Mair expects that most people who'd been served by the van will no longer be able to receive preventative services, and even those with the resources to go to the Stout Street Clinic will avoid doing so "unless things get really, really bad."
Parvensky sympathizes. "Our hope is that we'll be able to identify funding to allow us to continue our current services and to restore the programs that we cut -- in particular the mobile health clinic, because it allows us to see people we otherwise might not be able to." As such, "we're reaching out to the community at large, we're writing proposals to foundations, we're trying to convince our state legislators that they ought to reinstate the cuts they have made, so we can restore some of the programs."
Not that he's overly optimistic. "The reality is, the legislature is talking about cutting more money out of the budget. When they do their budget effective this July 1, we may end up having to cut services even further if we're not successful at arguing that they should restore some of the lost funding, or at least keep it at the same level."
Hence, the Stout Street van is likely to be mothballed for the foreseeable future. Parvensky calls the decision "a Hobson's choice -- a choice of the lesser evils."
And one that will take effect just over three weeks from today.