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Student Clinic Helping Vulnerable New Haven Residents

November 19, 2020
by Colin Poitras

A free health clinic run by Yale students is helping vulnerable New Haven residents during the COVID-19 pandemic.

The HAVEN Free Clinic recently expanded its services to not only provide telehealth consultations, but also cash assistance and home delivery of medications and important medical supplies to better meet community needs, said Claudia de Bruyn, M.P.H. Health Policy ’21, a student at the Yale School of Public Health and the clinic’s executive director.

Staffed by volunteers from the Yale schools of public health, medicine, law and nursing as well as undergraduate and physician associate programs, the clinic provides uninsured adults in New Haven with high-quality primary care, wellness education and assistance in securing health care.

Located in the Yale Physicians Building at 800 Howard Avenue, the clinic operates every Saturday in partnership with Yale University, Yale New Haven Hospital and the Yale Medical Group. Student care teams work under the guidance of faculty preceptors.

A significant proportion of HAVEN patients are undocumented. In addition to being barred from Medicaid and insurance subsidies, this patient population also disproportionately works in sectors that have been hardest hit by coronavirus-related closures. Many of those who continue to work do so in essential, frontline jobs with greater risk of COVID-19 transmission, de Bruyn said.

To help residents weather the crisis, Social Services Co-Directors Lakai Legg, M.P.H. Social and Behavioral Sciences ’21, and Erica Lin, B.S. Molecular, Cellular, and Developmental Biology ‘21, created a comprehensive online guide of community resources – from contact-free grocery delivery options to internet and energy assistance.

“A lot of our patients have lost their jobs due to the pandemic, so many of them are facing financial pressures when it comes to paying their rent, buying food and taking care of their other needs,” said de Bruyn. “Providing families with direct cash assistance is our way of helping them in addition to providing primary care.”

Financial support and food supplies for the clinic’s services is being provided in part by its community partners. The Semilla Collective’s New Haven Area Mutual Aid Fund provides direct cash and food aid for city residents disproportionately affected by the current health crisis, and FISH of Greater New Haven, formerly Pantry to Pantry, has been helpful for food deliveries. Junta for Progressive Action offers rental assistance for Greater New Haven Latinx and undocumented families who have lost wages as a result of COVID-19. Thanks to the hard work of advocacy organizations like Unidad Latina en Acción and through private funds like the 4-CT program, the clinic has also been able to provide direct cash relief for undocumented migrants who have been excluded from federal aid.

The clinic sees an average of 30 patients per week and has conducted over 4,000 patient visits representing more than 450 unique adult patients since it opened 15 years ago. The clinic’s patient population is predominantly Latinx (90%) and Spanish-speaking (85%) and many patients have not received medical care for at least 2-3 years prior to coming to the clinic. Some have never seen a medical provider before.

With many patients now staying home during the pandemic’s surge, the clinic’s education department, which offers nutrition and lifestyle counseling, adopted its programs to a remote format. The department also created a website where New Haven residents can learn more about home-based exercise options, healthy eating and how to manage conditions like hypertension and diabetes.

Since the clinic does not always have a primary care physician on site and its resources and capacity is limited, students spend much of their time providing medical, social and behavioral health counseling by phone and telehealth. During the pandemic, it has served as a COVID-19 information and resource hub, helping direct people to the care and services they need such as COVID-19 testing locations, de Bruyn said.

“A lot of people were very anxious at the beginning of the pandemic because they weren’t offering testing unless a patient had COVID-19 symptoms,” de Bruyn said. “So, we would advise them. Most importantly, if they did have symptoms, we would call the nearest emergency department and advise them that a patient was coming in. We’d then work really closely with the hospital to make sure that patient wasn’t billed.”

De Bruyn said the clinic’s pharmacy directors are also working closely with patients to make sure they get the medication they need. If the medication is expensive and patients are unable to pay for it, clinic staff work to find cheaper alternatives and ways to cover the cost. Additionally, every weekend since March 2020, dozens of volunteers have made home deliveries for patients who are unable to pick up their medications and equipment at a pharmacy or at the clinic.

“A lot of our patients tend to have comorbidities and they are also working on the frontlines in restaurants or other jobs that require them to be on site and expose them to increased risks,” said de Bruyn. “They don’t have the luxury of staying at home. So, we try to help them as much as we can by delivering medications and other medical supplies like blood pressure cuffs and glucometers directly to their homes.”

About 280 Yale students currently volunteer at the clinic, which provides them valuable real-world instruction and experience in community health services.

De Bruyn said the clinic prides itself on being a trusted community resource for COVID-19 information and care and for providing holistic services to help families in need beyond primary care.

“As a student-run clinic we hold ourselves to a higher standard and we always want to make sure we are delivering the best possible care,” said de Bruyn. “There is a lot of misinformation out there about COVID-19 and you need trusted resources like HAVEN. I think the sentiment is that our patients are just thankful we’re here.”

One priority for the clinic this year is to join the many voices advocating for extending Medicaid to include the estimated 140,000 undocumented residents living in Connecticut. The Center for Children’s Advocacy, CT Students for a Dream, and Yale faculty members, Dr. Marietta Vázquez and Dr. Julia Rosenberg, have all made significant contributions toward this.

“In an ideal world, our clinic would not need to exist for uninsured patients to get appropriate care. Despite our best efforts, there are still significant gaps in access to health services and health outcomes for the uninsured,” said de Bruyn. “We see it integral to our role as health professionals to foster advocacy work and continue fighting for our patients’ right to quality health care.”

The HAVEN (Healthcare, Advocacy, Volunteerism, Education, Neighborhood) Free Clinic is supported primarily by the John B. Goetsch Endowment for Medical Education and Service. But donations are always needed and appreciated to support its operations.

Anyone interested in donating to the clinic can find more information on the clinic’s website.

Submitted by Ivette Aquilino on November 19, 2020