Safety-net clinics are struggling to fill the gap after a Utah health system closed a KCK health clinic

In a shadeless parking lot in downtown Kansas City, Kansas, last week, Lulu Herrera waited inside a parked mobile clinic.

1. On June 1, Intermountain Health based in Utah shuttered the Duchesne Clinic in Kansas City, Kansas, leaving more than 1,000 patients without health care.
2. Care Beyond the Boulevard is trying to fill the gap with a mobile clinic on Wednesdays and Thursdays.
3. Other safety-net clinics, including Vibrant Health, say they can’t deal with the problem alone. They want Kansas lawmakers to pass Medicaid expansion.

She was hoping to see a patient. Any patient.

Herrera knew of hundreds who hadn’t had the care and medicine they needed since June 1, when Intermountain Health shuttered the Duchesne Clinic, just two years after acquiring SCL Health, Duchesne’s former owner.

For 35 years, Duchesne had offered free medical care to some of the city’s poorest residents. Its closing with only about a month’s notice left patients — many of them undocumented and most of them Spanish speakers — with few options for medical care.

“I’m worried about the patients,” said Herrera, Duchesne’s former manager. “We have hundreds of patients (who) we were not able to get a hold of. … A lot of them are running out of meds.”

Since July 10, on Wednesdays and Thursdays, Herrera and a team of clinicians from Care Beyond the Boulevard Inc. with help from Heart to Heart International have been bringing a mobile clinic to this parking lot, a few blocks from Duchesne’s former home, hoping that some of those patients find them.

A couple dozen have come to the temporary clinic, getting medication refills, checkups and referrals to other doctors.

But organizers worry that the temporary clinic, parked outside the Community Health Council of Wyandotte County at 803 Armstrong Ave., isn’t reaching close to everyone. Many former Duchesne patients, they said, have serious health issues that, if left unchecked, will become urgent.

“These are medically complex patients to take care of,” said Jaynell Assmann, a nurse practitioner and founder of Care Beyond the Boulevard, who organized the temporary clinic. “It’s not like they just come in to have their blood pressure checked.”

Assmann said the church that owns the building Duchesne once occupied, St. Mary-St. Anthony Catholic Church, declined her group’s request to park in the former clinic’s parking lot, which the church shares, because Care Beyond the Boulevard offers contraception.

Frank Lipovitz, a member of the parish, said the church wanted to help former Duchesne patients and was discussing how to balance the church’s teachings concerning birth control with Assmann’s request for space. But then church leaders learned that the mobile clinic had found an alternative nearby location.

“We were just as concerned about all those patients being left in a lurch,” Lipovitz said.

Church staff have not noticed former patients showing up at the site looking for care at the shuttered clinic, now a pregnancy center, he said.

Signs posted outside the old clinic office tell patients about free weekly clinics a half-mile northwest.

Still, Assmann worries that many patients may not be able to reach them. In a county with some of the state’s most concerning health trends, dropping hundreds of patients from care will only make things worse.

“The community as a whole is going to be more unhealthy,” Assmann said. “We’re talking about the county that has the worst outcomes in the state of Kansas for health and now we have a population of 1,300 patients who don’t have health care.”

Providing care in a parking lot, she said, is not a long-term solution. Care Beyond the Boulevard will offer the Wednesday and Thursday clinics through the end of the year, Assmann said, hoping that by then most patients can be shepherded to other clinics.

But that transition is proving difficult.

Most of Duchesne’s former patients don’t qualify for Medicaid, state-sponsored health insurance, because they are undocumented. That may also limit access to some doctors.

And although Wyandotte County is home to other safety-net clinics, including Vibrant Health and Mercy and Truth Healthcare Ministry , those clinics can’t quickly absorb hundreds of new, uninsured patients. Even if a patient can get an appointment at one of the other safety net clinics, the service they receive may not be free.

Even a $10 or $20 charge could be too much for some of Duchesne’s former patients, Herrera said.

When Sisters of Charity of Leavenworth founded Duchesne and two other safety-net clinics, known as the Caritas Clinics, they promised to take care of patients even if they couldn’t pay. That applied to medicine, too.

Utah-based Intermountain Health acquired Colorado-based SCL Health in 2022, creating a $12 billion health care chain with 33 hospitals and hundreds of clinics. But the three Caritas Clinics were the chain’s only presence in Kansas. It wasn’t surprising, then, when Intermountain announced plans in April to divest of those.

Two of the clinics — St. Vincent Clinic in Leavenworth and Marian Dental Clinic in Topeka — were transferred to Atchison Community Health Clinic, a federally qualified health center. But Duchesne was closed altogether.

Intermountain’s announcement promised that Duchesne patients would be “fully supported in transferring their care to one of the numerous similar clinics in that service area.”

But with just over a month’s notice, clinic staff struggled to help every patient find care elsewhere. And nearby safety-net clinics said they aren’t prepared to handle an influx of hundreds of uninsured patients.

“I wish that I had known months in advance so we could have geared up,” said Patrick Sallee, Vibrant Health’s president and CEO.

But he said absorbing uninsured patients is difficult for any health care system, including safety- net clinics.

“The economics of it don’t work,” Sallee said. “Wyandotte County has a large uninsured population, and so it is tough on the system as a whole. None of the other clinics are in a position to absorb all of it. None of us are.”

Sallee said Vibrant isn’t turning any patients away. But getting an appointment takes time when clinics are already fully booked.

“It’s putting more people through a smaller pipeline,” Sallee said.

The state of Kansas, he said, needs to expand Medicaid to get more coverage to more people.

“I’m not trying to make the argument that undocumented people would be qualified for Medicaid,” Sallee said. “But if more people were qualified, the system would have more resources to deal with the needs of all people.”

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