Clinic-Pharmacy Hits The Road

A National Institute of Health (NIH)-funded mobile pharmacy van is taking to the streets of New Haven to provide clinical testing, prescriptions, and medical treatment to underserved communities — i.e. ​“healthcare for everyone.”

The van, unveiled at a press conference at 789 Howard Ave. Wednesday morning, is the result of years of research and planning directed by Dr. Sandra Springer, a Yale School of Medicine professor and Yale New Haven Hospital infectious diseases specialist.

When in New Haven, the van will be parked at Columbus House in the Hill, from 9:30 in the morning to 3 in the afternoon.

The van operates under Springer’s InMOTION (Integrated Mobile Opioid Treatment and Infectious disease cOordinated care in your Neighborhood) project. Half-clinic, half-pharmacy, the van aims to be a ​“one-stop shop” for people who, for whatever reason, can’t access so-called ​“brick-and-mortar” medicine.

The van, which is already active in Waterbury and Norwich, stocks its medicine from Yale New Haven Hospital’s pharmacy before leaving for the day, according to YNHH Oncology Pharmacy Executive Director Osama Abdelghany.

There was the first hurdle: a mobile pharmacy wasn’t even legal in Connecticut until June 2023. The second, Abdelghany said, was making ​“something that [didn’t] even exist.”

“My job was getting the law passed,” said Abdelghany, who thanked legislative and government partners — State Sen. James Maroney, Connecticut Department of Consumer Protection Commissioner Brian Cafferelli, and Drug Control Division Director Rodrick Marriott — in his speech at Wednesday’s press conference. After a push from YNHH, Gov. Ned Lamont signed Public Act No. 23 – 19 last summer, legalizing mobile pharmacies, and making Connecticut the first state in the country to do so.

That push for legalization came after Dr. Springer applied for and received an Avant-Garde Award for HIV and Substance Use Disorder Research from the National Institute on Drug Abuse (NIDA), a sub-agency of the NIH, in 2022. NIDA funded Springer’s proposal to ​“meet people where they are” through ​“pharmacies and clinics on wheels” for $750,000/year for five years. The van itself cost $470,000 to design and build.

Springer’s proposal sprung from her previous research on medical treatments for opioid addiction, HIV, and Hepatitis C. For this project, though, she knew she wanted to tackle the problem of access. NIH studies, according to Springer, usually focus on whether treatments like PReP work — but, Springer said, ​“we know that a lot of the services are really effective. It’s a no-brainer.” The question to answer is, ​“How can we actually deliver?”

The goal of the van, Springer said, is to ​“bridge the gap” between medicine and the communities it aims to serve. Transportation, stigma (especially for people seeking treatment for opioid addiction), mistrust of medical infrastructure, and continuity of care are some of the barriers the InMOTION team seeks to overcome.

“For a population that’s unhoused,” Springer said, ​“it’s difficult to leave your belongings” to come to medical appointments. The van, according to Springer, can ​“assist with housing applications, employment applications, and insurance applications.”

Heather Goodwin is the pharmacist who works in the van. She said the most commonly prescribed medications are for high blood pressure, high cholesterol, and diabetes. ​“I love this work,” Goodwin said. ​“I love helping people understand their medications.”

The clinical side of the van is staffed by nurse practitioners Anne Stevens and Lauren Astorino, as well as a pair of community health workers. Stacey Cannon, one of those community health workers, acts as the spoke of the van’s hub-and-spoke model, meeting with community leaders to bring awareness about the van project and doing testing and follow-ups ​“in the field.”

Cannon also helps with those non-medical services that the van can provide. As for how to break down stigma for people seeking treatment for addiction, Cannon said it’s about ​“creating a place where they are listened to.” According to Astorino and Stevens, the van clinicians see five or six patients on a given day, and up to eight on a busy day.

For now, the van is mobile, but largely remains in one place when it visits cities, at community partners. In Norwich, that partner is the daytime shelter St. Vincent de Paul Place. St. Vincent de Paul Place’s Executive Director, Jillian Corbin, said the van reaches ​“so many people who have just not sought healthcare. This solves it. This solves everything.”

There remains a question about what will happen when NIH funding runs out. Springer is investigating the mobile pharmacy model’s sustainability. ​“We need more people to invest in this,” she said, adding that the mobile pharmacy van is an intervention that can reduce ER admissions and overdoses, among other medical emergencies — thus reducing healthcare costs overall.