When you enter the Care Beyond the Boulevard Mobile Health Clinic in Kansas City, Kansas, you'll see clients waiting for checkups or medicine like any other clinic. But walk into one of the shelters the mobile clinic operates from across the metro, and you may also see people sitting on recliners, watching television, or enjoying an ice cream bar — that’s all part of the vibe the health clinic is trying to create.
Care Beyond the Boulevard was created to be a refuge, in addition to a health clinic. And over the past eight months, its role quickly expanded from a mobile clinic operated out of an old school bus to a multi-location medical service center in response to the devastating loss of a community resource — the Duchesne Clinic in Kansas City, Kansas — over the summer.
The Duchesne Clinic was a nonprofit pharmacy and health center in Kansas City, Kansas, owned by Caritas Clinics, Inc. In 2022, Caritas was acquired by multibillion dollar, Utah-based nonprofit Intermountain Health. In July of 2024, Intermountain Health announced the Duchesne clinic in Kansas City, Kansas, would close in just six weeks. They also closed a clinic in Leavenworth, Kansas. Between the two clinics, nearly 70 people lost work and around 2,000 patients lost health care services.
“Intermountain Healthcare told me that, ‘Well, there are five safety net clinics within ‘X’ amount mile-radius of Duchesne,’” Assman said. “That is true, however, that doesn't mean that they can absorb 1,500 patients.”
Jaynelle Assman, whose patients call her K.K., is a nurse practitioner and the director of Care Beyond the Boulevard. She used to work at the Duchesne clinic. Assman says Duchesne’s closure caught the community off guard. Six weeks was not enough time to prepare surrounding safety net clinics for the influx of Duchesne’s roughly 1,400 patients.
Assman also takes issue with how Duschene was compensated for the closure. Caritas owned clinics in both Leavenworth and Kansas City. When Intermountain Health shut Caritas down, the company offered Wyandotte and Leavenworth Counties vastly different compensation packages.
“$4.2 (million) to Leavenworth, $1 million to Kansas City, Kansas,” Assman said. “And let's talk about the difference in patient numbers. Leavenworth had … somewhere around 700-800 patients, while Duchesne had 1,300-1,400 patients.”
Former staff rallied to fill gaps left by Duchesne
When staff received word in June they had just six weeks to close, Duchesne's team immediately sprung into action.
“(The question) was always, ‘What are our patients going to do? Where are we going to get them? How are we going to help them get their medications? How are we gonna help them get seen?'" Assman said.
In addition to its large number of patients, Duchesne served a particularly vulnerable community. Many of Duchesne’s patients were unhoused, uninsured, and lacked transportation. According to Assman, Duchesne’s clientele was almost entirely Spanish speaking. The specific needs of Duchesne’s patients, in addition to the sudden volume, posed a challenge for local safety net shelters.
Assman founded Care Beyond the Boulevard as a small, donation-funded volunteer clinic in 2016. After Duchesne closed, many of its former employees worked to transform Care Beyond the Boulevard to absorb the new influx of patients. However, not all of Duchesne’s services are readily available in the community, such as its patient services that helped people without insurance afford medication. And Care Beyond the Boulevard can only do so much with less than 10 full-time employees, compared to dozens at Duchesne.
When KCUR spoke to Assman, she had just seen a patient who had failed to receive his medication from a local safety net clinic. He was the exact type of patient who Duchesne’s services benefitted.
“He can't afford the copay on his medications because he doesn't have insurance,” Assman said. “Getting those patient assistance programs to bridge that gap will also be beneficial. He literally does not have an income.”
Communication is another barrier Care Beyond the Boulevard has faced. Getting the word out to Duchesne’s former patients has been difficult — many do not have access to a smart phone or computer. A language barrier also makes effective communication within the community difficult. In-house translation services were a vital resource for Duchesne to reach its patients, and are a service Care Beyond the Boulevard also offers.
Gustavo Martinez works as a Spanish translator at Care Beyond the Boulevard. He held the same position at Duchesne. He said quality in-person translation is increasingly hard to come by as such services are outsourced to virtual translators. Martinez thinks in-person translation is vital.
“You control the flow of the session. You can see a patient's body language. You can see your provider's body language. You can really bridge that gap and make sure that everyone is being understood,” Martinez said.
In-person translation is also vital for building trust within a community that is often hesitant to seek medical care.
“I know a lot of my friends, a lot of my family members, don't go to the clinic, because either they don't know about the clinics, they're scared, they're uninsured, they're undocumented,” Martinez said. “That's huge. If you can't check up on your health, then you never know what's gonna happen.”
Brutal winter is bringing new challenges
Winter has brought new challenges and opportunities to Care Beyond the Boulevard. The clinic has expanded its services to include dental care, as well as servicing more locations around the metro — particularly warming shelters, as several major winter storms have dumped up to a foot of snow in parts of the city and sent temperatures plunging into the negatives.
“Clinics have been a lot busier than usual. And then on top of that, we've added clinics at various cold weather shelters in town we go to: Hope Faith, Hope City and project 1020 in Johnson County, ” Martinez said.
Care Beyond the Boulevard has done what it can to fill a devastating loss of services to an underserved community. But Martinez still he misses the sense of community that Duchesne fostered.
“I still occasionally bump into my former patients, in the stores or just out in the community, and I'm able to say, 'Hi' to them, but it's just not the same.”
