Care Beyond the Boulevard (CBB) has been providing mobile medical clinic services to individuals experiencing homelessness on the streets in the Kansas City metro for over four years. With a mission of compassionate health care for all, CBB’s Big Green Bus mobile clinic and volunteer corps of practitioners and volunteers are out seeing patients four times a week.
When the pandemic arrived in our city, Mayor Quinton Lucas and the KCMO City Council were vocal with their concerns about our homeless neighbors and marshaled resources to strengthen an already fragile safety net. Likewise, CBB stepped up to the challenge of keeping our patients, practitioners, volunteers, and partners healthy and safe in these unprecedented times.
We immediately began developing protocols and navigating the challenging supply chain. Some of our local partners that provide food, clothing, and other essentials to homeless persons either closed temporarily or operated on a limited basis.
Many nights our patients were more concerned about their next meal, obtaining clean clothing, or finding a place to shower than they were about their asthma or cellulitis. And they were scared … very scared. On those nights, we provided emotional and mental health support at the Big Green Bus.
“We believe there is enough for everyone but resources are unequally distributed and structurally contained for the privileged class. Our work in street medicine is defined more by the values that guide our daily lives than by the medical care we deliver.”
Our new protocols include establishing a safe distance between volunteers and patients as they line up for treatment. We do this by:
Creating chalk lines at every point of entry to our services, our provider line, our pharmacy, and the hospitality line
Having practitioners in PPE at all times
Requiring patients to wear a mask
Treating more patients on the street rather than in the bus
Taking temperatures of patients, practitioners, and volunteers each night
On our Monday night clinic at Micah Ministries, we transitioned to an outside treatment area, placed chairs in the parking lot to encourage social distancing, and worked with our partner to help guide safe systems so they could continue food services.
For years, CBB has been blessed with generous donations of supplies but nothing could have prepared us for the first weeks of the pandemic. It was not unusual to go through a hundred thermometer probes a week. We required surgical and N95 masks for those treating high-risk patients. We struggled in obtaining gloves as we changed them between each patient contact. Hand sanitizer was something we had routinely had on the bus, but our use tripled, and there was a national shortage.
Fewer patients tested positive or were presumed positive than originally feared. However the need to treat other health problems continued and even intensified.
If a patient struggled with asthma, it was imperative that we get meds to them, so we had to keep our pharmacy well-stocked at all times.
We treated many more wounds than usual since our patients were not using the ER out of fear of being exposed to COVID.
We are concerned about a second wave of exposure as our patients were discharged from hospitals into the community to access feeding programs, clothing closets, day centers, and other community services.
We know the importance of planning for public health concerns and as a result have already received enough flu vaccines to get us through the upcoming season.
Kansas City displayed its generosity during the pandemic, and CBB was grateful to receive several first-time funding awards (including one from Health Forward).
Online donations and support from individuals increased significantly; supporters rallied to provide supplies and equipment.
We have found our place in the community and will continue to use our voice to advocate for our vision of a community where all have access to quality health care despite financial or social circumstances.
As COVID-19 and its disproportionate impact among people of color revealed the fatal outcomes of our failed health care system, the past months have revealed the fatal outcomes of racism.
On a daily basis, those of us at Care Beyond the Boulevard grieve and bear witness to the violence, marginalization, and oppression of excluded people right here in Kansas City. We see the bruises and scars, and we feel the emotional pain.
We believe there is enough for everyone but resources are unequally distributed and structurally contained for the privileged class. Our work in street medicine is defined more by the values that guide our daily lives than by the medical care we deliver.