Jamie Tulupan was homeless and eating a free dinner at a Loaves and Fishes community meal in Shakopee three years ago when Heidi Cianflone, a public health nurse, offered him a free health screening. River Valley Health Services was operating a floating clinic for low-income residents of Scott and Carver counties at the time, and it flagged residents who showed warning signs in their screenings.

Tulupan was one of those patients. His blood pressure was off the charts and his feet were so swollen from sleeping upright in his van that he couldn’t fit in his shoes.

When Tulupan went to River Valley Health Services — which operates two clinics out of Chaska and Shakopee — he was diagnosed with high blood pressure and atrial fibrillation. He was able to receive medication for his new diagnoses for free through the nonprofit organization. And he could do it all without having to present medical insurance or a social security number.

For the past three years, Tulupan, who lost his solid warehouse job when his body weakened from chemotherapy that was fending off testicular cancer in 1992, has visited the clinic twice a month. Cianflone coordinates the refilling of his medications and helps him manage the five different pills he needs to take each day, because sometimes he has lapses in memory.

“I don’t think I’d be here without this,” Tulupan said, motioning to the closet-sized room inside East Creek Family Center in Chaska. The room is so discreet, if you weren’t told to go there, you’d never notice it — and that’s on purpose.

River Valley Health Services is a free, no-questions-asked health screening clinic — a quiet, word-of-mouth resource for the uninsured, under insured, low-income and undocumented residents living in the Shakopee or Chaska area. The Shakopee and Chaska clinics are open for four hours on Mondays and Tuesdays. During that time, one of two public health nurses will screen patients, advocate for patients to receive free medication, coordinate free or reduced-rate doctor visits and work with several other local resources to help with housing, nutrition, paperwork issues and other barriers many people living without adequate health care tend to face.

Community safety net

Executive Director of River Valley Health Services William Swanstrom calls the screening clinics a “community safety net.”

“We don't have an accounting office or a billing desk,” Swanstrom said. “You just go right in and see the nurse… We guarantee when you walk out we'll fix at least one of your problems.”

While it can’t prescribe medication or offer services typical nurse practitioners or doctors can provide, the screening clinic doesn’t just refer patients to expensive, out-of-reach doctors when they need further treatment. If one of the nurses believes a patient needs to see a doctor, they will set up an appointment at La Clinica, which runs three free and reduced rate clinics in Ramsey County. If that doctor prescribes medicine for the patient, River Valley Health Services will advocate for the patient to receive free or reduced-cost medicine by working with the manufacturer.

“We think Scott and Carver counties and the business community needs to come together and help fund a free clinic available at least one day a week,” Swanstrom said, referring to a need for upgrading to a full-service clinic that offers a nurse practitioner or doctor. “We're sending our poor people to Ramsey County right now. That doesn't make any sense.”

Swanstrom said about half the patients who come into the Chaska and Shakopee clinics are immigrants, many of whom are undocumented and are either too afraid or financially unable to receive traditional health care.

“Who would you call?” he said. “What would you do if you were sick and didn’t have health insurance and didn’t have anyone who could help you?”

He said the clinic has especially seen an uptick in immigrant screenings in the past few months.

According to one testimony provided by River Valley, one 5-year-old girl whose family had recently moved to the area from Honduras visited the clinic so she could get help with spinal issues — she couldn’t walk due to severe scoliosis. When River Valley Health Services coordinated an appointment with Shriners Children’s Hospital, she was able to receive surgical care.

The clinic uses two interpreters who also act as cultural liaisons for patients who might not know how to speak English and who don’t have a friend or family member who can interpret for them.

River Valley’s target patients represent about 10,000 uninsured and 14,000 people in poverty concentrated within four miles of Shakopee and Chaska, according to research provided by the clinic. And the problem is growing.

Need for a full-service clinic

River Valley Health Services, which opened its doors in 2005, typically handles about 500 patient visits and screenings each year. In 2018, the clinics handled 444 appointments and walk-ins. But this year, the clinic has seen 675 patient visits. The nonprofit is bare-boned as it is, William Swanstrom, the Executive Director of River Valley Health Services, said, with no overhead fees and volunteers who help fill in many of the gaps. The dramatic spike in patient visits can’t be sustained without outside help.

Swanstrom said for 2019, the clinic has run off about $20,000 in state grants, $10,000 in Scott and Carver county grants, $40,000 from St. Francis Hospital in Shakopee and $10,000 from random donations.

But Swanstrom said the clinic will seek an additional $75,000 to $100,000 from Scott and Carver counties for next year so it can add a nurse practitioner or medical doctor and avoid having to send its patients to Ramsey County to be prescribed medicine.

“That's the price of two cars,” Swanstrom said. “It's not that hard.”

The clinic often has eight or 10 people in its Chaska and Shakopee lobbies, and the demand is outgrowing the supply, Swanstrom said, adding no patient has ever abused the system.

Scott County Commissioner Barb Weckman Brekke had a conversation with Swanstrom about the request recently and said it’s too soon to determine whether the county would get behind the proposal.

“I totally believe in the mission and support it,” Brekke told the Valley News. “But we haven’t even, from a county level, discussed (the funding request) or looked at it yet. I will be giving it to staff and we’ll go into conversations with it.”

In September, Jordan Mayor Tanya Velishek talked to the Jordan Independent about her long-term vision of adding a free health and dentistry clinic to Jordan’s new food shelf building. Swanstrom said he planned to meet with Velishek to talk about that vision. Velishek did not respond to the Valley News for a request for comment on this idea.

Maddie DeBilzan graduated with a journalism degree from Bethel University. She’s interned at Salon Media and the St. Paul Pioneer Press. Outside of work, she sifts through Goodwill clothing racks, listens to Ben Rector's music and goes on long runs.

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