“When it comes to a human life, I have a problem not solving the easy questions, like what they should be asking their physician, or what dietary changes could lead to reductions or elimination of some medications.” – Kristen Sanders, Executive Director, Third Street Clinic
Third Street Clinic is a nonprofit working to connect Greater Grand Forks residents without health insurance to affordable medical services. Rather than providing direct services itself, Third Street Clinic coordinates with local agencies to connect people to health care resources or other supportive services. It typically works with over 800 patients a year. Of those, 90% are at or below 50% of area median income (AMI), with 65% considered very low income (30% AMI or below). This may include individuals who have been experiencing homelessness for decades or a person who just lost their job.
A Pharmacy for All
A 2012 Community Health Needs Assessment done by the University of North Dakota Social Science Research Institute found that the cost of medications was a top area of concern for Grand Forks area respondents. The data bear this out: there are only 5 pharmacies in Grand Forks, which has a population of 65,000. None of those pharmacies are downtown, despite the four clinics located there. In response to this survey and lack of downtown pharmacy access, Third Street Clinic – which has long called itself a “clinic without walls” – decided to create a full-service pharmacy that could serve lower-income patients. Due to North Dakota laws requiring al pharmacies to be majority-owned by a pharmacist, Third Street Clinic partnered with a local pharmacist to open Inspire Pharmacy in 2016. Third Street Clinic owns 49% ownership of Inspire and uses profits from the pharmacy to help fund the medical referral part of Third Street Clinic’s business model.
Third Street Clinic partnered with Propel Nonprofits for a loan to finance the pharmacy start-up costs that remained after in-kind support from the building owner and a Grand Forks Community Development Block Grant. Since the pharmacy opened in 2016, the number of scripts it writes have been steadily increasing. In 2019, it averaged 2,000 scripts a month.
Health Care that Listens
For Kristen Sanders, Third Street Clinic’s new executive director, providing access to health care is only one part of the nonprofit’s mission. The more important benefit to patients, for her, is providing individuals feeling locked out of health care a listening ear, a feeling of worth, and a sense of hope. Kristen was raised in Grand Forks but moved away for nearly 30 years. She worked in several industries, including health care, which is where she thought she’d spend her entire career. However, Kristen experienced both a sense of burnout by working within a broken health care system and not being able to address underlying issues. She also experienced the effects of barriers to affordable, effective health care firsthand when she fell ill and had to take a couple of years to recover. During that time, she moved back home to Grand Forks.
When it came time to re-enter the workforce, Third Street Clinic’s executive director posting kept drawing Kristen’s eye, despite her husband’s reflections that going back into the health care system might not be the healthiest decision for her. When she did end up applying for, and then getting the job, there was a lot of work to do. The previous executive director had left almost a year and a half before and there was only so much the team of volunteers could manage. It turns out Kristen’s experience with both systems management as well as her empathy for people seeking help was the perfect fit. “One of the biggest things I’m finding with individuals is just the shame they feel,” she said. “They have no place to have their voices or concerns heard.”
Kristen finds that with eight out of 10 people she talks with have no idea why they’re taking certain medications and what alternative solutions might exist. “I had one person come in who was on 22 medications,” said Kristen. “He had no idea what any of them were for. We see the cracks of the health care system show up here.” She told of another client who was a military veteran and led a successful career, but who lost everything due to illness. He came to Third Street Clinic, and they were able to find him proper resources to assist him at the end of his life so he was at least able to experience death with dignity.
Kristen hopes to reach even more patients this year and to work toward a whole-person approach to health care. For her part, on behalf of Third Street Clinic, she will continue to greet every patient who comes to her with an open ear. “For me, when it comes to a human life, I have a problem not solving the easy questions, like what they should be asking their physician, or what dietary changes could lead to reductions or elimination of some medications,” she said. “We may not serve tens of thousands of patients like some huge health care systems, but we’re serving patients that are falling between everyone else’s cracks.”
To learn more about Third Street Clinic, visit its website: https://www.thirdstreetclinic.org/