People who have difficulty getting their medications or medical care or who are homeless now have an alternative.

A new mobile pharmacy and clinic now serves those in need in Norwich, New Haven and Danbury, according to Dr. Sandra Springer of the Yale School of Medicine, which is partnering with Yale New Haven Health on the project, called InMOTION.

“This is the first legalized mobile retail pharmacy in the United States,” said Springer, who led the effort to create it. “That’s in itself good, but it’s also a clinic as well.” The pharmacy is stocked by Yale New Haven’s pharmacy department.

“And then half is a clinic that has a family medicine APRN and a medical technician who can do phlebotomy, and also has community health workers who go out from the unit and can do blood pressure checks, sugar checks, and also do rapid HIV, hep C testing and help with community access,” she said. “So it’s basically, in my mind, a mobile hub-and-spoke health care system.”

The pharmacy and clinic is funded by a five-year $750,000 annual grant from the National Institutes of Health. “I was given an award for what we call an avant garde idea, or a big idea,” Springer said. That includes supporting Heather Goodwin, a full-time pharmacist.

The van came into being in July 2023, when Gov. Ned Lamont signed legislation legalizing it.

“Once we were hearing that that was happening, we were paying to have one built for us. So then that got delivered in September, and then we worked with the Department of Public Health to determine where should we go first,” Springer said. “And we wanted to go to an area that in particular might have been in need of services, had high overdoses and other needs.”

The choice was Danbury, where the van makes stops in several locations.

“We did all this groundwork first, literally on the ground, and meeting with people, so that when we’re ready to go, and the pharmacy was built and had finished all of its inspections and was legal, stocked and we … hired all our staff, we were able to go in December,” Springer said.

Two other locations were then added: St. Vincent de Paul Place, a soup kitchen in Norwich, and Columbus House homeless shelter in New Haven.

“Even in a highly urban setting … we were hearing that people could not access the pharmacy maybe a few blocks away or even one block away,” she said.

While it may appear that CVS and Walgreens are everywhere, that’s not true, Springer said.

“There was a recent article in JAMA, not too long ago, the Journal of the American Medical Association, that actually, first, there are more pharmacies closing down, and we’re starting to see more deserts, and it’s happening here in Connecticut as well,” Springer said. “So that idea that there are pharmacies around is not actually true for a lot of people.”

Even when there is a pharmacy nearby, it’s not easy for people who are unhoused to access them, she said.

“There still is difficulty for many people accessing a pharmacy for reasons of stigma, lack of insurance, issues regarding copays,” she said.

Other issues are homeless people being unwilling to leave their belongings for fear they’ll be stolen, “or not having adequate clothing or shoes to enter a pharmacy. And so those are some of the actual, real barriers for people,” Springer said.

“Many providers, even where there’s a pharmacy located right next door, were telling us that patients were not going to pick up their medications,” she said. “So the idea is, if you could potentially, in the moment, give the medication to that person when they’re there, then you can circumvent that whole problem for them.”

Another issue is that some pharmacies don’t carry some lesser-used medications. InMOTION is a specialty pharmacy, and has a wider variety of drugs on hand.

“We’ve had clinicians who are seeing a patient in their own clinic, and then the pharmacy near them doesn’t carry that medication,” Springer said. “They can send them to our mobile pharmacy, and we can dispense that medication, including injectable forms of medications too. In fact, all vaccines as well.”

The pharmacy also partners with the Dispensary of Hope, “which is a philanthropic group that stocks and carries medications that are free for those who are uninsured, including insulin, which, as everybody’s heard, is, sadly, incredibly expensive in this country,” Springer said.

“If they have insurance, the insurance can be billed for a clinical visit and their medications,” she said. “And then, because we partner with Dispensary of Hope, any medications that they might need can be filled for free.”

The clinic offers a wide variety of services, including screening for high blood pressure and diabetes. There is also testing and treatment for HIV, hepatitis C and sexually transmitted infections, wound care, mental health care and treatment of substance use disorders.

“Sometimes it’s the first time people have been ever offered treatment, in particular, say, for hepatitis C, which is curable now, with eight to 12 weeks of one pill a day,” Springer said. “Or for many, it’s the first time they actually could see somebody and get medications at the same time.”

The staff also follows up to make sure people get their refills and make follow-up appointments, she said.

So far, “we’ve had over 400 patients, but over about 600 patient engagements,” Springer said. “They could be seen more than once.”

The van also has dispensed more than 600 prescriptions. “I think the majority are for high blood pressure, diabetes, other things,” she said. “And we’ve had about 30-40% who come back for more than one appointment.”

The staff also helps with “community engagement”:  “I need help with housing. I need help with getting a form of personal identification, cell phone assistance, things like that, employment applications, insurance kind of applications,” Springer said.

“The biggest challenge has been making sure we’re meeting everybody’s needs,” she said. But she also faces the task of keeping it going after the five-year grant ends.

“It’s expensive,” she said. “I think it’s going well. It’s just, for me, (the challenge) is trying to figure out how to sustain the program.”