Kola Program faces major cuts from Hennepin County

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kolaprogramhoto1.jpgKola Program given three months notice from Hennepin County that its entire funding will be cut.

The American Indian Community Development Corporation (AICDC) in Minneapolis recently received a letter from Hennepin County announcing that it planned to cut all funding for the Kola Program, which

provides medical services to homeless people with a focus on Native people struggling with alcoholism. Kola, which means "friend" in Lakota, serves 30-60 clients a day and over the years has helped

thousands of homeless men and women.

The letter stated that Hennepin County would zero out its funds for Kola in three months, due to the county’s overall budget deficit. It invited AICDC to request a hearing if the agency wanted to appeal.

Michael Goze (Ho-Chunk), President of AICDC, said he participated in hearings on November 3 and 17 to protest the $164,000 cut. That amount represents 80% of the Kola Program budget."I understand the process and the deficit piece," said Goze. "We’re all for saving money, but that’s not what this cut would do. In addition, this population is vulnerable and services are often a challenge."Goze argues the cut won’t save money for Hennepin County, because Kola clients often have medical conditions that are ignored or do not receive treatment in other clinics due to inebriation. When these conditions are allowed to worsen, clients use county emergency rooms, which are more expensive.

kolaprogramhoto1.jpgKola Program given three months notice from Hennepin County that its entire funding will be cut.

The

American Indian Community Development Corporation (AICDC) in

Minneapolis recently received a letter from Hennepin County announcing

that it planned to cut all funding for the Kola Program, which

provides

medical services to homeless people with a focus on Native people

struggling with alcoholism. Kola, which means "friend" in Lakota,

serves 30-60 clients a day and over the years has helped

thousands of homeless men and women.

The

letter stated that Hennepin County would zero out its funds for Kola in

three months, due to the county’s overall budget deficit. It invited

AICDC to request a hearing if the agency wanted to appeal.

Michael

Goze (Ho-Chunk), President of AICDC, said he participated in hearings

on November 3 and 17 to protest the $164,000 cut. That amount

represents 80% of the Kola Program budget."I understand the process and

the deficit piece," said Goze. "We’re all for saving money, but that’s

not what this cut would do. In addition, this population is vulnerable

and services are often a challenge."Goze argues the cut won’t save

money for Hennepin County, because Kola clients often have medical

conditions that are ignored or do not receive treatment in other

clinics due to inebriation. When these conditions are allowed to

worsen, clients use county emergency rooms, which are more expensive.

Dr.

Ken McMillan, the physician for Kola, agrees. "I definitely believe

Kola saves the county money," Dr. McMillan said. "From a clinical point

of view, we see patients when they are questioning the

severity of

an injury or deciding if they need attention. We then provide the care

that prevents a situation from advancing to the ER." Dr. McMillan

described several typical scenarios, such as a client who asks for a

bus token to get to the ER, but Kola is able to offer treatment

instead. Or a client who requests medication for a condition which Dr.

McMillan then diagnoses as a more serious problem,

intervening before the condition deteriorates. In some cases, Kola treats an illness or injury and makes it

manageable

until a client can get to a specialist rather than rushing to the ER.

"We presented our contention at the hearings in front of the county

board," Goze said. "We pointed out that these cuts will affect a

population that has its own particular concerns and medical conditions.

As a result, Kola saves the county money." Goze is also worried about

the future health and treatment of Kola clients, many of whom face

aging with chronic disease and chemical dependency issues.

County

Commissioner Gail Dorfman, a past supporter of Kola, has introduced a

budget amendment that would restore full funding. "Kola is an important

program, but I’m not sure I’ll get my amendment

through," Dorfman

said. "It is a tight budget year, and a lot of agencies are facing

cuts. I’m not sure I have the support." If the board doesn’t approve

full funding, Dorfman says she will ask again for a lesser amount. The

board plans to vote December 4. Kola is an efficient and streamlined

program. Dr. McMillan works with a medical assistant and administrative

assistant to provide services.

"If Hennepin County doesn’t reinstate

the funds," Dr. McMillan said, "I don’t see how we could go on doing

what we do. I’d volunteer a few hours a week, but Kola would have to

cut to bare services. I would

have to look for other work." Dr. McMillan notes that 25-33% of the clients are uninsured, so Kola

cannot

bill for those services. When Kola does bill, the income covers some of

the medication, a program van, and malpractice insurance but not the

bulk of operating expenses. Typical Kola clients are men in their

thirties struggling with depression, mental illness, and chemical

addictions. They are often talented and self-sufficient, distrustful of

other shelters and clinics, and show extreme loyalty to

each other.

The

Kola staff is honest with clients about the potential cut in January.

Some clients offer to volunteer more time at the desk, which has helped

during small budget shortfalls in the past. Some ask why

the tribes

do not contribute more. Dr. McMillan noted that three or four tribes

have donated this year, but Kola would need a major infusion to replace

this cut. Dr. McMillan said he would be upset to lose the program,

because the clients have built it themselves, with their trust, work,

cooperation,

and referrals. Kola’s goal has always been to help

clients help themselves, and in anonymous client surveys, Kola receives

an 80-90% approval rating, which is high from a population wary of human

services.

He is also proud of the successes, not just clients avoiding death but

achieving stability in housing and sobriety. Dr. McMillan recently gave

a presentation about Kola at a Homeless and Trauma Medicine Conference

in Sioux Falls, SD. He ran into a former client who is nine months

sober in his own apartment. The man struggled for three years with

homelessness and alcoholism. "He was happy to see me, because Kola had

seen him when he was hopeless," Dr. McMillan said. "We connected him

with a single person, a support coach, who helped him."

Kola was

founded in 1999 to provide culturally-specific supportive services to

chronically-inebriated, homeless American Indians. Hennepin County

helped to launch Kola, and Dr. McMillan says he is grateful for that

assistance. "I would very much appreciate continued support until

homelessness is

not a problem anymore," he said. Kola continues to offer healthcare outreach, health screening, and

referral

services to many homeless American Indians who are chronic late-stage

inebriates. Dr. McMillan and the medical assistant do everything from

patching wounds, to ordering prescription refills, to

treating sore

feet, to screening for hypertension and diabetes. In addition to these

hands-on services, Kola staff offer education regarding HIV, hepatitis

C, and tuberculosis. They help clients meet

basic needs such as

showers, blankets, and clothing. Kola also encourages sober activities.

During its open daytime hours, it has telephones, computers, and

information technologies for clients to

use. The goals of Kola

include reducing the number of deaths on the street due to chronic

alcoholism or homelessness, improving the general health of a high-risk

vulnerable population, decreasing inappropriate use of ERs and detox

centers, encouraging periods of sobriety, restoring dignity through

goal setting, and providing a holistic approach to life change

(physical, social, emotional, spiritual).

Kola is open 7:00 a.m.-1:30 p.m., Monday-Friday. For more information, see www.aicdc-mn.org.