At the Casper city council meeting on Tuesday, two clinical workers of U.S. Renal Care, Catherine Cywinski and Linda Smith spoke about the issues with the ASSIST bus service that helps carry patients to and from their clinic.

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Cywinski spoke about how since she started working for the clinic in May 2021, there have been 18 instances where a patient requested to be taken off dialysis early due to needing to catch the ASSIST bus, four times where a patient was dropped off late missing their appointment, and five times where a patient missed an appointment due to closures.

Cywinski said that patients require to have appointments three days a week for four to five hours at a time, and missing or shortening an appointment risks organ damage, hospitalization, or death.

The issues Cywinski outlined include the need for the ASSIST to provide service to Evansville or the west side of town on Saturday and to have money to pay overtime.

Cywinski said that COVID-19 has also made things difficult as while normally, patients could get assistance from churches or people willing to offer their car, that is more difficult because of the threat of infection or churches not having the funds necessary to help.

Councilmember Bruce Knell said that while they would like to offer assistance, the ASSIST program has a limited budget that doesn't give them much room for changes.

"I apologize if I come off without a heart here because that's certainly not the case," Knell said. "So please believe that it's not. This is a taxpayer-funded, government-funded entity that only has so many dollars, and just like everything else in our city that requires those funds to run, I know for a fact that our budget is stretched to the limit and we still have everything from roads that need fixed to people who need care and need rides and that's a very delicate balance that we struggle with all the time...We're so stretched, and like they said, there are no overtime dollars, so how do we do that. At some point, we may have to put some of the responsibility on the people that are getting the care themselves. I don't know. I'm sorry to have to say that, but it's literally the truth."

Mayor Ray Pacheco said that budget meetings are approaching and that the city will look into what they

"It's easy to sit and say, they can deal with it, they can figure it out," Pacheco said. "I think that's an easy way to say that. I would say come budget time, the city needs to figure this out, and I don't know what that looks like, and I know that's easier said than done...If we can look at something, and if we fail, and if we can't figure it out, then so be it. But I think we need to have that conversation, and I think that at the very minimum for the dignity and respect of those individuals, we can have that conversation, then we can look at these people and say 'we did, we looked back at our budget, we can't do it.' But I'm saying we can look at that, we can look when budget comes, we can look at Carter, and we can say is this something we can do. I think we owe it to people who are in the most vulnerable situation to say how can we come up with that."

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