For the past 27 years, HiTOPS promoted adolescent health and well-being by providing services like counseling and by leading education programs for local youth. But as of December 5, its clinic—which was located on Wiggins Street across from the Princeton Cemetery (behind the main HiTOPS building) and supplied health services like pregnancy and HIV testing—has closed. The main HiTOPS building will remain open and continue to provide education programs and support groups.
The reasoning behind this closing stemmed from a decline in the number of clients, which the clinic associates with a change in the way contraceptives are viewed. “We discovered from talking to a lot of young people that a lot of parents are less uncomfortable about taking their kids to a healthcare provider to get birth control. That’s a change in the way things are now. That wasn’t true 20 years ago, when the clinic first opened,” said HiTOPS Executive Director Elizabeth Casparian. “The world has changed, and we’re trying to be adaptive and responsive to the environment in which we’re operating.”
Also contributing to the decrease in demand are several major changes in the medical world that have occurred over recent years. “[The clinic] attributes [the decline] to a few things: advances in healthcare, discoveries like Gardasil and other medications. Education is a lot better, so people are learning how to protect themselves, and Plan B is now available over the counter, so you don’t need to go to a clinic; you can just go to a drugstore and buy it,” said Sheryl Severance, physical education teacher and co-head of Teen PEP.
Due to recent legislation, more patients, including young Americans, have been able to gain access to healthcare. Government action has also changed how these young people receive services from their doctors. The Affordable Care Act, commonly known as Obamacare, was passed in 2010 to extend healthcare coverage to millions of uninsured Americans. “The Affordable Care Act meant that many young people could be on their parents’ health insurance, and health insurance covers things like birth control,” said Casparian.
Fewer people coming in for services has meant less funding from the government. “The number of patients has been decreasing ever since 2006 … [The HiTOPS clinic] was a healthcare service that needed money from the state, and the state said that, since their numbers are declining, they’re not going to give [HiTOPS] as much money anymore,” said Severance.
As a small non-profit, the organization does not have the medical infrastructure that many larger institutions possess. Casparian said, “We had to make a decision; we were … putting a lot of resources into a clinic that had electronic medical records and took multiple insurances and had a billing office, which would have taken up a lot of resources … That just didn’t make sense.”
For Princeton High School health programs such as Teen PEP, the clinic was always recommended place to go. “The HiTOPS clinic meant a lot to me. It was always very easy to recommend the clinic to a younger student looking for further guidance. It served as a staple of stability for this town and, most importantly, those struggling teens from PHS. Now that it is closing, I do not even know where to send the younger kids who ask me for help,” said former Teen PEP leader Max Tarter ’15.
Although the HiTOPS clinic will be closing, there will still be other clinics in the area available to those in need whose names can be found on the HiTOPS website. “For sexual healthcare, there is still Planned Parenthood, which is in both Trenton and Hamilton, and there is the Henry J. Austin [Health Center in] Trenton, which is a clinic. There are some places to go, but it’s just not as convenient,” said Severance.
Additionally, HiTOPS plans to allow another organization to use their building, such as Planned Parenthood, potentially for its own clinic. The property on Wiggins Street is home to both the clinic and the meeting space for their educational programs. “We own the property, so we might be renting the space to another healthcare provider … part of a larger structure that has the things that we don’t have, like infrastructure of the electronic medical records and billing office and so forth,” said Casparian.
One of the programs that HiTOPS runs is an LGBTQ support group called First & Third. “I’ve had a lot of fun at the meetings and also learned a lot and met many interesting people … I expect that some of the people who attend use [the clinic]. I think it’s a bad thing for the clinic to be closing, since it’s such an important part of the modern sex-ed mentality that HiTOPS tries to promote,” said group member Iona Binnie ’15.
As the closure of the clinic will increase the resources available to its other programs, HiTOPS additionally looks forward to expanding its education and counseling services outside of Princeton. “One of the things that we are doing right now is looking at the places in the state of New Jersey that have the highest rates of pregnancy, HIV, [and] STIs amongst adolescent populations and bringing our program and services to those places,” said Casparian. “We’re also looking at places where there have been incidents of LGBTQ bullying and trying to bring resources to there as well.”
Despite the closing, HiTOPS staff continues to look forward to a brighter future. Casparian said, “We’re not looking upon this as a tragedy; we’re looking upon this as a strategic vision.”