Jacksonville, Fla. (AP) – About 30 years ago, Ascension St. Vincent’s started a mobile health service to provide free medical care to migrant farm workers in St. John’s and Putnam counties.
Organized by the Daughters of Charity who founded the hospital, a small and dedicated team traveled from place to place in a serviceable minivan.
Since then, the ministry of mobile health services has expanded its footprint — adding Duval, Clay and Nassau counties — and its mission has become a key player in regional efforts to combat health disparities.
Now five fully equipped and staffed recreational vehicles serve uninsured, underinsured and low-income families in the five-county area with free programs for adults, children and seniors. Dental services for adults are provided by volunteer dentists.
The units offer most of the primary care services that can be found in a doctor’s office, including exams, management of adult chronic conditions, laboratory services, school and sports physicals and immunizations.
And by being mobile, the ministry has overcome the lack of transportation that is the number one barrier to healthcare access for the people of Northeast Florida.
“The goal is to serve the most vulnerable,” said registered nurse Claudia Portel, the ministry’s community outreach manager. “Making this care accessible.”
No other hospital or nonprofit offers a free mobile healthcare program at Ascension St. Vincent’s is as geographically spread and comprehensive as it offers, according to local health care representatives. .
Mobile clinics address barriers to healthcare.
According to Molly Williams, executive director of Harvard Medical School’s Mobile Health Map, there are at least 2,000 mobile health clinics nationwide, with a total of about 7 million health clinics.
Such clinics are supported by charities, state and federal grants and insurance payments in urban, suburban and rural communities in all 50 states, he said.
As a recent Mobile Health Map report shows, they are helping healthcare organizations address health equity and manage costs.
“The COVID-19 pandemic has shed light on fundamental problems in the health care system, including gaps in access to care, rising costs, attrition of providers, and a lack of trust, particularly in underserved and marginalized communities,” the report said. “Mobile health programs provide a community-based, cost-effective and sustainable solution.”
Williams, who co-authored the report, said mobile clinics address transportation barriers and many other issues that limit access to health care.
“People are struggling to access health care because of logistical reasons … and financial difficulties,” she said, citing travel time, lack of reliable transportation, clinic hours, wait times, as well as high deductibles and lack of insurance and paid sick leave.
Another obstacle is the lack of trust in the health care system.
“Mobile clinics go where people live, work, play and pray,” Williams said. “By going into the community and building relationships with local organizations and residents, mobile clinics develop trust, respect and relationships.”
The pandemic has further raised health care barriers. People lost jobs and insurance. Misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” have exacerbated the lack of trust, she said.
“Mobile health clinics are designed to be embedded in these communities by fostering relationships and meeting people where they are, not deciding their health care needs for them,” Williams said. “By integrating with communities in this way, mobile health clinics are uniquely positioned to improve equity.”
States should use mobile clinics to expand access to rural health care, says the Center for American Progress, a nonpartisan, independent policy institute. They are cost-effective because they can significantly reduce expensive hospital emergency room visits, among other things, the center’s February report said.
“Despite these advantages, mobile clinics face significant financial barriers to operation,” the report said. “For most parts of the country, mobile clinics are supported by private donations as opposed to state funding… (which) further contributes to the lack of mobile clinic expansion.
Victoria Nelson recently visited Ascension St. Vincent’s mobile clinic during a stop at Lakeshore Baptist Church in Jacksonville, about 10 miles from her home. Scheduling simplicity is a key benefit of the unit, she said.
“Usually you can plan ahead to be here, they’ll work with you,” Nelson said. “This was the closest thing to my home.”
‘Eye-opening experience’ for employees
From July 1, 2021, to June 30, 2022, St. Vincent’s mobile clinics provided approximately 8,400 medical services to approximately 6,500 different people, Portal said. The program has 18 employees, some full-time, some part-time, and each clinic has a team that includes a medical provider, three nurses and commercial drivers who help with patient checks. Bilingual staff available.
“We started small,” she said. “Over time, the program has really grown.”
The schedule features mostly standard stops, such as high-rise housing and low-income neighborhoods, and other stops that vary according to needs.
“We try to make patients learn … where they are operating,” she says.
Ascension St. A part of Vincent’s for 24 years, Portal has operated mobile services for five years. She takes shifts to keep her hand in nursing.
“I love going out on the mobile unit,” she said. “It’s a real ‘feel good’. … desire to serve. I take the mission very seriously.
And the mission becomes very clear on the shift of the mobile clinic.
“I used to have a little more shelter,” Portell said. But clinic workers see the “real-time impact of lack of healthcare, on basic needs like food and shelter,” he said.
“It’s an eye-opening experience to see the difference,” she says. “It’s meaningful work.”
A gap in specialist care still exists
The Ascension St. Vincent Foundation and its donors are funding the mobile clinics as part of the hospital’s commitment to “provide compassionate, personalized care to everyone, with a special focus on those who are struggling the most,” said Virginia Hall, the foundation’s president and chief development officer. Officer.
The clinic staff “did this by physically connecting the most vulnerable members of our community where they are,” she said. We know that the Mobile Health Outreach Ministry has truly helped people in our community as they tell us how much the care we provide has impacted their lives. It means the world to me to know that we are making a difference in the lives of people in our community who are not getting the care they need.
The foundation’s support was critical, as was Portal, which also collaborated with other local entities with a similar mission.
“We can’t meet everyone’s needs,” she said. “Every community has different challenges.”
Still, there is a gap in medical care for at-risk populations: access to independent specialists such as cardiologists and oncologists.
In Duval County, We Care Jacksonville connects uninsured patients with a network of free and charity clinics and, when needed, with specialty physicians. But there are no such programs in the other four localities.
Volunteer dentists are also needed to help with the clinics’ dental offerings, Portel said.
Despite the gaps, St. Vincent’s mobile service is providing care to thousands of people who otherwise would not. And it comes with a bargain.
The program’s budget is around $1.5 million, she said. If those patients had to purchase the services from brick-and-mortar facilities, the total cost would be $2 million to $2.5 million.
“That’s the price of the service,” she said.