Jacksonville, Fla. (AP) – Nearly 30 years ago, Ascension St. Vincent started Mobile Health Access 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, dedicated group traveled from site to site in a used mini-van.
Since then, the Mobile Health Outreach Ministry has expanded its footprint — adding Duval, Clay and Nassau counties — and its mission to 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 senior citizens. Adult dental services are also provided by volunteer dentists.
The units provide most of the primary care services that can be obtained in a doctor’s office, including exams, management of chronic conditions in adults, laboratory services, school and sports physicals and immunizations.
And by being mobile, the ministry overcomes the primary barrier to health care access for the Northeast Florida population: lack of transportation.
“The goal is to serve the most vulnerable,” said registered nurse Claudia Portell, community outreach manager for the ministry. “Making that care accessible.”
No other area hospital or nonprofit offers a free mobile health care program that is as geographically comprehensive and comprehensive as that offered by Ascension St. Vincent, according to area health care representatives. .
Mobile clinics address healthcare barriers
There are at least 2,000 mobile health clinics nationwide, according to Molly Williams, executive director of the Mobile Health Map at Harvard Medical School, a collaborative research network on mobile health clinics.
Such clinics exist in all 50 states, in urban, suburban and rural communities, funded by charities, state and federal grants and insurance reimbursement, she said.
According to a recent Mobile Health Map report, they are helping healthcare organizations manage health equity and costs.
“The COVID-19 pandemic has highlighted fundamental problems in the health care system, including access to care, rising costs, provider burnout and a lack of trust, particularly among underserved and marginalized communities,” according to the report. “Mobile health programs provide a community-based, high-value and sustainable solution.”
Williams, who co-authored the report, said mobile clinics address transportation barriers and many other factors that limit access to health care.
“People struggle to access health care for logistical reasons … and financial barriers,” 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 barrier is lack of trust in the healthcare system.
“Mobile clinics are where people live, work, play and pray,” Williams said. “By going into the community and building relationships with local organizations and residents, mobile clinics foster trust, respect and connection.”
The pandemic has further strained health care. People have lost jobs and insurance. Misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” fueled mistrust, she said.
“Mobile health clinics are designed to immerse themselves in these communities by fostering relationships and directing their health care by meeting people where they are,” Williams said. “By integrating into communities in this way, mobile health clinics are uniquely positioned to improve equity.”
According to the Center for American Progress, an independent, nonpartisan policy institute, states should use mobile clinics to expand rural health care access. They are cost-effective because they can reduce costly hospital emergency department visits, among other things, according to the center’s February report.
“Despite these advantages, mobile clinics face significant financial barriers to operating,” the report said. “In most parts of the country, mobile clinics are financed 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 when she stopped at Lakeshore Baptist Church in Jacksonville, 10 miles from her home. Ease of scheduling is the main advantage of the unit, she said.
“You can usually plan ahead to come here, they’ll work with you,” Nelson said. “It was the closest to my house.”
‘Eye-opening experience’ for employees
According to Portal, from July 1, 2021 to June 30, 2022, St. Vincent’s Mobile Clinic provided approximately 8,400 medical services to approximately 6,500 individual individuals. 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 a professional driver who helps with patient check-ins. Bilingual staff available.
She said, ‘We started small. “Over time, the program has really grown.”
The schedule often includes regular stops, such as senior housing facilities and low-income neighborhoods, and other stops that vary by need.
“We try to operate so patients can learn … where they can access care,” she said.
Part of Ascension St. Vincent for 24 years, Portel has run a mobile ministry for five years. She takes shifts herself to keep her hand in nursing.
“I love going out on the mobile unit,” she said. “It’s a real ‘feel-good’ thing. … The desire to serve. I take the mission very seriously.”
And the mission becomes very clear on the mobile clinic shift.
“Before, I had a bit more of a dependent existence,” Portell said. But clinic staff see the real-time effects of “lack of access to health care, basic needs like food and shelter.”
“Seeing the disparity that exists is an eye-opening experience,” she said. “It’s meaningful work.”
Gaps in specialist care still exist
The Ascension St. Vincent Foundation and its donors fund the mobile clinics as part of the hospital’s commitment to “providing compassionate, personalized care to all, with special attention to those who are struggling the most,” said Virginia Hall, the foundation’s president and chief development officer. official
Clinic staff have done this by “physically meeting the most vulnerable members of our community where they are,” she said. “We know that the Mobile Health Outreach Ministry has really helped people in our community because they tell us how much the care we provide has impacted their lives. It means the world to me that we are making a difference in the lives of people in our community who would otherwise not receive the care they need. May not be accessible.”
According to Portell, the foundation’s support has been critical, as has collaboration with other regional organizations with similar missions.
“We can’t meet everyone’s needs,” she said. “Every community has different challenges.”
Still, a medical care gap exists for vulnerable populations: access to free specialist care such as cardiologists and oncologists.
In Duval County, We Care Jacksonville connects uninsured patients to a network of free and charity clinics and to specialty physicians when needed. But four other surrounding counties do not have such programs.
Volunteer dentists are also needed to help with the clinics’ dental offerings, Portel said.
Even in empty spaces, St. Vincent’s Mobile Ministry is providing care to thousands of people who would otherwise not receive it. And it comes at a bargain.
She said that the budget of the program is about 1.5 million dollars. If those patients had to purchase services individually from brick-and-mortar facilities, the total cost would have been $2 million to $2.5 million.
“It’s the price of service,” she said.