JACKSONVILLE, Fla. (AP) — Nearly 30 years ago, Ascension St. Vincent launched a mobile health service to provide free medical care to migrant workers in St. Johns and Putnam counties.
Organized by the daughters of the charity that founded the hospital, a small, dedicated group traveled from place to place in a used minivan.
Since then, the Ministry of Mobile Health Outreach has expanded its footprint — adding Duval, Clay, and Nassau counties — and its mission has become a key player in regional efforts to address health inequalities.
Now, five fully 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 also provided by volunteer dentists.
The units provide most of the basic care services available in a doctor’s office, including physical exams, treatment of adult chronic illnesses, laboratory services, school and athletic screening, and immunizations.
And through its mobility, the Department overcomes the primary barrier to accessing health care for the population of Northeast Florida: lack of transportation.
“The goal is to help the most vulnerable,” said registered nurse Claudia Portel, the ministry’s community outreach manager. “Make that care accessible.”
According to healthcare officials, no other local hospital or nonprofit organization offers a free mobile healthcare program as comprehensive and geographically diverse as Ascension St. Vincent’s. ,
Mobile clinics remove barriers in healthcare
According to Molly Williams, executive director of Harvard Medical School’s Mobile Health Map, a collaborative research network of mobile health clinics, there are at least 2,000 mobile health clinics nationwide with a combined 7 million visits per year.
He said such clinics exist in urban, suburban and rural communities across all 50 states, funded through philanthropy, state and federal grants and insurance reimbursements.
They help healthcare organizations achieve health equity and manage costs, according to a recent Mobile Health Map report.
According to the report, “The COVID-19 pandemic is revealing fundamental health system issues, including gaps in access to care, rising costs, provider burnout, and lack of trust, particularly among disadvantaged and marginalized communities.” and sustainable solution.”
Williams, who co-authored the report, said mobile clinics address the transportation barrier and many other factors limiting access to healthcare.
Citing travel times, a lack of reliable transportation, clinic times, wait times, as well as high deductibles and a lack of insurance and paid sick leave, “people struggle to access healthcare for logistical reasons.” … and the financial bottlenecks.”
Another obstacle is the lack of trust in the healthcare system.
“Mobile clinics are where people live, work, play and pray,” Williams said. “By visiting the community and building relationships with local organizations and residents, mobile clinics foster trust, respect and connection.”
The pandemic has further increased barriers to healthcare. People lost jobs and insurance. He said misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” had fueled suspicion.
“Mobile health clinics are designed to nurture relationships and meet people in these communities where they don’t make decisions about their health care,” 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 access to rural health care. They are cost-effective because, among other things, they can significantly reduce costly visits to a hospital’s emergency department, according to the center’s February report.
“Despite these benefits, mobile clinics face significant financial constraints to operate,” the report said. “For much of the country, mobile clinics are funded by private donations, as opposed to government funding … (which) helps prevent mobile clinic expansion.”
Victoria Nelson recently visited an Ascension St. Vincent mobile clinic during a stopover at Lakeshore Baptist Church in Jacksonville, 10 miles from her home. The ease of planning is a big benefit of the unit, she said.
“You can usually plan in advance to be here, they will work with you,” Nelson said. “He was closest to my house.”
“Eye-opening experience” for employees
According to Portel, from July 1, 2021 to June 30, 2022, St. Vincent’s mobile clinics provided about 8,400 medical services to about 6,500 people with disabilities. The program has 18 employees, some full-time, others part-time, and each clinic has a team consisting of a medical provider, three nurses, and a commercial driver who also helps check in patients. Bilingual staff is available.
“We started small,” she says. “Over time, the program has really grown.”
The timetable consists mainly of regular stops such as senior housing and low-income neighborhoods, as well as other stops that vary according to need.
“We’re trying to do the surgery so patients know… where to come for treatment,” she said.
Portel has been part of Ascension Saint Vincent for 24 years and has led the Ministry of Mobile for five years. She shifts to helping in nursing.
“I love hanging out in the mobile unit,” she said. “It’s a real ‘feel good’ thing. … This desire to serve. I take the mission very seriously.”
And the mission is very clear in the mobile clinic layer.
“Before, I had a somewhat more sheltered existence,” Portell said. But clinic staff “are seeing real-time impacts of lack of access to health care, to basic needs like food and shelter,” she said.
“It’s an enlightening experience to see the inequality that exists,” she said. “It’s rewarding work.”
The gap in specialist medical care continues to exist
“The Ascension St. Vincent Foundation and its donors support mobile clinics as part of their commitment to “provide compassionate, personalized care to all, with a special focus on those most impacted,” said Virginia Hall, the foundation’s president and director of development. is funded as an officer.
Clinic workers “are doing this by meeting the most vulnerable members of our community where they are,” she said. “We know that the Ministry of Mobile Healthcare has really helped people in our community because they tell us how influential the care we provide is in their lives. What the world means to me is knowing that we are making a difference in the lives of people in their community who might not otherwise need their care.”
According to Portel, support from the foundation was important, as was working with other field units with similar missions.
“We cannot meet everyone’s needs,” she said. “Every community has different challenges.”
Still, there is a gap in medical care for vulnerable populations: access to free specialist care such as cardiologists and oncologists.
In Duval County, We Care connects uninsured Jacksonville patients to a network of free and charitable clinics and specialist physicians when needed. However, no such program exists in the other four surrounding counties.
Portell said there was also a need for volunteer dentists to help with the clinic’s dental offerings.
Despite the delay, St. Vincent’s mobile service is serving thousands of people who would not otherwise receive it. And a deal comes about.
The program’s budget is about $1.5 million, she said. If these patients had to purchase services from separate inpatient facilities, the total cost would have been $2 to $2.5 million.
“That’s the value of the service,” she said.