JACKSONVILLE, Fla. (AP) — About 30 years ago, Ascension St. Vincent’s launched a mobile health campaign to provide free medical care to migrant farm workers in St. Johns and Putnam counties.

Organized by the Daughters of Charity who founded the hospital, a small dedicated group traveled from site to site in a second-hand minivan.

Since then, the Mobile Health Outreach Ministry has expanded its footprint – adding Duval, Clay and Nassau counties – and its mission has become a key player in regional efforts to address 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. Adult dental services are also provided by volunteer dentists.

The units provide most primary care services that could be obtained in a doctor’s office, including examinations, adult chronic disease management, laboratory services, school and sports physical exams, and vaccinations.

And by being mobile, the ministry overcomes the biggest barrier to accessing health care for these populations in Northeast Florida: lack of transportation.

“The goal is to serve the most vulnerable,” said registered nurse Claudia Portell, community outreach manager for the ministry. “Make this care accessible.

No other hospital or nonprofit in the area offers a free mobile health care program as broad and geographically comprehensive as that offered by Ascension St. Vincent, according to health care officials from the region. .

Mobile clinics break down barriers to health care

Nationwide, there are at least 2,000 mobile health clinics, with a total of 7 million visits per year, according to Mollie Williams, executive director of Harvard Medical School’s Mobile Health Map, a collaborative research network mobile health clinics.

These clinics are in all 50 states, in urban, suburban and rural communities, funded by philanthropy, state and federal grants and insurance reimbursements, she said.

According to a recent report by Mobile Health Map, they help healthcare organizations fight health equity and manage costs.

“The COVID-19 pandemic has brought to light fundamental problems in the health system, including gaps in access to care, soaring costs, provider burnout and lack of trust, especially among communities. underserved and marginalized,” according to the report. “Mobile health programs offer a community-based, high-value, and sustainable solution.”

Williams, who co-authored the report, said mobile clinics address the transportation barrier 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 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 foster trust, respect and connection.

The pandemic has further exacerbated barriers to health care. People lost their jobs and their insurance. Misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” have deepened mistrust, she said.

“Mobile health clinics are designed to immerse themselves in these communities by fostering relationships and meeting people where they are, without dictating their healthcare to them,” Williams said. “By embedding themselves in communities in this way, mobile health clinics are uniquely placed to improve equity.”

States should use mobile clinics to expand rural health care access, according to the Center for American Progress, an independent, nonpartisan policy institute. They are cost-effective because they can significantly reduce costly visits to hospital emergency rooms, among other places, according to the center’s February report.

“Despite these benefits, mobile clinics face significant financial barriers to operation,” the report states. “For most of the country, mobile clinics are funded by private donations, not public funds… (which) further contributes to the lack of expansion of mobile clinics.”

Victoria Nelson recently visited an Ascension St. Vincent mobile clinic during a stop at Lakeshore Baptist Church in Jacksonville, 10 miles from her home. Ease of planning is a key benefit of the unit, she said.

“You can usually plan well in advance to be here, they’ll work with you,” Nelson said. “It was the closest to my house.”

“Revealing experience” for staff

From July 1, 2021 to June 30, 2022, St. Vincent mobile clinics provided approximately 8,400 medical services to approximately 6,500 separate individuals, according to Portell. The program has 18 staff members, some full-time, some part-time, and each clinic has a team that includes a medical provider, three nurses, and a commercial driver who also helps with patient registration. Bilingual employees are available.

“We started small,” she said. “Over time, the program has really grown.”

The schedule mainly includes regular stops, such as seniors’ residences and low-income neighborhoods, and other stops that vary according to need.

“We try to operate so patients can know … where they can come to access care,” she said.

A part of Ascension St. Vincent for 24 years, Portell has led the 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. … This desire to serve. I take the mission very seriously.

And the mission becomes very clear during a mobile clinic shift.

“Before, I had a little more sheltered existence,” Portell said. But clinic staff see the real-time impacts of “lack of access to health care, basic necessities like food and shelter,” she said.

“It’s an eye-opening experience to see the disparity that exists,” she said. “It’s meaningful work.”

The lack of specialist care still exists

The Ascension St. Vincent Foundation and its donors fund the mobile clinics as part of the hospital’s commitment to “provide compassionate, personalized care for everyone, with special attention to those who struggle the most,” Virginia said. Hall, president and chief development officer of the foundation. officer.

Clinic staff “did this by physically meeting the most vulnerable members of our community where they are,” she said. “We know that 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 is very important to me to know that we are making a difference in the lives of people in our community who otherwise might not have access to the care they need.

Support from the foundation has been essential, according to Portell, as has collaboration with other entities in the region with similar missions.

“We can’t meet everyone’s needs,” she said. “Every community has different challenges.”

Yet, a medical care deficit 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, charitable clinics and, when needed, specialty physicians. But no such program exists in the other four surrounding counties.

Volunteer dentists are also needed to help with clinic dental offerings, Portell said.

Even with the gaps, St. Vincent’s Mobile Ministry provides care to thousands of people who otherwise would not have access to it. And it comes at a great price.

The program’s budget is about $1.5 million, she said. If these patients had to purchase the services individually from physical establishments, the total cost would have been $2 million to $2.5 million.

“It’s the value of service,” she says.

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