St. Vincent’s Mobile Health Ministry is helping Florida’s “most vulnerable.”

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, dedicated group traveled from place to place in a used minivan.

Since then, the Ministry of Mobile Health has expanded its reach — adding Duval, Clay and Nassau counties — and its mission has become a key player in regional efforts to combat health disparities.

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 departments provide most of the primary medical services that can be obtained in a doctor’s office, including examinations, treatment of chronic diseases in adults, laboratory services, school and sports examinations and immunizations.

And by being mobile, the ministry overcomes the main barrier to healthcare access for Northeast Florida’s population: lack of transportation.

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

No other area hospital or nonprofit organization offers a free mobile health care program that is as geographically distributed and comprehensive as that offered by Ascension St. Vincent’s, according to local health officials. .

Mobile clinics address barriers in healthcare

There are at least 2,000 mobile health clinics nationwide, with a total of 7 million visits annually, according to Molly Williams, executive director of Harvard Medical School’s Mobile Health Map, a collaborative research network of mobile health clinics.

There are such clinics 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 Mobile Health Map report, they help healthcare organizations address healthcare equity and manage costs.

“The COVID-19 pandemic has shined a light on underlying problems with the health care system, including gaps in 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 the transportation barrier and many other factors that limit access to health care.

“People struggle to access health care because of logistical reasons … and financial barriers,” she said, citing travel times, 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 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 made the barriers to healthcare even higher. People lost jobs and insurance. Misinformation, frequently changing safety guidelines and “the politicization of masks and vaccines” have exacerbated mistrust, she said.

“Mobile health clinics are designed to immerse themselves in these communities by fostering relationships and encounters with people where they are, not dictating their health care,” Williams said. “By integrating into communities in this way, mobile health clinics are uniquely positioned to improve equity.”

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

“Despite these advantages, mobile clinics face significant financial barriers to operation,” the report said. “In most of the country, mobile clinics are funded through private donations as opposed to government funds … (which) further contributes to the lack of expansion of mobile clinics.”

Victoria Nelson recently visited the mobile clinic on Ascension St. Vincent during a stop at Lakeshore Baptist Church in Jacksonville, 10 miles from her home. Ease of scheduling is a key advantage 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 thing to my house.”

An “eye-opening experience” for staff

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

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

The schedule includes mostly regular stops, such as senior housing and low-income neighborhoods, as well as other stops that vary based on need.

“We’re trying to operate so patients can learn … where they can come to access care,” she said.

Part of Ascension St. Vincent’s for 24 years, Portell led the mobile ministry for five years. She takes shifts herself to keep her hand at nursing.

“I love going out on mobile,” she said. “It’s a real ‘feel good.’ … That desire to serve. I take the mission very seriously.”

And the mission becomes very clear when changing mobile clinic.

“I used to have a bit more of a sheltered existence,” Portell said. But clinic staff are seeing in real time the impact of “not having access to health care, to basic needs like food and shelter,” she said.

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

There is still a lack of specialist help

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

The clinic staff “did this by physically meeting the most vulnerable members of our community right where they are,” she said. “We know that Mobile Health Outreach Ministry has really helped people in our community because they tell us how impactful the care we provide has been in 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 may not otherwise have access to the care they need.”

The foundation’s support is critical, according to Portell, as is collaboration with other regional organizations with similar missions.

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

However, 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 Jacksonville connects uninsured patients with a network of free and charity clinics and, when needed, with specialist physicians. But no such programs exist in the other four neighboring counties.

Volunteer dentists are also needed to help with the clinics’ dental offerings, Portell said.

Even with the gaps, St. Vincent’s mobile ministry provides care to thousands of people who would otherwise not receive it. And it comes at a bargain price.

The program’s budget is about $1.5 million, she said. If these patients were to purchase the services separately from physical facilities, the total cost would be $2 to $2.5 million.

“That’s the value of the service,” she said.

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