JACKSONVILLE, Fla. (AP) – About 30 years ago Ascension St. Vincent started a mobile health service to provide free medical care to migrant farm workers in St. Louis counties. Johns and Putnam.

Organized by the Daughters of Charity who founded the hospital, a small and dedicated group traveled from place to place 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 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 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 adult conditions, laboratory services, school and sports physicals, and immunizations.

And by being mobile, the ministry overcomes Northeast Florida’s main barrier to accessing health care: 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 widespread and geographically comprehensive as that offered by Ascension St. Vincent’s, according to area health care officials. .

Mobile clinics address healthcare barriers

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

Such 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 Mobile Health Map report, they are helping healthcare organizations address health equity and manage costs.

“The COVID-19 pandemic shed light on fundamental problems with the health care system, including gaps in access to care, rising costs, provider burnout, and a lack of trust, especially 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 gain access to 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 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 made the barriers to health care even higher. People lost their jobs and insurance. Misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” exacerbated mistrust, she said.

“Mobile health clinics are designed to immerse themselves in these communities by fostering relationships and meeting people where they are, not dictating their health care to them,” 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 rural health care access, according to the Center for American Progress, an independent, nonpartisan policy think tank. They are cost-effective because they can significantly reduce expensive hospital emergency department visits, among other things, 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 through private donations as opposed to government funding… (which) further contributes to the lack of expansion of mobile clinics.”

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

“Usually you can plan far in advance to be here, they’ll work with you,” Nelson said. “That was the closest to my house.”

‘Eye-opening experience’ for staff

From July 1, 2021 to June 30, 2022, the mobile clinics of St. Vincent provided about 8,400 medical services to about 6,500 unique people, according to Portell. 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 commercial driver who also helps screen patients. Bilingual staff are available.

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

The schedule features mostly regular stops, such as senior housing facilities and low-income neighborhoods, and other stops that vary depending on needs.

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

Part of Ascension St. Vincent’s for 24 years, Portell has led the mobile ministry for five years. She takes shifts on her own to keep a hand in nursing.

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

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

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

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

The specialist care gap still exists

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

The clinic staff “has done this by physically meeting the most vulnerable members of our community where they are,” she said. “We know that Mobile Health Ministry has really helped people in our community because they tell us how much of an impact the care we provide has had in their lives. To me it means letting the world know that we are making a difference in the lives of people in our community who might not otherwise have access to the care they need.”

The foundation’s support has been critical, according to Portell, as has collaboration with other entities in the area with similar missions.

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

However, there is a medical care gap 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 charity clinics and, when needed, with specialty physicians. But no such programs exist in the other four surrounding counties.

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

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

The program’s budget is about $1.5 million, she said. If these patients had to purchase services individually from brick-and-mortar facilities, the total cost would be $2 million to $2.5 million.

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

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