St. Vincent’s mobile health ministry helps Florida’s “most vulnerable.”

JACKSONVILLE, Fla. (AP) — About 30 years ago, Ascension St. Vincent started a mobile health campaign to provide free medical care to migrant farm workers in the counties of St. 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 van.

Since then, the Mobile Health Care 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.

Five fully equipped and staffed RVs now 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, adult chronic disease management, laboratory services, school and sports physicals, and immunizations.

And by being mobile, the ministry overcomes Northeast Florida’s primary barrier to accessing health care: lack of transportation.

“The aim is to attend to the most vulnerable,” said registered nurse Claudia Portell, responsible for community outreach at the ministry. “Making this care accessible.”

No other hospital or nonprofit in the area offers a free mobile health care program that is as geographically widespread and comprehensive as Ascension St.’s. Vincent’s, according to health officials. .

Mobile clinics address healthcare barriers

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

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

According to a recent Mobile Health Map report, they are helping healthcare organizations address healthcare equity and manage costs.

“The COVID-19 pandemic has shed light on fundamental problems with the health care system, including gaps in access to care, rising costs, attrition of providers, and a lack of trust, especially among marginalized and marginalized communities,” according to the report. “Mobile health programs provide a community-based, high-value and sustainable solution.”

Williams, who wrote 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 time, lack of reliable transportation, clinic hours, wait times, etc. such as high deductibles and the 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 further increased barriers to health care. People lost jobs and insurance. Misinformation, frequently changing safety guidelines and the “politicization of masks and vaccines” made mistrust worse, he 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,” 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 rural health care, according to the Center for American Progress, an independent, nonpartisan policy institute. They are cost-effective because they can significantly reduce costly hospital emergency room visits, among other things, according to the center’s February report.

“Despite these advantages, mobile clinics face significant financial obstacles to operation,” the report said. “For most of the country, mobile clinics are funded by private donations rather than state funds … (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 his home. Ease of programming is a key advantage of the unit, he said.

“Generally, you can plan well in advance to be here, they’ll work with you,” Nelson said. “This 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 for about 6,500 separate 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 with patient registration. Bilingual staff available.

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

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

“We try to operate so patients can learn … where they can get access to care,” he said.

Part of Ascension Saint Vincent for 24 years, Portell has led the mobile ministry for five years. She herself takes turns keeping a hand in the infirmary.

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

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

“Before, I had a little 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,” he said.

“It’s an eye-opening experience to see the disparity there is,” he said. “It’s significant work.”

There is still a lack of specialized attention

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

Clinic staff “have done this by physically meeting with the most vulnerable members of our community where they are,” he said. “We know that the Ministry of Mobile Health Care 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 to know that we are making a difference in the lives of people in our community who would otherwise not have access to the care they need.”

The support of the foundation has been essential, according to Portell, as well as the collaboration with other entities in the territory with similar missions.

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

Still, a health care gap exists for vulnerable populations: access to free specialty care such as cardiologists and oncologists.

In Duval County, We Care Jacksonville connects uninsured patients with a network of free and charitable clinics and, when needed, with specialty physicians. But these programs do not 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 provides care to thousands of people who otherwise would not have it. And it comes to a bargain.

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

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

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