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Health equity solutions: Mobile clinics take care to underserved neighborhoods






Once a month, a bright blue-colored bus containing a Mobile Medical Clinic pulls up to Central Tampa Family Resource Center on East Palm Avenue in Tampa for a visit. 

The Mobile Medical Clinic (MMC) provides access to health services for Hillsborough County children 18 years and younger from low-income families without insurance or on Medicaid.

On a recent visit, the MMC team is using a telephone translation service on the bus to assist a family who speaks Creole. Meanwhile, a young father sits inside the Family Resource Center office with his two sons and one daughter -- ages 6, 10 and 8 respectively -- the children quietly coloring as they wait to be called. 

Etienne Thomas had been in Tampa just one week since the family relocated from Minnesota. and had brought his kids for immunizations and physicals to start elementary school in Hillsborough County the following Monday. His concerns for his childrens' well-being are no different than those of other parents. 

“I want to make sure my kids get the proper care they need, that they are treated well and get the right shots safe for them,” Thomas says.

Connecting patients to resources

Kate Kennedy has overseen operations of the MMC clinic operated by St. Joseph’s Children’s Hospital for seven years. Her daily responsibilities can include everything from driving the 40-foot bus to assisting with paperwork preparation and translation.

She also manages relationships with community partners such as the Healthy Start Coalition, Philanthropic Women of St. Joseph’s and Children’s Board of Hillsborough County whose Family Resource Centers serve as six of eight monthly stops for the MMC’s 40-foot bus, along with Layla’s House in the Sulphur Springs neighborhood of Tampa and La Esperanza Clinic in Wimauma in southern Hillsborough County.

Kennedy says her team can be a catch-all for families, especially in times of transition such as loss of health care coverage or a transfer from out of state or another country. Filling the role of patient, caring listener can uncover a family’s underlying needs. 

“Instability is difficult for parents, and the best service we can provide is to help them feel grounded and part of the community, not floating out there on their own,” Kennedy says.

She notes that over time team members adjust to maneuvering through narrow passageways and sharing close quarters in the parked, air-conditioned unit as they escort patients to each care professional on board one at a time. 

 
“We do this because we want to help people and give back to the community,” says Kate Kennedy. “One of the beautiful things about mobile medicine is that we can take whatever care is needed directly to those places.”
Comprised of a board-certified nurse practitioner, two registered nurses, a developmental specialist, licensed clinical social worker, and care coordinator, the MMC team serves multiple roles whenever the Clinic stops at a community. In addition to their clinical roles offering vaccinations as well as developmental, audio and vision screenings, performing around 1,000 physicals annually and seeing as many as 1,500 children per year, team members also provide a communications channel. 

“Families express relief because they have this service and can get their kids into school, but also because they have someone they can contact to say, ‘I have this problem – do you know where to go to find help?’ We can be a bridge to the rest of the services they may need,” Kennedy says.

The MMC team has built a library of success stories over its 14 years. In partnership with Seminole Audiology, it has identified nearly 400 children with hearing concerns. Its developmental specialist who provides ages and stages questionnaires for children under age 5 has identified over 1,000 kids with developmental concerns during the past eight years.

Kennedy says it is a collective desire to serve and help others that keeps the team focused and energized. 

“We do this because we want to help people and give back to the community,” she says. “One of the beautiful things about mobile medicine is that we can take whatever care is needed directly to those places.”

Kate Reed, President of St. Joseph’s Children’s Hospital and St. Joseph’s Women’s Hospital since May 2017, has stopped by the Ybor City site on this February visit to see the Clinic in action. Reed is enthusiastic about the team’s ability to work in tandem with a community partner like the Children’s Board to deliver access to health care where it is needed most. 

“This program is so interwoven with other community programs that it helps parents gain easy access to any services they need for their children,” says Reed.

Meeting a community’s needs

Heather Coats coordinates South Florida Baptist Hospital’s Wellness on Wheels mobile unit, which served over 6,000 adults and children in 2017. The Wellness on Wheels bus is one of three adult mobile medical units in BayCare Health System’s Community Health program. She says the most commonly expressed concerns and questions she and the rest of the Community Health team of 30 nurses, health educators, screening technicians and onsite coordinators hear are related to health insurance coverage and access to health care. 

“It comes up while we are talking to them about risk factors and referring them to others to let them know where there is a resource available,” Coats says. 

One of the adult mobile health clinic’s longest-running programs is the Plant City-based Wellness on Wheels program, which offers free screenings and wellness education to the entire Plant City community regardless of age or income. With an aggressive flu season at hand, Coats says there has been a greater demand from churches and corporate clients across the Bay area for onsite flu shot clinics and hand-washing education events. Her ultimate goal is to fulfill as many of the community requests as possible, and she’s not alone in this objective.

“We take a lot of pride in what we do,” she says. “It’s a great thing to have a dedicated and committed team that knows what they’re doing and is passionate about it.”

New destinations for care

Each month as they return to the Clinic’s scheduled stops and interact with the community, members of the MMC team at St. Joseph’s Children’s Hospital remain focused on listening to identify health care needs voiced by families and seeking ways to address those needs. One area of care being added is counseling services, which the Clinic will be launching soon. The team also has identified dental care as a frequently expressed health care need by families and one for which they will be studying further though no services are currently offered through the Clinic.

Kennedy says that whatever new directions their team goes next, it can only be successful when working as partners with the communities being served. “You can’t just show up to a place and expect people to use your services,” she says. “You must build trust in a community first.”

Other mobile clinics 

Florida Hospital Tampa hosts the bi-monthly USF BRIDGE clinic, a free clinic offering general primary care services for uninsured and underserved adults 18 and older living in the University area of Tampa.

Florida Hospital Zephyrhills and Florida Hospital Wesley Chapel also have mobile health care services in partnership with Pioneer Medical Group and its Pioneer Medical Foundation, an initiative through which Florida Hospital provides medical supplies, vaccines and staff to homeless shelters, soup kitchens, transition houses, churches, and refugee schools.

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