Many health centers are now incorporating mobile clinics as a key strategy for improving access to health care, especially in rural areas, farmworker communities, housing projects and homeless populations. Mobile clinics help overcome barriers, such as transportation, that prevent people from accessing health care. A mobile unit can also be more flexible so care can be provided during non-traditional hours such as evening and weekends.
Utilizing mobile care presents a tremendous opportunity for outreach into the community to raise awareness about the community health center and its offerings. Mobile programs usually work closely with the schools and other community partners fostering more cooperation and overall collaboration with the health center. Often these partners are interested in using the mobile unit to provide health education and prevention services for the people they serve. Luckily, these services can easily lend themselves to mobile care. Depending on the needs of your community, a mobile unit may also provide a variety of other services such as health screenings, immunizations, physicals, and comprehensive dental care.
In addition, a mobile program serves as an effective referral source to the fixed site locations of the health center. This ensures continuity of care for those seen on the mobile unit. A health center should never underestimate the importance of continuity of care. Many communities have become upset with a mobile program that hasn't effectively planned its services and coordination of care. For example, a mobile dental program that provides screenings and preventive services, while billing Medicaid or other insurers for these services, but then doesn't connect the patients to an ongoing source of care is a sure fire way to garner ill will. When these patients seek care in the community, providers have to repeat the exams and x-rays to create a treatment plan, but do not get paid for repeating the services because there are time interval limitations with the insurers. If a program is only going to provide preventive dental services, it is imperative that there is coordination and referral systems in place so patients have a "dental home" for ongoing care and that services are not duplicative. By not following through with continuity of care, you risk losing community support which is crucial to a mobile program’s success.
Operating a mobile health clinic isn't cheap. The first year costs can easily exceed $500,000, when factoring in the vehicle, and more than $250,000 annually, depending on staffing and services provided. Fortunately, there are often a variety of local and federal grants available, as well as Medicaid reimbursement. Fundraising is also an option for covering the gap between program reimbursements and cost of care. Depending on services provided, there is usually a revenue shortfall since health screenings are generally not reimbursable and mobile units are often used for outreach, prevention and education.
Despite the expense of mobile units, health centers are poised to reap many intangible rewards such as increased visibility, awareness and name recognition. An effectively branded mobile unit is essentially a roving billboard for the health center.
Lesa Peterson is a Director at FQHC Germane and a consultant for Merces Consulting. Previously, as the Director of Operations for a community health center, she was responsible for the administrative operations of the organization, including a Ronald McDonald Care Mobile® program.
To contact Lesa, email her at LPeterson@FQHC.org.