Mobile Health Fuels Up After New Change in Law

By Olivia Lewis

Editor’s note: This article is part of a joint editorial initiative between the National Association of Community Health Centers and Direct Relief deliver reliable and trustworthy healthcare content.

Mobile medical units travel across city lines to reach rural and underserved residents in need of medical care. According to the National Association of Community Health Centers, the number of health centers using mobile health units has increased by 47% since 2019. That increase is expected to continue in 2024. when new MOBILE Health Care legislation goes into effect and will allow federally qualified health centers to use new grant dollars on mobile units. Health centers have used mobile units in the past to meet patients where they are for their dental, emergency services, family planning, and general medical care, with great success.

Rhonda Johnson saw this firsthand. She runs a mobile unit that provides mammograms to patients in underserved communities in rural Nevada who might otherwise go without. “Eighty-seven percent of the cities where people love to live are in rural Nevada, but they don’t have the access (to health care) that the area cities have. So what about everyone else?”

The Nevada Health Center has operated the Mammovan since 2000 to increase access to mammograms throughout Nevada. At the time, Nevada had one of the highest breast cancer rates in the country, with many women never having a mammogram before being diagnosed. The Mammovan was a pioneering program among health center mobile units that survived on philanthropic dollars.

Johnson said it costs about $1.5 million to put the van on the road and $1.2 million for operations. The travel burden is the heaviest cost, due to maintenance on the vans, and easy burnout on employees who are subject to constant travel across the state.

Beginning in 2024, the MOBILE Health Care Act allows health centers to use new access grant program dollars for mobile health units. Under the new legislation, the expanded access will allow dollars to be spent to provide care in rural and underserved communities. Before the legislative change, the grant program prohibited health centers from using grant dollars on construction costs or expanding services with mobile units.

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Rep. Susie Lee (D) of Nevada introduced the bill to the House in August of 2021 and Sen. Jacky Rosen (D) of Nevada introduced it to the Senate. The Senate bill quickly passed with overwhelming bipartisan support and was approved in a 414-to-7 vote on September 29.

“The pandemic has exposed long-standing inequities in our health care system, and I am fighting to make health care more accessible to Nevadans, no matter where they live. Federally Qualified Health Centers provide essential care for thousands of Nevada families who need it. With the passage of this bill, we are one step closer to ensuring that every Nevadan has access to the care they deserve,” Lee said in a news release from his office about the legislation. Lee’s county is home to the Mammovan, which employs 10. people who work to increase access to mammograms across the state.

Under the guise of the new legislation, Nevada Health Center hopes to purchase another van so that one will travel the southern part of the state, a second will stay in the Las Vegas area, and a third will travel the northern part of the state. Johnson said this method will reduce the time employees will have to stay on the road, travel costs and overall van maintenance.

The Mammovan did not travel during the winter months due to variations in weather, but the extra money could improve travel skills. “That’s three months [the patients] lose,” Johnson said.

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Although there was widespread support for expanding the use of grant dollars, Congress must approve a budget for health centers to see more financial support.

“For it to really work, you have to have money,” said Deila Davis, assistant director of federal affairs for the National Association of Community Health Centers. “Health Centers get a lot of federal money, and this is one more string for them to run on.”

Davis said mobile units help health centers build trust with patients, remove transportation barriers and increase labor availability.

In Puerto Rico, mobile medical units were used to support residents affected by Hurricane Fiona in 2022. In Mississippi, mobile units were used to care for women in rural areas who needed maternal health care, and across Florida in partnership with school districts where students. does not have consistent health care or regular access to pediatric care.

In a report published by the National Library of Medicine, mobile health units were described as advantageous because of their flexibility in where patients can receive care, their ability to meet the evolving health needs of a community and address the social determinants of health.

“MHCs (Mobile Health Clinics) produce significant savings and represent a cost-effective care delivery model that improves health outcomes in underserved groups,” the authors wrote.

PanCare Health Center of Florida has 12 mobile health units that travel to five school districts and several Head Start programs across nine counties to visit 15,000 students each year.

Robert Thompson, chief operating officer of PanCare Florida, said their mobile school health program allows students to have regular vision exams dental exams, and annual physicals—many of which are required for students enrolled in local school systems. Of the 12 units, three are dental vans, seven are medical units, and two are used for optometry.

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The mobile program employs 20 people, some seasonally and some year-round. Thompson said using donation dollars could allow them to hire more people and buy another mobile unit. According to Thompson, the dental mobile health unit is in high demand, but all mobile units are driven at high costs to the health center. “We take care of them way more than what they’re designed for,” he said. “We have maintenance problems often because they are campers basically and we have problems because we use them so much, but it’s needed.”

Thompson said the majority of the students seen through the mobile school health program do not visit the health center’s brick-and-mortar locations. Parents can’t always leave work in the middle of the day and not every student has reliable transportation to get to the center. Meeting the students at their schools created a consistent approach to medical care.

“It emphasizes the importance of regular maintenance,” he said. “It’s not just a one-time thing; for a lot of these kids, it becomes their regular dental check-up. And it’s interactive, they have videos on how to brush your teeth and floss, and they get a bag with a toothbrush and floss to keep using when they will be finished.”

PanCare Florida has also used the mobile units at local events, to support veterans, and migrant workers who often don’t have health insurance or transportation to visit the health center.” If we had funding available now, especially dental, within six months. we probably could to have it full (of patients),” Thompson said. “There’s a lot more opportunity out there.”

Direct Relief has funded the purchase of dozens of mobile health units across the United States to support the efforts of health centers beyond clinic walls, including after disasters such as Hurricanes Harvey, Irma and Maria.


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