Ted Glynn remembers meeting an 8-year-old who had never received a childhood immunization. It wasn’t that the child’s parents were opposed to vaccinations. The child hadn’t been vaccinated because of the barriers that kept the family from accessing health care.
Glynn met the boy and his parents through the Lansing area’s only Mobile Health Clinic. Housed in a bus donated and renovated by Dean Transportation, the mobile clinic represents a partnership between Dean, Sparrow and the Ingham County Health Department.
Since 2016, the full-size repurposed motor coach has visited neighborhood sites and centers—most in low-income areas—to offer free medical screenings, referral and basic services to anyone. Branded “health on wheels,” the motor coach is divided into receiving and staff areas, as well as private rooms for exams and screenings.
Glynn is often the attending physician on the bus. He is also the vice president of medical education and research at Sparrow. As a board-certified emergency medicine professional, Glynn has worked more than 20 years in emergency medicine in Lansing and the southern U.S. A major frustration, he says, are the inequities in care across populations—and the reliance on emergency departments as a safety net for the uninsured or impoverished.
“My interest is knowing there has to be a better way to keep people healthy,” says Glynn. “There is a human cost for the delays and fragmented care they receive, and there is a cost to society. Health care costs are unsustainable in the U.S. And when we render care late in the emergency department, it’s at the highest cost.”
Going mobile
Glynn was part of the team that launched the mobile health clinic more than two years ago. The concept grew from Sparrow’s Community Health Needs Assessment that revealed access to care, chronic disease management, and behavioral health as one of the area’s top health concerns—particularly in low-income neighborhoods.
Sparrow’s Director of Health and Wellness Leslie Polack has also played a part in getting people on the bus. She remarks that the mobile health clinic represents a new model for Greater Lansing that helps overcome barriers to medical care.
“We recognize that care needs to take place outside the four walls of a hospital,” says Polack. “We’re finding it works better if we engage in efforts that are less traditional and get at the foundational reasons why people are unable to access care.”
Polack says lack of access presents in variety of ways—and that having an insurance card doesn’t necessarily ensure people can get medical care. A recent report by Sparrow quantifies the systematic barriers that restrict access to care for vulnerable populations. Twenty-five percent lack transportation, while 11 percent lack insurance coverage. Another 20 percent go without care because of the high cost. Low income Americans also share a distrust of the health care system, with 53 percent agreeing that U.S. doctors can’t be trusted.
Linda Vail of the Ingham County Health Department says those barriers are mirrored in Greater Lansing. She points out that mobile health clinics have emerged across the U.S. as a viable health and business model. Some operate in areas of southeast and southwest Michigan, and a few in rural parts of the state.
“Our priority is to meet people’s needs and to meet people where they are,” says the chief health officer. “Rather than to be judgmental or say people have to be at a specific place, this is how we can meet them where they are in their journey toward health, health improvement and recovery.”
On the bus
About 40 percent of patients visiting Greater Lansing’s mobile clinics are minors. Close to 20 percent of patients have no health insurance, while the rest primarily rely on Medicaid or Medicare. The majority had no meaningful or consistent access to health care other than the emergency room.
In April, the mobile care clinic began its slate of six site visits for the spring. A similar number of mobile clinics and sites will take place this summer. Site visits are in the works for the fall, with an eye toward offering year-round services.
The expansion is due to strong turnout. About 250 children and adults received free services in the clinic’s first two years on the road. Those services include childhood and adult immunizations and flu shots, as well as screening for lead, blood pressure, body mass index, cholesterol, diabetes and behavioral health. Confidential testing and counseling for HIV is available, with testing for Hepatitis C offered in the near future.
Referrals to physicians, specialists and cancer prevention screenings such as mammography and colonoscopy are available. Mobile clinic staff also refer patients to community resources for food, clothing, shelter and other essential needs, and assist with sign-up for various health insurances.
“Our hope is that people and families leverage what’s out there for them and connect with resources,” says Vail. “We have staff out at the clinic helping people, so we don’t lose that touch point.”
Destination health
Organizers say the number of people coming out for site visits is steady or increasing. Of returning patients, many report to be following through with referrals and personal and family health care.
“We found that if we work with community leaders and the centers and sites we visit, we start to gain the trust of people in the community,” says Glynn. “If we have a recurring presence and work with those leaders, these patients are more apt to trust us and receive care.”
The Allen Neighborhood Center was among the recent spring stops, and was paired with the Center’s weekly Breadbasket Food Pantry. Glynn was there as the attending physician, joined by a combined team from the ICHD and Sparrow. Professionals included a community health worker, medical assistant, point-of-care lab technician, HIV counselor, a nurse, and community health worker Angie Boughner.
“I love doing this type of outreach,” says Boughner. “It’s nice to see people here asking for resources and using the information to help better their situation. Sometimes, I even run into people at the store months later, and they say ‘hey, I remember you helped me with insurance and to get a doctor appointment.’ It’s rewarding.”
Joan Nelson, executive director of the ANC, remarks that the people who frequent the center are pleased by the outreach of the mobile clinic. She says the area served by ANC is richly diverse with a large refugee population. About 25 percent of the households in the area are below poverty level. One in 10 is headed by someone from another country.
“We’ve learned the value of working simultaneously with health organizations in this community,” says Nelson. “It means a lot to folks who are under-resourced to have an opportunity to get screened, and to talk to a physician about any medical or general health concern they might have.
Down the road
In addition to the ANC, the mobile clinic has visited the South Washington Square Apartments, Capital Commons Apartments, and Edgewood Village Apartments. Baker-Donor Neighborhood and Capital Area Career Center are also among the stops. Other sites will be added as interest grows.
As the mobile unit rolls into its third year of service, Glynn believes in its mission. The clinic, he says, fills a geographical gap amidst the 2,000 mobile units reported to be operating nationwide by Mobile Health Map—a collaborative research community studying the impact of mobile health.
In Mid-Michigan, the returns are both human and economic. Glynn sites statistics that calculate the return on investment in a mobile health clinic at 35:1—or $35 saved for every $1 spent. That savings includes the avoided cost of emergency room care and the improved quality of life for the patient or family.
“On face value, it seems like the noble and right thing to do—to help those who don’t have the same access or enjoy what others do,” says Glynn. “From a societal standpoint, if we can help maintain a higher level of health within our community, it’s good from a workforce perspective, for the economy, and our overall health care costs.”
In Lansing, the benefit is increasingly recognized. Funding for the Mobile Health Clinic comes through community partnerships and individual gifts made to the Sparrow Foundation. While the current bus runs smoothly with a bit of TLC, Sparrow and ICHD expect delivery on a state-of-the-art mobile clinic this September thanks to the support of private donors.
The new 40-foot vehicle, Glynn says, will enable providers to serve more patients and families with an expanded staff, and to realize increased savings and benefits to the community. The wheelchair accessible unit will have two exam rooms, a waiting and registration area, and a bathroom and sink. Point-of-care lab testing, electronic communications, and secure, private access to data will also be supported.
“We’ve come full spectrum,” says Glynn. “Three years ago, we were in the feasibility stage of ‘Can we do this?’ We had a hypothesis, that there was a need and patients would respond. We had to crawl before we could walk.”
Ann Kammerer writes occasional features for Capital Gains and Michigan Nightlight. She is a freelance writer based in Mid-Michigan.
Photos © Dave Trumpie
Dave Trumpie is the managing photographer for Capital Gains. He is a freelance photographer and owner of Trumpie Photography.