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Mobile clinics, launched to help with COVID, now fill the gap in rural healthcare : Shots


Rural clinics with fewer doctors, dentists and nurses are turning to mobile healthcare clinics to get care where it’s needed most. The Alliance for Healthy Communities organizes several itinerant dental events each year in Lyon County, Nev.

Wendy Madson/KHN


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Wendy Madson/KHN


Rural clinics with fewer doctors, dentists and nurses are turning to mobile healthcare clinics to get care where it’s needed most. The Alliance for Healthy Communities organizes several itinerant dental events each year in Lyon County, Nev.

Wendy Madson/KHN

Nearly 12 years ago, a nonprofit focused on substance abuse prevention in Lyon County, Nev., expanded its services to dental care.

Leaders of the Alliance for Healthy Communities were shocked to have to act after two volunteers in their pantry used pliers to pull out each other’s abscessed teeth. The volunteers saw no other option to alleviate their overwhelming grief in the small town they lived in, 40 miles southeast of Reno, because of a lack of dental care providers.

That drastic action spurred her organization to use mobile clinics to deliver medical and dental services in rural communities, said Wendy Madson, the alliance’s executive director. where there are not enough patients to support traditional offices.

The union now sends a truck equipped with dental equipment to schools in the district to treat hundreds of students each stop several times a year. They also organize events that provide free care to adults in the area. The response has been overwhelming.

“Dental is the hot ticket,” says Madson. “Everybody wants a dental check-up. Availability of those services comes first in those big mobile events.”

The alliance’s mobility programs reflect nationwide efforts to deliver services to patients experiencing gaps in the healthcare system, especially in rural areas.

Rural residents face more severe health care provider shortages, including dentists, compared to their counterparts in larger cities. Since the start of the pandemic, mobile clinics have increased access to a wide range of services in hard-to-reach places with sparse populations.

A recently passed law, making it easier for rural communities to pay for new mobile clinics, could expand on this trend. In the past, clinics serving low-income rural residents were unable to spend federal funds — known as the new hotspot subsidy — on cellular services in communities where they did not have the opportunity. facilities.

Then last fall, Congress passed MOBILE Health Care Actsponsored by Sens. Jacky Rosen, D-Nev., and Susan Collins, R-Maine, give federally qualified medical centers—medical clinics that serve underserved areas—more flexibility in what they can do. use federal funds to set up and operate mobile units.

Healthy Communities Alliance CEO Wendy Madson said mobile dental clinics in Lyon County, Nevada, help reach younger students whose parents may lack the means or insurance to schedule visits. regular examination.

Wendy Madson/KHN


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Wendy Madson/KHN

Since 2019, the number of mobile clinics on the road has increased, according to the National Association of Public Health Centers. Many have been used for COVID-19 testing and vaccination. And health and community organizations are beginning to use mobile units to bring primary care, behavioral health and reproductive services to distant patients. The new funding route could soon put more mobile medical trucks on the road.

Currently, the law relies on congressional funding, and experts predict it could take at least a year before medical centers can access the funding.

Freed from traditional requirements, medical centers can roll out trucks

Once funded, the regulatory change will allow medical centers to partner with independent organizations like Madson’s Health Community Alliance in Nevada to expand services in underserved areas. serve. Because the union was not a federally qualified medical center, it relied on a combination of other federal and state grants.

Nearly 1,400 federally qualified medical centers nationwide receive federal funding to provide comprehensive health services in underserved areas. Steve Messinger, policy director for the Nevada Primary Care Association, said the previous requirement that medical centers set up in-person clinics before expanding mobile clinics prevented many people from signing up. sign. It is burdensome and costly for medical centers.

But in rural areas with small populations, well served by mobile clinics, it doesn’t make sense to set up a building with a full-time provider first, he said. That could eat up the budget of a federally qualified medical center.

While the health center lobbies Congress for basic funding, the Alliance for Healthy Communities is running three dental events this year sponsored by a grant from the Regulatory Authority. Health Services and Resources, a division of the Department of Health and Human Services.

At the alliance’s first health outreach event in 2012 in Lyon County, where 61,400 residents live across more than 2,000 square miles, more than 200 people showed up for free care and 150 teeth were removed. plucked, Madson said. Since then, the organization has hosted several events each year — with the exception of 2020, when the pandemic halted operations.

Mobile dental clinics organized by the Alliance with ties to Healthy Communi(Wendy Madson) help ensure Lyon County, Nev., students are cleaned, screened, x-rayed, etc.

Wendy Madson/KHN


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Wendy Madson/KHN

Many dental events are school-focused and provide children with services such as screenings, X-rays, fillings, polishing, and cleanings. But overwhelming need for care also exists among adults in the region, says Madson, because Nevada’s Medicare and Medicaid don’t include comprehensive adult dental coverage. She says it’s more difficult to fund those events.

Of the five communities in Lyon County, at least one, Silver Springs, does not have a dentist. There are a total of 10 dentists in Fernley and Dayton, communities with a combined population of 38,600, but only two of those facilities accept Medicaid, which covers low-income people under the age of 21 and other dentists. Limited dental services for adults.

Meeting urgent needs for dental and health services

Traci Rothman, the union’s food pantry manager, says dental outreach events have made a difference for her 29-year-old son, who moved to Silver Springs last year. He went to two mobile clinics for free care, which Rothman said was a huge relief because he had no insurance and desperately needed dental care.

“Otherwise, you’re going to have to pay someone cash,” she said. “Honestly, sometimes I can’t afford it; it’s out of reach for some, or most people… in the countryside.”

Madson said the alliance joined to help a young student in dire need of a root canal. The union is helping the girl’s family apply for Medicaid or Nevada Check Up, the state’s Children’s Health Insurance Program, and is paying $1,600 to cover the service with federal funds. Another student had to be referred to several specialists before she had surgery to remove her decayed baby teeth and receive restorative treatment for adult teeth that had begun to decay.

“Her mother was so grateful, she was in tears,” Madson said. “She told me that for the first time in years, her daughter woke up without immediate pain.”

Madson said her organization has enough funding to fund three events through the end of May, but she hopes the Mobile Healthcare Act will help expand services. In addition to dental care, the group also provides primary care mobile clinics for migrant workers in Yerington, a small farm town about 70 miles southeast of Reno.

Sara Rich, CEO of Choptank Community Health in Maryland, said she shares Madson’s hope.

Choptank serves five counties in Maryland, including small towns between the Chesapeake Bay and the Delmarva Peninsula. In the midst of the pandemic, the health organization forged an unlikely partnership with an auto dealer and used federal COVID relief money to purchase a Ford Transit cargo van for emergency rooms. mobile examination.

Choptank used its new truck to deliver vaccines but has since started using it to provide primary care for migrant workers and dental services for children at 36 schools. learn. Mobile clinics have been so successful that the medical center is working to buy more trucks to expand its services.

Rich said mobile clinics are “breaking down the barriers many of us have been working on for a long time.”

Among the new services Choptank seeks to provide are behavioral health, substance use disorder prevention and treatment, and skin screenings for people who work on the Maryland coast.

“Flexibility has become a theme over the past few years,” says Rich. “I think this MOBILE Healthcare Act will help us do that even more in the future.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Exploration, KHN is one of the three main activities in Vietnam KFF (Kaiser Family Foundation). KFF is a funded non-profit organization that provides information on health issues to the nation.

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