Mobile clinic that helps so many has its funding cut


The mobile outreach clinic is parked at the Downtown library on Wednesday, July 3, 2013, in Gainesville, Fla.

Elizabeth Hamilton/Correspondent
Published: Thursday, July 11, 2013 at 6:01 a.m.
Last Modified: Wednesday, July 10, 2013 at 8:21 p.m.

Outside the downtown library in Gainesville, Michael Lovett sat in the mid-afternoon heat with others on Wednesday until it was his turn to climb inside the bus.

When he moved here about a year ago, he heard about this mobile clinic from other folks in town. He's been in a tight financial situation since his Medicaid and federal disability benefits ended, and people told him the University of Florida College of Medicine's Mobile Outreach Clinic could help.

The volunteers there have treated him nicely and helped him to manage his health problems, which he said leave him unable to work. Lovett, 40, takes medication for diabetes, high blood pressure, sleep apnea and anxiety.

The clinic's care is a great help, he said, but his financial struggles still take a toll on his health.

He doesn't always have the money to pay for his medications, so he sometimes skips doses or cuts pills in half to make the prescriptions last longer.

"I'm just happy and blessed that they have this right here, because, without this, I don't know..." he said, trailing off as he sat inside the bus's small intake room where volunteers jot down patient information.

The driver's seat sits on the left side of the makeshift room and a tall scale is stationed in front of a latched door at the back of the space that separates this segment of the clinic from the mini-examination room behind it.

Throughout the week, the mobile clinic visits local neighborhoods and libraries, where it provides health care to mostly uninsured residents. It operates on an annual budget of about $250,000 and gets about 4,500 visits per year from patients, according to Dr. Nancy Hardt, the clinic's director.

The clinic is primarily staffed by volunteer health care professionals and UF students, although it employs a nurse and a driver. This team of volunteers offers medical care and advice to local residents who often can't get help elsewhere.

"We don't have a fancy facility. We don't have a fancy budget," Hardt said. "But we have fantastic volunteers."

The clinic has a return on investment of about $34 for every $1 invested in its program.

That ratio takes into account the number of prevented emergency room visits and prevented Medicaid births, many of which are unintended, but it doesn't factor in the heart attacks, strokes and hospitalizations that are averted because of the clinic's care.

The clinic can't take credit for all those prevented emergency visits and taxpayer-funded births and the corresponding cost savings, but it does play a significant role in those reductions, Hardt said.

Using its $250,000 budget and a team of experienced volunteers, the clinic serves six at-risk neighborhoods around Alachua County. Of that $250,000 in funding, $107,000 comes from the county's CHOICES program while the UF College of Medicine provides the rest.

CHOICES is a voter-approved program that helps uninsured county residents gain access to health services. But it is set to end in December, which means the clinic can say goodbye to that significant source of funding.

UF can't pick up the slack from CHOICES, so the money will have to come from somewhere else, Hardt said. The clinic needs to find another source of funding within the next calendar year or else it will have to cut back on its services.

"We won't be able to go to all the neighborhoods that we go to now," she said.

The clinic might be able to keep visiting the same neighborhoods less often, or it may need to eliminate some of those locations from its roster altogether.

Hardt recently gave a presentation to the County Commission at which she demonstrated the clinic's considerable success as well as its uncertain financial future.

The overall commission was supportive of the program and of trying to find another way to fund it. She said commissioners have always been supportive of this operation and understand its value.

"I was very gratified by the response of the County Commission," she said. But she isn't banking on the county being able to fund the clinic in the future, although she hopes it can.

Now that she's explained the situation to the county, her plan is to talk about the clinic and its financial needs to anyone who might be able to provide the necessary funding and is willing to listen.

Over the past few years, Hardt has seen the impact the clinic has on the lives of the people it serves and the valuable lessons the health professionals and students who volunteer on the bus have learned from their patients in return.

Hardt emphasized the need for students to see that people without insurance who visit the mobile clinic are just like the insured patients they see at the hospital.

When the clinic launched in January 2010, however, Hardt wasn't sure who to expect.

"We don't see the patients that don't come," she said.

Working at the university, she and her co-workers were only familiar with the patients who came there for treatment, so they weren't in a position to perceive who they weren't reaching when it came to care. Hardt wasn't sure what residents would be looking for when they visited the mobile clinic.

What they asked for wasn't extraordinary at all. They just wanted ordinary health care from a provider they could trust.

Before she got involved with the clinic, she used to think people without health insurance didn't have jobs. But many of the clinic's uninsured patients have one or more jobs. They just aren't jobs that offer insurance.

The people with the most difficulty getting access to health care are those who don't have insurance, cars, babysitters, or cash, according to Hardt.

The most common requests from patients are for family planning, diagnosis and treatment of sexually transmitted infections and care for hypertension and diabetes.

Some patients know they have hypertension or diabetes when they come to the clinic, while others have no idea until they get checked out.

"Hypertension is a really important one because it's a silent disease, and a lot of times the first time people know they have high blood pressure is the day they have a heart attack or a stroke," she said.

Analucia Cadavid, a 21-year-old undergraduate student at UF who is applying to medical school, said she has met a wide range of people while volunteering with the mobile clinic. People who recently lost their insurance and are struggling to find employment come in for help, as do homeless people and other residents stuck in tough situations.

The clinic is always getting new patients.

"It's definitely sad to see the situation some of these people are in. You know, it can get a little emotional sometimes," Cadavid said.

Eric Rosario, a 67-year-old Gainesville resident, said the clinic provides a humane service to its patients.

"They will die if they don't get the help they get over here," Rosario said. "We need to help it continue because this is something that has to do with a person's life or death."

Rosario has seen the attention and care the clinic's volunteers give to him and other patients from the moment they arrive until the second they leave. Jorge Herrera, a clinic employee, will tell him and other patients to go sit inside the air-conditioned library on hot days and then Herrera will come get them when it's their turn.

"If I had money, I would be donating," said Rosario, who receives Social Security benefits. "It's a miracle that we have this kind of service in Gainesville."

Contact Morgan Watkins at 338-3104 or morgan.watkins@gainesville.com.

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