Whether they offer tooth cleanings or postpartum check-ins, mobile medical units are a growing fixture of health care. These roving clinics make it possible for health workers to serve hard-to-reach patients — those who don’t have access to reliable transportation, can’t take time off work for appointments, or live in rural areas with long distances to the nearest clinic.

Now, four community health centers across Florida are expanding their fleets with new mobile health units, each retrofitted to meet a different local need.

Orange Blossom Family Health Center, Evara Health Center, Central Florida Health Care Center, and the Healthcare Network of Southwest Florida were awarded the units earlier this year. The trucks were fitted out for dental care, medical support, prenatal and postpartum care, and disaster response. Representatives from each health center said that increasing their mobile capacity will allow them to reach more patients more effectively.

The Florida Association of Community Health Centers secured several box trucks through the State of Florida’s Division of Emergency Management. In the summer of 2021, the State was winding down mobile covid testing, which it had conducted using the trucks. The Association offered the vehicles to its members through a raffle.

Over twenty-five health facilities showed interest. Seven members were awarded units and over half of these received additional funding from Direct Relief to retrofit the trucks for specific medical needs.

Gregory Hall, director of operations at Central Florida Health Center, said their mobile unit will provide optometry care. The health center serves three counties, including the fast-growing Polk County. Hall says the health center needs more resources to serve their expanding population.

“It’s going to be a tremendous add in those rural parts of our service area…areas where folks are just not getting care,” Hall said.

Polk County is situated between Orlando and Tampa. According to census data, the median household income is just over $62,000. About 40% of households in the county earn less than $50,000 annually.

Florida is one of ten states that has not expanded access to Medicaid. Under the current law, residents who qualify may earn a household income that is considered low or very low; for a three-person household the annual income before taxes must be below $34,341, according to the state of Florida.

John Fletcher, chief operating officer and general counsel at Healthcare Network of Southwest Florida (HNSWF), said their mobile unit will be used for general medical support and disaster response. The health center covers an expansive rural area with limited public transportation. Fletcher said the ease of mobility will allow them to further support migrant and farmworker populations.

HNSWF has a smaller patient base than other health centers in the state, but there’s a catch: That small patient population is scattered over a vast landmass. The rural setting creates transportation challenges and limits the center’s accessibility.

“It makes a big difference for our people,” Fletcher said.

In 2017, Hurricane Irma tore through the area, causing severe damage and limiting access to health services. Fletcher said the area experienced damage again in 2022 from Hurricane Ian.

Mobile units have been an effective way for HNSWF to provide post-disaster care in the past. Health workers have used them to give tetanus shots and other vaccinations, treat cuts and scrapes, and dispense emergency medications. Fletcher said that they also consider waterborne illnesses that people don’t generally think about when they’re trying to recover their homes

Irma “basically shut down the whole community for two weeks, and for some much longer than that,” Fletcher said.

All four health centers are adding to existing mobile unit fleets. Some had larger buses that can be difficult to bring to community functions with limited space or are costly to gas up for long road trips. The smaller, 25-to-40-foot box trucks allow health workers to maneuver wherever they are needed to provide services, even for simple needs like providing air conditioning or a clean bathroom in a rural area.

Gianna Van Winkle, Director of Emergency Management Programs at FACHC, was the mastermind behind the program.

“We really encourage our health centers to tap into available resources,” Van Winkle said. “This project exemplifies what can happen when everyone works together, and everything works out well.” 

Jermaine Forrest, chief operating officer at Orange Blossom, said the new mobile unit provides the health center with six in total. In 2022, the health center responded to Hurricane Ian and used the mobile units at sister properties to serve patients who were in flooded areas or who were experiencing power outages.

The new unit will serve another, specialized function: providing optometry services to patients who might otherwise go without.

With its custom retrofitting materials, this mobile optometry clinic would have cost the health center hundreds of thousands of dollars. 

“Without grants, most organizations would probably back out and not be able to afford a machine like this,” said Forrest.

In Pinellas County, the new mobile unit will be used to increase marketing tactics, support community health measures like regular physicals for student athletes, and provide prenatal care.

Kim Schuknecht, chief operating office and compliance officer at Evara Health in Pinellas, said the health center received an additional grant to provide care for at-risk moms and soon-to-be mothers. The additional financial assistance will allow the health center to meet expectant and postpartum mothers at their homes.

“For those that have really complex issues and then post-delivery, the plan is for the first couple of visits with mom and baby and we will send the unit back out to the home and do a visit there with them as well,” Schuknecht said.