“If you had a dream, what would it be?”
When Kasey Harding, a veteran health care administrator who directs the Center for Key Populations at Community Health Center, Inc. (CHC), heard her CEO ask this question, she knew he was serious. The year was 2020, and COVID emergency funds were making it possible for organizations across the country to invest in health care infrastructure. Which dream would they like to come true?
“For us, it was easy,” Harding recalled: “A mobile health care van.”
Harding and her team engage in some of healthcare’s toughest work—providing care to people with HIV and Hepatitis C, bringing suboxone treatment to substance users, offering primary care at homeless shelters and food pantries, serving elderly and disabled persons in congregate care settings.
They also provide primary care to hundreds of migrant farm workers across their state as part of the Connecticut River Valley Farmworker Health Program.
Back in 2020, Harding’s farm worker health care team drove a regular four-door van down dirt roads speckled with ruts and puddles, medical supplies rattling in the rear. They set up tents in the open air. There were no restrooms. Despite its challenges, this makeshift system worked better than trying to transport workers to one of the health center’s physical buildings. Migrant farm workers work 12-hour shifts and can’t leave the fields. For them, taking time out for health care is nearly impossible.
They’re not alone. Across the United States, the health care access problem exists in every community. “When you go somewhere and find 40 people who haven’t had any health care, first of all, there’s a problem,” Harding reflected of her team’s everyday experience.
“During the COVID pandemic,” she continued, “we realized we had to do a better job with equity. How can we deliver care in a way that makes people comfortable and confident and reduces barriers?”
Enter the health care van.
“We thought, ‘Can you imagine?’ said Harding, her face lighting up at the prospect of helping people in a more dignified way. “A mobile unit that we could actually drive to every one of our ten different sites, with everything we need inside?”
Their dream came true. The van, with electricity, heat, waiting room, restroom, and private exam room, is “glorious,” Harding said. The first time they took it on the road, the team stopped at Dunkin’ Donuts. A dozen people crowded around, asking what the vehicle was. With the words “MOBILE MEDICAL UNIT” painted boldly on its side, the van’s purpose was easy to explain.
“It draws people to us like I’ve never seen before,” said Harding.
On the farms, the van has expanded options for patients and providers. “Until we had the van, the workers would come for acute problems, such as injury or cold,” Harding explained. “Now we’re working with them on controlling their hypertension and diabetes. We’re building relationships. We can even help with continuity of care” when workers return home in the off-season.
“They love it,” she added. “For many, it’s the first time they’ve ever been able to close a door and talk to their provider.”
Now, thanks to recent funding from the City of Wallingford, Connecticut, Harding’s group just received its second licensed mobile health unit. They’re proud to participate in a growing trend in health care, as vans expand access for people in underserved neighborhoods. With the MOBILE Health Care Act (S. 958) taking effect on January 1, 2024, federally qualified health centers like CHC, Inc. are more likely than ever to put their outreach and services on wheels.
While the dirt roads may still be muddy, the patient experience has been transformed. Patients describe the mobile unit as a place they feel comfortable, never judged. By improving conditions and enabling better health outcomes, mobile units are, in fact, making dreams come true.
“We are able to provide immediate access,” said Harding. “We build their confidence. We have seen that it works.”