With the help of a four-year $3.85 million grant, the University of South Florida College of Nursing will soon provide access to mobile healthcare in medically underserved communities like South St. Petersburg.
The grant, awarded by the Health Resources and Services Administration (HRSA), enables the USF College of Nursing to build a 21-foot mobile health unit (MHU), complete with two exam rooms, a bathroom and a pop-up awning. The MHU will serve areas in Tampa Bay desperate for holistic health care, and provide invaluable educational opportunities for students.
The mobile clinic’s staff will include two advanced practice registered nurses (APRNs), a patient care coordinator, a faculty preceptor and students. Dr. Usha Menon, senior associate vice president of USF Health and dean of the college, said the goal is to build students’ skills in a portable setting while addressing health disparities and inequities in underserved communities.
“Those are the communities they (HRSA) want us to work in, and they want to make sure that students know how to handle a treatment plan, a plan of care for an individual,” said Menon. “Not only taking into account their physical conditions but the social determinants of health that impact that person’s health outcomes.”
Menon explained that a person’s environment, income, housing instability and food insecurity impact their health. She said the MHU initiative would teach students to care for patients while accounting for those external factors.
Using high blood pressure as an example, Menon said that instead of just giving a patient a pill, the idea is to consider that they might be unable to afford medication. She added that their diet could contribute to the problem and said nutrition students from the College of Public Health would participate in the program.
“If you tell somebody who’s very poor and can’t make rent every month and is trying to keep food on the table for the family that they have to buy fresh foods from Whole Foods – it doesn’t work,” said Menon. “So, we refer them over to the nutrition students, and those students work with them on a plan that is feasible for them.”
Construction on the custom MHU is underway, and Menon expects its completion in about eight months. She said it would serve as a mobile primary care facility for 15-20 patients daily. Once operational, it will alternate serving the communities in South St. Pete, Port Tampa Bay, Sulphur Springs, Tampa Heights and Wimauma.
Menon said the students would undergo training specific to the MHU’s mission before going into the communities. That includes education on social determinants, health disparities and cultural sensitivity.
“So, remembering that different cultures eat differently,” she said. “And it’s not always possible for somebody to change their diet immediately because we’re telling them to because they have to cook a certain way for the whole family.”
Menon said that every patient they serve would first fill out a 26-item form that asks about the social factors that affect health. The students and nurse practitioners will then refer to the information as they create a care plan.
Community partnerships are critical to the program’s success, and Menon said she is meeting next week with Alison Barlow, executive director of the St. Petersburg Innovation District, to discuss planning. Menon said she would also work closely with the Sanderlin Health Center as the primary medical partner in the city.
Menon added that she is discussing a referral partnership with BayCare for patients needing immediate assistance outside the MHU’s scope.
“What if somebody comes and they need an immediate referral to an ER?” she asked rhetorically. “So, a lot of setup is happening.”
Officials have ordered the chassis for the 21-foot van from Ford, and Menon plans for it to hit the streets of St. Petersburg as soon as it is ready. She “would very much like” to have a Tampa and St. Pete location open simultaneously but noted with just one van, they will have to alternate days – for now.
The hope, said Menon, is that once the St. Petersburg community realizes the MHU’s value to the city’s south side, various stakeholders will put resources together to increase routes and services.
“Perhaps get a second van,” she added. “All of those things are very possible through the partnerships.”
Menon realizes the program is only possible due to the HRSA grant, as USF could not afford the initiative’s scope and staffing. She is already looking toward the future, and what will happen when the funding goes away in four years, and ensuring the program’s sustainability is atop her priority list.
The MHU, said Menon, will feature a freezer to hold vaccines so its staff can provide vaccinations. She said there is a private exam room for gynecological services, and she expects to see a lot of patients with hypertension, high blood pressure and diabetes.
“That’s not well-controlled because of the typical disparities that exist in these communities we’re going to,” said Menon. “A lot of heart diseases related things and then physicals – you know, people who have not had a regular place to go for health care.
“So, those are some of the major things I’m anticipating, but we are doing a solid needs assessment before we go into these communities.”
Menon said that over the next eight months, students would conduct walking surveys throughout the communities, observing and recording factors contributing to poor health outcomes. She said that information would go into a database to assist with creating care plans.
Building trust in the community is critical to its success, said Menon, which underlies the importance of building partnerships with trusted entities in the city. Another key aspect, she said, is consistency.
“We’re showing up, we’re honest and transparent about what we can and cannot do, and we don’t change midstream,” said Menon. “I think the response will be good once we’re in the community.”
Although it will take eight months before the MHU is operational, Menon already envisions launch events where city leaders come out to have services performed, such as blood pressure readings. If her dream of acquiring another van comes to fruition, she also hopes to serve other communities in need in Hillsborough and Pinellas Counties.
Menon relayed that when recently discussing all of her goals with her team, they noted the amount of time she must have spent thinking about the project. She said that the assessment was accurate.
“I’ve been dreaming of doing this for about 10 years,” said Menon with a laugh. “So, I’m excited.
“But really, I’m excited about getting our students into the communities – because ultimately, they have to serve these same people when they graduate, and they have to understand what inequities mean.”