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Mobile Units: Helping to (Re)Build Trust for People Experiencing Homelessness

This post is part of NACHC’s Innovation Blog Series. This series is hosted monthly by our Center for Community Health Innovation.

Community Health Centers many times function as more than a care provider, they are a connector and anchor in their communities. Before joining NACHC, my training ground in Community Health Centers was at Unity Health Care (Unity) in Washington, DC, where most of my work was at a medical respite site.

Unity grew out of a Healthcare for the Homeless Project and continues to center the care for people experiencing homelessness in their work and mission. During this experience I was able to witness the complexity of homelessness and its impact for health centers. In an intersectional issue like homelessness, it almost goes without saying that systems fail people and part of the ongoing work is (re)building trust. Enter mobile health units as one piece of the puzzle!

Mobile units add to the existing network of care and outreach

Mobile units, in concert with other efforts such as “street medicine” practices, reach people and start developing trust. Community Health Centers get proximate to communities in physical location, partnering with like-minded community-based organizations, engaging with consumers on their Board of Directors and employing people from the communities they serve. These are among the many ways that health centers build trust. However, proximity is not the full picture of why people choose to go to one clinic versus another. As this story of a new clinic in the District of Columbia by Street Sense Media shows, an individual’s relationship with the care team means they may prefer to travel to a less convenient location.

Taking a mobile unit out to the community to provide services lowers barriers even further. During the COVID-19 public health emergency, they have been essential in vaccination and testing as well. Sometimes, a mobile unit may not be enough of a first step to connect with an individual. As Dr. Catherine Crosland from Unity shares with Washington City Paper, for someone staying on this corner while the van is parked on that corner, they may not leave their belongings to come for services. Rather, outreach teams going to parks, underpasses, and encampments initiate a connection. Mobile units are an important piece to the network that, with street medicine and Community Health Centers, try to reconstitute relationships.

How many mobile units are in use: The numbers

Based on 2020 UDS data, health centers operate about 655 individual mobile units, of which, 453 (~70%) are in urban settings and 202 (~30%) are in rural settings. On average, health centers with mobile units see more patients who are experiencing homelessness and slightly more patients who are agricultural workers. Unfortunately, the current UDS data reporting system is not broken down to individual sites; therefore, the information listed are trends and are not correlative or causal.

Coming soon: An opportunity to learn more about the impact of mobile units

We are thrilled for an upcoming grant opportunity for FQHCs (Federally Qualified Health Centers) and Look-Alikes, funded by the Leon Lowenstein Foundation, to support mobile health units while learning more about the current state of these sites and new innovative mobile practices. More information will be coming. Check out NACHC’s social media for announcements or feel free to email us at innovation@nachc.org.

We also have an upcoming educational session at the Conference for Agricultural Worker Health. The panel will explore the mission, rationale, and operational considerations for starting or expanding a mobile health program to care for agricultural and migrant workers.

It’s exciting to dream about what might come next as components of the safety net are strengthened and/or reimagined to also (re)build trust. For example, community response teams as an alternative to police involvement in situations like mental health crises, including:

Interested in learning more? Check out the great work by these organizations:

Does your health center have a mobile unit? Reach out to us at innovation@nachc.org or add a comment below!

3 Comments

  1. Brockton Neighborhood Health Center operates a mobile harm reduction and substance use treatment program in Brockton, Massachusetts. We operate from a medical unit trailer that we wheel around the city 4 days per week! We provide low-threshold MOUD, syringe and safer smoking supplies, drug checking, basic medical care and more.

    1. Thanks for sharing the work you’re doing at Brockton Neighborhood Health Center, Allyson! What a truly meaningful way to utilize a mobile unit for your community!

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