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Mobile Health Clinic



Information for prospective medical providers.
 
Mobile Clinic Update-2013
 
In 2013: we had 587 clinic visits! About two-thirds of our clinic visits are return visits – indicating our continuing role in assisting patients not only to regain their health but also to maintain their health.  Some of these return visits have prevented unnecessary visits to the ER, which helps to preserve emergency resources for those situations which warrant it.
 
About two-thirds of our patients were from the Edmonds-Lynnwood area. 

 
New technology:
This past year has seen an exponential increase in our use of texting to communicate with patients via our Edmonds clinic phone line. Texting has allowed us to personalize our scheduling, increase efficiency in communicating information to patients (such as notifying them we are sending lab slips or confirming appointments). When language barriers inhibit understanding between patient and clinic staff over the phone – texting often provides communication that is easier to understand. With incredible investment of patient schedulers and interpreters’ time and clinic staff personalized care, our no-show rate for 2013 was less than 10%. 
 

OUR HOSPITALITY TEAM puts in an undetermined amount of time, effort and expense preparing food on behalf of clinic staff!  This cadre of cooks has provided at least 490 breakfasts  and 370 lunches for  mobile clinic volunteers.
 


OF NOTE: The Rusty Pelican in Edmonds invites all clinic staff to their restaurant once a month for free lunches!



OUR INTERPRETERS:
In addition, our dedicated interpreters put in countless hours that are not included in the total number of volunteer hours. They not only interpret at appointments, but make countless calls throughout the week to assist patients to get lab work or follow up on doctors’ orders. Our Spanish interpreters have invested many hours translating patient forms into Spanish.




New community outreach:
Free sports physicals for high school students  who might not be able to play sports due to cost of getting a sports physical. We held our first sports physical clinic at Lynnwood High School on Nov. 14th; our second was on Feb 3, 2014.
 
On-site mental health counseling:
Appointments began Fall of 2013; services will double in Fall of 2014.

Diabetic Education appointments:
Fall 2013, we began offering diabetic appointments with a diabetic nurse specialist for diabetic patients immediately following their medical appointments. This has had a measurable positive impact on improved diabetic compliance, and overall health maintenance.




Affordable Care Act:
Starting mid-January, a staff person from the WithinReach organization will be on-site at the clinic to assist patients to sign up for Apple Health (WA Medicaid) or health insurance. We are committed to facilitating a smooth transition for those patients who will now be covered under Apple Health or other insurance. There will be challenges in assisting patients to navigate the new health care system; our role will be to walk along side them until they are securely established within their new adequate medical care – however long that takes. For those who are not eligible for Apple Health or insurance, patients have been reassured that the clinic will continue to provide care for them.


Legislative visits:
In late fall, the mobile clinic was honored with visits from US Congressman, Jim McDermott, and State Sen. Paull Shin, Rep. Marco Liias and Dan Haugen, representing Rep. Mary Helen Roberts.   




On-Site Homeless Clinic:
On Jan. 23,  2014, we offered on-site health screening and clinic visits for homeless families and individuals who participated in the yearly HUD "Point-in-Time Count" of sheltered and unsheltered homeless persons on the 4th Thursday in January. HUD requires that an annual count must be made of homeless persons who are sheltered in emergency shelter, transitional housing, and Safe Havens on a single night.  Each count is planned, coordinated, and carried out locally. The event was held in Lynnwood.

 


We continue to be amazed at what a handful of us can accomplish on behalf of our patients! What a privilege God has given us to be able to serve in this ministry, and to be able to serve alongside such a remarkable team of volunteers.

With gratefulness,
Lynn and Ron

 
 
Mobile Clinic Update-June 2012
 
New partnerships facilitate expanded services
for the community!

Through grant proposal efforts of the Puget Sound Christian Clinic, the Edmonds mobile medical clinic was awarded a grant from the Verdant Health Commission. Grant funding began March 1, 2012.
 
For nearly half a century, the Verdant Health Commission served the health needs of our community by managing the local community (Stevens) hospital. The Verdant Health Commission is now focused on investing in innovative programs that will make a lasting impact on the health and well-being of South Snohomish County residents.

The Edmonds mobile medical clinic is extremely grateful to the Commission for awarding us this grant which provides both financial support and tangible confidence in our clinic’s ability to positively impact the health and well-being of our low-income, uninsured neighbors.

The Verdant Health Commission funding provides some new equipment for the mobile unit, and most importantly, provides salaries for two Puget Sound medical staff who are on site each week to guarantee our success: Sandy Stolle, RN, Case Management Supervisor, providing nursing staff assistance; and Annie Chamberlain, ARNP, Clinical Administrator of PSCC. Annie is on site each week for administrative assistance for our medical providers, and also functions in the role of medical provider, herself.

The addition of Sandy and Annie to our mobile clinic medical staff enabled us to responsibly move to weekly clinics – beginning March 20, 2012.
 

Blessings of grant funding are evident; challenges are also apparent…
 
Sowing seeds…
  • Grant funding is financial “seed money.” While helping to stabilize and offset our initial start-up expenses, any type of grant funding must always be viewed as provisional. We must continue to pursue efforts to invite additional faith communities to partner with us financially to ensure the long-term sustainability of the mobile clinic.
  • Grant funding also provides “seed staff.” While blessed with the Puget Sound Christian Clinic staff who are on-site as a weekly medical provider and weekly nurse manager, we must not waver in efforts to recruit more medical providers and nursing staff. An especially welcome addition to our volunteer staff would be medical providers and nurses from local Spanish, Arabic and Russian communities.
     
 Expansion with excellence …

Another challenge presented by the grant funding is the expectation that the mobile clinic will log 700 patient visits this year - from March 1, 2012 to March 1, 2013. In reality, providing 700 patient visits in our first year seems unattainable. To that end, we must trust God to create the possible out of the impossible. On our end, we remain committed to providing quality and compassionate health care to just as many patients as we possibly can.

While expanding the number of patients seen, our patients will continue to be served with excellence. Patients are scheduled for no less than 30-minutes with their medical providers - with the exceptions of new patients and those requiring translation assistance who are scheduled for longer appointments. In addition to a minimum 30-minutes of personal time with medical providers, each patient receives a warm welcome from the reception staff, a respectful and caring intake process from nursing staff, and holistic emotional/spiritual/tangible needs care from our Care Support volunteers. As well, when necessary, patients are transferred to personal Case Managers, who follow them through whatever process is necessary to successfully receive the specialty care or procedures they require.

The transition to weekly clinics has been both exciting and challenging – a scenario that has required doubling the scheduling of clinic staff while simultaneously multiplying the numbers of patients cared-for. The entire clinic team has experienced increased demands in individual roles – and our terrific volunteers have responded with their characteristic joyful enthusiasm.
 

The mobile clinic ministry is documented in print and on film…
 
A film crew from the Pacific Northwest Conference of the United Methodist Church arrived in the pre-dawn hours of March 20th to see HOPE roll in to EUMC. The crew came to document the ministry of the mobile clinic for Channels, the monthly publication from the Office of Connectional Ministries of the United Methodist Church.
The printed Channels article can be viewed at the following link:
http://www.pnwumc.org/index.php?option=com_content&view=category&layout=blog&id=49&Itemid=66

Over the course of the clinic, film footage of volunteers, patients and pastors was gathered. This raw film data is being edited and will result in a video for viewing at the Pacific Northwest Annual Conference in June. The video will highlight the mobile clinic ministry as an example of a church making a significant impact within their local community.

The Edmonds Mobile Clinic rings in the New Year...Mobile Clinic Update-January 2012
 
Who are our patients?
And...who are our patients?
It takes more than a village...
We've only just begun...
Join us in bringing HOPE to Edmonds
 
Who are our patients?

The Edmonds Mobile Medical Clinic is a thriving community outreach intended to meet basic health needs of our lower-income, uninsured neighbors. The clinic is currently providing free care for patients from the Edmonds, Lynnwood, Shoreline, and Everett communities.

Our patients have ranged in age from early 20s to late 60s; nearly three-quarters of our patients are female. Medical treatment plans are addressing health concerns such as hypertension, diabetes, upper respiratory infections, back/joint pain, thyroid dysfunction, coronary artery disease and skin infections, among other conditions.

The first languages of our patients are diverse, including English, Arabic, Spanish, Mongolian and Russian. In nearly all cases, we have been able to provide translation services from native speakers who volunteer their professional services to enhance our patients’ ability to explain their condition and to understand the treatment plan of our medical providers.
 
and…who are our patients?

“It’s free? Are you sure?”
A woman in her mid-40s has not had health insurance for nine years, and has been unable to afford medical care. A friend told her about the Edmonds mobile clinic. “It’s free? Are you sure?” We warmly welcomed this woman to the clinic’s reception area, provided a translator to assist her with medical terminology in her native language, and begin some much-neglected treatment for an underlying endocrine condition. Further tests may be warranted that are beyond the scope of the mobile clinic. In that case, one of our Edmonds case managers will guide the patient through the Project Access program to ensure that the patient receives the specialty care she needs.

Child’s play…
A woman in her mid-60s arrives at the mobile clinic accompanied by her daughter, son-in-law and two pre-schoolers. Inside the mobile clinic, the daughter assists with translation. Inside the church in the reception area, the pre-schoolers are entertained by one of the two Care Support volunteers on duty that day. The mobile clinic toy box is always at the ready (with age-appropriate toys that can be sanitized), and with coloring books and crayons for “artwork” that can be taken home. As the young father watches his children at play, another Care Support volunteer sits beside him, offering bottled water and a welcoming presence.

Welcome back…
About a third of our patients have returned for follow-up care, a vital component of restoring and maintaining health to those with chronic conditions. A young man in his mid-30s is greeted with a big smile by the mobile clinic receptionist as he returns for his follow-up appointment. His elevated blood pressure is now being monitored by our medical providers, reducing risks of complications due to untreated hypertension.
 
It takes more than a village…

Acquiring free medical care for our patients requires navigating an alternative universe of healthcare services. Thanks to the remarkable networking established and maintained by the Puget Sound Christian Clinic (PSCC) over the past nine years, the Edmonds mobile clinic has access to medical facilities that provide “charity care” lab work at no cost to our patients. Not only must our medical providers and nursing staff learn the mobile unit’s specific electronic medical records computer program, but they must also become familiar with a charity care medical system that requires specific paperwork and documentation. Here are a couple of examples…

Three local healthcare facilities provide charity care lab work for our patients - Swedish Edmonds, Northwest Hospital and PacLabs in Everett – and each of these resources has specific parameters for the services they provide. Our medical team must learn these individual parameters and instruct patients accordingly.

Through connections established by PSCC, the Edmonds mobile clinic has been able to provide reduced-rate optometry services and free eye glasses for some of our patients. This requires a six-step process, involving the expertise of our clinic volunteers, charity care resources offered by local vendors and persistent follow-through efforts on the part of the patients.
 
We’ve only just begun…

There are five local churches partnering with Edmonds United Methodist Church, each providing $100 per month toward the minimum funding required to bring HOPE to Edmonds. We need at least five more faith communities to join with us to ensure financial sustainability.

We have five incredibly dedicated, competent and compassionate medical providers. With this medical team, we can offer clinics twice each month. We need five more medical providers – family practitioners, internists, family practice nurse practitioners and PA-Cs – in order to expand our clinic to four Tuesdays per month.

We are seeking a few medical providers and nursing staff from some of the diverse communities reflected by our clinic population. We would welcome Spanish, Russian and Arabic-speaking medical providers and nurses.

We especially seek medical/nursing staff with a high degree of computer literacy, as the mobile clinic operates entirely with a web-based electronic medical records computer program that complies with state HIPAA guidelines for patient privacy. Many are not aware that when the truck rolls in to the Edmonds United Methodist Church parking lot at 6:45 AM on Tuesday mornings, the truck driver sets up five computers – one for each of the two medical providers, one for each of the two nurses and one for the receptionist. The mobile unit contains its own router and secure wireless internet system, linking all five computers together. Just amazing!
 
Join us in bringing HOPE to Edmonds!

The Edmonds mobile clinic volunteer team is simply wonderful! Starting with our “front line” patient schedulers, the volunteers’ sense of shared mission and dedication to our patients’ welfare is evidenced by warm patient handshakes, hugs and sometimes even kisses – on both cheeks! The opportunity to serve in this ministry is an incredible blessing. We continue to build on the foundation we have established - and we invite you to join us!

Lynn Heitritter, RN, PhD
Site Coordinator, Edmonds Mobile Medical Clinic

“Right now, therefore, every time we get the chance, let us work for the benefit of all, starting with the people closest to us in the community of faith." [Galatians 6:10, The Message]


Mobile Clinic Update-November 7, 2011

Rejoicing in our blessings...
How we got here...
Acknowledging our challenges...
Information for prospective medical providers...

Rejoicing in our blessings ….
Our first “live” clinic is November 15th–exactly 6 months from our May 15 Edmonds mobile medical clinic “kick off” event with both Diane Steward, Executive Director of the Puget Sound Christian Clinic, and the mobile unit on site at EUMC. The mobile medical unit truck is named “HOPE.”

A second clinic is December 6th. A third is December 13th. The fourth is January 3rd.

Beginning January 3, 2012…
The Edmonds mobile clinic will operate on the 1st and 3rd Tuesday of each month. We currently have five dedicated medical providers, which means we can host clinics every two weeks.

When additional medical providers join us, we can move ahead to our ideal goal of hosting weekly clinics.

How the clinic operates…
Patients are greeted by name in the church lobby by one of our Care Support volunteers and escorted to our receptionist in the church library - our reception area. Our Care Support volunteers will offer many types of assistance - from helping patients to fill out paperwork, to help with finding other community resources, and all the while - listening with compassion and respect, and if requested, praying with patients.
The Care Support volunteer is the first and last volunteer to spend time with the patient; currently, all Care Support volunteers are trained Stephen ministers.

From the reception area, the patient is escorted by one of our volunteer nurses to the mobile unit, where vital signs and other pertinent information is gathered and entered into the electronic medical records computer program. We have no access to other records of the patient, so each patient is new to us and therefore, all patients must have new information put into our electronic medical records data base.

The nurse introduces the patient to one of our medical providers who will have at least 30 minute appointments with each patient.

After the patient visit, the Care Support volunteers stand by offering further assistance.

We have additional specialized volunteers who will help patients go through the application process to pharmaceutical companies for getting necessary medications at low- or no cost; we also have a licensed case manager volunteer who will follow up on our patients when our medical providers request tests or referrals or services beyond what our mobile clinic can provide.

How we got here...
The following time line shows our progress from our kick-off in May to the present.



The initial tasks at hand…
The Site Coordinator’s task was simple and straighforward…recruit medical providers, nurses, patient schedulers, receptionists, truck drivers with commercial CDL class B licenses, spiritual care team members, licensed case managers, a catering team for providing food during volunteer clinic shifts, locate translators and train and create a team out of this diverse volunteer staff.

In addition to recruiting and training volunteers, there were many other things required in preparation for clinic operations…such as providing a 220 volt outlet to deliver power to the mobile unit. The trustees of EUMC supplied nearly $1500 to complete this necessary step in late August.

We received clearance from the fire marshall to park the mobile unit at the front door of the church, and consulted with the Edmonds police department to deal with the issue of driving a 14-ton truck over 5-ton limit streets.

Recruiting and training volunteers…
For the past several months, the application process has required much work from many dedicated volunteers.

Minimum requirements for each volunteer include a negative TB test, Hepatitis B immunizations, personal interview, HIPAA patient privacy laws and BloodBorne Pathogens training, personal references, criminal background checks, and – most daunting for many – learning an electronic medical records computer program.

Nursing staff and medical providers have additional requirements, such as current licensure, current CPR certification, and acquiring malpractice insurance from WA state – provided at no cost for those who volunteer to provide health care for low-income, under-served patients. This state-provided malpractice insurance is a crucial component that enables volunteer health care workers to volunteer their skills.

40 volunteers have completed the arduous application process required by both PSCC and the state of Washington to be in compliance with a fully-operational medical clinic.

Thus far, volunteers have joined our medical clinic team from four local churches, from within the wider community; our volunteers commute to the clinic from Edmonds, Shoreline, Mukilteo, Lynnwood, Brier, Mill Creek, Camano Island and Federal Way.

Training and team-building events began in June, as volunteers were trained in cohorts - receptionists, care support, patient schedulers. All medical providers, nurses and support staff volunteers participated in computer classes to learn the clinic’s electronic medical records program.

Training concluded with two “mock clinics”…
The mock clinics required tremendous organization and effort in order to provide our volunteers with the best “simulated’ training experience possible. It was necessary to organize everything from signage outside and inside the church (to direct patients to the proper location to sign in), to getting flyers translated from English to Spanish and Russian, to providing bottled water for our “patients” in the waiting room, designing appointment cards, creating a children’s space with toys in the reception area, and much more.

Unique to our setting is our close association with the Edmonds food bank, operating on Tuesdays during the same morning hours as the mobile clinic. We had to establish a HIPAA-compliant system of communication between the mobile clinic and the food bank whereby the patrons of the food bank would not lose their place in the food line by going to their mobile clinic appointment.

To prepare our volunteers for the mock clinic, the Puget Sound Christian Clinic Medical Program Manager contacted “mock” patients, gave them a diagnosis and symptoms unknown to any of the rest of us.

The mock clinics simulated the same process that patients will go through in contacting the mobile clinic to make actual appointments.

Patients call our mobile clinic message line, leave a message, and our patient schedulers return their call within 24-48 hours to schedule appointments.

The mock patients arrived at the mock clinic with an appointment to see one of our five medical providers – again simulating the exact process that real patients will experience when coming to the mobile clinic.

Acknowledging our challenges…
Due to WA state deficit reduction strategies, the Dept. of Health has proposed a budget cut to eliminate malpractice insurance for all volunteer health care providers.

This would be devastating, because our medical providers and nurses cannot volunteer without malpractice insurance. This proposed budget cut not only affects our clinic – but all free and low-cost clinics across WA state.

On October 23, the EUMC congregation wrote letters to the governor, state senator and state representatives – urging them not to cut this vital program which protects our under-served and uninsured neighbors. Over 1000 letters were sent out on October 24.

We are actively praying and advocating for the preservation of the Volunteer Retired Program which provides malpractice insurance at no cost to volunteer providers.

The cost of this insurance to the state is $297,000 per year, which contrasts with the $82 million in annual health care provided through free and low-cost clinics. Over 67,500 persons each year are cared for by volunteer health care providers. [Source: Western Washington Area Health Education Center]

Thus, the cost of malpractice insurance works out to be $4.40 per client seen as opposed to an average cost of $600 per ER visit paid for by public insurance. Patients with no other alternatives will be forced to utilize ER services, and the cost to the state will be far greater than the savings from the $297,000 proposed cut from the Dept. of Health budget.

This development was certainly an unexpected turn of events, and has required a huge amount of time and energy to address to the best of our ability.

Not to offer discouraging news without some hope, there is the possibility that this program might be spared; there is also the possibility of gaining access to malpractice insurance through a federal program. However, this involves months of paperwork for the Puget Sound Christian Clinic to complete, gaining federal approval and subsequent malpractice coverage. The current WA state malpractice policies that our providers and nurses have is issued through July 2012. If the state honors this policy, that time frame might give us a fighting chance to have another insurance plan in place if the current malpractice insurance program is terminated in July.

Because the proposed state budget cuts are extensive and affect the most vulnerable, we expect even greater need for the services the mobile clinic will provide.

So what do we do now?

We press on, running with perseverance the race set before us…

Our mobile clinic phone message line went “live” on November 2. Within two days, our first clinic was fully scheduled with patients.

Please note: we are scheduling fewer patients during our first few clinics. This is in order to allow longer appointment times which best accommodate the steep learning curve required by our volunteer staff for gaining familiarity with the electronic medical records program and the myriad of associated processes and procedures for running the clinic.

As we progress, we will expand the number of patients seen per clinic.

As we are joined by more medical providers, we will also expand the number of clinics we are able to offer.

We are passionately committed to this ministry, and appreciate your willingness to come along side us.

Blessings!
Lynn Heitritter, Site Coordinator
 
Information for Prospective Medical Providers...

Click HERE to download this flier.