The doctor is on her way.
Or, to be more precise, a mobile, primary health care center, the first in the Adirondacks, is on its way to under-served communities between the Canadian border and the Capital District.
Thanks to a three-year, $1 million grant from the Glens Falls-based Charles R. Wood Foundation, Hudson Headwaters Health Network can start constructing, configuring and deploying mobile units to those local communities most in need of primary care services.
“Building a health center in every community in the Adirondacks is neither feasible nor cost-effective,” said Jessica Rubin, the health network’s vice-president for development and the executive director of its fund-raising arm, the Hudson Headwaters Health Foundation. “Mobile health centers will help us meet the needs of the region in a more efficient manner.”
As many as four mobile units will be in operation and on the road within four years, said Rubin.
The Charles R. Wood Foundation announced the grant on Nov. 25.
Dr. Tucker Slingerland, the network’s CEO, said the first unit will roll out in 2021.
“The exterior of the vehicle will probably resemble a mobile home. The interior, however, will in many ways be indistinguishable from the exam rooms in our health centers. There will also be reception areas and work space,” said Slingerland.
According to Slingerland, there are only a few firms in the country that design and build mobile health units, and Hudson Headwaters will begin working with one of them soon.
Slingerland said the health network had long considered developing a mobile health care system.
“We see roughly 1100 patients every day in our health centers, but we know there are still people struggling to get care. And because we seek to meet the needs of an entire population, we are always looking at creative, innovative solutions to the challenges of delivering health care,” Slingerland said.
Slingerland added that the greatest obstacle to the creation of a mobile health care system was the initial cost of building and outfitting the units.
“Once the mobile health centers were up and running, we knew we could get them to a place where they were sustainable,” he said. “That’s what the Charles R. Wood Foundation appeared to recognize.”
July, 2019: Wood Foundation Commits One Million Dollars to Population Health
The Wood Foundation’s $1 million population health initiative, therefore, seemed like a solution in search of a problem – which Hudson Headwaters had.
“We lacked the resources to bring access to good health care to where people live, often in remote, more rural areas,” said Slingerland.
“The problems and the needs of the Adirondack region are well documented,” said Charlene Wood, the board’s Chairperson.
Among them: disparities in health care due to shortages of providers or distances from medical facilities.
To address those issues, the foundation created its million-dollar initiative.
Institutions, organizations and health care providers serving communities in the eight-county Adirondack-North Country region were invited to submit applications for funds to address one or more issue related to population health, including those which have the potential to deliver health care more efficiently and less expensively.
“Our objective was our own ‘triple aim,’” said Charlene Wood, referring to the “triple aim” of New York State’s population health programs: better care, better health and lower health care costs.
Hudson Headwaters’ proposal to deploy mobile health centers met the foundation’s criteria.
So, rather than dividing the grant among competing applicants, the foundation board chose to award the entire sum to Hudson Headwaters’ center pilot project.
Jessica Rubin said the grant is the largest in the network’s history.
“Mobile health centers may be so-called ‘no-brainers,’ but even ‘no brainers’ can be a challenge to those who have to make them work. That’s why this is a three-year pilot project. There’s no single model for mobile health care systems that can be applied everywhere. We’re in uncharted territory,” said Rubin.
The Planning Phase
According to Slingerland, a small group within Hudson Headwaters, consisting of representatives of several departments, is at work establishing the program.
“There has been a great deal of work done to date; and there is much more to do before launching the program. It will be many months before clinical staff is fully prepared to begin offering services to the public,” he said.
Among other things, the group will select a vendor to design the first unit and collect and analyze data that will enable the network to determine which communities would benefit most from mobile health units.
“We’re using objective data to help us prioritize the places in need. We’ll then pivot and spend time identifying partners in the various communities who can help us meet the needs of the folks who live there,” said Slingerland.
Those partners, he said, might not only help the network identify a town’s specific health care needs, but host the mobile health center.
“We don’t assume that we know what any given town’s specific health needs might be. We need help understanding the community if we are to ensure that our service is utilized as it should be. We need champions on the ground,” said Slingerland.
Staffing the Mobile Health Centers
Rather than rotating medical staff from health centers to the mobile units, the mobile system should have a dedicated staff, said Slingerland.
“We feel this initiative will require a group of people who do this day in, day out. So we have to recruit the clinical leaders – not to mention someone to drive this vehicle,” said Slingerland.
The providers staffing the mobile health centers will focus on primary and preventive care, said Slingerland.
“Things such as back strains and any number of chronic conditions are best dealt with a primary care setting,” said Slingerland. “We know the challenges that people living in or near the Adirondack Park face: with aging, there’s more chronic disease management and other issues that we can help them address. These are people who could benefit from mobile health resources available on a predictable basis, especially if they have transportation issues.”
Funding Mobile Health Centers
As is the case with all Hudson Headwaters health centers, the mobile health centers will see all patients, regardless of their ability to pay.
“And we will manage the costs of the mobile health centers just as we manage the costs of our other health centers, keeping our costs as low as possible, making certain that we’re efficiently scheduling and coordinating with our patients.”
Nevertheless, it is likely that the mobile health centers will require the financial support of donors in the years ahead.
Hudson Headwaters Health Foundation will need to help raise funds for the mobile health centers in the years
“Community support and resources will be essential to realizing the full potential of mobile health,” said Hudson Headwaters Health Foundation President Jim Himoff.
But, he said, “the Charles R. Wood Foundation’s tremendous investment is a crucial step for getting mobile health care moving. We are grateful for their leadership commitment, which is an exciting beginning.”
The Doctor is In
According to Jessica Rubin, mobile health centers will help Hudson Headwaters fulfill its mission: “making health care accessible to all.”
Or as Tucker Slingerland puts it, “we have a responsibility to identify people in need. However many people we see in our health centers every day, there are still plenty who are struggling, and if we can assist those folks, we’re doing a better job for the population in general and the entire region.”
Slingerland continued, “We have amazing resources here in the Adirondacks; our goal is to maintain the overall health of everyone so that we can all enjoy what we have here and make the most of it every day.”So while the good news for people living in isolated areas today may be that the doctor is on her way, within a few years, the news will be even better: the doctor is in.