Molloy's mobile clinic takes health care on the road

As Annette Brundidge pulls up to the Freeport Memorial Library on a recent Saturday, a multidisciplinary team of students majoring in the health fields at Molloy University is already inside setting up its free Community Care Mobile Clinic.

Brundidge, 62, a recently retired school crossing guard who has diabetes and high blood pressure, admits that her guilty food pleasures include bagels dripping with butter and sugar-laced barbecue sauce. Today, the Freeport resident has come to have her blood sugar, cholesterol and blood pressure checked.

After Alejandra Wilson, 45, of Brooklyn, a nurse enrolled in the Rockville Centre Catholic university’s nurse practitioner doctoral program, declares her blood pressure normal, Brundidge moves to an adjacent table where Cecily Offner, of Dix Hills, who is in her 40s and also a doctoral nurse practitioner student, performs a finger-stick test for blood sugar and cholesterol.

Several minutes later, under the watchful eye of her instructor, Ethel Ulrich, interim associate dean of the advanced nursing practice and doctor of nursing programs, Offner tells Brundidge that her “good” cholesterol level, which helps clear the “bad” cholesterol from her body, is low — and her blood sugar is high.

“I eat too much junk food,” Brundidge says.

“Bagels are empty calories,” Offner says, then adds, “My rule of thumb is, if it comes in a package, don’t eat it.”

She recommends that Brundidge, who is given a document with her results, follow up with her primary care doctor about her blood sugar level and regulate her cholesterol with diet and exercise.

Launched in June 2021, Molloy University’s Community Care Mobile Clinic is funded entirely by a grant from the Manhattan-based nonprofit Mother Cabrini Health Foundation. The clinic is staffed by faculty members and their undergraduate, graduate and doctoral students who are preparing to become nurses, nurse practitioners, speech-language pathologists, clinical mental health counselors, social workers and music therapists.

In nearly two years, they have provided Brundidge and more than 3,000 other Long Island adults and children in more than 40 low-income, medically underserved communities — from the Queens border to Montauk — free health screenings, education and referrals. The clinic does not provide primary care, which is the diagnosis and treatment of illness.

Easier access

“Long Island is known as one of the most expensive places to live; it is assumed that everyone is wealthy,” said Angie Malone, director of clinical services for Molloy’s mobile clinic. “But within specific communities, there are a number of people who don’t have health insurance and don’t have access to health care.”

Of the estimated 2,000 mobile health clinics in the nation, nearly one-quarter are university-affiliated, according to the Mobile Health Map, a network of mobile clinics that serve marginalized communities in the United States. Officials at Molloy and organizations that track the number of mobile clinics in the nation said they do not know of any other university-operated programs on Long Island that offer screening, education and referral services.

Advocates and health care professionals say mobile clinics provide easier access to health care for people who live in disadvantaged communities and face a formidable list of obstacles, from language barriers and lack of transportation to insufficient insurance coverage, child care issues and difficulty navigating the health care system.

“People who have to take three buses to get there [to a doctor’s appointment] or who are working three jobs don’t have the flexibility to take time off,” Malone said. “The mobile clinic is very welcoming; it’s not an intimidating environment because there are students, and we don’t ask for identification, insurance or fees. We give people more information about their own health care, including mental health, and what they might need and where they can go to get additional services.”

Of the more than 1,500 people served in Molloy’s mobile clinic’s first year, 73.5% and 30% had high blood pressure and high cholesterol, respectively, 76% were overweight or obese and 38% had elevated blood sugar.

Ulrich said the mobile unit “saw a lot of people with [health] indicators that needed attention, and that is exactly the outcome we wanted ... to get people screened, educated and referred.”

According to the Mobile Health Map, the impact of rolling clinics nationwide was shown to have averted more than 10,000 trips to the emergency room and resulted in nearly 3,500 additional years of life as a result of people receiving treatment.

Identifying communities to target requires due diligence, Malone said. She explained that New York State mandates that each of its counties conduct a community health assessment that determines the health status, behaviors and needs of residents within a service area.

“We look at the data to make sure we are going where we can do the most good,” said Malone, who added that the mobile clinic visits community centers, food pantries, neighborhood festivals, preschools, libraries and senior centers. “We also collaborate with community organizations to make sure we are reaching as many vulnerable people as possible ... These organizations bring us their participants and we refer community members to them.”

Building empathy

While the rolling clinic aims to advance health equity, it also provides students with hands-on clinical experience, teaches them how to work collaboratively with a multidisciplinary team and deepens their knowledge of community health and outreach. So far, the program has provided practical field experience to more than 100 Molloy students, Malone said.

But in addition to clinical skills, students learn how to engage the public. “Everyone learns pretty quickly that if we sit there [at the mobile clinic], they [community members] will not come,” Malone said. “We have to go out and talk to people and learn the skills to help people feel comfortable to sit down and have their vitals taken ... Our hope is that when they [the students] go on in their careers, they will be more empathetic providers.”

Leikah Delille, 23, is a speech-language pathology graduate student. The Mastic Beach resident, who has worked two semesters at the mobile clinic, says she understands vulnerable populations because she and her family had once “been there.”

In 2010, Delille and her family left their native Haiti after a devastating earthquake to settle on Long Island. Her father, an engineer, and her mother, an architect, had to “start over.” “My dad worked parking cars in New York City and driving buses, and my mother is a home health aide ... money was tight,” she said. Delille, thankful that her family is now on better financial footing, looks forward to receiving her master’s degree in May and starting a career working with the underserved.

“I want to work in a Haitian community [on Long Island] where they speak Creole and where they don’t know about the field [of speech-language pathology],” she said, “so I can help them and give back.”

Delille and her classmates, along with the faculty who staff the clinic, say they identify with Molloy’s mission of community service, spirituality and study.

“The mobile clinic is a natural progression of service and community,” Ulrich said. “We want to empower people so they know what their health risks are so they can take an active part in their health. The students are meeting these community members where they live and learning about cultural differences and helping them gain a deeper understanding of what we have to do to provide health care to all.”

To that end, Molloy’s mobile clinic hosts several community organizations, such as Fans for the Cure, a nonprofit that works to increase awareness of the importance of prostate cancer screening for men over 40, and Women, Infants and Children (WIC) of Catholic Charities. Catholic Charities administers the federal supplemental nutrition program for low-income pregnant, breastfeeding and postpartum women, infants and children, two services the mobile clinic itself does not offer.

The WIC program conducts height and weight measurements of its participants. It also performs noninvasive tests to check for iron deficiency in the blood. Likewise, Molloy University refers its low-income pregnant, breastfeeding and postpartum community members to WIC. “It’s a win-win situation for us and them,” said Lauren Sondey, registered dietitian and the WIC program coordinator.

Advocates for equitable health care access say mobile clinics help the community in ways brick-and-mortar health care centers cannot.

“Mobile clinics look at individuals as a whole person emotionally and physically, and they can get a person enrolled in insurance or connected to a food pantry,” said Elizabeth Wallace, executive director of the Mobile Healthcare Association in St. Louis. “It’s a unique model.”

Mollie Williams, executive director of the Family Van, a mobile health clinic based in Boston, and lecturer of global health and social medicine at Harvard Medical School, agrees that mobile health clinics build community engagement and trust, which drive improvements in public health.

“Some people won’t ever go to an outpatient clinic, for many reasons,” Williams said. “A big one is that they may have had a bad experience or know someone who did, or they don’t trust the care they’ll receive. Mobile clinics have a unique way of building trust because they come into the community, and it shows they care about the residents there.”

Operating a rolling clinic comes with challenges. Vans are limited in space. Molloy’s 30-foot-long van, equipped with an exam room, a sink and a waiting area, comfortably fits only two to three people at a time, so the clinic often spreads out into the community facility it’s visiting. The university’s van runs during the spring, summer and fall semesters. But the clinic pauses from mid- to late January, when the temperatures can be frigid, discouraging foot traffic.

Yet another issue is vehicles that require regular maintenance to avoid costly repairs. A mobile clinic’s biggest challenge, however, is financial sustainability, Williams said. “Many depend on grants, and also philanthropy — that is one business model,” she said. “But more and more clinics are billing insurance.”

$2.6M in grants

To launch the clinic, the Mother Cabrini Health Foundation provided Molloy with grant funding of $1 million in 2021, $750,000 in 2022 and $850,000 in 2023, said Marc Damsky, a senior program officer at the foundation.

Despite the challenges and limitations of mobile clinics, experts say the COVID-19 pandemic has caused a surge in the number of health mobile units — a trend that is expected to continue.

“COVID forced people to ‘get creative’ about how they delivered health care, and then there was an influx of money through the CARES Act, which people in states and cities used to buy mobile clinics,” Williams said, referring to the federal Coronavirus Aid, Relief and Economic Security Act, an economic stimulus bill. “Some van manufacturers were back-ordered for up to 24 months due to supply chain issues and the [computer] chip issue. So some of those mobile clinics are just hitting the road now. There has been an increase in the number of clinics, and we will continue to see this.”

Looking ahead, Molloy University plans to expand its offerings by providing limited primary care and follow-up for those who are referred for additional services.

“We do a good job with [health] screening, education and referral, but now we want to provide continuing care on a limited basis for community members who need further interventions,” Ulrich said. For example, the clinic would provide free hearing evaluations for 50 people and hearing aids for 25 people.

In another pilot program starting this semester, undergraduate social work students will follow up with community members by phone and email to ensure that they connect to referral services, said Lisa Zakiya Newland, professor and chairwoman of the Department of Social Work.

The clinic is also setting its sights on reaching homeless people in shelters, encampments and libraries, where advocates for equitable health access say the “roughly housed” spend the day. “The grant will also provide money if someone needs transportation for medication, an ER visit or urgent care,” Ulrich said.

She added: “There are homeless encampments all over Long Island. Sometimes we don’t see them, but once you see them, you can’t stop seeing them. We have an ethical obligation to take care of all people

— and what a wonderful lesson for students to learn.”

Where to find the van

Molloy University’s Community Care Clinic will be offering free health screenings, education and referrals on Long Island on the following dates. For more information, visit bit.ly/Molloymobileclinic.

March 23 (time to be determined): Pronto of Long Island, Food Pantry Thrift Center, 128 Pine Aire Dr., Bay Shore

March 25, 12:30-3:30 p.m.: Community Development Corp. of Long Island, Hempstead Housing Authority, Gladys Gardens, 260 Clinton St., No. 100, Hempstead

March 31, 9 a.m.-noon: Dr. Martin Luther King Jr. Community Center, 150 N. Centre Ave., Rockville Centre

April 14, 9 a.m.-noon: Catholic Charities, Women, Infants and Children, 333 N. Main St., Freeport

April 18, 1:30-5:30 p.m.: Center for Advocacy, Support and Transformation North Fork, 53930 Main Rd., Southold

April 19, 9 a.m.-noon: Long Island Council of Churches Food Pantry, 230 Hanse Ave., Freeport