Nearly 12 years ago, a nonprofit organization focused on substance abuse prevention in Lyon County, Nevada, expanded its services to dental care.
Leaders of the Healthy Communities Coalition have taken action after two of their pantry volunteers used pliers to pull out their abscessed teeth. The volunteers saw no other option for their overwhelming pain in the small town where they lived, 40 miles southeast of Reno, due to a shortage of dental providers.
The sweeping act, said Wendy Madson, the coalition’s executive director, prompted her organization to use mobile clinics to deliver health and dental services in rural communities where there aren’t enough patients to sustain offices. physical.
The coalition now sends a van equipped with dental equipment to county schools to treat hundreds of students per stop several times a year. They also organize events offering free care to adults in the area. The response was overwhelming.
“Dental care is the hot ticket,” Madson said. “Everyone wants dental care. The availability of these services is what runs out first at these big mobile events.”
The coalition’s mobile programs reflect nationwide efforts to send services to patients facing gaps in the health care system, particularly in rural areas.
Rural residents face greater shortages of health care providers, including dentists, compared to their counterparts in large cities. Since the start of the pandemic, mobile clinics have increased access to a range of services in hard-to-reach and sparsely populated places.
A recently passed law, which makes it easier for rural communities to pay for new mobile clinics, could extend this trend. In the past, clinics that serve low-income rural residents couldn’t spend federal grant money — called New Access Point Grants — on mobile services in communities where they didn’t already have facilities. .
Then last fall, Congress passed the MOBILE Healthcare Actsponsored by Sens. Jacky Rosen, D-Nev., and Susan Collins, R-Maine, which gives federally qualified health centers — health clinics serving medically underserved areas — greater flexibility to use federal funding to create and operate mobile units.
Since 2019, the number of mobile clinics on the road has increased, according to the National Association of Community Health Centers. Many have been used for COVID-19 testing and vaccinations. And health and community organizations have begun using mobile units to bring primary care, behavioral health and reproductive services to remote patients. The new funding avenue could soon put even more mobile health vans on the road.
For now, the law depends on funding from Congress, and experts predict it could be at least a year before health centers can access the grant money.
Freed from physical demands, health centers can deploy the vans
Once funded, the regulatory change will allow health centers to work with independent organizations like the Madson Health Communities Coalition in Nevada to expand services in underserved areas. Because the coalition is not a federally qualified health center, it relied on a mix of other federal and state grants.
Nearly 1,400 federally licensed health centers nationwide receive federal funding to provide comprehensive health services in underserved areas. The previous requirement that health centers establish physical clinics before expanding mobile clinics kept many people from applying, said Steve Messinger, policy director for the Nevada Primary Care Association. It was cumbersome and expensive for the health centers.
But in sparsely populated rural areas well served by mobile clinics, it wouldn’t make sense to first establish a building with a full-time provider, he said. This could eat into the budget of a federally licensed health center.
As health center advocates lobby Congress for core funding, the Healthy Communities Coalition is moving forward with three dental events this year funded by a grant from the Health Resources and Services Administration, which is part of of the Department of Health and Social Services.
At the coalition’s first medical outreach event in 2012 in Lyon County, where 61,400 residents are spread over more than 2,000 square miles, more than 200 people showed up for free care and 150 teeth were removed. ripped off, Madson said. Since then, the organization has organized several events per year – except in 2020, when the pandemic interrupted work.
Many dental events are school-based and provide children with services such as screenings, x-rays, sealings, varnishes and cleanings. But an overwhelming need for care also exists among area adults, Madson said, because Nevada’s Medicare and Medicaid don’t include comprehensive dental coverage for adults. Funding these events is harder, she says.
Of the five communities in Lyon County, at least one, Silver Springs, does not have a single dentist. There are 10 total dentists in Fernley and Dayton, communities with a combined population of 38,600, but only two of those practices accept Medicaid, which covers low-income people under 21 and limited dental services for the adults.
Responding to a Desperate Need for Dental and Health Services
Traci Rothman, who manages the coalition pantries, said the dental awareness events made a difference for her 29-year-old son, who moved to Silver Springs last year. He went to two mobile clinics to receive free treatment, which Rothman said was a big relief because he is uninsured and in dire need of dental treatment.
“Otherwise you go to someone you pay cash,” she said. “A lot of times, honestly, I can’t pay; it’s just out of reach for some people, or most people…in rural areas.”
Madson said the coalition stepped in to help a young student in desperate need of a root canal. The coalition helps the girl’s family apply for Medicaid or Nevada Check Up, the state’s children’s health insurance program, and pays $1,600 to cover the service with a federal grant. Another student had to be referred to several specialists before having her decayed baby teeth surgically removed and receiving restorative treatment for adult teeth that had begun to decay.
“Her mother was so grateful she was in tears,” Madson said. “She told me her daughter woke up without instant pain for the first time in years.”
Madson said her organization has enough grants for three events through May, but she hopes the MOBILE Healthcare Act will help expand services. In addition to dental care, the group offers mobile primary care clinics to immigrant workers in Yerington, a small town in agricultural country about 70 miles southeast of Reno.
Sara Rich, CEO of Choptank Community Health in Maryland, said she shares Madson’s hope.
Choptank serves five counties in Maryland, including small towns between the Chesapeake Bay and the Delmarva Peninsula. Amid the pandemic, the health organization entered into an unlikely partnership with a car dealership and used federal COVID relief money to purchase a Ford Transit van for mobile clinics.
Choptank used its new van to deliver vaccines, but has since started using it to provide primary care to immigrant workers and dental services to children at 36 schools. The mobile clinics have been so successful that the health center is considering buying more vans to expand its services.
Rich said mobile clinics “break down barriers that many of us have been working on for a long time.”
Among the new services Choptank seeks to provide are behavioral health, prevention and treatment of substance use disorders, and skin screenings for people working on Maryland shores.
“Flexibility has been a theme over the past few years,” Rich said. “I think this MOBILE healthcare law will help us do that even more in the future.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.