Effort aims to keep popular mobile health clinic on the road

The big white mobile health clinic that parks at Safeway in Bonners Ferry once a month is a welcome sight to dozens of families with no health insurance.

They’ve learned during the past 18 months to count on the clinic, which looks like a bloodmobile, for dental checkups, immunizations, X-rays and help for ailments from colds and flu to stomach problems and mysterious headaches.

“People have learned that we’re going to be there,” says Mark Anderson, who manages the North Idaho Partners in Health mobile clinic. “If we hadn’t been here for the last 18 months, 2,500 people wouldn’t have had care.”

Anderson believes the clinic will continue to serve rural communities in the Panhandle, but the grant that keeps it running disappears at the end of April. North Idaho’s three community clinics may adopt the mobile clinic from North Idaho Partners in Health, which runs it now. But first the community clinics need to figure out where to find money to operate the mobile clinic.

“For us right now it’s about cash flow, and the van (mobile clinic) is quite expensive to run,” says Joel Hughes. He directs Coeur d’Alene’s Dirne Community Health Clinic, which offers care primarily to people with no health insurance. “We can’t make it top priority.”

Partners in Health consists of the Panhandle Health District, the five Panhandle hospitals, Benewah Medical and Wellness Center, Aging and Adult Services and North Idaho College Head Start. The agencies combined efforts to win the federal grant that launched the mobile clinic three years ago.

The grant fed nearly $200,000 a year into the mobile operation that takes dental and health care from the Canadian border to Fernwood, Idaho. Anderson met with representatives of the three community clinics recently to discuss giving them ownership of the mobile clinic after April. The plan makes sense, he says, because the community clinics share the mobile clinic’s public health mission. He envisions a smooth takeover patients won’t notice.

But Hughes says it’s not that easy. The community clinics operate under a federal grant. So many uninsured people are seeking Dirne’s services that the Dirne Clinic, unwilling to turn away patients, is falling about $30,000 short a month. Anderson says the mobile clinic costs about $15,000 a year to maintain, but that doesn’t include the salaries of the three people who work in it.

Statistics that Anderson has collected show that people in Boundary and Bonner counties use the mobile clinic the most. Hughes said his group is proposing that Boundary Community Clinic own the lion’s share of the mobile clinic and lease it out a few times a year to the Dirne Clinic, Benewah Clinic and Shoshone Medical Center for use in other counties.

The plan is in its infant stage and has much discussion and reworking ahead, but the community clinics know North Idaho can’t afford to abandon such a needed and popular service, Hughes says.

“We’re all in it with the right heart,” he says.

Many people would miss the mobile clinic that burst onto the scene in July 2003 if it suddenly stopped rolling. Partners in Health had sought a grant to help with rural dental and health care for five years. The grant finally came through in June 2002 and Anderson was hired to lead the project.

He began by meeting with the public in each county and asking what they needed. He heard a loud cry for dental care. Anderson knew he needed a mobile unit with room for a medical exam room and a dental room and one that could negotiate Idaho’s poor rural roads in the middle of winter.

He had only $180,000 with which to work. The first bids he received were all over budget. The Partners had no extra cash to plug into the project, so Anderson shopped until he found a 2001 Freightliner truck with only 475 miles on it. He bought it and came in $1,700 under budget, then took it to California to attach and outfit the clinic.

He raised $38,000 from local service organizations and hospitals to help buy supplies and equipment. He bought a dental chair in Boise at a federal surplus sale for $200 and found 22 free exam tables at a clinic in Yakima, which had purchased new tables and wanted to get rid of its used ones. Anderson needed only one but he distributed the ones he didn’t use to other clinics, including one in Mexico, and left the worst ones at the dump.

He took the clinic out to show it off in April 2003, but it didn’t start a regular schedule until it had a dental hygienist and nurse practitioner on staff that summer. Anderson distributed the schedule to community centers, senior centers, churches, even taverns throughout the Panhandle. He couldn’t offer house calls but he found central sites that didn’t require patients to drive very far.

Some stops weren’t worth the drive. Anderson took them off the schedule if no one showed up.

Fees for services ranged from nothing to $25, depending on a patient’s income.

The clinic can handle only about 15 patients per day. Dental work takes longer than most medical visits and the dental area needs all equipment wiped down and aired after each patient. The hygienist can get to about five people each day.

Since July 2003, the clinic has served 2,519 patients. Many came for flu vaccines and immunizations.

“We get people who haven’t seen a dentist in 12 years,” Anderson says. “We refer 50 percent of them for higher dental care.”

Two mobile clinics most likely could stay busy in the Panhandle, he says, but his goal at this stage is to keep at least one on the road and serving patients.

“We started seeing people with no insurance and no incomes and they paid nothing for their visits,” Anderson says. “Now we see mostly working poor – people who work and have no insurance, who used to tough out medical problems but finally got to trust that we’re here. I look at this as a success.”