For more than a quarter century, the Visiting Nurse Association has provided the Treasure Coast’s Mobile Clinic with an alternative to costly emergency care and hospital emergency room visits, and the service is more popular than ever with 4,000 patients seen directly in their own neighborhoods in the past year .
The nonprofit VNA received $350,000 from the Indian River County Hospital District in 2022. That’s more than half of their funding, according to Liz Adams, VNA’s director of community health services. Additional funding comes from the VNA Foundation, the John’s Island Foundation, and individual contributions.
Adams took time out from caring for patients at a busy mobile clinic in the parking lot of VNA’s main campus to provide a snapshot of the operations.
“I feel like we’re catching the people who fall through the cracks in the healthcare system,” she said. “We reach people in need who otherwise have no contact point.”
In an average month, the clinic treats 150 to 300 patients. This includes annual and athletic physical exams, as well as health screenings for blood pressure, diabetes, and cholesterol.
The mobile clinic is open Monday to Friday from 9 a.m. to 5 p.m. at various locations.
On Mondays and Fridays, the VNA team sets up a store at the Vero Beach Walmart. On Tuesdays, the Sebastian Walmart is the venue for the clinic. The clinic travels to the St Vincent DePaul Thrift Shop on the CR 510 on Wednesdays and Fellsmere on Thursdays. The schedule is shifting due to public holidays, so it’s best to check the days and times on www.vnatc.com.
To publicize the mobile clinic and the services it provides, the VNA distributes flyers at schools, church groups, unincorporated areas, the United Against Poverty Center, and in newspaper newsletters.
Memory Semprevivo, 38, a stay-at-home mother who homeschools her children, waited patiently to see a nurse after her 12-year-old son Giovani woke up with an ear infection. Semprevivo’s family has a family doctor, but he was fully booked.
She turned to the mobile clinic despite having health insurance through her husband Joseph’s employer, Indian River State College.
Semprevivo has been coming to the mobile clinic for three years after hearing about it from friends. However, she does not want to give up her family doctor.
“The clinic offers me an option for more flexibility. And having my doctor gives me another choice. I would say the mobile clinic is Indian River County’s best kept secret,” she said.
Angelica Ramirez waited in her vehicle for her turn to look after her 7-year-old son Leamsil, who had a fever and what she suspected had some kind of infection. Ramirez has been at the clinic for 15 years. She once had employer-provided health services but does not offer them.
“I look on the internet where the clinic ends,” she said. “Sometimes I go to the Sebastian Walmart. You posted it every day. I am 100 percent satisfied with the care here. I would recommend it to friends.”
Ann Marie McCrystal, who served as the Hospital District Trustee for 7 1/2 years, was a co-founder of VNA and a former Nurse Administrator. She characterized the mobile clinic as an invaluable tool for the community.
“It’s for professionals who can’t go to the doctor or have very little time,” McCrystal said. “The mobile clinic is located throughout Indian River County for professionals who cannot take time off from work.”
She also noted that the clinic is a tool that can treat acute symptoms, which can help avoid the need for an emergency room visit. “But the mobile clinic is also a resource for finding out where to go for further treatment if needed,” she said.
Of the 4,000 patients treated at the mobile clinic so far in fiscal 2022-23, 3,000 required diagnosis and treatment, recalled Patricia Knipper, a registered nurse and VNA senior special projects director.
Lundy Fields, CEO of VNA, said today’s young professionals, raised in the digital age, have higher expectations and prefer to forgo outdated HMOs and their limitations in order to make the clinic more attractive.
“They want to know what technology can do for them,” he said. “Can I get remote support? Is there an app I can use? Can I make appointments at 8am or 7pm? They’re more looking for convenience. And I think that our mobile home clinic will adapt well to the new environment.”
In addition to a lack of access to treatment from a family doctor, many mobile clinic patients have recently faced housing and food insecurity.
“That’s why over the past year we’ve seen a lot of uninsured or insured people who can’t afford co-payments or who go to emergency centers and don’t want to go to the emergency room,” Knipper said.
Based on studies Adams and Knipper completed, 60 to 70 percent of mobile clinic patients are uninsured. “An emergency room visit costs at least $1,000,” Adams said.
“We charge $20 for a physical exam and $30 for an athletic exam. It’s $5 for a sick visit,” she said. “Sometimes someone can’t afford that amount. And once we had a customer who gave us a debit card that only had $4 left. We refused to take his remaining balance.”
The mobile clinic’s outreach program also serves seniors living at Orange Blossom Village Apartments and St. Francis Manor.
“We see ourselves as a bridge between the patient and other healthcare facilities,” said Knipper. “We encourage patients to continue treatment, but cannot be sure if they are going. But we continue to find ways to work with the Indian River County Hospital District.”
Photos by Joshua Kodis and provided