In our Strategic Plan we stated that we’d increase patient capacity by 40%. Knowing the importance of this comes with understanding the lack of specialty care in some of the most at-risk neighborhoods throughout the greater Chicago area. By increasing our patient capacity, we are creating systems, programs and avenues to assist with closing the gap as it pertains to access to quality care, with the goal being to reduce health disparities, increase health equity and level the playing field in availability of care. In an effort to reach this goal, Mobile Care will continue with the tried and true method of adding new school sites as well as resurveying current school populations for new patients and further removing the barrier of location and transportation by permanently offering virtual visits as an option. We have also added additional services like physicals and immunizations, partnered with Howard Brown Health to meet the demands of COVID-19 testing and vaccinations in addition to performing HIV testing in partnership with Howard Brown Health. We’ve worked with PerfectVision to deliver no cost eye exams and glasses to kids and most recently we’ve partnered with UIC to address the opioid crisis. All of these efforts have greatly expanded our reach. Using some of the tactics above we are diligently working to bring our unique patient (for asthma) volume up to 1,200 by the close of the current fiscal year. When this is accomplished, more families across the Chicagoland area will have received high quality care to address various needs. Thousands of kids will have reduced their trips to the ER, hospital stays and school absences related to asthma/allergies and, hopefully, have a better quality of life.
-Kamari Thompson, Director of Patient Services
Children with untreated chronic conditions experience increased school absenteeism and poorer performance in school compared to their peers. Children with untreated chronic conditions use expensive ERs and hospitals for medical care at triple the rate of other children. The vast majority of preventable emergency department visits among children, as well as negative health outcomes and cost, are being shouldered by economically disadvantaged parents who have children with chronic health conditions. This cannot be a reality we allow ourselves to accept.
Mobile Care Chicago’s Board and staff are committed to maintaining healthcare access for the thousands of people who came to us for the first time during the pandemic, but doing so will mean substantially increasing our clinic capacity. I feel very fortunate to report that, thanks to our many individual and grantmaking supporters, this expansion is already well underway. We’ve dramatically expanded our clinic staff (from 13 staff in the first year of our Strategic Plan to 20 staff currently), and we’re going to be hiring more positions in 2022. Our ultimate goal is to serve over 10,000 children annually across all of our programs by the end of 2023. Just as important, however, is to use this opportunity to streamline our protocols and make it easier to scale beyond 10,000 children in the years beyond. There are tens of thousands of children in and around Chicago lacking necessary medical and dental care. As an organization nationally recognized for its ability to reach and effectively treat people in need, we must do everything possible to drive the health clinics people need to their neighborhoods quickly and consistently. I’m excited to implement our plan through 2023—I know many lives will be changed for the better because of this effort.
The expansion of the Patient Services Department is important because Mobile Care is expanding. Mobile Care is expanding its reach, in terms of the services we provide, the regions we serve, and our patient population. By doing this we are able to offer our services to a greater number of families and address a greater need. Patient Services has hired additional staff and added indoor air quality monitoring to our home assessments. We’ve expanded our home assessment and physicals/immunizations programs, we’ve partnered with other organizations to address the COVID-19 pandemic and the opioid crisis. We’ve added additional school sites in the south suburbs and assisted with providing much-needed specialty care that had not been available in the area previously. Mobile Care is always looking for opportunities to meet the needs of our communities and to do whatever we can to improve health equity. As we expand, we will hopefully provide the best care for not only asthma, allergies and dental but also for primary care, mental health, violence prevention, etc. Perhaps one day, the name Mobile Care will ring bells throughout our region, because we created access regardless of financial status, social status, race, or geographic location. We paved new roads to quality care.
-Kamari Thompson, Director of Patient Services
When we speak in public health conversations about the Social Determinants of Health (SDOH), because it has become a buzzword for so many different things, I fear that we tend to abstract them into the realm of mystical complexity where they remain acknowledged but unaddressed, present in discussion but too all-consuming to affect. Healthy People 2030 lists five different sub-groups of SDOH, and any one of these categories would require us to up-end our present social structure to comprehensively address. Yet, at the heart of SDOH is a simple and urgent syllogism:
In our society, a lot of people don’t have enough money to meet their basic needs
As a result, they are forced to make concessions on many or all of their basic needs
Keeping people, and families in particular, in an economic position where their basic needs cannot be met is not free or economically responsible because, ultimately, there is a massive social cost that must be paid, through our healthcare spending and in other areas; far higher than if people had been given the funds to meet their needs in the first place
Because the social cost is so high, we as a society need to document all of the areas where low-income people have had to concede their basic needs partially or fully so that we can understand and try to remediate the price we, collectively, are paying
In doing this accounting, we are documenting a road: once people are set upon this road it leads to poor health, dramatically increased risk of chronic health conditions, huge unpaid hospital bills, and untimely death. We may not see where this road leads in each individual step, when the end is not yet on the horizon, but we know where it goes because people have walked this road before and are now in the process of walking it, everyday.
Mobile Care Chicago is a very small charitable organization that specializes in delivering medical care to people with chronic conditions, and the question might naturally arise what meaningful role an organization like ours can play in creating systemic change, the likes of which would move the needle on mortality rates, healthcare spending, and the prevalence of chronic health issues.
The answer, which may surprise you, is that a small organization can do an awful lot, and we are committed to doing even more. Our approach to social determinants starts with people and their specific needs. Not every family experiences all social determinants of health in the same way or to the same degree. One issue, like housing, might be at a crisis level, while something else, like access to nutritious foods, might not be an issue at that time. Addressing needs, then, starts by listening to specific people, and developing unique plans. The reason we emphasize an expansion of the community health workers in our Patient Services Department when discussing SDOH, is because building capacity allows us to ask more questions and resolve a greater set of issues.
Based on the answers our families gave us last year, we know that these are the social determinants that we mitigate currently:
Transportation – over 70% of MCC patients report that a significant barrier to receiving consistent medical care is an inability to take time off work to travel to distant clinics that accept public insurance or will grant appointments without charge for uninsured patients. By driving high-quality medical care within blocks of patients’ homes, and offering all services free of charge, MCC removes a substantial barrier. The organization also offers telehealth appointments so that parents do not have to take off work and travel in order to be present at medical appointments.
Health Behaviors – Effective preventative care is not necessarily about how often one sees a doctor, it’s about strong, intentional health habits that promote wellness. All of MCC’s medical appointments have a substantial focus on education and empowerment, teaching and reinforcing for families the specific actions, like regular tooth brushing, use asthma control medications, allergy trigger avoidance/reduction, that will aid them in their goal of overall wellness. MCC’s Patient Services department continues to provide education with regular case management calls between regularly scheduled patient appointments.
Safe Housing – Mobile Care Chicago offers Home Environmental Assessments, in partnership with the EPA Region 5 and the American Lung Association’s Illinois Chapter. These assessments proactively identify and remove allergy triggers that make a home potentially dangerous for a person with severe allergic reactions. These assessments also feed back into reinforcement of positive health habits, giving Patient Services staff a better idea of what they can emphasize through education.
Equal Access to Education – Asthma and tooth pain are the two most common causes of school absenteeism, according to the CPS Office of Student Health and Wellness. Over 50% of new MCC patients had missed days of school for a chronic medical condition in the year before enrollment in their mobile clinic. One year later, 96% of those same patients had not missed any days of school.
Access to nutritious foods and physical activity opportunities – MCC tries to partner directly with local food distribution points to ensure that families who need both resources do not have to make multiple trips to receive the assistance that they need. Physical activity is a major indicator of asthma control, and through providing sport physicals so that students can participate in athletics, and by offering comprehensive asthma management, MCC allows children who would have significant barriers to athletics and healthy play to participate in those activities.
Polluted air and water – MCC frequently collaborates on research that can measure and address potential causes of harm in air and water. Most recently, MCC and UIC partnered on a study of particulate matter and airborne heavy metals in Chicago’s Southeast side. The findings are being presented to community groups presently, and are published in the International Journal of Environmental Research and Public Health under the title “Assessment of Metal Concentrations and Associations with Pulmonary Function among Children with Asthma in Chicago, Illinois.” Other publications on other aspects of metal exposure are planned in 2022.
Language barriers – All of MCC’s clinics are bi-lingual (Eng/Spn) so that the portion of MCC’s patient population that feels more comfortable speaking Spanish, which is over 60% of current patients, can receive education and support in their native language.
Is this a comprehensive methodology to address all Social Determinants of Health? No. It’s not even close. We’re frequently in discussions with our patients and community partners to understand how we can do more.
Through addressing these substantial health barriers, however, there’s no doubt that Mobile Care Chicago has helped change the trajectory of patient families. We’ve shared stories publicly in the past about patients who were able to focus more in school, participate in athletics, go on to college, or were inspired to pursue jobs in healthcare because of their experience on the mobile units. We’ve also shared stories of families who had close brushes with death and found their health completely transformed through regular access to a specialist aboard our Asthma Vans. Indeed, if every child had the same access to medical providers as our patients, it would save the City of Chicago over $11.7 million dollars annually in decreased hospitalizations, and another $24.9 million in decreased ER utilization. Sometimes resolving health barriers for families doesn’t require a place that can do a little of everything, but rather a place that can do some things really, really well. Expanding our Patient Services Department translates into expanded capacity to listen to what our patient families need and, ultimately, to adapt our organization to resolve their most urgent issues.
Many of our current readers may know the story of how Mobile Care came to be. After learning of the tragic reports of asthma-related deaths in Chicago, four Chicagoland physicians — Dr. Philip Sheridan, Sr., Dr. Philip Sheridan, Jr., Dr. Paul Detjen, and Dr. Eric H. Gluck — were inspired to form Mobile C.A.R.E. Foundation (now Mobile Care Chicago) in 1998.
In 2000, Mobile Care’s first mobile clinic, originally named The Breathmobile, was launched.
Over the next few weeks, we will be celebrating our 20th anniversary by sharing stories from those who have gotten us to where we are today. We hope you learn more about us, and share our story with a friend. We will also be opening up donations to help us achieve our future goals in helping kids in Chicago access the health services they need, as well as helping our community fight the pandemic. To those of you following our blog, look out for new content, and a link to our 20th Anniversary Website, which will go live next week.
Our goal in this celebration is to not only raise money, but to also spread awareness. We encourage you to share the content we post throughout the next few weeks with a friend or family member who might not know about Mobile Care Chicago, or those who might not know how hard it is for many kids in Chicago to access life-changing health services.