After two decades of providing care in the Sinai-Grace emergency room, nurse Josephine Quaye-Molex has embraced a new way of connecting with patients.
In late July, the venue was a van parked outside Immanuel Grace AME Church on Conner.
Quaye-Molex joined the Wayne Health Mobile Unit about a year ago and said the ease of access has been reassuring for those who often have felt dismissed or mistrustful of doctors in traditional healthcare settings.
The mobile units, she said, are meeting residents where they are and, in turn, building trust in the community. The setting also has given Quaye-Molex a chance to offer more feedback than the hospital’s ER might typically allow, she said.
“I get a lot more time to be able to sit and talk with my patients, or whoever it is that has approached,” Quaye-Molex told BridgeDetroit. “They don’t necessarily have to get services, they just may have questions, and I’m able to answer those questions now.”
The unit keeps an online schedule of the neighborhoods and events where it can be found to provide an assortment of free services, including health screenings, COVID-19 vaccinations, primary care doctor referrals, behavioral health aid, as well as resources to help with food or utility payments.
Quaye-Molex said she often talks with patients about prescriptions or treatments and encourages them to do their own research, too. For those who need care beyond what the mobile site offers, such as an advanced heart screening, staffers like Quaye-Molex help patients plan their next moves, including lining up resources to travel to and from medical center visits and resources to help cover some of the costs.
Easing access
Born out of necessity during the early peaks of the COVID-19 pandemic, some of the most vocal advocates behind mobile health said they are hopeful that the concept will alleviate barriers to healthcare access and increase trust in underserved communities, like Detroit.
Dr. Phillip Levy practices emergency room medicine at DMC Sinai-Grace Hospital in Detroit and leads the Wayne State University and Wayne Health Mobile Unit program.
Levy, a main force behind a recent expansion of mobile health services, is hopeful that they will help revolutionize medicine in at least two ways; Easing access to care and preventing serious diseases before they start.
After COVID hit, Levy and his team worked with the state to create mobile testing sites for the virus, at first only for first responders. Eventually, the group used ER research methods to investigate COVID data. They then wondered, he said, what they could do with that information and the ability to meet patients where they are, like with mobile testing units.
Two years and millions of dollars in funding later, with vehicles donated by Ford Motor Co. and others, the initiative is operating with 10 mobile units, including an Americans with Disability Act-compliant van.
The New York-trained Levy came to Detroit about 20 years ago and as he worked in the ER said he realized many patients coming in for treatment for acute medical issues had something in common.
“These folks aren’t getting the care they need that prevents these consequences from occurring,” Levy said.
Levy and his team assessed social determinants, such as socioeconomic factors, food and housing security, access to utilities and more. The results, he said, showed a connection between underserved populations and higher risk for certain conditions.
Levy says five factors – high blood pressure, diabetes, smoking, high cholesterol and obesity – contribute to 80% of chronic illnesses in the country, especially heart disease.
Already the No. 1 killer of Americans, heart disease the past 20 years has killed Detroiters at least 1.6 times faster than others. During COVID, heart disease killed Detroiters at two times the national rate.
Levy’s findings resulted in a grant and Wayne State University supported efforts to turn that data into a tool. Levy said the tool, coined PHOENIX, is intended to be used by community members and healthcare professionals to identify and curb risk factors before they turn to deadly disease.
“At the end of the day, we’re going to affect the most people by screening for the most common disorders and diseases and fixing those problems,” he said.
The mobile vans have awnings on each side to shield from the elements and tables set up underneath for patients to undergo basic screenings, like blood pressure checks.
A visit to these vans, Levy said, also cuts down on wasted time at a doctor’s office – for the patient and the doctor.
The mobile health units host events throughout the community and they travel to places of business. Levy noted some workers might not have issues with the cost of medical care or with insurance access, but they simply can’t take the time off to go to the doctor.
Understanding needs
Other care providers in Detroit have been aiming to improve access and awareness about their services, too.
Detroiter David Pierson was diagnosed about a decade ago with multiple sclerosis and said that it eventually forced him to retire from his job at a logistics factory.
After battling the disease and related difficulties, Pierson, 57, felt he was in need of mental health help. He wasn’t ashamed, but said he was unsure where to turn.
A connected relative directed Pierson to Certified Community Behavioral Health Clinic (CCBHC), an arm of the community behavioral health agency Development Centers, which provides an array of services, including mental and behavioral help for residents.
Next year, the Development Centers will celebrate 40 years, though CCBHC is in its second year of operating. The centers have multiple locations, but Pierson’s visits are at the McKenny Community Center on Burt Road, just off Seven Mile Road in northwest Detroit.
The distance proves challenging for Pierson, who can’t drive much anymore and lives about 15 miles away on the city’s east side. But the CCBHC offers transportation to clients who need it, so Pierson gets picked up and dropped off, he said.
Pierson said he’s appreciative of the transportation service and said he’s also getting housing, career and community college guidance.
“I’m the kind of person who knows what I need, you know, physically, emotionally, spiritually and mentally,” he said. “I appreciate the development center so much.
“They have given me a lot of help, a lot of encouragement,” he added. “I would encourage people to go there if they need it.”
Pierson credits his sister, Donna Chavous, the community engagement lead for CCBHC, for introducing him to the clinic. As part of her work, Chavous engages with the community to promote the services CCBHC offers.
The clinic, she said, focuses on helping adults and children with behavioral health issues, especially mental health.
“…He is happier,” Chavous said of her brother. “He has someone that will listen to him and understand his needs.”
Like Levy and his team, CCBHC is working to make its services more accessible. This summer, the clinic debuted a mobile health unit at the McKenney Center focused on physical health, offering screenings and similar services as the Wayne Health Mobile Unit.
Chavous said patients in need of behavioral health services often need help with their physical health as well. Representatives from CCBHC, she said, have reached out to Wayne Health to see about forming an alliance.
Chavous said it’s important to erase stigmas around mental health.
“We do need the community,” she said. “We need families and friends to guide them here…”
The CCBHC mobile unit is open on-site at the McKenny Center from 9 a.m. to 3 p.m. every Tuesday. Services are free for Michigan residents ages 6 and up. Drop-ins are welcome and visitors are encouraged, but not required, to bring photo identification and an insurance card. For information, contact the McKenny Center at (313) 977-9550, Ext. 5249.
The Wayne Health Mobile Unit website provides locations, features for requesting an appointment and for finding a doctor or medical services. Click here for the October calendar. Identification and/or insurance is not required for services, but Wayne Health collects the information, if possible.
Patients do not receive a bill for most services. Wayne Health also provides care through partnerships with schools, community centers, churches, workplaces and nonprofits. With proper accommodations, Wayne Health offers its services indoors or outdoors, as a walk-up, drive-thru, or both. A site request form is available online, via email or call (313) 448-9850.
Editors note: This story has been updated to correct the spelling of Josephine Quaye-Molex.