Family nurse practitioner Georgette George providing services at SAAF. (Photo: Patricia Philbin)
Family nurse practitioner Georgette George providing services at SAAF. (Photo: Patricia Philbin)

UA Mobile Health Program Expands Services

The expansion will provide whole-person wellness and increased support for the LGBTQ community as well as women and children experiencing homelessness.
June 5, 2019

The University of Arizona’s Mobile Health Program has again expanded its primary care, dental and prenatal services to a larger, more diverse swath of the Tucson community.

New partnerships forged with the Southern Arizona AIDS Foundation, or SAAF, Youth on Their Own, or YOTO, and the Primavera Foundation’s Casa Paloma began May 1, allowing the mobile clinic access to an additional 2,000 patients a year, said the clinic’s medical director Ravi Grivois-Shah.

The program, which is part of the UA Department of Family and Community Medicine, provides care to the underserved and trains family medicine resident-physicians and UA medical and nursing students.

The additional services were made possible thanks to a $450,000 gift from the Banner Health Foundation earlier this year. It enables the program to hire a full-time family nurse practitioner, two medical assistants and another driver, and bring a second mobile health clinic into full service.

Nearly half of the clinic’s patients are children. More than 80% are uninsured, and 94% make less than the cut off for AHCCCS, Arizona’s Medicaid program, but might not have coverage due to barriers such as immigration status, language, system navigation, not having the required documents or not understanding their eligibility.

Muhammad Sohab Arif, a second-year medical student at the UA and the clinic’s volunteer coordinator, works with patients to build their health history. He reports on patient health and reason for visiting, and his report is checked by an attending resident or a nurse practitioner.

“My favorite part is working with the patients, of course,” Arif said.

One particular case taught him an important lesson, he said. A man with back pain visited the clinic looking for treatment, but he requested that Arif and the other providers not tell his employer, because he feared losing his job.

“We have to think not just about the patient’s health, but about their whole wellness experience,” Arif said.

The Mobile Health Program’s new partnerships further that philosophy.

When the Mobile Clinic rolls into the SAAF parking lot two times a month, SAAF clientele will have more access to complete care than ever before. SAAF has long provided on-site HIV testing, as well as support related to housing, anti-violence, food and more for individuals living with and affected by HIV or AIDS.

Now, with the UA Mobile Health Program, SAAF will also have increased access to immediate clinical care, sexually transmitted infection testing and HIV-prevention medications, according to Michael Lopez, SAAF’s associate director of LGBTQ prevention services.

Post-exposure prophylaxis, or PEP, is an emergency HIV-prevention pill taken in the first 72 hours after exposure, while pre-exposure prophylaxis, or PrEP, is a daily pill taken to prevent HIV infection when there may be ongoing risk.

“For people coming through our doors, we offered rapid HIV testing on site, but nothing else. But now, we can link them right away with PEP or PrEP, or even schedule them for primary care. Now, we can engage in complete care,” Lopez said.

The partnership excites Lopez because it allows SAAF to continue caring for the underserved, the LGBTQ+ community and others that are at risk of acquiring HIV.

“Many LGBTQ+ folks already feel disproportionately marginalized by the health care system. That’s why the partnership is so important for us. Working with Ravi, who’s been a leader in our community around LGBTQ care, is a win-win for all of us,” Lopez said.

“SAAF has sent us some patients that are either uninsured or under-insured, but this is the first time we’re working on a larger scale to provide those services,” Grivois-Shah said.

At YOTO and the Primavera Foundation’s Casa Paloma, the Mobile Health Program will provide health care for individuals who are homeless or are experiencing insecure housing.

“Many of the women have recent or long-term experiences with trauma and violence, and are not people usually engaged with the health-care system, so having health care come to them is really important,” said Beth Carey, chief operating officer of the Primavera Foundation. “The clinic offers regular, preventive care and wellness skills.”

The first day the UA Mobile Health clinic visited the drop-in center, one of the women was immediately hospitalized, Carey said. The drop-in center is located in a neighborhood, and by the second visit, some neighbors came in and used in the clinic.

“The word is out,” she said.

The Primavera Foundation has a partnership with other local community health centers, but gaps in care, especially of women, persisted.

“That’s where the UA came in. It’s great to have both,” Carey said.

“Each site is unique,” Grivois-Shah said. “For some individuals at the Primavera Foundation women’s shelter, this might be the first time they’re getting health care in years. We’re focusing on the LGBTQ health with SAAF and Youth on Their Own because many homeless youths identify as LGBTQ.”

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