Medicine gets mobile on Reservations

From left: Marlene Allshouse, nurse practitioner; Melvin Acothley, driver/patient registrar; Patricia Bartholomew, CHC program director; Luis Soria; Angie Begay, certified medial assistant; Roselyn Riggs, CHC mobile health program manager. Not pictured: Terris Thompson, nurse practitioner. Submitted Photo

From left: Marlene Allshouse, nurse practitioner; Melvin Acothley, driver/patient registrar; Patricia Bartholomew, CHC program director; Luis Soria; Angie Begay, certified medial assistant; Roselyn Riggs, CHC mobile health program manager. Not pictured: Terris Thompson, nurse practitioner. Submitted Photo

TUBA CITY, Ariz. - In February, the hospital in Tuba City began sending mobile medical vehicles into communities on the reservation to improve access to healthcare.

The vehicles are part of a community health centered program that is regulated by the federal government and the sole purpose is to address the needs of the underserved areas, which is how they differ from an outpatient clinic. The government gives them money to get started and to support the programs growth.

Tuba City Regional Healthcare Corporation (TCRHCC) has two mobile units, one is a medical van and one is a full service dental van.

Patricia Bartholomew, director for community health for the hospital in Tuba, said that the reservation in Arizona is exactly where this type of service is needed the most because of how many people live on the 26,000 square mile reservation. She said that there are on average six community members per square mile. It is difficult for many of those people to come to Tuba City for healthcare.

"Our hope for the program is to take primary healthcare and dental services out to the chapters and senior centers of the Western Service Agency to address the needs of the community," Bartholomew said.

In July, the mobile vehicles will visit Bodaway-Gap, Cameron, Dinnebito, Kaibeto, LeChee and Tonalea. During the school year, the vehicles will visit Hopi schools.

There are some limitations to what the mobile vehicles can handle. The medical vehicle cannot handle urgent or emergent medical care, although staff can assess patients' needs and can call for an ambulance to transfer patients to the hospital or emergency room.

Doctors will provide physicals, healthy men checks, healthy women checks, mother baby checks, immunizations and flu shots. The hospital is setting up a pharmacy on board, and while it will not be a full pharmacy, staff will be able to write prescriptions and there will be some medications available.

The dental van will provide full restorative care but the focus will be on dental exams and scheduling patients into the Tuba City dental clinic. The dental van will visit chapter houses and senior centers during the summer and, during the school year, visit schools and Head Start programs.

In the medical unit, there are two drivers trained to register patients, one certified medical assistant and one nurse practitioner. In the dental unit there is a dentist, a rotation of a pediatric dentist and a non-pediatric dentist, dental hygienist and one to two dental assistants. The registration clerks speak Navajo and are from the communities the units will serve.

Joette Walters, clinical education manager for the hospital, said the goal is to improve access to healthcare and ensuring there are Navajo translators on board will help.

"You want that cultural aspect, you want that cultural sensitivity because that in itself can be a barrier so it's not just about bringing the mobile van to the person, we also want to bridge that cultural sensitivity as well so that it welcomes our patients to come and receive services," Walters said.

Roselyn Riggs, manager for the mobile unit program for the hospital, said that so far she hasn't heard any complaints.

"When I go to the community chapter meetings they are really happy about this program and they are really looking forward to having the dental unit out in their community as well," said Riggs. "Nothing but good, positive feedback."

Bartholomew said that preventative care is always the hospital's goal but right now there are a lot of chronic issues in the communities where patients cannot make it into the outpatient clinic. The goal of the mobile unit program is to intervene and help the community with its health to avoid emergency room visits and reduce hospital stays and catch declining health issues when the units are in the community.

"If someone has to travel 80 miles on a road that is not conducive to travel and they would make that choice to not come here, we can see them in the community and help them with their health before it declines, everybody wins, the hospital wins, the community wins," Bartholomew said.

More information about the schedule and program services is available from Roselyn Riggs at (928) 283-2607 and (928) 640-1626.

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