Rolling relief: A day on the road with UTC’s MobileMOC health team

Carly Chastain (left) treats DeAnna Grove in the MobileMOC health clinic. Photo by Angela Foster.

DeAnna Grove—better known as “Dee” by the attendees of the Rhea Richland Senior Neighbors Center in Dayton, Tennessee—is one of the MobileMOC health clinic’s biggest fans.

“Are you going down to the clinic?” Grove yelled to her friend, both dressed in red, white and blue as part of a Flag Day celebration at the center. “You need to.”

As someone who experienced a traumatic health scare in 2000 that left her in a three-month coma, Grove is conscious of her own and her friend’s health.

“It’s forever on my mind,” she said. “I’m very cautious of how I take care of myself.”

With monthly access to the MobileMOC right outside the senior center door, Grove finds some comfort.

MobileMOC—an outreach health clinic on wheels—is designed to provide health care access for older adults in local rural communities, offering services such as preventive care, screenings, chronic disease management and social services.

Earlier this year, the University of Tennessee at Chattanooga School of Nursing launched the mobile clinic as part of its ROAD MAP initiative (Rural Health and Older ADult Interprofessional Mobile HeAlth Program) thanks to a $2.6 million grant from the Tennessee Department of Health. Designed to meet the needs of older adults where they are, the project brings essential health services directly to rural communities that often face barriers to consistent care.

The clinic currently provides care for underserved areas in Bledsoe, Bradley, Grundy, Hamilton, Marion, McMinn, Meigs, Polk, Rhea and Sequatchie counties.

If you board the vehicle on any of the three days of the week it operates, you will find a small community of UTC faculty, staff and students that ensure its smooth operation.

Dr. Cathy Scott

One of those is Dr. Cathy Scott, an associate professor in UTC’s Department of Social Work. Her responsibility, she said, is to address any socio-emotional needs that are identified in any of the patients seen.

“I normally get referrals if there needs to be any discussion regarding advanced care planning or other social services,” Scott said. “I do depression screenings and cognitive screenings, and if there is a caregiver involved, I do a caregiver assessment to screen for caregiver burden and to help with resources to alleviate the caregiver strain.”

She acknowledged that when people think of a health clinic, social work may not be the first thing that comes to mind. That’s what makes MobileMOC so special.

“The whole perspective of the MobileMOC is interprofessional, and that means we serve every aspect of an individual,” she said. “When we think about social work, it’s important for us to be here because we can provide insight or help with anything that’s interfering with their daily interactions or mood. We can link to community resources that may be needed.

“The overall mission of social work is to enhance the lives of any individual that we serve, particularly those who are vulnerable. When we think about rural elders, there are scarce resources and you run the risk of isolation. The social worker on this team would help identify and meet those needs.”

Rebecca Miller, the nurse practitioner for MobileMOC, discussed more of the struggles rural elders face and how the clinic works to address those needs.

“We find they have a hard time getting to their primary care providers, or it’s a financial burden if they either don’t have insurance or have copays,” said Miller, who previously worked in UTC’s University Health Services. “It’s really great to be able to meet those needs of people that may not get their needs met elsewhere.

“What they really need to do is just be listened to. Sometimes we find really simple solutions just by hearing what the problems actually are.”

Rebecca Miller consults with a patient.

Helping lead the student side of MobileMOC is Dr. Meagan Oslund, interprofessional education and practice coordinator in the UTC School of Nursing.

Oslund, an occupational therapist, organizes and recruits students to complete clinical hours and volunteer experiences with MobileMOC while occasionally stepping in to do OT consults herself.

“Our unit relies solely on service provided by faculty and students,” Oslund said. “Any programming and services that we can offer our patients come directly from the students and staff.”

In the fall, Oslund said the goal is to establish a community course within the nursing program to encourage more students to work in the MobileMOC health unit. With its multidisciplinary aspect, MobileMOC will welcome students from various areas of study, including occupational therapy, nutrition, music therapy and social work. Business students are also in the process of helping with marketing and creating a sustainability plan.

“The goal of this unit is to be an all-encompassing interdisciplinary approach for older adults,” she said. “It will serve as the one-stop shop for any health and wellness needs you might have. We need students from all across campus to help.”

Oslund said she noticed students are a bit apprehensive before boarding the bus.

“This is kind of a novel concept,” she said. “Nobody has practiced medicine on a bus before.”

That attitude quickly changes, though.

“When they see all the things the bus can do on the inside and they get to interact with the older adults—which is something that a lot of people maybe have done in the hospital but not in a community setting—they come out enlightened and excited to do it again,” she said.

One of those students is Carly Chastain, a senior nursing student in UTC’s RN-BSN Gateway program. Chastain, who works in the mother-baby unit at Erlanger Hospital, chose MobileMOC from a list of clinical opportunities.

“This one sounded pretty interesting—to get to go out in the community and meet new people,” said Chastain, a native of Cleveland, Tennessee. “I’ve never been to a senior center like this, so I think the community here is really neat.”

Carly Chastain takes a patient’s blood pressure.

It takes more than medical professionals to keep the MobileMOC alive and running. Josh Epperson is the operator of the unit, handling nearly everything that keeps the unit operational, including driving, safety checks, maintenance, cleaning and even patient support.

One who is not familiar with a vehicle like the MobileMOC may not understand the demands the job entails. Epperson said the bus usually needs some form of maintenance after each trip.

Though his role may sound more “behind-the-scenes,” you will most often find Epperson sitting outside of the bus when it’s on location, interacting with faculty, students and patients.

“I’m starting to learn the system,” said Epperson, who began working full-time for UTC in January. “If someone is out, I can check patients in or enter them into the system. I support patients getting in and out of the vehicle and if they need me to go get them, I’ll get them from inside the building.”

Even when the work becomes labor-intensive, Epperson said he loves it all.

“Everybody I work with on board is awesome,” he said. “We joke around and kid with each other. We’re already like a big family.

“It’s good outreach for everyone. When you see what they are doing for the people here that can’t afford to go to places or can’t get out to it, it’s an awesome thing to see happening.”

Dr. Meagan Oslund (left) and Josh Epperson

Leading the overall effort is Dr. Kristi Wick, UC Foundation assistant professor and Vicky B. Gregg Chair in Gerontology.

Wick is involved with nearly every aspect of the clinic day—grabbing supplies, helping set up, checking in with patients, and supporting students in the field.

“What I think is most special for me is seeing the team develop those relationships with our older adults in the senior centers,” she said. “It’s why I do what I do, but I love seeing our team. I love seeing Josh, I love seeing the faculty, I love seeing the students because that to me is the ultimate gift.

“When we can develop those relationships, it ends up paying off in that people feel more comfortable talking about not only their medical issues but things that may be going on at home, like if someone’s sick or maybe there’s a death in the family. That allows us to help them holistically.”

Wick said the next step is making sure the clinic reaches more people in more places, including those who aren’t connected to senior centers.

“I really want to maximize our reach,” she said. “We’ve started with senior centers and that’s been a great way for us to get our feet under us, but I want us to be accessible to people who live out in the rural communities, too.”

Those at the Rhea Richland Senior Neighbors Center are already seeing the benefits.

“They’re here and they’ll listen to you,” said patient Carol Hughes. “Anything I ask them, they’re going to try to take care of it.”

For Robert Salter, who gets his blood pressure checked each month during the unit’s visit, it’s about convenience.

“It saves time because you don’t have to go to the doctor’s office and sit and wait,” Salter said. “There are quite a few different aspects I like about it. It’s very convenient for the average person to sit in.”

Zella Pelfrey had similar sentiments.

“If you really need something done and you can’t get an appointment, you can take advantage of it,” Pelfrey said. “Sometimes it’s hard to get down there when you need to and you know they’re going to be here once a month, so you can go ahead and make an appointment.”

And then there’s Grove, still keeping an eye out for friends and making sure they make it down to the bus.

“It’s been wonderful. They have just been great,” Grove said. “It’s like a doctor’s clinic. You go in and it’s very satisfying. I got some answers today that I’m going to take back to my doctor.”

She laughed: “I always try to spread the word whenever I go to Walmart.”