While receiving my internal medicine training at San Francisco General Hospital in the early 1990s, I met an individual who helped shape my view of public health needs. Each week, I and other interns would work the “Homeless Van” that delivered primary health care to vulnerable populations throughout the city. Raoul, a chronically ill man who lived in his van with several dogs, was a frequent patient. The “Homeless Van” served as a lifeline for Raoul by providing necessary medications, health counseling, and trips to the hospital when needed. This experience taught me how many people have a profound distrust of the health care system and therefore must have services brought to them. Additionally, it is important for health care professionals to see their patients within the context in which they live because you definitely get a greater appreciation for the obstacles that vulnerable individuals must face in order to keep themselves healthy.

 

For many individuals mobile health clinics serve as a bridge to health care services, and, in some instances, they are a true lifeline to health care. The Illinois Department of Public Health began our entrance into the mobile health clinic arena through a partnership with the Champaign-Urbana Public Health District to provide funding for its HIV/sexually transmitted disease mobile outreach in central Illinois. This highly successful outreach was then expanded into the Wellness On Wheels Initiative that currently operates two additional vans in the southern and central parts of the state. In the next three years the agency plans to add three more vans that will operate in areas that will include Aurora and Rockford.

 

The Wellness on Wheels vans provide health screenings including HIV Rapid Testing, blood pressure, glucose, cholesterol, prostate exams and pap smears. Urban and rural communities are important targets, and people of all ages, races, and ethnicities can benefit. Public-private partnerships are critical to the success of mobile outreach efforts. In the case of the Wellness on Wheels vans, health professionals from local health departments, hospitals, and faith based organizations are used to staff the vehicles. By working with local organizations, appropriate services and locations can be identified to ensure the optimal use of the vehicles and the most appropriate health care services.

 

Mobile health care is an important public health tool. It brings much needed services to the public; provides confidential off site outreach services; allows services to be tailored to meet the needs of individual communities; provides mobility and flexibility to address public health incidents, i.e. outbreaks, catastrophic health emergencies; accommodates community events; results in increased case finding, increased trust and partnerships with communities, and an increase in compliance with prescribed health care regimens. I see mobile health care as a win-win situation for both public health and the communities we seek to serve.

 

 

This presentation focused on the structure and dynamics of successful Public/Private partnerships. Public/Private partnerships are the genesis of many of the Mobile Health Clinic facilities that exist across the nation.

 

Examples were provided to illustrate the individual and collective strengths that Public and Private entities bring to the table when establishing working partnerships and how these are used in developing strategies to achieve common goals and objectives.

 

To illustrate the parameters in the creation of one successful partnership a case study of a children’s oral health coalition was described which includes private practices of pediatric dentistry, general dentistry and a spectrum of public agencies which have partnered and worked together in Monterey County, California to solve the problem of adequate access to comprehensive oral health care and the establishment of a dental home for all children regardless the families socioeconomic status.

 

The overarching goal of this partnership was not only to provide a dental home for all children in our community but also to reduce the disease burden experienced over the past two decades thru education and primary prevention. It is widely recognized that it is difficult for the private partners to focus on education and prevention as primary goals since the current system of reimbursement does not place value on the provision of these services. The private partners do excel in the delivery of the highest quality of surgical and restorative care to the patients they serve. The public arm of the partnership is funded and exists to provide case management and educational and preventive services that brings the “partnership” full circle to the end goal of truly comprehensive care.

 

The “key stone” of the Public/Private partnership is the Community Oral Health Services program. The combined efforts and services provided by the various public and private partners results in a collaborative effort of “magic” proportions.