Bringing Health Care in a "Suitcase Clinic"

Mar 19, 2015

For many people, 6:30 on a Wednesday evening means settling down for dinner with family, attending a religious or civic group meeting, or listening to the business news on WMRA.

For Terri Stone, the nurse case manager of the Suitcase Clinic, 6:30 on Wednesday evening means it’s time to set up the mobile health clinic at the Open Doors homeless shelter, and orient the volunteer nursing students.  WMRA’s Rebekah Greenfield attended the clinic recently and filed this report.

Margaret Bagnardi, a professor of nursing at JMU, is here, too.  Along with the volunteers, she’ll help triage the guests of the Open Doors program who have requested to see the clinician on site that evening.

[sounds of Bagnardi asking patient Mark questions]

Shortly after 7:00, Mark, the first patient of the evening, walks in and the four nursing students jump into action with Margaret shadowing and providing guidance.

For Terri Stone, the volunteers are integral to a successful Suitcase Clinic.

STONE: If they are indeed nursing students or nurses, they can go ahead and get their vital signs and find out exactly why they are here before they get sent to the provider.  The volunteers also help fill out the eligibility papers for the free clinic.  They’re still Suitcase patients but they can have services, labs, referrals that sort of thing through the free clinic.

The idea for the Suitcase Clinic was first introduced in 2009 by members of the Healthcare for Homeless Collation, and put into action in 2011. Since then, it’s grown to offer onsite healthcare at the five homeless shelters in Harrisonburg.  The clinic and its five volunteer clinicians can be found twice a week at the Salvation Army, every other week at First Step and Mercy House, every Wednesday at Our Community Place and November-April on Wednesday Evening for Open Doors. 

Terri reports that nine out of every ten people they treat have absolutely no health insurance and while some meet the criteria for insurance, they don’t have the means or transportation to get where they need to go.  The Suitcase clinic has the ability to treat patients, write prescriptions, pay for medications and make referrals.  Nurse practitioner Jo Wallis speaks to the importance of the foot clinic that was started by another volunteer clinician, Rachelle Martindale.

WALLIS: A lot of the men and women here are put out at 8:00 in the morning rain or shine and there’s not a lot of places around town for them to go.  A lot of them walk. They walk all over the place so feet are so important and Rachelle decided to start this clinic to assess feet, and bathe feet, trim nails and it’s a beautiful clinic. It’s a great thing that she has done.

Jo is the clinician on site for the Suitcase clinic held on Wednesday evenings.  She said this time of year they see a lot of people who are suffering from respiratory issues such as COPD and asthma.

WALLIS: Part of our goal is to keep people who don’t need to be in the emergency room for emergency things but more urgent care kind of things.  We are trying to keep them out of the emergency room but we have several cliental who have chronic obstructive lung disease and so if they have an exacerbation because of the cold or whatever, then it’s hard to get the medications they need.  Inhaled corticosteroids are expensive.  People with COPD sometimes it’s hard to get medication for them.  That’s my biggest frustration.  There just isn’t the funding for that.

While the Suitcase clinic provides necessary and often absent health care to men, women and children, Terri Stone says… that’s not the main objective. 

STONE: The main objective is to help individuals obtain safe affordable and permanent housing that will offer the greatest benefit for improving their overall health.

Terri notes that by decreasing the financial strain that frequently comes from receiving health care, the hope is that this will free up funds to put towards housing.    

STONE:  We also point them in the right direction, you know like section 8 housing.  We are always there for them to talk to.  Even if I don’t have all the answers we try to find the person who can help them out.

While waiting to be seen by Jo Wallis, Mark talks about what it means to have the Suitcase Clinic available.

MARK: It’s the difference between instantly getting an understanding of the problem rather than going through an appointment process, and that’s a blessing.