Mobile Medical Health Services: An emerging clinical system optimal for low-income, displaced families following a disaster

Research shows that one of the most vulnerable populations post disaster is the children. Disaster plans rarely include stipulations for their care or strategies for the recovery phase. Access to care post Hurricane Katrina was severely compromised for all populations; however, the children were at greatest risk for disconnection. The departure or relocation of providers left numerous children without a primary care physician; and the loss of records, including immunizations and birth certificates, posed problems for school reentry and acquisition of federal program assistance such as Medicaid. Additionally, significant changes in the city infrastructure, displacement of families from their primary residence, and lack of transportation placed an enormous strain on access. The Mississippi Gulf Coast Children's Health Project consists of two mobile units providing primary care and mental health services for an extended pediatric population of ages 0-24. The Program's intent is provision of access, continuity of care, and reconnection with community resources. In 2006 the program amassed over 5000 encounters. Particularly, mental health concerns have been prominent placing an immense demand for the services provided by the mental health team. A significant barrier is lack of access to psychiatric support for more severely affected children. Other barriers in general include funding, marketing, and assuring viability and legitimacy. Despite these issues, this program is the model example of an emerging clinical system permitting comprehensive pediatric medical and mental health services, community support resources, and provision of access necessary for stabilizing healthcare for children post disaster.