Spotlight on the Safety Net

Opportunities Industrialization Center, Inc. (OIC) is an organization dedicated to providing support services to marginalized groups in Edgecombe and Nash counties. Their work began in 1969, at the height of the Civil Rights Movement, with the goal of providing employment opportunities to historically African-American and low-income communities in Rocky Mount, NC. Today, they offer a variety of support services, including alternative education, employment training, business support, and health education and outreach services [1]. An integral part of their health service is the Mobile Area Health Clinic (MAHC).

MAHC began in 1996, when the AIDS epidemic was in full swing. Embracing the concept of health services on wheels, it was created in order to provide access to HIV testing services to high-risk individuals living in rural areas. At the time, it was one of the only HIV-testing resources in the state for this population.

Since its inception, the unit has expanded its services and operates using an evidence-based, wellness-focused model. MAHC staff includes a medical provider, a medical assistant, and a care coordinator who helps address patient needs as related to social determinants of health. STI testing continues to be a major resource, including testing for HIV; syphilis; hepatitis A, B, and C; chlamydia; and gonorrhea. A variety of medical and social services are also offered based on individual patient needs, including blood pressure testing, blood sugar testing, and coordination of services. MAHC provides STI testing at no cost for all patients, and because OIC is a HRSA-designated Federally Qualified Health Center (FQHC), any patients identified and referred for primary care services have copays based on a sliding scale, accounting for family size and income.

MAHC locations are chosen based on the Centers for Disease Control and Prevention (CDC) hotspot criteria. These specified geographic locations have increased incidence and morbidity for STIs. They are also defined as geographic locations associated with high-risk behaviors, including intravenous drug use and prostitution (Luckey, personal communication, April 2018). One of the greatest strengths of the unit is its strong connection with the community. Local community members and organizations often reach out to the unit for services. MAHC is able to serve these individuals directly in areas and at times that are convenient for them. Through this engagement, MAHC has become an asset to the community it serves.

The impact of MAHC cannot be overstated. Serving 1,200 to 1,400 unique individuals per year, it has helped stifle the spread of STIs, increase access to services for vulnerable populations, and build trusting relationships with the surrounding community. Increased health status awareness, as noted by Bridgett Luckey, program development manager for OIC, has led to improved health outcomes.

Despite MAHC's continuous work and engagement, there is always more to be done. For example, since the rise of the opioid epidemic, MAHC has seen increased incidence rates of hepatitis C. When detected early, this can be treated in a primary care setting. “The screenings that we have been able to provide allow clients to receive care at an earlier stage before the progression of the disease,” said Luckey.

The Edgecombe and Nash communities continue to struggle to gain widespread access to services and to deal with negative consequences of a lack of focus on social determinants of health, both issues that MAHC is determined to tackle in full force.

For more information on the Mobile Area Health Clinic, visit https://www.oicone.org/mobile-area-health-clinic.

• ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.