Mobile Clinic Model for Improving Access to MOUD
To improve patients' access to care and expand capacity, rural medication for opioid use disorder (MOUD) programs can provide services through mobile clinics. Mobile clinics are vehicles equipped with medical supplies and staff. This model allows health professionals to travel to patients and provide medical services in close proximity to patients' homes, rather than asking patients to travel to brick-and-mortar clinic offices.
A mobile clinic for an MOUD program may provide services including harm reduction, primary care, and treatment for substance use disorder (SUD). Harm reduction services may include syringe exchange, naloxone distribution, and referrals to MOUD programs. Primary care services offered in a mobile clinic may include vaccinations, sexually transmitted infection (STI) screenings, and wound care. SUD treatment may include prescriptions for MOUD or referrals to methadone treatment programs or other services. On average, mobile health clinics have a 12-to-1 return on investment in the United States.
Examples of Rural Mobile Clinics for MOUD
- The Colorado Department of Human Services Office of Behavioral Health created a mobile health service with six mobile clinics for delivering MOUD services. These mobile clinics are designed to help reach patients in rural areas of Colorado. Staff for these clinics include a nurse, a licensed addiction counselor, and a peer recovery coach. The clinics provide patients with access to a prescriber who can provide MOUD prescriptions, naloxone, and referral to support services. Some mobile clinics also have syringe disposal services.
Implementation Considerations
The Mobile Addiction Services Toolkit, developed by the Kraft Center for Community Health, offers guidance programs can use to plan and implement a mobile health clinic model. First, a program should consider the logistics of purchasing and licensing a mobile health clinic. Guidelines and regulations for licensure may vary by state. Programs should consider the cost of starting and maintaining a mobile health clinic. Initial costs include the price of the mobile clinic(s) and licensing fees. Ongoing costs include staff and personnel, such as waivered medical providers, nurse care managers, and outreach workers; and non-personnel expenses like vehicle insurance, gas, maintenance, medical supplies, and other supplies for patients.
Rural mobile clinics may choose to use telehealth to enhance the provision of services. Programs incorporating telehealth will have expenses for equipment, installation, power, and Wi-Fi on the mobile unit.
Drug Enforcement Agency (DEA) regulations do not allow for the storage of buprenorphine on a mobile clinic. Programs should consider the proximity of the mobile clinic to nearby pharmacies and, if needed, establish procedures to reduce barriers for patients filling MOUD prescriptions. For example, programs may want staff to either deliver medication from the pharmacy to the patient or accompany the patient to the pharmacy.
For additional information about mobile clinics in rural areas, see Mobile Clinics in the Rural Transportation Toolkit and the Mobile Unit Model in the Rural Services Integration Toolkit.
Program Clearinghouse Examples
Resources to Learn More
Mobile
Addiction Services Toolkit
Document
Provides guidelines to help organizations develop and implement a mobile health program offering MOUD treatment
and other addiction services to expand and integrate clinical care and harm reduction.
Organization(s): Kraft Center for Community Health, Massachusetts General Hospital
Date: 1/2020