All Aboard

Myriad barriers exist for parents trying to seek medical care for their children. Scheduling, work, school and distance from a provider with availability can make routine health care nearly impossible for some families. Access to affordable care can often be an insurmountable barrier for those living in rural areas.

In 2009, then Le Bonheur President Meri Armour identified the need to increase access to health care for children in West Tennessee. Partnering with the Children’s Health Fund, Le Bonheur became part of a national network of mobile health providers for children and began providing school-based health visits to underserved and underinsured West Tennessee children.

Armour approached Le Bonheur hospitalist Cynthia Cross, MD, who agreed to serve as medical director of a new initiative called Le Bonheur on the Move (LOM). Since its inception more than 15 years ago, the mobile unit has traveled thousands of miles to counties across West Tennessee providing much-needed health care to children spanning elementary to high school. From sick visits to well-child care to routine childhood vaccines, Le Bonheur on the Move provides comprehensive pediatric health care and eliminates barriers to care.

In the 2023-2024 school year, the LOM mobile health program served 39 schools and 822 children including 120 children with RN Health Education via the 85210 program, 53 families with Behavioral Health Counseling, 186 families with Health Navigation services, and more than 200 families with RN Care Coordination and referral tracking. LOM operates a mobile medical unit during the school year with rural public schools in Crockett, Dyer, Obion, Lauderdale, Tipton, Gibson, McNairy, Haywood and Decatur counties in West Tennessee.

Children from age 4-17, the majority of whom are enrolled in the state of Tennessee’s Medicaid program called TennCare, are sent home with a consent packet that parents complete prior to their child’s appointment. 

Mobile Health

Four days per week, the Le Bonheur on the Move team, which includes nurses, social workers, a nurse practitioner and a behavioral health counselor, visits schools across West Tennessee to care for kids. Children climb aboard the mobile unit in their school’s parking lot for a routine health screening that includes hearing and vision tests and a hunger screening.

“The Le Bonheur brand and name carry so much trust and mean so much in West Tennessee,” Hogg said. “We have a duty to do the best and right thing all the time for kids and ensure they have access to the care they need.”

While LOM is not meant to replace regular visits with a local pediatrician, Hogg and her team understand that for some families, attending a doctor’s appointment can be challenging and the mobile unit can help bridge the gap.

“Sometimes patients are assigned a primary care provider by TennCare in the next county over or children in the same family are sent to different providers,” Hogg said. “This can be a hardship for families, and we have a social work team that can help families navigate TennCare and access the resources they need.”

While well-child visits make up the bulk of LOM’s cases, the routine checkups often lead to diagnoses that necessitate a specialist referral. The most common referrals are for cardiology, pulmonary and neurological services, and LOM nurses follow up with families both to ensure the patient gets a timely specialist appointment and to learn the outcomes.

Behavioral Health Helps

In the past few years, the need for behavioral and mental health services — including treatment for anxiety and depression — has grown exponentially. Social workers can connect families with the resources they need, which is one reason Evette Higgs, LMSW, a behavioral health counselor, is an integral part of the LOM team.

Higgs has made a difference in the lives of kids like A’mir Jones. Last year, kindergartener A’mir climbed aboard the Le Bonheur on the Move mobile medical unit when it visited Dyersburg Primary School. At his appointment, A’mir’s care team raised health concerns and then addressed the feelings of anxiety he was experiencing. Having lost his mom two years prior, A’mir lives with his grandmother, Stacy Grant, and was struggling to cope with the feelings caused by his mother’s death.

Following A’mir’s LOM appointment, he was referred to Higgs for care. A’mir felt comfortable being open with Higgs and sharing his fears and anxieties.

Partnering for Success

Supervisor of Community Health/Project Director of HRSA Delta Grant Julie McKee, MSN, RN, CCM, said LOM seeks to partner and collaborate with local resources in each area to connect children and families to ongoing, necessary care that may have otherwise gone unaddressed.

“Our program is important to rural communities because we are not trying to replace the good work that is going on in
these communities, we are simply offering another set of resources that parents can trust,” McKee said. “When the LOM mobile medical unit arrives at the school, parents, teachers and community leaders can be assured that their children are in great hands.”

To meet the growing need for families moving to West Tennessee’s Stanton area with the opening of the Ford Blue Oval site, Le Bonheur on the Move will be on-site monthly to care for children at the local community center. Kids will be able to have sick and well-child visits.

“Ford Philanthropy puts services together to create a community initiative to help people impacted by a new plant who might otherwise not see ‘upward mobility’, and they do this by forming a community center with all types of community services,” Hogg said. “We will continue to participate in community events such as the Chow-Chow Festival in Stanton, where we provide health education and information about the services our organization can provide.”

Le Bonheur also received a generous grant from Ford Philanthropy to purchase equipment and supplies for pediatric programming across West Tennessee.

As the region grows, both Cross and Hogg would like to see the addition of a second mobile unit and the capacity to serve students five days a week.

History of Le Bonheur Community Outreach

Since 1985, Le Bonheur Community Outreach has provided a coordinated, integrated community practice that provides equal access to high-quality care through engagement, education, prevention and intervention to improve the health and well-being of all children and families. The program began when Le Bonheur identified the need to reduce the growing number of children coming to the hospital’s Emergency Department with injuries caused by abuse. Grant funding requests were submitted to address child abuse prevention and treatment for pediatric victims in the community.

As additional needs in the community were identified, Le Bonheur Community Outreach grew. From schools to homes, to clinics, Le Bonheur is committed to meeting the needs of children and families where they are.

Key to the program’s success are the long-established partnerships throughout the region, including across West Tennessee, and a strong commitment to health equity and serving communities of need. With 225 Associates, Le Bonheur Community Outreach operates 25 evidence-based or best-practice community health programs, reaching more than 50,000 individuals annually.

“Community partners are essential to our accomplishments in Le Bonheur Community Outreach programs,” said Jennilyn Utkov, BSN, RN, MBA, Vice President of Methodist Le Bonheur Community Outreach. “I’m so proud that our system allows us to do this important community work. We not only look at the acute health needs of children, but at the overall health and we have invested in quality programs to improve kids’ lives.”

According to Utkov, at the core of the 25 community programs is a solid plan for the administration of these programs. From grant administration to development and program evaluation, it is truly a collaborative effort from a team of passionate professionals.