Last week I found myself in Annapolis, MD standing before the Senate Executive Nominations committee discussing my recent appointment to the Governor’s Wellmobile Advisory Board. I am extremely proud to be affiliated with this nurse-led care initiative, managed by the University of Maryland School of Nursing, that brings health care to underserved communities throughout Maryland. Using mobile vans, hypertension, diabetes, and cancer screenings, health education, medication assistance, and other services are delivered to vulnerable populations in Maryland’s Western, Central, and Eastern Shore regions.

Mobile nurse-managed centers are not unique to Maryland. For example, Samford University's mobile vans deliver healthcare services to children and adults with developmental disabilities throughout Birmingham, AL, the Senior HealthMobile project in Idaho focuses on keeping older adults in rural areas healthy, and UMDNJ’s mobile vans address the healthcare needs of at-risk residents in Newark, NJ.

In each case, these mobile centers are nurse-managed entities staffed with faculty and students from local nursing schools. Not only do these mobile clinics bring needed care to underserved areas, they also offer unique practice experiences. In addition, mobile clinics have proven to be effective delivery models in times of disaster.

While the advantages of such programs have been well documented, funding remains challenging. In many cases, public-private partnerships have sustained these services. However, without a financial investment from the state, it is difficult for such programs to attract matching private support. Last year, due to a lack of funding Maryland’s Wellmobile Program was only able to circulate one of its four vans. Even so, the program saved the state more than $957,600 in averted emergency department visits.

Program staff continues to explore innovative funding opportunities to allow them to serve their constituents. However, the question remains, where do these programs fit in the emerging medical home model? The Nursing Alliance for Quality Care is hosting a symposium on April 5, 2011 to discuss the role of APRNs in the medical home model and to identify ways in which nurses and APRNs can assume leadership roles in the future. Nurses and nurse-led programs have a critical role in the changing healthcare landscape.