Turning Vision Into Action

For Executive Director Donna Sines and the rest of the Community Vision staff in Kissimmee, Florida, the phone call telling them GAWDA had selected their organization as the 2006 GAWDA Gives Back recipient was the most recent in a series of small miracles.

The group rose from humble beginnings, founded in 1995 by a builder who, frustrated by graffiti on the walls of a development he'd constructed, began hosting small focus groups to discuss ways to increase community pride in Osceola County, Florida. From those focus groups grew a steering committee of 22 volunteers dedicated to rallying the community around a shared vision. Osceola County is one of the fastest-growing counties in Florida, with its population doubling every ten years. “We wanted to focus on what we had in common, rather than what divided us,” says Sines.

Community Vision's Mobile Medical Express is equipped with a waiting area, nurse station, caseworker room and exam room.

Every year the Community Vision board focuses on a major issue the community needs to tackle—including job creation, teen pregnancy and access to health care—and finds resources to address it. The objective is to take a systems-based approach to community issues, rather than treating each one as a separate problem, because it's all of those issues combined that affect quality of life in the region. And it's an approach that works—the county annually hosts successful teambuilding retreats for local officials, welcoming events for new residents, and leadership programs, and it currently is second in the state in high-wage job creation.

Health Care for the Uninsured
Two years ago, Community Vision turned its attention to the problem of lack of access to health care for the uninsured. According to the U.S. Census Bureau, in 2004 (the most recent figures available), 15.7 percent of Americans had no health insurance. In Osceola County, Florida, that number is 32 percent.

“Because we're right near Disney World, we have a very service-based economy, with a lot of people making minimum wage and not having access to health benefits,” explains Sines. “There are state programs available for children and seniors without insurance, so our focus became the working poor between the ages of 18 and 62.”

The mobile unit is staffed with a caseworker, nurse practitioners and nurses, as well as a volunteer medical director.

Opening a clinic was one option, but the question became how to get health care to people who desperately needed it, especially in rural parts of the county without available transportation. The group decided to apply for a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) to run a mobile medical unit that could travel throughout the county. The grant application process was a grueling one, particularly for a small organization like Community Vision. The group even hosted a team who arrived from Washington, D.C., to conduct a site visit.

Then an unexpected blow was dealt to the group that summer when Hurricane Charley swept through Florida in August 2004 and destroyed Community Vision's donated office space. The organization was left homeless.

“It seems like whenever we experience a dark period like that, something amazing happens,” Sines says now. In the midst of the crisis, Community Vision received word from the Department of Health and Human Services that the grant for the mobile medical unit had been approved, promising $1 million in 2004, $700,000 in 2005, and a final $500,000 in 2006. With that, Community Vision had a new goal to work toward.

Mobile Medical Express
In April 2005, the Mobile Medical Express—a 205-square-foot bus equipped with a waiting area, nurse station, caseworker room and exam room—took to the road for the first time, providing free medical care to the uninsured and under-insured. The Osceola County Council on Aging keeps the mobile unit staffed with a caseworker, nurse practitioners and nurses, as well as a volunteer medical director who is a physician. Today, the Mobile Medical Express travels six days a week to nine different locations throughout the county, serving 1,800 patients.

When the program launched, Community Vision anticipated the Mobile Medical Express would serve mostly patients' primary care needs—minor ailments like colds and infections. Startlingly, though, what they often found instead were very, very ill people who hadn't been to a doctor in decades, suffering from chronic conditions including high blood pressure, diabetes and cancer.

Sines shares the story of a patient who passed away last spring. The man had worked seven days a week to support his mother and family, and had to save money to receive treatment for his chronic sinus pain. However, he couldn't afford expensive diagnostic tests. By the time he came to the Mobile Medical Express for the first time, he'd developed a tumor that had grown so large, it had broken his jawbone.

To make your tax-deductible donation to GAWDA Gives Back, please contact GAWDA Headquarters or visit www.gawda.org. Help us match last year's goal of $75,000.

“It was too late for us to do anything,” says Sines. “Here was someone who died young—in his early 50s—who could have been saved if he'd had access to health care, instead of having to save up for months at a time and not get the testing he needed because he had no insurance. This is the United States of America, and people shouldn't die because they have no health insurance, but in many cases that's exactly what happens. That's why it's so critical that we have somewhere people can go and get health care when they need it most.”

Recognizing that the needs of the Mobile Medical Express's patients were far different from what they'd anticipated, Community Vision immediately began working to develop a network of specialist physicians who volunteer their time and take referrals from the mobile unit. The network currently includes 52 specialists, including cardiologists, dermatologists and a neurosurgeon. Area hospitals donate lab work and radiology, and offer free stays for four patients a year. Community Vision also helped develop a local pharmacy co-op so that patients have timely access to the prescription drugs they need.

“This program is saving lives,” says Sines. “We've had patients who were diagnosed with cancer early enough that we were able to arrange for them to have surgery and chemotherapy, which they couldn't have afforded otherwise, and it saved their lives. Out of all the things we've done at Community Vision, this is the most tangible, and the most wonderful.”

The Mobile Medical Express travels six days a week to nine different locations throughout Osceola County.

Then, in late 2005, Community Vision received word from the federal government: The $500,000 HRSA grant the group had been promised in 2006, which formed the entire third year of funding for the Mobile Medical Express, had been cut from the budget. The news was devastating.

It was that same week that Community Vision received a call from GAWDA, saying the organization had been selected as the 2006 GAWDA Gives Back recipient.

GAWDA Gives Back
In a way, GAWDA's promised support of Community Vision's Mobile Medical Express already is serving as a lifeline for the project. “The timing was amazing,” says Sines. “It was somebody from the outside reaching in. You cannot even understand how that changed the tide for us emotionally, mentally and philosophically.”

Being named by GAWDA as the 2006 Gives Back recipient has served as a source of inspiration and motivation for Community Vision. The group has mobilized its forces to make up the shortfall left by the elimination of the half-million-dollar HRSA grant. The donations from GAWDA Gives Back will be a vital contribution to the continued operation of the Mobile Medical Express, allowing Community Vision to purchase much-needed medical equipment and even helping to pay for fuel, as gas prices make it increasingly difficult for the unit to serve the far corners of the county.

“GAWDA's call came at a very dark time, and it was the first thing to make us feel like we really could make this effort work, even without the funding we were supposed to get for the rest of the life of the project,” says Sines. “It was much more than a conversation—it was hope. You are going to be touching the lives of thousands of hard-working people, and I don't know how we can say thank you enough.”