CDC-RFA-OT21-2103:

UNMH COVID-19 Mobile Health Clinic for

People Experiencing Homelessness

Prepared by the UNMH COVID-19 Incident Management Team:

Document Owners Project Role

Ginger Wright UNMH Incident Commander

Anthony Mendoza, Betty Apodaca, Alexa UNMH Command Staff
Schmitt
Barbara Lee, Max Montoya, Greg Mourinho, UNMH General Staff
Emily Riley
CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

EXECUTIVE SUMMARY
The University of New Mexico Hospital (UNMH) seeks $57,000 in start-up funding from the
Centers for Disease Control toward the development of UNMH’s COVID-19 Mobile Health
Clinic project. This mobile clinic will be used by healthcare professionals to administer Johnson
& Johnson vaccinations to people experiencing homelessness (PEH) in Albuquerque, New
Mexico.
Given the complex nature of the COVID-19 disease and our role as a hospital to protect the
health of our Albuquerque community, we have not overlooked the health of those facing
homelessness in Albuquerque. Especially those that are outside of homeless systems.
To fill in this vaccination gap, we have developed a vaccination strategy that involves the
coordination of many partners, including homeless systems, public health authorities, and
community stakeholders. The University of New Mexico Hospital’s (UNMH) COVID-19
Incident Management Team has been closely collaborating with the City of Albuquerque’s
Department of Family and Community Services to learn how to reach this target population more
effectively. We expect the outcomes of our UNMH COVID-19 Mobile Health Clinic to include
having PEH outside of homeless systems in Albuquerque willingly vaccinated, inhibiting the
spread of COVID-19 in Albuquerque, and maximizing the impact of our current federal COVID-
19 funding and support.
This project is managed by UNMH’s COVID-19 Incident Management Team (C9IMT); an
impromptu team set up by the UNMH Leadership team when the spread of COVID-19 came to
the State of New Mexico.
The purpose of this proposal is to inform the CDC grant review committee about the details of
this project and to request funding for start-up expenses. This unique project aligns with your
fourth strategy to “develop new mitigation and prevention resources and services to reduce
COVID-19 related disparities among populations at higher risk and that are underserved” [1].
The committee will find that this proposal consists of five main components:

• The introduction to the vaccination-related issue and UNMH’s qualifications

• The analysis of the vaccination issue UNMH is trying to solve
• This approach UNMH has designed to address the problem
• The conclusion to tie the provided information together
• The budget narrative to breakdown start-up costs

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

TABLE OF CONTENTS

Executive Summary........................................................................................................... 2
Table of Contents ............................................................................................................... 3
Introduction: UNM Hospital Has the Qualifications ..................................................... 4
Problem Statement: Vaccinating PEH against COVID-19 ........................................... 5
Approach ............................................................................................................................ 6
Purpose .......................................................................................................................... 6
Outcome ........................................................................................................................ 6
Goals and Objectives ..................................................................................................... 6
Methods ......................................................................................................................... 7
Evaluation of Project Deliverables ................................................................................ 8
Deliverables Out of Scope ............................................................................................. 9
Conclusion .......................................................................................................................... 9
Budget Narrative ............................................................................................................. 10
Reference List .................................................................................................................. 11

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

INTRODUCTION: UNM HOSPITAL HAS THE QUALIFICATIONS

With most of the Albuquerque PEH population unvaccinated against COVID-19 and just under
half of this population outside of homeless systems, they are at an increased risk of facing
adverse outcomes if affected. It is difficult for this population to receive vaccinations from
healthcare facilities and homeless systems due to lack of transportation, beliefs of unacceptance,
and unstable locations.
By establishing a mobile health clinic, we can combat these difficulties by going to these isolated
locations, demonstrating our desire to help, and offering Johnson & Johnson vaccines. To
successfully coordinate this project, UNMH’s COVID-19 Incident Management Team is
collaborating with the City of Albuquerque’s Department of Family and Community Services.
They are persistently providing “quality health and social services, housing, recreation and
education to improve the quality of life for the entire Albuquerque Community” [2]. Through
this collaboration, the Department of Family and Community Services has informed UNMH on
the locations of segregate populations of PEH and supported us with developing a vaccine
distribution strategy.
The UNM Hospital's COVID-19 Incident Management Team consists of non-medical experts
who have actively upheld many of UNMH’s management operations. This team operates under
the Intermediate Incident Command System 300 model.

The emergency management structure of a non-medical organization is based on ICS 300 [3].

• Ginger Wright is the Incident Commander and the hospital’s emergency manager. Ms.
Wright oversees the planning and response to emergencies that can affect UNMH and
communities that rely on UNMH. She has been with UNMH for over 15 years.
• Anthony Mendoza, Betty Apodaca, and Alexa Schmitt make up the Command Team’s
Public Information Officer, Safety Officer, and Liaison Officer, respectively. They carry
out staff functions including interagency liaison, incident safety, and public information.
Between the three of them, they have over 20 years’ worth of experience at UNMH.
• Barbara Lee, Max Montoya, Greg Mourinho, and Emily Riley lead the Operations
Section, Planning Section, Logistics, and Finance/Administration Section, respectively.
These individuals lead their functional teams and report directly to the Incident
Commander. Between the four of them, they have 30 years’ worth of experience at
UNMH.

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

UNMH and the City of Albuquerque know that, with your help, we can tackle our next project:
getting PEH outside of homeless systems vaccinated using the UNMH COVID-19 Mobile
Health Clinic. This unique project aligns with your fourth strategy to “develop new mitigation
and prevention resources and services to reduce COVID-19 related disparities among
populations at higher risk and that are underserved” [1]. UNMH is the best-qualified
organization to execute this mobile health clinic for Albuquerque. That is because UNMH knows
the people of Albuquerque better than the federal government, has had continuous support from
our community since the start of the pandemic, and has the grit to be the first hospital in New
Mexico to take an attempt at tackling this issue.

PROBLEM STATEMENT: VACCINATING PEH AGAINST COVID-19

According to the New Mexico Department of Health’s most recent COVID-19 Case Report,
Bernalillo County has had a total of 55,897 cases and 912 deaths since the disease’s first
confirmed arrival date on 11 March 2020 [4]. However, there is no evidence to ensure that these
numbers accurately include cases of PEH outside of homeless systems. The latest data from the
Continuums of Care reveals that as of January 2019, New Mexico has an estimated 3,241 people
who experience homelessness on any given day [5]. Also, in 2019, the Albuquerque Coalition of
Care conducted a Point-In-Time Count in Albuquerque. They estimated that of PEH, 567 are
living unsheltered and 735 are living in an Emergency shelter [6].

Despite numbers like that across the States, the U.S. Department of Housing and Urban
Development – the federal agency to oversee homeless programs – has not required its national
network of providers to gather information on infections and deaths of PEH. They are
disregarding that PEH interact more with the public compared to other high-risk, congregate-
living groups [7] and that PEH are the most vulnerable population at risk of adverse health
outcomes.

PEH were supposed to be one of the first groups prioritized for vaccination (Phase 1B) according
to New Mexico’s Vaccine Allocation Plan. However, the plan did not address people who were
facing homelessness outside of a homeless system [8]. Without prioritizing the vaccination of
these PEH, we risk several things:

• The compromise of PEH's health by the disease

• The compromise of PEH's lives
• The disease spreading to other PEH and the public
• The disease mutating and then causing another wave of infections

Upon identifying these gaps, UNMH has taken the initiative to identify the main issues and
dynamics of this pandemic that directly impact the local community. We then developed a plan
that would result in an effective response for the sake of community health.

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

We found that one of the most appropriate responses to vaccinate PEH during this health crisis,
especially those outside of an Albuquerque homeless system, is to start a UNM Hospital Mobile
Health Clinic. That is because mobile health clinics have several advantages over other potential
healthcare options for practical and socio-political reasons. By establishing this clinic, we would
reinforce UNMH’s mission to be “an accessible, high-quality, safety-focused, comprehensive
care provider for all the people of Bernalillo County” [9] and the CDC’s mission to advance
health equity in higher-risk populations as they relate to COVID-19 [1].

By ignoring this health issue, UNMH and the CDC would contradict our efforts in preventing
more people from being made sick or hospitalized by the COVID-19 disease. Therefore, it is in
the best interest of UNMH and the CDC to collaborate on developing a mobile health clinic for
PEH outside of homeless systems in Albuquerque.

APPROACH

Purpose
This project addresses the CDC’s public health problem because it reduces the “burden of
COVID-19 among populations that are disproportionately affected.” Wherein, UNMH is
coordinating a holistic approach that is essential to building and sustaining trust in this segment
of the population. UNMH is also ensuring “equitable access to COVID-19 related services and
advancing health equity” [1].

Outcome
UNMH’s COVID-19 Mobile Health Clinics offers versatility to UNMH’s healthcare
infrastructures and, due to our community-focused delivery model, it fills in gaps by reaching
socially and economically underserved populations in urban and rural locations. With a start-up
cost of $57,000, an overall program cost of $300,000, and an annual operation cost of
approximately $450,000 [10], we will use this clinic to initially provide displaced and isolated
individuals with access to the Johnson & Johnson vaccine. (We will use the Johnson & Johnson
vaccine because of its one-shot convenience.) We will then use the clinic to offer accessible
healthcare to medically underserved communities and rural communities.

Goals and Objectives

Goals Objectives

Provide persistent support in 2021 for
PEH outside of homeless services (in
urban and rural areas) with access to be
vaccinated against the COVID-19
disease.
• UNMH Mobile Health Clinic will be
ready to distribute Johnson & Johnson
vaccines in May 2021
• At least 50% of voluntary PEH in
Albuquerque will be vaccinated by 1 July
2021

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

• At least 80% of voluntary PEH in

Albuquerque will be vaccinated by 1
August 2021
• The remaining voluntary individuals and
populations of PEH will be vaccinated by
1 December 2021
• COVID-19 infections in PEH will be
reduced down to 95% by 2022

Methods
Tasks Task Owner / Details

Obtain an already refit van and prepare
for usage.
Spread awareness about this project to
the public.
• The Finance/Administration Section will
allocate granted funding to purchase a refit
van in May 2021. The van will be purchased
through Used Mobile Clinics, a Dart
Colorado LLC so that we can have this clinic
by the end of May. After getting a customized
design on the van, we will be ready to use it
in early June. (Note that despite the rush, a
customized design is necessary to create an
appealing van that will invite trust from our
community.)
• Our Safety Officer will identify and mitigate
all hazardous situations, as well as review the
Incident Action Plan and approve our
Medical Plans.
• Our Liaison Officer will be the point of
contact for agency representatives and
homeless services and monitor for inter-
organizational issues.
• Our Public Information Officer will develop
accurate, accessible, and timely information
to the media and press about this project.
• Our Public Information Officer will inform
the public about our timeline.
• Our Liaison Officer will work with homeless
sector leaders, service providers, and
community partners to share this information.
She will lead the initiative of putting up
informative flyers.

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

Develop our timeline to send out the
mobile health clinic and assign staff to
work in the mobile health clinic.
Begin vaccine plan and distribution for
PEH.
Ensure the safety of our staff.
• Our Planning Section will develop an
appropriate timeline by looking at past data of
how many Johnson & Johnson vaccines we
typically receive in a week.
• Our Planning Section will design work
schedules for UNMH nurses and UNM
nursing students to staff the van on a given
day.
• Our Logistics Section will equip our staff
with the appropriate supplies for distributing
vaccines and assure that there is fueling and
maintenance coverage 24/7.
• Our Logistics Section will provide food
services to staff.
• We will divide the City of Albuquerque into
small sections, starting voluntary vaccinations
in more concentrated areas and working out
towards more rural locations.
• Our Public Information Officer will develop a
plan to inform the public of each location 2-3
weeks in advance.
• Our Liaison Officer will work with homeless
sector leaders, service providers, and
community partners to share this information.
• We will be limited by the number of Johnson
& Johnson vaccines we have; however, each
weekday we will distribute what we have.
Any vaccines that are left over will be
immediately used at a partnering location.
• Our Safety Officer will identify and mitigate
all hazardous situations that may arise.
• We will request support from the
Albuquerque police situation to be on-call
when needed.
• We will always have a diverse team assigned
to the clinic at any given time.

Evaluation of Project Deliverables

In evaluating the success of a UNMH Mobile Health Clinic, the COVID-19 Incident
Management Team aims to answer the following questions:
• Did we launch a UNMH Mobile Health Clinic program that will vaccinate PEH?
• In what ways was the development of the UNMH Mobile Health Clinic aligned with our
goals, objectives, and methods?

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

• How many people who are experiencing homelessness got vaccinated by 1 July 2021, 1
August 2021, and 1 December 2021?
• When looking at the estimated homeless population of Albuquerque, what percentage of
PEH were vaccinated by 1 July 2021, 1 August 2021, and 1 December 2021?
• At the end of 2021, what is the estimated risk of PEH to get the COVID-19 disease?
Data will be carefully tracked at the van by our nurses, who will keep a log of information for
each patient. Reports will be written at each key stage by the C9IMT, which will include an
evaluation of the data, progress made towards each key stage, and research regarding current
PEH statistics by the Albuquerque Coalition of Care.

Deliverables Out of Scope

Key logical areas which are not considered part of the boundaries of this project include:
• Solving the spread of the COVID-19 disease in Albuquerque
• Work instructions to doctors, nurses, and nursing students within the mobile clinic

CONCLUSION
The COVID-19 Incident Management Team asks that the Centers for Disease Control’s grant
review committee to consider making a start-up gift of $57,000, toward the development of our
UNMH COVID-19 Mobile Health Clinic. By being able to directly visit numerous locations and
provide vaccinations, UNMH will improve the wellbeing of the most vulnerable population in
Albuquerque while serving the CDC’s fourth strategy during this unprecedented time.
By UNMH managing and coordinating this mobile health clinic program with the help of the
City of Albuquerque, we will be able to bring together a wealth of practical experience and
highly knowledgeable people to ensure the optimum operation of this project. Such a
contribution will inspire hope in our community that more can be done to help everyone feel
safer and that we are working together to help us return to a state of normality again.
The UNM Hospital would like to thank you, the Centers for Disease Control’s grant review
committee, for your consideration of this project and we sincerely hope for your support.

We can be reached with confidence at covid19icm@unmhospital.org.

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

BUDGET NARRATIVE
Category Description Cost
Supplies Medical Mobile Van - Used $51,018.00 [11]
Signage Branding $2,500.00 [12]
Equipment Medical Refrigerator $350.00
Equipment Autoclave $369.00
Supplies Blood Pressure Monitor $63.00
Supplies Dressing Kits $800.00 [11]
Travel Gas $1,900 [13]

Grand Total: $57,000

Notes:
• During the first month of this project, we will purchase a used medical mobile van that is
currently on an emergency hold for us by Used Mobile Clinics, a Dart Colorado LLC.
We will brand our van through a local company, NM Graphix, who has confirmed to
UNMH that they would expedite their services on this van.
• The medical refrigerator will hold the vaccines at the appropriate temperature to expand
their lifetime. The autoclave will sterilize any lab equipment that is used on our patients.
The blood pressure monitor will be needed to check the conditions of patients who may
react adversely to the vaccine. The dressing kits contain items, including medical gloves,
sterile wipes, and Band-Aids. The kits will be used by nurses while administering
vaccines.
• Funding for vaccine kits is not requested because Ancillary Supply Administration is
routinely supplying kits with Johnson & Johnson vaccines.
• Gas expenses were found by the following calculation: (1) dividing the estimated ‘total
monthly mileage’ by the ‘average MPG of the van’ to get the ‘number of gallons
needed’; (2) multiplying the estimated ‘number of gallons needed’ by the ‘price of gas’ to
get the estimated ‘cost of gas per month’; (3) multiplying the estimated ‘cost of gas per
month’ by ‘seven’ to account for the months of June through December.
• These start-up costs do not consider the wages of our medical and non-medical staff
because UNMH will be covering this typical expense.

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

REFERENCE LIST
[1] C. f. D. C. a. Prevention, "National Initiative to Address COVID-19 Health Disparities
Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority
Populations and Rural Communities," 2021. [Online]. Available:
https://apply07.grants.gov/apply/opportunities/instructions/PKG00265994-instructions.pdf.
[Accessed 27 April 2021].
[2] C. o. Albuquerque, "Family and Community Services," 2021. [Online]. Available:
https://www.cabq.gov/family/our-department. [Accessed 27 April 2021].
[3] A. Lebron, "What Makes a Comprehensive Hospital Emergency Management Team?," 7
May 2019. [Online]. Available: https://www.ravemobilesafety.com/blog/what-makes-a-
comprehensive-hospital-emergency-management-team.
[4] New Mexico Department of Health, "COVID-19 in New Mexico," 5 April 2021. [Online].
Available: https://cvprovider.nmhealth.org/public-dashboard.html.
[5] United States Interagency Council on Homelessness, "New Mexico Homelessness
Statistics," [Online]. Available: https://www.usich.gov/homelessness-statistics/nm/.
[6] NM Coalition to End Homelessness, "2019 Point-In-Time Count," July 2019. [Online].
Available:
https://nmceh.org/pages/reports/2019%20ABQ/Final%202019%20ABQ%20PIT%20Report
.pdf.
[7] Modern Healthcare, "COVID-19 is 'a crisis within a crisis' for homeless people," 24 August
2020. [Online].
[8] NM Department of Health, "State of New Mexico COVID-19 Vaccine Allocation Plan
Phases 1A, 1B, 1C, and 2," 8 January 2021. [Online]. Available:
https://cv.nmhealth.org/wp-content/uploads/2021/01/2021.1.8-DOH-Phase-Guidance.pdf.
[9] UNM Hospital, "UNM Hospital's Mission, Vision & Values," 2021. [Online]. Available:
https://unmhealth.org/locations/unm-hospital/about/.
[10 Population Health Advisor, "Mobile Health Clinics: Improving Access to Care for the
] Underserved," March 2017. [Online]. Available:
https://www.mobilehealthmap.org/sites/default/files/uploads/PHA_Mobile%20Clinic%20Br
ief_0317_General.pdf.
[11 R. Foundation, "Rotary Foundation Donations (International Funding)," [Online].
] Available: http://www.rotarygrants.org/global/pdf/doc1126-1162.pdf. [Accessed 28 April
2021].
[12 NM Graphix, "Wraps," 2021. [Online]. Available: https://www.nmgraphix.com/vehicle-
] wraps/. [Accessed 28 April 2021].

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CDC-RFA-OT21-2103: UNMH COVID-19 Mobile Health Clinic for People Experiencing Homelessness

[13 H. Bird, "How to Calculate Gas Costs Per Month for Van Life," 8 November 2019.
] [Online]. Available: https://www.greenvango.com/calculate-gas-costs-per-month/.
[Accessed 28 April 2021].
[14 Hud Exchange, "Vaccine Planning and Distribution: Roles and Responsibilities," January
] 2021. [Online]. Available: https://files.hudexchange.info/resources/documents/Vaccine-
Planning-and-Distribution-Roles-and-Responsibilities.pdf.
[15 N. Malone, M. Williams, M. Fawzi, J. Bennet, C. Hill, J. Katz and N. Oriol, "Mobile health
] clinics in the United States," 20 March 2020. [Online]. Available:
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-1135-7#Sec2.

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