From Nightlife to Spin Cycles: NYC Mobile Clinic Meets Patients Where They Are

In Jackson Heights, Queens, one of the most culturally diverse neighborhoods in the United States, a mobile medical unit quietly sets up outside a nightclub and begins its shift just as most clinics are closing.

From 6 p.m. to 2 a.m., the Community Healthcare Network, or CHN, mobile clinic offers primary care, STI testing, HIV prevention, vaccinations, and gender-affirming services to patients, including those who identify as immigrants, asylum seekers, sex workers, and transgender patients—many of whom have no stable housing or access to traditional healthcare.

Staffed by a team of 45 and led by Dr. Freddy Molano, vice president of Infectious Diseases and LGBTQ Programs and Services, a 35-year vet at CHN, the goal is to deliver as much care as possible to the city’s most vulnerable, wherever they are and for whatever they need.

CHN operates 14 clinics across the city, but its mobile medical unit is central to the organization’s mission. The mobile unit can be found near subway stations, street corners, dance clubs, and even laundromats in Queens and beyond, particularly in places where healthcare is often out of reach.

Harvey Diaz, Director of ID/LGBTQ Programs at CHN, noted that many patients actively choose the mobile clinic over a brick-and-mortar facility due to the personalized care and accessibility it offers.

This strategy was critical to CHN’s ability to continue offering care during the Covid-19 pandemic, when the mobile unit operated program operated weekly, even as the city shut down and CHN lost three staff members and more than 50 patients.

Now, the needs have shifted but remain urgent. Molano estimates that 90% of CHN’s mobile unit patients are asylum seekers or recent immigrants. Many come with histories of trauma, including abuse, exploitation, and physical hardship from long journeys through Central America and the U.S. southern border.

Molano visited El Paso recently to better understand what his patients had endured. He described hundreds of people in one room, sleeping under metallic blankets at night, baking in heat during the day.

Once in New York, many of those same people were placed in shelters for 90 days, with no guaranteed access to healthcare. CHN’s mobile units fill the gap, often being the first point of contact for people who have gone months without seeing a doctor.

Molano tries to maximize the impact of the mobile unit, parking in spots that might not be obvious locations, like laundromats.

“Everyone needs to do laundry,” Molano said, describing one method of outreach. “They stay there so that no one takes their clothes. It’s a captive audience,” he said with a smile.

Molano’s team has also taken to making house calls, delivering care as well as other aid, such as food, which has become unaffordable for many in the Queens neighborhoods in which he makes his rounds. His staff also organized a community dinner during the holidays to make patients “feel like they belong somewhere,” he said.

Many of the mobile unit staff have similar lived experiences as the patients they treat, which builds trust.

“We’re not here to criticize or judge,” Molano said. “If you go little by little getting their confidence, not criticizing them for getting an STI, for example, and connecting them to care, that raises the confidence level for people to then seek care,” he said.

For many of CHN’s transgender patients, most of whom are in their 30s and 40s and newly arrived, gender-affirming care is a matter of survival. With help from a local foundation, CHN provides hormone therapy at low cost. The stakes are high. Molano said one patient died recently after receiving a deadly cocktail of counterfeit estrogen hormones.  

Facing an ongoing and shifting array of obstacles, from political to financial, Molano remains driven by his own past and a sense of justice. An immigrant and early HIV educator, he remembers being told women couldn’t get AIDS. “I knew that wasn’t true. The first patient I tested was a woman, and she was positive.” That courage of conviction, now applied more broadly to vulnerable communities, motivates his work today.

“I’ve been to too many funerals,” he said. “When I look at my team, when I see them cooking meals for patients or doing home visits, I know we’re doing the right thing… the most important thing is to continue to move forward. I owe it to my patients, and I believe it’s my obligation to fight for my community.”

For Molano, the mobile unit represents more than just a healthcare access point. He sees it as a front door to the city’s care system, and a show of dignity in action.

“We have an obligation to meet people with kindness,” he said.

CHN is a winner of this year’s Pfizer-supported Innovation Awards in Community Health: Addressing Infectious Disease in Underserved Communities.