Shepherd InternshipRachel Tullio

Little Flower Clinic● Healthcare for the homeless clinic● Services

○ Visits with a Medical Provider○ Disease/Case Management○ Medication Assistance Programs○ Referrals for Dental Services○ Onsite Mental Health Services○ Referrals for Mental Health/Substance Abuse Services ○ Insurance Enrollment and Eligibility through Kynect

ensure access for all people and eliminate health

disparities through the provision of quality holistic

care

Vision:

Population

● City of Hazard, Perry Countyo Hazard: approx. 5,000 residentso Perry County: 28,241 residents

● Poverty Rate: 28.7 % (USA 15.1%)● Race: 98.7 % white● Smoking rate: 31%

o highest smoking rate of all states

Chronic Disease

Perry KY USA

Prevalence of Asthma (% adults)

15% 13% 8.2%

Diabetes 9% 8% 11.9%

Hypertension 40.8% 38% 32.5%

Responsibilities● shadowed all staff positions at the clinic● observed patient appointments with APRNs● worked in community garden program● mental health home visits with Outreach and Enrollment● shadowed Family Health Navigator● community service

o Corner Haven Crisis Sheltero Hospice of the Bluegrass

Accomplishments● provides many non-medical resources

o food boxeso transportationo kynectors and insurance enrollment

● prevents and alleviates homelessness● accepts all patients regardless of ability to pay● strong relationships with patients and community● case management

Observations & Challenges● Health

o understanding food culture, traditional meals,preparation

o soda consumptiono diabetes, hypertension, and lifestyle choices

● Political Viewso President Obama unpopularo perception of Affordable Care Act

● Economyo strong support for coal industry

Frontier Nursing Service● supporting organization that arranged my

internship at Little Flowero provided housing and food

● founded by Mary Breckinridge in 1925● birthplace of midwifery in United States● nurses served people of rural Appalachia● central hospital and outpost clinics● now a distance education program that trains

nurse-midwives, DNPs, advanced nursing degrees

My SSLP● Maggie’s Place

o home of hospitality for pregnant women (& their babies up to 6 months)

● Glendale, Arizona● Director of Donations● building relationships with

the moms

Comparisons

Little Flower Clinic● exposure to medical setting and

careers in medical field● focus: provide primary care

services● community service component● public health background

o Community Health Profileo interviews with community

members, leaders, and medical staff

● rural environment

Maggie’s Place● office and home setting at the

Michael House● focus: provide love, support,

safety, home security to mothers● little research into health profile

of the community● less rural, 30 minutes outside of

Phoenix

Understanding Poverty

Little Flower Clinic● transportation problems in a rural

area● policy focus and ACA● public health issues including

smoking, diabetes, hypertension, drug abuse

● diet and exercise habits● food desert and access and

affordability of produce● homelessness

Maggie’s Place● importance of soft skills and

social interaction in job market● effects of lack of education● effects of poor or no family

support, few mentors● need for parenting classes,

women’s health education● faith based organization● homelessness● substance and alcohol abuse