Project: Homeless Access to Health Care
Fellow: Greta J. Kuphal
Mentor: Dr. Cynthia Haq

Fellow Bio:
I grew up 6 miles outside of Kewaskum, WI (a little farm town about 40 minutes north of Milwaukee). I have 7 incredible older siblings who have served as a great source of inspiration and support along with my parents. Service has been a part of my life since I was about 15 years old. It has become a passion and a calling. After graduating from the University of Wisconsin-Madison with a degree in molecular biology, I spent a year as an AmeriCorps*VISTA volunteer in Casper, Wyoming. I worked in a Health Care for the Homeless clinic there and had the great opportunity to see how a small, efficient facility can provide primary medical and mental health care, case management, and outreach to a population of people for whom that is a rare luxury. When my AmeriCorps term was over, I spent another year enjoying the beauty of Wyoming and its people before having the great privilege beginning the grind of medical school here in Madison.

Project Description:

a. Inputs for this project will be coming from a wide range of community resources. A list of agencies I would like to contact and possibly work with include the area homeless collaborative, various homeless shelters, Dane County Medical Society, University of Wisconsin-Madison Medical School, public health, local hospitals and urgent care centers, South Madison Health and Family Center, and homless individuals themselves. This list may increase as the project develops. Coming up with "ideas" is one of the goals of this project. I would like to go into the community and elicit perspectives, ideals, possibilities, and thoughts from individuals about the provision of health care to the homeless population. Stakeholders, in my mind, include the entire community--businesses, residents, service providers, service recipients, etc. However, the agencies listed above with whom I would potentially work, may be the most interested in addressing this need.

b. Activities in this program will intitially include meetings, volunteering, and research. I intend to meet with community leaders, providers of services for the homeless, representatives of health care facilities, and homeless individuals to get a feel for the "inside" picture of health care delivery to this population in this area. I believe volunteering in homeless shelters and other service facilities will allow me to gain a better perspective of the community than I would only meeting with executive directors or social workers, etc. in the confines of conference rooms and private offices. The research I will need to do will involve finding out what resources are currently being used to provide homeless individuals with health care, where money is currently going (e.g. how much is being spent on treatment in emergency rooms and urgent care centers that could be more efficiently spent on preventative care), what types of facilities or services area agencies and potential clients would like to see, and what private and/or governmental resources are available on local, state, and federal levels to provide these services. Sources of data for this research will include, but not be limited to, agency directors, homeless individuals, government websites, MEDIC statistics, etc.

c. Short term outcomes will include the collection of data--both statistical and subjective, the acquisition of familiarity with the current network of services in this area available to homeless individuals, development of relationships between a LOCUS fellow and the greater service community (and therefore LOCUS itself and the community), and possible facilitation of new/improved communication between entities within the community that are interested in the provision of health care to the homeless population.

d. Ideally, this effort will lead to greater collaboration and commitment within this community to provide effective, comprehensive health care to the homeless population of Madison/Dane County. This may lead to an effort to establish a network of clinics that could each individually provide consistent health care to a small percentage of homeless individuals, or it may lead to something as large scale as the opening of a Health Care for the Homeless Clinic here in Madison.

Project Goals:

The overall goal of this project is to improve the provision of health care to the homeless population of Madison/Dane County through greater committment and collaboration and/or new >resources being introduced into the community. Personally, I would like to get more involved in the already existing network of service providers that work with the homeless population in this region. Care for the underserved is the reason I went into medicine, and I would like to learn as much as I can so that I will be able to use the acquired experience in my own future practice.

Challenges and Solutions:

I see time restriction as a challenge. One summer of part time work is not enough to complete a comprehensive study of medical service provision to the homeless population. I will simply do as much as I can and be sure to research the most important information. I also see being a relative "outsider" to the local service community as a challenge. I know very little about how this local network is organized have no contacts outside of the academic realm. I will need to carefully approach those with whom I wish to work in order to ensure they understand that I sincerely desire to help individuals they work with. Lastly, in a strange way, I see the high density of medical professionals in this area as a barrier. It seems that the local community health center had a difficult time obtaining federal funding because of this. I believe that with well organized and thoughtful preparation, it would be possible to receive some sort of governmental funding if the community so desires.

Next Steps:
Locus Project Objectives and Key Tasks Target Date for Completion
Volunteer/work at local CHC to understand its role in community health care. May 29, 2003
Set up meetings with public health, Dane County Medical Society, area homeless collaborative, and local homelss shelters. June 10, 2003
Meet with representatives of aforementioned agencies. June 30, 2003
Volunteer afternoons at homeless shelters at least 2 times per week. Start week of June 16, 2003
Research local, state, and federal resources which could be of use for health care provision to homeless individuals in this area. June 23, 2003
Resource Needs:

Resources needed could be broken down into two categories, those needed for the project and those to be investigated. IN terms of the project, at this point, only my time and that of individuals with whom I will be meeting will be required. However, the resources to be investigated include local, state, and federal resources that may be in place or could potentially be used to provide health care for homeless individuals.

Last update:

June 1, 2003

Graduation Requirements Progress Chart
If you complete the requirements outlined below, you will graduate as a LOCUS fellow.

A check indicates the item has been completed.

Completed When What On-line
check Year 1: Beginning of Semester 2 New Project Report Submit Report
  Year 2: Beginning of Semester 1 Project Update Submit Update
  Year 2: Beginning of Semester 2 Project Update Submit Update
  Year 3: Beginning of third year Project Update Submit Update
  Year 4: August of fourth year 2-3 page final summary of project that includes a reflective evaluation of the project process N/A
  Ongoing Participate in program evaluation (written and/or focus group) View Options
  By the end of fourth year Select poster, presentation, paper, creative option or your own idea View Options

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