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Beattyville's HUB offers coordinating healthcare services for Appalachian homeless

Stu Johnson

Homelessness is a reality in virtually every section of Kentucky. Although often thought of as an urban challenge, rural Kentucky also finds the plight of the unhoused a pressing issue. In part two of our series on rural health, we get a glimpse on how one Appalachian community is addressing homelessness needs.

There is a gathering spot inside the HUB in downtown Beattyville. It’s the Lee County Health Center Annex and it's situated right across from the health department. Staff at the HUB work to connect clients with various providers in the area. Christina Sargent has been homeless for four years and faces a common health challenge in rural Kentucky, problems with her teeth.

“I need them pulled. They hurt all the time. They break off. They’re just bad,” said Sargent.

Christina Sargent
Stu Johnson
Christina Sargent

Sargent said she still needs to get in to see a dentist. She said the HUB is awesome with its services, including food, clothing, and bathing supplies.

HUB client Nathan Tipton said he’s been four months clean after struggling with drugs for years.

“Well I was on meth and drinking real bad and after my papa and mama died, it got worse and stayed out there in the woods for about four and half year..still homeless, but life makes a big difference when you got God on your side,” said Tipton.

Nathan Tipton
Stu Johnson
Nathan Tipton

Tipton said it’s different now, before, he was stealing and robbing to get a fix.

Michael Hicks is a HUB drug and alcohol counselor. Hicks said he was homeless from age 17 to 38, moving up and down the east coast-Maryland and South Carolina.

“The best options I could have had that I didn’t take was going into treatment. Because that would have gotten me into a program that would have led to sober living and employment and sustainability. That would have been the quick easy way..the best option but I wasn’t ready at that point,” said Hicks.

Michael Hicks
Stu Johnson
Michael Hicks

Hicks noted finding other resources at that point was a lot harder. He added, for many homeless addicts, none of it is easy because of the stigma.

Another staff member at the HUB is Shawn Maynard. He was a user of oxycontin, pain pills, and then meth, along with alcohol. Maynard’s been clean six years and works with clients to address barriers. He said the homeless lifestyle itself creates health risks.

Shawn Maynard
Shawn Maynard

“Hygiene, I mean goes down to when you’re homeless you’re hygiene’s not gonna be good and that’s gonna create infection, staff infection. If you do get a cut and you’re not getting the proper wound care for it, it’s gonna get infected,” said Maynard.

The HUB is situated in an active area in Beattyville. JoAnn Fraley is the director, and a social worker who’s worked in addiction and recovery. Fraley said about 80% of HUB clients are currently living on the streets or couch surfing. She noted many just don’t realize their health status.

“Lot of them have blood pressure issues and they don’t even know. A lot of them have diabetes and they don’t even know. So, those issues we need to address as quick as we can,” said Fraley.

JoAnn Fraley
Stu Johnson
JoAnn Fraley

Fraley said the focus is getting people hooked up with doctors and health providers. And the harm reduction program coordinator said, quote, “we can’t expect change if we don’t help with the changing process.”

“They’ve lost hope. They give up. They’ve burnt every bridge that they have with family. And so, they let themselves go and they just think nobody cares about them. And whenever someone goes somewhere and they’re not treated very nice, they don’t go back,” said Fraley.

The HUB is associated with Kentucky River Health District. District Health Director Scott Lockard said he and Fraley brainstormed over the HUB concept. Lockard added creating bonding relationships is important.

“We form that relationship. We show them that they can be treated with dignity. We establish trust and then when the timing is right and they’re ready for treatment, we can link them to treatment immediately,” said Lockard.

Lockard said transportation can be provided, if needed. And it’s in improving health status that carries longterm benefits.

“You know I say health is the foundation for everything. If you don’t have health, you can’t worry about education, you can’t worry about employment. You can’t worry about everything else," said Lockard.

Scott Lochard
Stu Johnson
Scott Lochard

So, Lochard said that means linking up to a medical home and making sure the clients have a payer source, which for most is Medicaid. Lochard said some don’t even realize they are eligible for Medicaid. The Kentucky River District Health director noted efforts are underway in Letcher County to establish a similar program. Lockard envisions similar HUB-like services in all seven Ky River District counties, ideally in the next five years or so.

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Stu has been reporting for WEKU for more than 35 years. His primary beat is Lexington/Fayette government.
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