Seeking to improve access to health care, the UofL School of Nursing spearheads efforts to partner with the Kentucky Racing Health and Welfare Fund to provide health care services to uninsured workers in the Kentucky horse racing industry. Many workers are non-English speaking with little access to health care or support finding health care. The partnership provides primary care, women’s health care, and mental health care to workers and their families as well as care focused on preventing costly chronic diseases such as diabetes, hypertension and asthma.

UofL School of Nursing faculty and advanced practice registered nurses Krista Roach and Dedra Hayden, who also serves as the program’s director, engage UofL Latin American and Latino Studies program students to help with interpretation, dental students to provide care to patients with complex dental cases, and nursing students to provide care alongside nurse practitioners. In addition to ongoing year-round health services, during the pandemic the program’s nurse practitioner providers played an indispensable role in addressing vaccine hesitancy among their client population.

“At UofL, we are committed to directly impacting the health and well-being of Louisville and beyond,” said UofL Interim Vice President for Community Engagement Douglas Craddock. “Our clinic for equine industry workers both cares for an often-marginalized community and provides essential hands-on, experiential learning to our students, empowering them to make a difference in the lives of the people they serve.”

“Health care provided by our highly qualified nurse practitioners is critical to helping address the shortage of primary care providers in Kentucky. The UofL School of Nursing is honored to play such an important role in providing care to those who otherwise may not have access. We are thrilled by this recognition,” said Interim Dean of the School of Nursing Mary DeLetter. 

Since 2007, APLU and the Engagement Scholarship Consortium, with support from the W.K. Kellogg Foundation, have partnered to honor the engagement scholarship and partnerships of four-year public universities. The award recognizes programs that demonstrate how colleges and universities have redesigned their learning, discovery and engagement missions to deepen their partnerships and achieve broader impacts in their communities. The national award is named for C. Peter Magrath, APLU president from 1992 to 2005.

Recently, the Kentucky Racing Health Services Center – an award-winning, nonprofit clinic run by University of Louisville School of Nursing faculty – began offering mental health services to grooms, hotwalkers, exercise riders and other backside racetrack workers.

Catherine Batscha, DNP MSN, UofL School of Nursing assistant professor and psychiatric-mental health nurse practitioner, provides counseling at the clinic to workers with anxiety and depression. A majority of the patients are from Latin America and speak limited English. Most also consistently travel across the United States throughout the year to work at other racetracks.

“It’s a hard life,” Batscha said. “When you look at the track, a lot of the people who work there have families that are far away. They miss their children. Some have been sexually abused, raped or have grown up in families with alcoholism and substance abuse.”

Previously, the clinic had to send patients to other facilities in the community for mental health treatment, which often took months for an appointment.

“If you’re in the middle of a crisis, you don’t want to wait the eight weeks it’s going to take to find a provider,” Batscha said. “If they have someone who needs to be seen today, I can see them today.”

Providing mental health treatment in-house has made it easier to coordinate care with other nurse practitioners at the clinic, which offers comprehensive services including physicals and women’s annual exams, treatment of minor illnesses and maintenance treatment for conditions such as diabetes, asthma and hypertension.

Founded 11 years ago, the clinic is a joint venture between UofL and the Kentucky Racing Health and Welfare Fund to provide free or low-cost health care to backside track workers and their families. Nursing students see patients under the supervision of faculty members. Students from the Latin American and Latino Studies program also gain experience by serving as translators.

Because most of her patients are transient, Batscha gives them ways to manage anxiety on the road.

Batscha created a SoundCloud relaxation audio in Spanish that patients can access through their smart phones. The audio walks users though progressive muscle relaxation techniques, useful for people who need help getting to sleep or calming their bodies and minds.

The clinic has eliminated barriers to care for the backside workers.

Maria Rinosa, a hotwalker at Churchill Downs and a native of Guatemala, sought mental health treatment for depression at the clinic after the death of her 1-year-old son due to a viral infection.

Without the clinic, Rinosa said she would have limited health care options.

“I don’t know where else I would go,” Rinosa said. “Without medical insurance, the cost is really expensive and the little we earn doesn’t stretch that far.”

Despite their hardships, the workers are incredibly dedicated to their jobs and take pride in their work, Batscha said.

“Everyone is up at 3 in the morning with their horses on the track,” Batscha said. “It’s just humbling to work with folks who have been through so much. They’re still on their feet and working to do a good job and make a difference for Kentucky.”

The clinic is located across from Churchill Downs at the Kentucky Racing Health & Welfare Fund office, 422 Heywood Ave. For more information, .