Three years ago, the Shalom Free Clinic opened in Chico, Calif., with a mission of providing underinsured and uninsured children and adults with health screenings, primary care interventions, health services and education, including physical and mental/behavioral health services, all free of charge.

Karen Kushner, PA-C, says a "cosmic coming together of three people" resulted in the opening of the free clinic. For her role as one of those founders, Kushner has been named the 2009 Family Practice Physician Assistant of the Year by ADVANCE for Physician Assistants and the Association of Family Practice Physician Assistants. Sponsors of the competition are Medelita and Brymill Cryogenic Systems.

Kushner, along with Frederic Jones, PhD, who had been a pastor at the Congregational Church of Chico, and church member Nancy Morgans-Ferguson, sought to put together a medical mission to help the congregation and the community and came up with the idea of a free clinic. "Nancy had the connection in town because she'd been a pharmaceutical rep, the pastor had tried to do a free clinic in the past in another town, I had the medical background, and voilà--clinic!"

Located in the education building next to the church, the Shalom Free Clinic is open on Sundays from 1 p.m. to 4 p.m. All ages are welcome, and patients do not need an appointment.

Morgans-Ferguson nominated Kushner for the Family Practice PA of the Year competition, and a panel of AFPPA board members chose Kushner to receive this year's award. Morgans-Ferguson wrote in the nomination, "She spends time getting to know each client and their situation. Our patients are without insurance or are underinsured, and most also have a mental health problem. Karen brings years of finely honed skills to see that our clients are treated in a loving and accepting environment. Our many physician volunteers love working with Karen because her skills in family practice care are outstanding, and her compassion for patients goes beyond what is usually seen in most practices. Karen truly cares about our clients and their families, and the patients know it."

The clinic is funded solely by donations; two to three large fundraisers are held each year. Plus, patients often return and donate either money or time. "They're very loyal to our cause, and very, very appreciative of what we do," Kushner says.

The medications provided to patients are from samples or donations from private offices. And all of the clinic's equipment is donated, says Kushner, except for two portable sinks that were purchased through a grant from the United Church of Christ's Neighbors in Need program.

In addition to the uninsured or underinsured, patients include people who have insurance but who can't afford their large co-pay or who can't afford medication after discharge from a hospital or a mental health/psychiatric facility.

"People are told to come to our clinic to see what we can do for them," Kushner says. "Oftentimes, it's not medication that these folks need--there are other social issues that are not being addressed, and typically these are folks who are discouraged, disenfranchised and just disappointed at the entire health care system for one reason or another and need a place to be heard."

Kushner encourages her patients to tell their stories as many times as they need to, so that they are heard and some sort of resolution occurs.

While Kushner's official title at the clinic is medical coordinator, she provides much more. "Whether it's through a medical intervention, a psychiatric intervention, a legal intervention, sometimes it's getting people heard, housing, clothes," she says. "So that's what we do at the clinic."

Over the years, the Shalom Free Clinic has provided services to thousands of patients. On average, 50 patients seek care each Sunday. Kushner notes that the clinic is getting busier as a result of the extreme budget cuts in California. "I think that if we consider health care for all, perhaps our little clinic wouldn't be so busy," she says.

Kushner typically comes to the clinic on Wednesday nights, along with any other times necessary to catch up on paperwork such as medication refills, chart reviews and other correspondence.

When not at the clinic, Kushner works for various programs in the Butte County Department of Behavioral Health, including the Drug Endangered Children Team, where in partnership with local law enforcement and child protective services she provides medical and mental health services for children who have been removed from hazardous environments. She also participates in the Connecting Circles of Care program, a multidisciplinary team for at-risk youth and their families.

Kushner is a 1982 graduate of the Lake Erie College/Cleveland Clinic Foundation PA program in Ohio. Throughout her career, she has worked with numerous patient populations--including developmentally challenged young adult and geriatric patients at a center in Massachusetts, outpatients at an Air Force clinic in Arizona and teenagers at a high school-based clinic in Oregon--that have prepared her for where she is today.

The native New Yorker also offered her services for three weeks in Manhattan as a Red Cross volunteer immediately after 9/11. "It was a life-altering experience, a time when caring for people and coworkers who were shell-shocked forced me to take stock of my own life, and I felt I needed to do more somehow," she says. "Feeling the city come together without reservation or judgment tapped my soul and inspired me to go forth with a long buried dream: a free clinic," she says.

Kushner offers this advice to all family practice PAs: "Try to remember why you became a family practice PA, what it was that attracted you to teaching and healing others, and find that passion and go for it. This clinic is my passion, and this is what I'm doing for the rest of my life."

Kushner received a plaque, a cash prize and a gift certificate to the ADVANCE Healthcare Shop, along with airfare, two nights' hotel stay and registration for the AFPPA conference in Phoenix, Nov. 4 to 7.

ADVANCE for Physician Assistants is the official publication of the AFPPA.

Visit the clinic's Web site at www.shalomfreeclinic.org.