Project Grant T3555302

PRIMARY CARE TRAINING AND ENHANCEMENT -- RESIDENCY TRAINING IN STREET MEDICINE - ACCESS TO PRIMARY CARE FOR INDIVIDUALS EXPERIENCING HOMELESSNESS IN LEON COUNTY AND SURROUNDING AREAS REMAINS A SIGNIFICANT CHALLENGE. THESE POPULATIONS FACE HIGH RATES OF CHRONIC DISEASE, BEHAVIORAL HEALTH CONDITIONS, AND SUBSTANCE USE DISORDERS, ALL COMPOUNDED BY SYSTEMIC BARRIERS TO HEALTHCARE ACCESS. THIS PROJECT AIMS TO ADDRESS THESE ISSUES BY ENHANCING PRIMARY CARE RESIDENCY TRAINING IN STREET MEDICINE, IN COLLABORATION WITH FLORIDA STATE UNIVERSITY (FSU) COLLEGE OF MEDICINE, TALLAHASSEE MEMORIAL HOSPITAL (TMH) FAMILY MEDICINE RESIDENCY PROGRAM, FSU COLLEGE OF NURSING, FSU COLLEGE OF SOCIAL WORK, LEON COUNTY EMS, LEON COUNTY SHERIFF'S DEPARTMENT, THE KEARNEY CENTER, AND BIG BEND CONTINUUM OF CARE. THIS INITIATIVE WILL EQUIP FAMILY MEDICINE RESIDENTS AND HEALTHCARE STUDENTS WITH THE SKILLS TO PROVIDE INTERPROFESSIONAL, TRAUMA-INFORMED PRIMARY CARE TO INDIVIDUALS EXPERIENCING HOMELESSNESS. THROUGH A CURRICULUM THAT INTEGRATES STREET MEDICINE, BEHAVIORAL HEALTH, AND SOCIAL DETERMINANTS OF HEALTH (SDOH), RESIDENTS WILL GAIN HANDS-ON EXPERIENCE IN NON-TRADITIONAL SETTINGS SUCH AS SHELTERS, ENCAMPMENTS, AND MOBILE UNITS. THE PROGRAM WILL ALSO FOSTER COLLABORATION BETWEEN MEDICAL, NURSING, SOCIAL WORK, AND PHARMACY STUDENTS, PROMOTING CARE COORDINATION AND PATIENT ADVOCACY. EXPECTED OUTCOMES INCLUDE A TRAINED WORKFORCE OF FAMILY MEDICINE PHYSICIANS PROFICIENT IN STREET MEDICINE, IMPROVED HEALTHCARE ACCESS FOR HOMELESS INDIVIDUALS, AND STRENGTHENED ACADEMIC-COMMUNITY PARTNERSHIPS. BY EMBEDDING STREET MEDICINE PRINCIPLES INTO RESIDENCY TRAINING, THE PROGRAM AIMS TO IMPROVE HEALTH OUTCOMES FOR VULNERABLE POPULATIONS AND CREATE A SUSTAINABLE, COMMUNITY-DRIVEN MODEL OF MEDICAL EDUCATION. LOCAL CONTEXT AND NEED TALLAHASSEE IS EXPERIENCING A HOMELESSNESS CRISIS, WITH A 5% INCREASE IN THE HOMELESS POPULATION, ACCORDING TO THE 2024 POINT-IN-TIME REPORT. THE REPORT IDENTIFIES 840 PEOPLE EXPERIENCING HOMELESSNESS IN LEON COUNTY, INCLUDING 192 YOUTH AND 112 VETERANS. FLORIDA RANKS AMONG THE HIGHEST IN UNSHELTERED HOMELESSNESS, WITH 63% OF HOMELESS INDIVIDUALS LIVING WITHOUT SHELTER. THIS UNDERSCORES THE URGENT NEED FOR COMPREHENSIVE, COMMUNITY-BASED HEALTHCARE SOLUTIONS. LOCAL AGENCIES, SUCH AS FAMILY PROMISE OF THE BIG BEND, SERVED 545 FAMILIES IN EMERGENCY SHELTER IN 2023, AND PROVIDED SUPPORTIVE SERVICES TO 291 VETERANS. HOWEVER, PRIMARY CARE ACCESS REMAINS INSUFFICIENT. THE KEARNEY CENTER, WHICH HOUSES OVER 100 ELDERLY RESIDENTS, HAS HIGHLIGHTED THE CRITICAL NEED FOR MEDICAL RESPITE BEDS FOR INDIVIDUALS WITH COMPLEX CONDITIONS. THE CLOSURE OF THE KAY FREEMAN CLINIC HAS WORSENED THE SHORTAGE OF PRIMARY CARE, ESPECIALLY FOR INDIVIDUALS DEPENDING ON THE BOND MOBILE RESPONSE, WHICH CANNOT MEET DEMAND. THE CITY OF TALLAHASSEE'S HOMELESSNESS DASHBOARD SHOWS A DECLINE IN SHELTERED INDIVIDUALS, WITH ONLY 393 PERMANENT SUPPORTIVE HOUSING UNITS AVAILABLE. THIS FURTHER EMPHASIZES THE NEED FOR MOBILE HEALTHCARE MODELS THAT PROVIDE CARE DIRECTLY TO UNSHELTERED POPULATIONS. THE NORTH FLORIDA STREET MEDICINE COLLABORATIVE SOLUTION THE NORTH FLORIDA STREET MEDICINE COLLABORATIVE WILL ADDRESS THESE GAPS THROUGH A COLLABORATIVE, INTERDISCIPLINARY APPROACH TO TRAINING HEALTHCARE PROFESSIONALS IN STREET MEDICINE. BY ENHANCING RESIDENCY TRAINING IN NON-TRADITIONAL CARE SETTINGS, THE INITIATIVE AIMS TO IMPROVE HEALTHCARE ACCESS, PROVIDE TRAUMA-INFORMED CARE, AND ADDRESS SOCIAL DETERMINANTS OF HEALTH. THE PROJECT WILL CREATE A SUSTAINABLE, COMMUNITY-DRIVEN MODEL OF CARE, BENEFITING BOTH THE HOMELESS POPULATION AND THE HEALTHCARE WORKFORCE IN NORTH FLORIDA.