Primary Care Training and Enhancement -- Residency Training in Street Medicine - Applicant Organization: East Tennessee State University Address: PO Box 70621, Johnson City, TN 37614-1709 Project Director: Morgan Buda, MD Contact Phone Numbers: 423-439-6464 E-mail Address: budamc@mail.etsu.edu Website: https://www.etsu.edu/com/familymed/ Funds Requested: $2,439,093 in direct and indirect costs over 5 years Funding Priority and Preference: Rural Training and High MUC Placement Rate Taking to the STREETs: Building Bridges to Healthcare for the Unhoused will provide a multi-faceted training program in street medicine for family medicine residents enrolled in three residency programs offered at clinical training sites in medically underserved communities in Appalachian Northeast Tennessee. The project will enhance the residency curriculum provided by Department of Family Medicine (DFM), James H. Quillen College of Medicine (QCOM), East Tennessee State University (ETSU). Our project team will develop and implement an interprofessional, team-based street medicine curriculum focused on delivering compassionate primary care for people experiencing homelessness. Street medicine training will be provided to all 60 residents in Year 1 and an additional 20 residents each year thereafter, for a total of 140 trainees throughout the 5-year grant period. This work will significantly increase the number of family medicine physicians prepared to provide primary care for this vulnerable population, by bringing health care to unhoused people outside of traditional clinical settings. The project will strengthen the primary care workforce in underserved and rural areas and improve patient outcomes and quality of health and health care in a region with substantial health disparities. The STREETs project will meet all RTSM program requirements and expectations, including partnering with community-based organizations (CBOs) to develop the equivalent of two one-month rotations that focus on providing primary health care to the homeless. Residents who choose to pursue this rotation will spend one half-day every week in both the last half of PGYII and beginning half of PGYIII caring for unhoused patients. Time spent completing this rotation will total 200 hours of clinical experience (50 half-days of 4 hours each), equaling two one-month elective rotations that focus on providing care to the homeless. The rotations will be offered in partnership with Johnson City CBOs in Year 1 and expanded to include CBO partners in Kingsport and Bristol in Years 2 and 3 respectively. In Year 1, rotation sites for the STREETs project include several outdoor encampments through community outreach in partnership with ETSU Health Downtown Day Center; Johnson City Salvation Army's 33-bed emergency shelter and 15-bed transitional housing for veterans; Family Promise of Greater Johnson City, which works with five families at a time to provide emergency and transitional housing for low-income, unhoused families; and Frontier Health's Safe House, a 28-bed shelter for domestic violence survivors and their dependent children. Our plan is to visit encampments as a group one-half day per month and provide care at the CBO shelters on a rotating basis the other three half-days, ensuring that unhoused patients in each of these settings will have the opportunity to receive primary care at least once per month. We will also host annual community roundtables, providing opportunities for CBOs to compare notes about current efforts to serve the homeless population and ways we can work together to enhance and expand resources in our area for people experiencing homelessness. These gatherings will also provide a means to disseminate results of the project locally to CBO partners and other community leaders as well as ETSU leadership. Grant funds will also support dissemination of findings at national and regional conferences attended by residents and faculty and through journal publications.
