Primary Care Training and Enhancement -- Residency Training in Street Medicine - St. Luke’s University Health Network (SLUHN), applying as St. Luke’s Hospital, seeks funding through the PCTE-RTSM initiative to expand and enhance one of its five Primary Care Residency Training Programs, the Rural Family Medicine Residency Training Program by developing a Street Medicine Academic Track. The initiative aims to bridge gaps in residency education by ensuring future physicians are well-prepared to serve medically underserved populations in rural Carbon and Schuylkill Counties. Traditional family medicine residency programs, including SLUHN’s, lack structured training in street medicine, leaving residents underprepared to care for individuals experiencing homelessness. Most curricula focus on in-clinic patient care, limiting residents’ exposure to interdisciplinary learning and non-traditional settings. The demand for physicians trained in street medicine is increasing. According to the 2024 Point-in-Time (PIT) Count, homelessness in Pennsylvania has increased by 11% over the past five years. Carbon and Schuylkill Counties experience high rates of chronic disease, mental illness, and substance use disorders (SUDs) among individuals experiencing homelessness. Carbon County’s opioid overdose death rate (56.6 per 100,000) exceeds both state (35.8) and national (24.7) averages, highlighting the urgent need for addiction medicine expertise in primary care. Many individuals experiencing homelessness cycle between emergency departments (EDs), shelters, and incarceration, exacerbating poor health outcomes, high mortality rates, and healthcare costs. This initiative will implement a Street Medicine Academic Track within SLUHN’s Rural Family Medicine Residency Program, equipping residents with specialized training to provide healthcare for individuals experiencing homelessness. The program will enhance residency education by incorporating structured clinical rotations in shelters, mobile outreach units, and telemedicine services, ensuring that residents gain hands-on experience in delivering care in non-traditional settings. Additionally, the project will expand behavioral health and addiction medicine training by integrating trauma-informed care, harm reduction strategies, and Medication for Opioid Use Disorder (MOUD) protocols, addressing the high rates of substance use disorders and mental illness among the homeless population. To further support understanding of the social determinants of health affecting this population, the initiative will establish Medical-Legal Partnerships (MLPs) to train residents in legal advocacy, assisting patients with securing Medicaid, disability benefits, and housing stability services. Cultural competency will also be a key focus, with the implementation of Medical Spanish training and National Culturally and Linguistically Appropriate Services (CLAS)-based strategies, ensuring effective communication with diverse patient populations. Additionally, the project will strengthen interprofessional collaboration by engaging residents in interdisciplinary training alongside emergency medical technicians (EMTs), social workers, addiction specialists, and legal professionals, fostering a team-based approach to healthcare delivery. The primary beneficiaries of the PCTE-RTSM initiative at SLUHN will be the medical residents in the Rural Family Medicine Residency Program, as it integrates a Street Medicine Academic Track into their training. SLUHN requests rural funding priority points for its focus on expanding the rural primary care workforce and improving healthcare access in Carbon and Schuylkill Counties. Additionally, it seeks funding preference for demonstrating a 25-percentage point increase in placing program graduates into practice settings that serve Medically Underserved Communities (MUCs) from AY 2022–2023 to AY 2023–2024.
