Primary Care Training and Enhancement -- Residency Training in Street Medicine - Our project’s purpose is to create a solid curricular foundation in Street Medicine for HealthPoint’s new family medicine residency program located in Auburn, Washington. There is a critical need to train future physicians to work with marginalized and vulnerable populations - such as the unhoused, where healthcare disparities are most pronounced. Physicians must be equipped to handle the complex medical and social challenges often faced by these communities, who are disproportionately affected by race, income, and other social determinants of health (SDOH). Without proper training, future doctors may struggle to effectively care for patients who are frequently overlooked and left behind by the healthcare system. It is essential that residents are prepared to deliver comprehensive, compassionate care to the sickest and most underserved patients. HealthPoint’s Residency Training in Street Medicine will demonstrate cultural and linguistic competency by continuously listening to and learning from patients and then developing and testing innovations in the learning environment to better serve them. An example is establishing partnerships with local agencies who have gained the trust of the unhoused populations we jointly care for. In our “multidisciplinary street medicine rounds” we plan to incorporate residents into an existing structure that brings HealthPoint’s teams into the streets, or encampments in the wooded areas, with community partners who serve as cultural and/or linguistic interpreters for our team. We make sure we focus care on the individual. We take the lead from our community partner outreach teams who know the patients best. We use a trauma-informed approach that emphasizes self-awareness, respect for cultural diversity, connecting on a human level, and learning about each patient’s cultural context and experience. The ZIP code tabulation areas that make up the primary service area of HealthPoint Auburn are situated in the heart of the south region of King County, the most racially diverse and highest-need region of the county. Of 307,000 people in the service area, 78,000 (26%) are low-income. About 77,000 (25%) are covered by Medicaid or other public insurance, 25,000 (8%) of service area residents are uninsured, and 30,000 (10%) service area adults delayed or did not seek care due to cost. A third of all homeless people in King County are in suburban areas like south King County. In 2020’s point-in-time count, there were nearly 12,000 people experiencing homelessness, a third of whom were living outside Seattle’s urban core. While the 2024 countywide point-in-time count found over 16,000 people sleeping outdoors or in shelters (a 33% increase since 2020), the actual number of people that experienced homelessness across our region is believed to be higher. Recently, King County officials estimated that 40,000 or more people experienced homelessness in a given year. Further, the Auburn area’s drug-induced death rate is 26.8 per 100,000, higher than the countywide figure of 19.4/100,000. After the urban core of Seattle, deaths among people experiencing homelessness were highest in south King County. Auburn, where our program is based, also makes up the southern end of a designated medically-underserved area (MUA ID #03695) that runs through south King County, forming the basis for our application for funding preference under Qualification #3. That is, our residency program is new and was first accredited in late 2024 and will launch in July 2025 and thus have no graduates yet; our mission is to prepare residents to serve underserved populations and our curriculum reflects this; and at least 20% of our clinical faculty spends at least 50% of their time providing or supervising care in this MUA.
