Primary Care Training and Enhancement -- Residency Training in Street Medicine - The Jessie Trice Community Health System (JTCHS) Street Medicine Residency (SMR) Project is a comprehensive initiative to train family medicine residents to deliver high-quality, trauma-informed, and culturally competent care to individuals experiencing homelessness in Miami-Dade County, Florida—home to one of the largest homeless populations in the state. Individuals without stable housing face significant barriers to care, including limited access to primary and behavioral health services, lack of transportation, and the ongoing impacts of poverty, stigma, and chronic health conditions. As a result, these individuals often rely on emergency services and suffer from unmanaged chronic disease, mental illness, and substance use disorders (SUDs). The SMR Project addresses these disparities by embedding two required one-month clinical rotations into the JTCHS residency curriculum, where residents receive hands-on training in mobile units, shelters, and street-based environments. Key clinical sites include JTCHS community health centers, Lotus House, and the Miami Center for Mental Health and Recovery. Residents are trained to provide preventive care, chronic disease management, behavioral health interventions, and Medication for Opioid Use Disorder (MOUD). The program integrates a medical-legal partnership with local legal aid organizations, allowing residents to assist patients in navigating housing rights, disability claims, and other legal issues that directly impact their health. Through an interprofessional training model, residents work alongside community health workers (CHWs), behavioral health specialists, social workers, legal aid providers, and harm reduction experts. Training includes didactic learning, simulation, journal clubs, and case-based discussions that emphasize the social determinants of health (SDoH), harm reduction strategies, and whole-person care. Residents also participate in mobile outreach efforts to encampments and shelters, where they help ensure continuity of care and link patients to supportive services using a closed-loop referral system. The program’s long-term goals are to enhance the residency curriculum through a street medicine track, improve healthcare access and outcomes for homeless individuals, reduce unnecessary emergency room visits, and create a replicable, sustainable model of interprofessional training. JTCHS will leverage its expertise in underserved healthcare delivery, residency education, and mobile health innovation to transform how care is delivered to one of the most vulnerable populations in the region. JTCHS is requesting a funding preference in support of this innovative and urgently needed training model, which aims to develop a skilled and compassionate healthcare workforce equipped to advance health equity and address homelessness as a public health issue.
