Primary Care Training and Enhancement -- Residency Training in Street Medicine - To address the growing need for primary care providers skilled in street-based healthcare, La Maestra Family Clinic, Inc. is seeking funding to establish a Street Medicine Training Track within its Family Medicine Residency Program. This initiative will equip residents with the skills to provide comprehensive, trauma-informed care to people experiencing homelessness (PEH) in San Diego County. With over 10,000 individuals experiencing homelessness in the county, including 6,110 unsheltered individuals, there is an urgent need for physician training in mobile, community-based, and harm-reduction healthcare to address chronic disease management, behavioral health disorders, and substance use treatment in non-traditional clinical settings. The proposed program will integrate structured didactic learning, clinical training, and interdisciplinary collaboration, featuring three one-month street medicine rotations, one per postgraduate year (PGY). Residents will gain hands-on experience with providing medical care in mobile clinics, encampments, shelters, and transitional housing sites, with a focus on chronic disease management, mental health care, harm reduction strategies, and social determinants of health (SDoH) screenings. Training will include Medication for Opioid Use Disorder (MOUD), wound care, infectious disease screening, and interdisciplinary coordination with behavioral health providers, social workers, and legal advocates. The program is supported by partnerships with La Maestra’s Community Health Access Department (CHAD), the San Diego Police Department’s Homeless Outreach Team (HOT), and local shelters, ensuring a continuum of care for PEH. La Maestra Family Clinic qualifies for a funding preference under 42 USC § 295j (Section 791 of the Public Health Service Act) based on its High Rate of Placement in Medically Underserved Communities (MUCs). The residency program is committed to ensuring that 100% of graduates will practice in MUCs, directly addressing physician shortages. As a Federally Qualified Health Center (FQHC), La Maestra serves 97 Medically Underserved Areas (MUAs) and 122 Mental Health Professional Shortage Areas (HPSAs) in San Diego County, underscoring its ability to train and retain physicians in high-need communities. The proposed program will track performance outcomes, ensuring that each resident completes at least 225 patient encounters over the course of their three-year residency program and that at least 75% of PEH patients receive referrals for behavioral health or social services. By embedding street medicine training into residency education, this initiative will strengthen the primary care workforce, improve health outcomes for PEH, and expand access to care for medically underserved communities in San Diego County.
