Primary Care Training and Enhancement -- Residency Training in Street Medicine - Description of proposed project. Sunset Park Health Council, Inc. (dba the Family Health Centers at NYU Langone or FHC) requests funding from the HRSA Bureau of Health Workforce, Division of Medicine and Dentistry, Medical Training and Geriatrics Branch, for the “Primary Care Training and Enhancement-Residency Training in Street Medicine (PCTE-RTSM)” (HRSA-25-078) program to enhance training in Street Medicine for residents enrolled in the FHC’s ACGME accredited primary care residency program. In accordance with HRSA’s goal, the FHC will utilize HRSA-25-078 funding to increase the number of physicians trained in Internal Medicine who are prepared to provide care for people experiencing homelessness, by bringing care to people outside of traditional clinical settings. Project objectives include: 1) To develop or enhance trainings, clinical rotations, and didactic and clinical curricula content to train residents in Street Medicine to provide sensitive and quality care for people experiencing homelessness. Attention to mental health and substance use disorders is expected; 2) To increase residents’ knowledge and skills to meet the unique needs of people experiencing homelessness and assist patients with navigation of the medical, behavioral health, legal, and social support systems related to clinical care; and 3) To increase residents’ knowledge and skills to work in interprofessional teams, including chronic disease management, mental health, substance use, and medical-legal interprofessional teams, to address the SDoH that impact patient care. As the institutional sponsor of a HRSA-funded THCGME program in Internal Medicine since 2014, the FHC has the requisite infrastructure and capacity to continuously expand its didactic and experiential training to internal medicine residents utilizing innovative and contextually relevant approaches. Needs to be addressed. FHC draws patients from communities throughout central, northwest, and southwest Brooklyn (Kings County), with a primary service area encompassing the neighborhoods of Sunset Park, East Flatbush-Flatbush, Park Slope, Red Hook, Brownsville, and Bedford Stuyvesant-Crown Heights across 14 zip codes with over 915,000 residents. The primary service area consists of low-income, minority households with large subpopulations of Hispanic/Latino, Afro-Caribbean, Russian, Arabic, and Chinese (Mandarin-speaking) immigrants with barriers to needed health services. Social determinants of health (SDOH) such as low educational attainment, unstable housing, poor physical conditions of neighborhoods, disproportionate incarceration rates, and patterns of residential segregation all contribute to the high incidence and prevalence of chronic diseases and other poor health outcomes. Poorer health outcomes are pronounced for individuals living with or at risk for HIV and/or hepatitis, and homelessness within NYC is on the rise, further exacerbating long entrenched health inequities faced in the service area. Population groups to be served. The proposed program will target physician residents in FHC’s Internal Medicine program, training them to provide care for people experiencing homelessness in the service area, including those living in shelters served by FHC’s Community Medicine Program and those in unsheltered settings who could benefit from street medicine. Funding priority or preference. FHC requests a Funding Preference based on a “a high rate of placement of graduates in practice settings that primarily focus on serving residents of Medically Underserved Communities” (NOFO p. 37). Documentation of eligibility for this Funding Preference is included in Attachment 6 of this application.
