Federal Grants Expand Street Medicine Training to Bring Care Directly to People Experiencing Homelessness
核心洞察
Penn State College of Medicine (搜索) received a five-year, $2.5 million grant from the Health Resources and Services Administration (搜索) to launch a street medicine program serving unsheltered populations in southcentral Pennsylvania.
Washington State University secured a matching $2.5 million, five-year HRSA grant to establish street medicine rotations in Everett and Spokane for internal medicine residents.
Both programs aim to train the next generation of physicians to deliver primary, mental health, and substance use care directly where people experiencing homelessness (搜索) live.
Two new federal grants will train physicians to deliver healthcare directly to people experiencing homelessness (搜索), addressing a persistent gap in access to care for unsheltered populations. The Health Resources and Services Administration (搜索) (HRSA), an agency within the U.S. Department of Health and Human Services, awarded separate five-year, $2.5 million grants to Penn State College of Medicine (搜索) and Washington State University (WSU) to establish street medicine programs and integrate them into graduate medical education.
Street medicine is a model of care in which healthcare providers go to people experiencing unsheltered homelessness (搜索) where they live, whether that is an encampment underneath a bridge, on the street, or deep within rural green spaces. With patient permission and on their terms, street medicine teams provide primary care within that setting, offering the same care individuals would receive in a traditional clinic, including diagnosis and treatment of physical, mental, and substance use conditions.
Penn State Launches Street Medicine Program in Southcentral Pennsylvania
At Penn State College of Medicine (搜索), the new funding will support a street medicine program serving unsheltered populations in both urban and rural areas in southcentral Pennsylvania. Ami DeWaters, principal investigator and associate professor of medicine, said the grant honors the mission of Milton Hershey, who founded the college, to care for community members.
The program will create a street medicine curriculum for internal medicine residents as well as develop a clinical street medicine program. DeWaters said the goal is to have the street medicine team begin seeing individuals in January 2027, likely beginning with an urban area in Lebanon County where there are existing community partnerships. Once the program is operational, the team will begin reaching out to communities and unsheltered populations in rural areas.
Joanie Miller, physician assistant in palliative care at Penn State Health and medical director of the street medicine program, emphasized the human dimension of the model. "Most people go into healthcare because they want to be able to help," Miller said. "Sometimes it takes taking off the proverbial white coat and entering someone else's space to really connect with them on a human level and provide the care that they really need. It's a chance to keep the human aspect of medicine alive."
DeWaters noted that the grant leverages Penn State's expertise as a national leader in health systems science, which focuses on understanding the complex systems and environments in which healthcare is provided. It builds on previous awards from the American Medical Association (AMA) to design experiences within graduate medical education that align medical education with health system needs and improve systems-based practice, such as identifying and addressing social drivers of health.
"We have a broken healthcare system," DeWaters said. "It's critical to understand where the holes in the healthcare system are, so that you learn how to try and address those gaps for all of your patients, no matter who they are. I can't imagine a better venue to see how broken the system is than to go out and see people who essentially don't have access to the system at all."
Internal medicine residents will begin classroom instruction, including multimedia educational materials such as podcasts and videos, and clinical rotations through the street medicine program. The team plans to incorporate human-centered design, which places people and their needs at the heart of the design process, to continuously improve the program as it is built.
Beyond improving patient health and well-being, the program has the potential to serve as an antidote to burnout for medical residents, an outcome DeWaters witnessed during the AMA grant work. "The residents saw that you can leverage quality improvement skills to make improvements in your day-to-day work," DeWaters said. "They believed that they could make the system better, that the system isn't a fixed thing that you can't change."
One of the first undergraduate courses in street medicine in the country was developed at Penn State College of Health and Human Development. With the creation of a street medicine program and its integration into graduate medical education, Penn State students will now have the opportunity to take part in street medicine through all levels of education, from undergraduate to medical school to residency.
WSU Establishes Street Medicine Rotations in Everett and Spokane
Washington State University received a matching $2.5 million, five-year grant from HRSA to establish street medicine rotations in Everett and Spokane for residents in the Internal Medicine Residency Program, a partnership between WSU's Elson S. Floyd College of Medicine and Providence Regional Medical Center Everett. Each year, six to 12 doctors will learn to care for people experiencing homelessness (搜索) in mobile clinics, shelters, and other settings outside a traditional doctor's office. This is the residency program's first federal grant.
"When you see patients in the place where they live, you truly see the barriers they face, like not having refrigeration for medications or transportation to pharmacies," said Dr. Delaney Goulet, associate program director of the Internal Medicine Residency Program. "You realize how much you need to change a treatment plan to actually get them the care they need."
The training comes as homelessness (搜索) and opioid use continue to strain communities across Washington. In Snohomish County, which includes Everett, the number of people experiencing homelessness rose 35%, from 858 in 2018 to 1,161 in 2024. Statewide, the number increased by more than 40% during the same period, from about 22,000 to 31,554. Meanwhile, opioid overdose deaths in Snohomish County nearly tripled from 2017 to 2023, reflecting a broader statewide crisis that claimed more than 2,800 lives in 2024.
"I would consider the two street medicine rotations a great success if they help our residents feel more confident in providing excellent care to people experiencing homelessness (搜索), whether they are seeing them in the hospital, in clinic, or in an outreach setting," said Dr. Elizabeth "Izzy" Westling, a core faculty member who served as the grant's principal investigator and took the lead on the grant application.
Residents in the new program will be able to choose between two rotations. In Spokane, they will spend a month working with CHAS Health, which operates one of the most innovative street medicine programs in the state and leads the Cascadia Street Medicine Alliance. In Everett, residents will work with several community organizations, providing care through Mercy Watch's mobile medical van, treating patients at Conquer Clinics' Health Engagement Hub, and joining Compass Health teams that bring behavioral health services to people who have difficulty reaching traditional clinics.
Dr. Matthew Hansen, program director of the Internal Medicine residency program, said the experience will help residents understand how factors outside a doctor's office affect a patient's health and become comfortable providing care in nontraditional settings. "Sometimes the barrier for a practicing physician who might volunteer is discomfort in those settings," Dr. Hansen said. "If we expose trainees early in their careers, it's more likely they'll practice that sort of medicine in the future and broaden the impact of our graduates on the community."
The Everett residency program opened in 2021 with a goal of training doctors to serve Washington's rural and underserved communities. Program leaders hope the rotations will ultimately strengthen street medicine services in Everett, Spokane, and elsewhere across the state. Dr. Goulet said the program will also explore whether bringing preventive care directly to people experiencing homelessness (搜索) can improve their health and reduce costly hospital visits, helping make the case for continuing the work after the grant ends.