$2.5M grant to start street medicine program at Penn State College of Medicine

HERSHEY, Pa. — Delivering healthcare services directly to people experiencing homelessness and training the next generation of physicians in street medicine is the goal of a new five-year, $2.5 million grant from the Human Resources and Services Administration, an agency within the U.S. Department of Health and Human Services, to Penn State College of Medicine. The new funding will support a new street medicine program that will serve unsheltered populations in both urban and rural areas in southcentral Pennsylvania.

“This grant honors the mission of Milton Hershey, who founded the Penn State College of Medicine, to care for our community members,” said principal investigator Ami DeWaters, associate professor of medicine at Penn State College of Medicine. “We are thrilled to start this critical work and look forward to serving our community and trainees.”

Street medicine aims to break down the barriers that have historically kept vulnerable populations from receiving healthcare, explained Joanie Miller, physician assistant in palliative care at Penn State Health and medical director of the street medicine program. It’s a model of care where healthcare providers go to people experiencing unsheltered homelessness where they live — whether that’s an encampment underneath a bridge, on the street or deep within rural green spaces. With their permission and on their terms, street medicine teams provide primary care within that setting. Individuals receive the same care they would in a traditional medical clinic, including diagnosis and treatment of physical, mental and substance use conditions.

“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.”

According to DeWaters, the new 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 also builds on previous awards from the American Medical Association (AMA) to design experiences within graduate medicine education at Penn State College of Medicine that align medical education with health system needs and to 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.”

With support from the new award, Penn State College of Medicine will create a street medicine curriculum for internal medicine residents as well as develop a clinical street medicine program. DeWaters said that 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 up and running, the team will begin reaching out to communities and unsheltered populations in rural areas.

Internal medicine residents will begin classroom instruction, which will include multimedia educational materials like 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 they build it.

Beyond improving the health and well-being of patients, the street medicine program also has the potential to be an antidote to burnout for medical residents, DeWaters said. It was an outcome she witnessed during the AMA grant work. Through participation in the human-centered design work and open discussions about problems in the healthcare system, burnout symptoms among residents seemed to ease.

“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. Now, with the creation of a street medicine program and its integration into graduate medical education, Penn State students will have the opportunity to take part in street medicine through all levels of education — from undergraduate to medical school to residency.

In addition to DeWaters and Miller, other members of the grant team include Alia Chisty, Program Director of Internal Medicine Residency; Leah Ross, Associate Program Director of Internal Medicine Residency at Penn State; Amanda Cooper, professor of surgery; Paul Haidet, Distinguished Professor of medicine and public health sciences; Jennie Adams, grant program manager; and Tanush Vanamala. Chisty and Ross will help coordinate resident involvement in the street medicine curriculum.

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