Creating a Community-Based Medical Clinic Dedicated to Patients Experiencing Homelessness in New York City (NYC): The Weill Cornell Street Medicine Clinic.

Abstract

Patients experiencing homelessness (PEH) continue to experience acute and chronic medical vulnerabilities in the United States. In the acute setting, these disparities increase hospital readmission rates, utilization of optimal treatment, and mortality. In the chronic setting, these disparities increase housing instability, medical deterioration, and mortality. These vulnerabilities are exacerbated in New York City (NYC), with PEH experiencing longer hospital stays, increased hospitalization costs, and disproportionate mental health and substance use hospitalizations. Over the past few decades, community interventions delivering medical care directly to PEH, in unison with social support structures, have shown improvements in both medical and housing-based outcomes. Here, we describe the step-wise approach we used in founding the Weill Cornell Street Medicine Clinic, a free, community-based medical clinic dedicated to serving the medical and social needs of PEH in NYC. We walk through our processes for conducting needs assessments, community partner selection, stakeholder recruitment, acquiring funding, establishing a robust legal framework, creating electronic medical record infrastructure, developing free prescription and transportation programs, establishing a free laboratory partnership, and reflections from our first year of operations. Through this report, we hope to provide a reproducible methodology to support the implementation of similar programs serving PEH in communities across the United States.