Public Health Institute

The Bridge Center at the Public Health Institute ("Bridge") is dedicated to dramatically expanding low-barrier access to critical medical care that is free of stigma and available when and where people need it most. The Bridge model has three pillars: (1) immediate access to low-barrier treatment, (2) a culture of harm reduction that offers treatment without stigma, and (3) connection to continued care in the community through trained navigators. Led by a team of active emergency department (ED) clinicians, Bridge comprises five programs focused on addiction treatment (CA Bridge, EMS Bridge, and the Bridge National Expansion Project), reproductive health (Access Bridge), and public health screening (Emergency Department Syphilis/HIV/HCV Screening Program). Our foundational program, CA Bridge, aims to expand access to medications for addiction treatment (MAT), prevent opioid overdoses, and save lives. To date, CA Bridge has supported the implementation of our model in more than 80 percent of California's acute care hospitals, establishing and scaling open access settings for evidence-based treatment for substance use disorders (SUDs) across the state. Now, we are working to significantly increase the number of Californians with easy access to MAT beyond the ED. Through our publicly available platform-CA Bridge Connect-people interested in treatment will be able to connect through phone, SMS, or an online chat feature with navigators and be linked to providers such as primary care, street medicine, telemedicine, harm reduction, and other community care providers to receive addiction treatment. Our EMS Bridge and Bridge National Expansion Projects extend our addiction work into the prehospital space-through engagement of emergency medical services agencies and personnel in the treatment of opioid use disorder (OUD) and prevention of overdose-and across the United States. Through our EMSBUP model, patients are offered treatment with buprenorphine from the ambulance, receive naloxone, and are encouraged to be transported for additional care and treatment at a nearby ED that treats OUD. Our Bridge National Expansion Project offers intensive training, technical assistance, and customized support for clinicians and administrators at the hospital/system, state or local, and federal levels, and has led to implementation of the Bridge model in 20 states, the District of Columbia, and four tribal communities. Modeled on our ED-based addiction work, our Emergency Department Syphilis/HIV/HCV Screening Program (EDSP) increases public health equity through routine opt-out screening in EDs. EDSP provides immediate care for people at the highest risk for syphilis, HIV, and hepatitis C virus (HCV) infection and helps control these growing epidemics statewide. We support hospitals through funding and capacity building to identify and treat those who might otherwise remain undiagnosed, reduce care barriers, and strengthen opt-out screening processes. Access Bridge fills critical gaps in reproductive health care by building the capacity of EDs across the United States to serve as reproductive health safety nets. We aim to improve access to evidence-based reproductive health services and increase health equity, focusing on communities with limited access to primary care and reproductive health care services. Using evidence-based protocols and ED-friendly training approaches to realize practice and culture change, Access Bridge helps emergency medicine clinicians integrate critical reproductive health protocols at participating EDs.

For 60 years, phi has implemented research and programs to improve the health and well-being of people across california, the u.s., and the world. Phi is a hub for public health innovation, providing supportive infrastructure, resources, and intellectual community with some of the best minds in public health. With over 100 researchers and project directors - and over 1000 staff worldwide - phi leads new research, tests novel interventions, and implements and builds capacity for on-the-ground programs to address new and emerging public health problems. For example, phi programs comprise one of the largest obesity networks in the country, addressing an epidemic that has reached communities in the u.s. And around the world, raising the risk for chronic diseases like cancer, heart disease, and diabetes. Globally, phi is dismantling the barriers to health and opportunity experienced by women and girls in the u.s. And creating gender equity partnerships. Phi is developing workforce pipeline programs to train and graduate health care professionals representing the diversity of our population and who will meet the growing demand for care. Phi is also at the forefront of the opioid epidemic, supporting local multi-sector coalitions addressing prevention and new substance use disorder and behavioral health care models. Implementing programs, systems and research that connect public health and health care delivery thru new design methods and data tools, we are bridging historic gaps in population health. Phi spearheads trainings and solutions to address climate change, which, although typically framed as an environmental issue, represents a huge threat to human health. Together, phi programs are helping to create healthy communities where individuals can achieve their highest potential. The breadth of phi expertise and experience positions us as a premier partner and leader in public health. Civicspark fellows assist in building local workforce capacity to respond to community identified priorities on a variety of local issues such as disaster preparedness and response, water, natural resource management, housing, economic development, transportation and infrastructure, parks and recreation, public health and community engagement. Fellows work for up to 11 months and complete research, planning and implementation projects for their communities and lead volunteer engagement activities. Civicspark fellows have provided over 1,250,000 hours of service to communities in three states (california, colorado, and washington) with expansion planned for 2025.