March 26, 2026 • 21 mins
How is Temple Health showing up in your neighborhood? I’m Loraine Ballard Morrill with Care that Connects—bringing you stories that uplift, inform, and inspire you to take control of your health and connect to care where you live.
In this episode, we explore how Temple Health and Project HOME are working together to address addiction and housing insecurity through a compassionate, coordinated approach rooted in dignity and long-term recovery. Guests Patrick Vulgamore of Temple Health and Christina Fidanza of Project HOME discuss the Estadt-Lubert Collaborative for Housing and Recovery—a citywide initiative connecting hospital systems to permanent supportive housing. By combining healthcare, housing, and community-based support, this partnership is helping people stabilize, heal, and rebuild their lives. Together, they’re not just meeting people where they are—they’re creating real pathways to lasting recovery.
Connect with Temple Health:
Visit templehealth.org/events for free screenings and health fairs, and follow @TempleHealth on social media for updates on mobile health services. Many programs welcome walk-ups—no insurance or pre-registration required.
Together, we’re building healthier communities—one neighbor at a time.
In this episode, we explore how Temple Health and Project HOME are working together to address addiction and housing insecurity through a compassionate, coordinated approach rooted in dignity and long-term recovery. Guests Patrick Vulgamore of Temple Health and Christina Fidanza of Project HOME discuss the Estadt-Lubert Collaborative for Housing and Recovery—a citywide initiative connecting hospital systems to permanent supportive housing. By combining healthcare, housing, and community-based support, this partnership is helping people stabilize, heal, and rebuild their lives. Together, they’re not just meeting people where they are—they’re creating real pathways to lasting recovery.
Connect with Temple Health:
Visit templehealth.org/events for free screenings and health fairs, and follow @TempleHealth on social media for updates on mobile health services. Many programs welcome walk-ups—no insurance or pre-registration required.
Together, we’re building healthier communities—one neighbor at a time.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I'm Lorraine Balladmorrow. In this episode, we explore how Temple
Health and Project Home are working together to address two
of Philadelphia's most urgent challenges, addiction and housing security, through
a compassionate, coordinated response rooted in dignity and long term recovery.
We have guests Patrick Volgemoor of Temple Health and Christina
(00:20):
Fidenza of Project Home joining us to talk about their
role in the s STAT Lubert Collaborative for Housing and Recovery,
a citywide initiative that connects hospital systems directly to permanent,
supportive housing. More than a medical intervention, the partnership centers
human connection, community based support, and the power of stable
housing to improve health outcomes. Together, Temple Health and Project
(00:43):
Home are not just meeting people where they are, but
they're building pathways to lasting recovery informed by shared values
and lived experience. So thank you both for joining us
here today. Patrick and Christina, Let's talk about the long
history that the two of you and two institutions have
had working and serving Philadelphia's most vulnerable communities. Can you
(01:04):
each share how your organizations are working together to make
real impacts in community health? Start with you, Patrick, so.
Speaker 2 (01:12):
Over the last few years. The pattern has been for
Temple Health not only to expand best practice treatment of
addiction by leaps and bounds over the last few years,
but also extending the finish line to when our work
is quote unquote completed. Through this collaborative and within the
(01:33):
partnership between Project Home and Temple, we are building longer
extensions of when we provide care and also integrating our
teams together to provide co management of participants and so
where previously we would connect patients to a Project Home
site or program and we would throw a party. We've
(01:56):
done our job. Our work here is done. Project Home
has it. Now with this current collaborative that doesn't end.
We are helping to pro participants up by overcoming barriers
that has been put into place due to their long
history of not engaging in healthcare, not having stable housing,
(02:18):
and our teams work together collaboratively to help folks overcome
those barriers.
Speaker 1 (02:25):
Christina, what about you?
Speaker 3 (02:27):
So Project Home has worked to make an impact in
community health. We've always used a holistic approach to ending homelessness,
understanding that medical support is a crucial part of housing,
and this partnership that we have with Temple in this
collaborative approach has provided the opportunity to truly connect housing
with medical care to support individuals.
Speaker 4 (02:47):
In their journey home.
Speaker 3 (02:48):
The purpose of the Estat Lubert Collaborative for Housing and
Recovery is to create an ecosystem of healing for unsheltered
individuals with opiate use disorder, and really our primary area
focus is we're improving the collaboration between the hospital partners
and homeless service providers to connect those individuals experiencing homelessness,
(03:08):
especially those with complex medical needs and opiate use disorder,
to housing, medical and comprehensive supportive services. The program itself
is grounded in the belief that stable housing is essential
for health and recovery, and I think in our partnership
with Temple, we've learned so much from each other and
how to work together to really support the person wholly
(03:31):
in their recovery process.
Speaker 1 (03:34):
Patrick, I wonder if we can dig down a little
bit more in detail about the impact of the St.
Leeward Collaborative for Housing and Recovery. How does it connect
with Project Home to create this supportive environment that combines
housing with medical support. What are some of the supports
that Temple provides on your side of the equation. Sure.
Speaker 2 (03:57):
So what sets this program apart from other programs that
we've built to help support patients with addiction and social
supports and being able to lift off to independence in
the community is the fact that these teams are mobile,
not only mobile within all levels of care in all
campuses at Temple, but also in the community. And what
(04:20):
this does from a patient or participant perspective is builds
trust quickly. So, for example, there are many instances of
the current participants where they're met out on the street
with our begin the turn van that provides street medicine
and addiction treatment. That linkage happens there, or it happens
(04:42):
in the emergency department or the hospital where housing is
identified as an issue along with other complex medical, behavioral, health,
psychiatric needs that folks may have, and that's where the
work begins and wherever that patient or participant up because
it certainly is not a straight line to independence, our
(05:04):
teams magically pop up and are there with a smiling face. Hey,
great to see you. Are you interested in taking the
next step. That's been the huge impact on our ability
to continue to help people get to independence in recovery
and it certainly has helped link people to the more
(05:25):
in depth work that's required to get there, whether that's
social determinants of health support, which our community health workers
focus on, whether it's linkage to primary care, addiction care,
behavioral healthcare ultimately linking to job training, or whether it's
social security benefits getting income. But our team is made
(05:48):
up of a community health worker, a certified recovery specialist
who is somebody with lived experience that helps people establish
and follow a recovery plan, a nurse practitioner that provides insights,
and a role called a housing advocate that helps people
along the way because as they go along that line
(06:08):
to recovery, there are different housing sites that we work with,
from Lowes Barrier to more programmatic based housing Christina.
Speaker 1 (06:20):
It sounds like the magic that Patrick refers to is
about meeting people where they are and creating that level
of trust and certainly providing those mobile units going out
into the community. Really advocates for that tell us more
about that connection and how building trust and meeting people
where they are creates a more effective and holistic approach
(06:43):
to addressing homelessness, healthcare and housing.
Speaker 3 (06:47):
Yeah, meeting people where they are is very important. People
come to us in all different places in their journey
and are at their most vulnerable and trust is hard.
And I think to what Patrick spoke to the fact
that in this partnership they already have trust built with
the staff the mobile team from Temple. When they come
(07:07):
to our site as a referral from Temple, the staff
of that mobile team are also coming to our site
and supporting them, So they're kind of helping to bridge
the trust with our supportive housing staff at the site
and help that process happen quicker. So that the individual
sees everybody on the team, those that the housing site
as well as the medical team all working together to support.
Speaker 4 (07:30):
Them in this journey. It is, you know, person centered.
Speaker 3 (07:33):
It's about each individual and where they are, needs that
they have, and then how our teams together are supporting
that person to be successful in their transition into housing,
stabilizing their medical challenges, mental health challenges, substance use challenges,
and then working with them once they're stabilized on their
long term goals, which is permanent housing so that they're
(07:54):
in their own apartment with the appropriate supports at that point.
So it definitely is a learning experience.
Speaker 4 (08:00):
For all of us.
Speaker 3 (08:01):
I think the hospital staff and the housing staff have
really learned from each other about their different areas of expertise.
And we have appreciated the partnership with Temple because in
the housing side previously, you know, if we had a
referral from a hospital, they send the referral and then
that's it and it's left to our supportive housing staff
(08:21):
to really do all the care coordination and connections that
are needed. And that's challenging when that's not their area
of expertise and they don't fully understand the medical system
and how to access the correct resources for individuals. So
it's definitely been great experience, a learning experience for all
and a great experience of how we're working together to
really support the individual I love that.
Speaker 1 (08:42):
So, Patrick and Christina, what does success look like for
this kind of work? And can you share some examples
of what this looks like for you? Make it kind
of life for us? Give us some examples.
Speaker 2 (08:56):
So I'll let Christina give a great case example that
she doesn't want to job of summarizing, but really, in
my opinion, not only is success based on patient or
participant outcomes, where somebody who is street homeless and frequenting
the emergency department for their medical care, for their addiction care,
for their behavioral health care. In some cases ultimately gets
(09:20):
set onto a path of appropriate utilization of services. On
the outpatient side, somebody who says, yes, I'm ready, I'm
ready to move to the path of independence, and I
am trusting this team to move forward with the path
that they've described to me. In some cases multiple times,
(09:43):
in multiple settings, they allow the team to work collaboratively
with the participant to get them on that path. But Christina,
I'll pass it to you to provide that case example.
Speaker 3 (09:56):
Sure, So we did have an individual referred to the
collaborative from the hospital with very complex medical and behavioral
health history. She was living with end stage renal disease
requiring dialysis. She had experienced multiple digit amputations and was
managing opiate use disorder, mental health challenges, and obviously homelessness.
(10:19):
Due to the unstable housing and her active substance use,
she couldn't be referred to an outpatient dialysis clinic, and
what that meant was she relied on the emergency department
for a routine dialysis, so she was often spending up
to thirty six hours a week in the er for
this dialysis, and then when leaving there, she didn't have
(10:39):
anywhere to go to recover from her dialysis treatment. She
was going back to the streets and just surviving the
next day. So once she came to the collaborative program,
with the support from her hospital care team and the
increased stability due to her housing, she began to receive
dialysis at an outpatient clinic. They came and picked her
up daily, took her to her and returned her to
(11:01):
the site. That reduced her weekly treatment time from thirty
six hours a week to just nine which obviously this
dramatically improved her quality of life and freedom time to
really focus on her recovery and long term goals. You know,
she had a bed to recover in after her treatment
and she could focus on her opiate use disorder and
those treatment avenues that were offered to her by the
(11:22):
support team. She eventually signed a lease for a permanent
bed within our housing sites, and she's maintained her recovery.
She continues to attend her medical appointments and engages with
the community. So her journey really highlights the critical role
of housing and achieving the stability, recovery and improved health outcomes.
And before entering the collaborative model, you know, her medical
(11:45):
conditions were unmanaged and definitely exacerbated by her housing and stability.
So the consistent support that was offered and the stable
living environment were really crucial to stabilizing her health. But
also like reclaiming her ENDO tendance and being able to
actually work on her recovery and her long term goals.
Speaker 1 (12:04):
Wow, that sounds so rewarding to be able to see
somebody's journey traveling through what essentially would have been a
death sentence for her having to constantly go to the
er to get that life saving dialysis to now having
a lease and a home a stable schedule of treatment,
which is really quite amazing. Now, finally, what's next for
(12:25):
Temple Health and Project Home. What would it take to
make housing integrated recovery this standard of care across Philadelphia.
It seems as though you are really a great example
of what is possible. So Patrick, let's start with you.
What's next?
Speaker 2 (12:40):
So, I think some of the things that we've alluded
to has been a learning process on both sides on
how to get into the in depth details of what
it takes to get somebody who is unhoused and not
engaged in appropriate medical care to get ahead of certain
issues to independence. I think what we've identified are two things.
(13:04):
Number One, this model works, being that this is fully
grant funded at the moment, Finding sustainable opportunities to continue
a model like this is certainly high on our priority
list as a collaborative. Secondly, we do know that there
continues to be an expansion of housing opportunities in the
city of Philadelphia. What we found in this collaborative is
(13:27):
folks that are coming off of the street may need
a little less structure to provide housing in order to
get to recovery. So what I mean by that is,
as I said earlier, it's not a straight line to independence.
Sometimes people will take a step or two back, and
(13:47):
we need those housing programs to understand that there may
be a slip up or two. This team will continue
to support them and we're going to do everything that
we can to get them through to the next stage.
But ultimately there needs to be a trauma informed understanding
that it is not a straight line. So we've identified
that level of housing and those types of beds that
(14:11):
need to expand in the city because there are limited
beds for that level of care, and then focusing on
the sustainability so that a program like this can continue
in twenty years.
Speaker 1 (14:23):
And Christina, what do you have to say, what's next?
Speaker 4 (14:25):
I mean Project Home.
Speaker 3 (14:26):
We are working to expand beds this year for this
program specifically, and we do have two permanent housing sites
in our pipeline which would also help provide permanent housing
for this program. But as Patrick said, this is grant
funded currently, and sustainable funding is really our goal. We
know in the work we do with people in recovery
that it is a process working when someone is not
(14:48):
a straight line and having the allowance within the funding
sources to be able to work with people individually as
their needs see fit. There's a lot of structure in
the funding sources that we receive from housing programs within
the city, state, federal government, so it's hard to really
work with people and work with them in the way
they need.
Speaker 4 (15:08):
To be supported to be successful.
Speaker 3 (15:10):
This program has allowed us to take that time and
work individually with each person, and when there are instances
that they are taking a few steps back, as Patrick noted,
we can still support them and work with them through
this process and having this team of hospital staff and
support of housing staff together working with the person. We've
seen a lot more success as we work with people
(15:32):
to get them back on track, as we like to
call it, so that they can continue working in their
goals towards independence. And I think it's also that trust
component with the individuals that they know that we're not
expecting perfection out of them, like we are working with
them and we understand the challenges that do arise and
will support them through it, and we are here as
a true support to them because we want to see
(15:53):
them be successful. You know, anybody returning to the street
is something that we are not wanting to do. So
that we can keep them housed in a stable environment
so that they can get all the care they need
is the overall goal, and I think this program has
allowed us to have some flexibility in how we manage that,
and we do need to see more of that to
really work with people coming directly from the street, because
(16:14):
their needs are different and they've been through a lot
in the time they've been out there and around their
substance use, and really needing to have that trust and
support is how they're going to be successful long.
Speaker 1 (16:25):
Term, and I'm going to give you both the opportunity
to say one more thing that perhaps was unset and
perhaps also just to acknowledge each other for the partnership
that you have been engaged in.
Speaker 2 (16:38):
So I think maybe a word that wasn't used yet
was dignity. I do feel like this program is a
blueprint for how to provide care that's focused on dignity
and a lot of the work what we're learning is
really about establishing the trust and treating people the way
(17:00):
they want to be treated, which what we're learning is
it may have not happened for a very long time.
So we have a large hill to climb in the
beginning stages of enrolling somebody in this program, and I
think that some of the small wins in the beginning
really build quickly for somebody who is a participant of
(17:21):
this program. Christina and I and Project Home and Temple
have learned.
Speaker 4 (17:25):
A lot together.
Speaker 2 (17:26):
It also hasn't been a straight line for us, and
I do believe we are in a rhythm now from
an operational standpoint where if there are things that need
to be corrected, this has been such an iterative process
because of all the learning on both sides, that we've
hit a rhythm that allows for extreme flexibility, extreme nudges
(17:49):
in one way or another in the way the program
is working. That I think that as much as staff
has built trust with participants, I think that leadership from
Temple and leadership from Project Home have built trust with
each other to understand, Okay, this isn't working and it's
nobody's fault. We just need to fix it. And I
think the most beautiful part about this is we've never
(18:11):
been to that point. It's always been Okay, we're done, now,
you take over, or somebody needs to come for extreme
medical care, you take over. It's not like that, and
it really is the model that needs.
Speaker 1 (18:23):
To sustain wonderful collaboration. And Christina, what do you have
to say.
Speaker 4 (18:28):
Yeah, echo Patrick's sentiments about working together.
Speaker 3 (18:30):
I think you know, in the beginning of this program,
it was learning for all of us of how we
work together, understanding everyone's processes and procedures, and especially.
Speaker 4 (18:39):
At the housing site.
Speaker 3 (18:40):
And I think our teams as well as our leadership
teams have learned working together, being respectful of each other's
roles and expertise, but also when we are having challenges,
being able to come together, talk about it, work through it,
and be open to.
Speaker 4 (18:55):
Each other's suggestions.
Speaker 3 (18:56):
I think in the housing world, I've been a project
home for almost twelve the year, and as I always say,
we all.
Speaker 4 (19:02):
Have to be flexible all the time.
Speaker 3 (19:04):
We shift all the time because something may no longer
be working, the population we're serving may have changed, and
we kind of have to shift how we practice. So
I think using that kind of thought process and model
as we've work through this collaborative has been very helpful
in us being able to work together in the way
that we do now and that our teams work together
as they do now.
Speaker 4 (19:24):
And I think just like.
Speaker 3 (19:25):
Having an overall understanding for the individuals that we are
working with, and you need flexibility in that too, you know.
I think the dignity piece of it is crucial and
a lot of the feedback that we've heard from people
that have been in the collaborative program. In our research
component of it, they do surveys and things with individuals,
and a high level feedback that we have received is
(19:46):
that people have been happy with their time and collaborative
because of the way they are treated, because of the
way they have been welcomed in and treated by the
hospital teams and the housing teams, and that is something
that they're not always finding when they're going into other
houses or shelter systems within the city. So I think
that also speaks volumes because we really at Project Home,
(20:07):
you know, it's our mission and values at the core,
and we are concerned about treating people with dignity and
respect at all times. And I think folks in the
collaborative that have given us feedback are really speaking to
that level of support and love that they feel when
they come in and they can come in as they.
Speaker 4 (20:21):
Are and we'll accept them and work with them.
Speaker 3 (20:24):
And the hospital is functioning in that same way, really
meeting people where they are.
Speaker 4 (20:28):
So I think that is something to be spoken highly
of too well.
Speaker 1 (20:32):
It's a beautiful thing. Certainly when we talk about the
issue of homelessness, so many people throw their hands up
and say there's no solution, but clearly there are solutions,
and you are creating a model that hopefully will be
expanded and replicated not only in Philadelphia, but across the
state and across the country. Temple Health and Project Home
building Pathways to lasting Recovery. Patrick Voldemore, who is with
(20:53):
Temple Health and Christina Fidenza of Project Home. Thank you
both for joining us today.
Speaker 4 (20:58):
Thank you
I'm Lorraine Balladmorrow. In this episode, we explore how Temple
Health and Project Home are working together to address two
of Philadelphia's most urgent challenges, addiction and housing security, through
a compassionate, coordinated response rooted in dignity and long term recovery.
We have guests Patrick Volgemoor of Temple Health and Christina
(00:20):
Fidenza of Project Home joining us to talk about their
role in the s STAT Lubert Collaborative for Housing and Recovery,
a citywide initiative that connects hospital systems directly to permanent,
supportive housing. More than a medical intervention, the partnership centers
human connection, community based support, and the power of stable
housing to improve health outcomes. Together, Temple Health and Project
(00:43):
Home are not just meeting people where they are, but
they're building pathways to lasting recovery informed by shared values
and lived experience. So thank you both for joining us
here today. Patrick and Christina, Let's talk about the long
history that the two of you and two institutions have
had working and serving Philadelphia's most vulnerable communities. Can you
(01:04):
each share how your organizations are working together to make
real impacts in community health? Start with you, Patrick, so.
Speaker 2 (01:12):
Over the last few years. The pattern has been for
Temple Health not only to expand best practice treatment of
addiction by leaps and bounds over the last few years,
but also extending the finish line to when our work
is quote unquote completed. Through this collaborative and within the
(01:33):
partnership between Project Home and Temple, we are building longer
extensions of when we provide care and also integrating our
teams together to provide co management of participants and so
where previously we would connect patients to a Project Home
site or program and we would throw a party. We've
(01:56):
done our job. Our work here is done. Project Home
has it. Now with this current collaborative that doesn't end.
We are helping to pro participants up by overcoming barriers
that has been put into place due to their long
history of not engaging in healthcare, not having stable housing,
(02:18):
and our teams work together collaboratively to help folks overcome
those barriers.
Speaker 1 (02:25):
Christina, what about you?
Speaker 3 (02:27):
So Project Home has worked to make an impact in
community health. We've always used a holistic approach to ending homelessness,
understanding that medical support is a crucial part of housing,
and this partnership that we have with Temple in this
collaborative approach has provided the opportunity to truly connect housing
with medical care to support individuals.
Speaker 4 (02:47):
In their journey home.
Speaker 3 (02:48):
The purpose of the Estat Lubert Collaborative for Housing and
Recovery is to create an ecosystem of healing for unsheltered
individuals with opiate use disorder, and really our primary area
focus is we're improving the collaboration between the hospital partners
and homeless service providers to connect those individuals experiencing homelessness,
(03:08):
especially those with complex medical needs and opiate use disorder,
to housing, medical and comprehensive supportive services. The program itself
is grounded in the belief that stable housing is essential
for health and recovery, and I think in our partnership
with Temple, we've learned so much from each other and
how to work together to really support the person wholly
(03:31):
in their recovery process.
Speaker 1 (03:34):
Patrick, I wonder if we can dig down a little
bit more in detail about the impact of the St.
Leeward Collaborative for Housing and Recovery. How does it connect
with Project Home to create this supportive environment that combines
housing with medical support. What are some of the supports
that Temple provides on your side of the equation. Sure.
Speaker 2 (03:57):
So what sets this program apart from other programs that
we've built to help support patients with addiction and social
supports and being able to lift off to independence in
the community is the fact that these teams are mobile,
not only mobile within all levels of care in all
campuses at Temple, but also in the community. And what
(04:20):
this does from a patient or participant perspective is builds
trust quickly. So, for example, there are many instances of
the current participants where they're met out on the street
with our begin the turn van that provides street medicine
and addiction treatment. That linkage happens there, or it happens
(04:42):
in the emergency department or the hospital where housing is
identified as an issue along with other complex medical, behavioral, health,
psychiatric needs that folks may have, and that's where the
work begins and wherever that patient or participant up because
it certainly is not a straight line to independence, our
(05:04):
teams magically pop up and are there with a smiling face. Hey,
great to see you. Are you interested in taking the
next step. That's been the huge impact on our ability
to continue to help people get to independence in recovery
and it certainly has helped link people to the more
(05:25):
in depth work that's required to get there, whether that's
social determinants of health support, which our community health workers
focus on, whether it's linkage to primary care, addiction care,
behavioral healthcare ultimately linking to job training, or whether it's
social security benefits getting income. But our team is made
(05:48):
up of a community health worker, a certified recovery specialist
who is somebody with lived experience that helps people establish
and follow a recovery plan, a nurse practitioner that provides insights,
and a role called a housing advocate that helps people
along the way because as they go along that line
(06:08):
to recovery, there are different housing sites that we work with,
from Lowes Barrier to more programmatic based housing Christina.
Speaker 1 (06:20):
It sounds like the magic that Patrick refers to is
about meeting people where they are and creating that level
of trust and certainly providing those mobile units going out
into the community. Really advocates for that tell us more
about that connection and how building trust and meeting people
where they are creates a more effective and holistic approach
(06:43):
to addressing homelessness, healthcare and housing.
Speaker 3 (06:47):
Yeah, meeting people where they are is very important. People
come to us in all different places in their journey
and are at their most vulnerable and trust is hard.
And I think to what Patrick spoke to the fact
that in this partnership they already have trust built with
the staff the mobile team from Temple. When they come
(07:07):
to our site as a referral from Temple, the staff
of that mobile team are also coming to our site
and supporting them, So they're kind of helping to bridge
the trust with our supportive housing staff at the site
and help that process happen quicker. So that the individual
sees everybody on the team, those that the housing site
as well as the medical team all working together to support.
Speaker 4 (07:30):
Them in this journey. It is, you know, person centered.
Speaker 3 (07:33):
It's about each individual and where they are, needs that
they have, and then how our teams together are supporting
that person to be successful in their transition into housing,
stabilizing their medical challenges, mental health challenges, substance use challenges,
and then working with them once they're stabilized on their
long term goals, which is permanent housing so that they're
(07:54):
in their own apartment with the appropriate supports at that point.
So it definitely is a learning experience.
Speaker 4 (08:00):
For all of us.
Speaker 3 (08:01):
I think the hospital staff and the housing staff have
really learned from each other about their different areas of expertise.
And we have appreciated the partnership with Temple because in
the housing side previously, you know, if we had a
referral from a hospital, they send the referral and then
that's it and it's left to our supportive housing staff
(08:21):
to really do all the care coordination and connections that
are needed. And that's challenging when that's not their area
of expertise and they don't fully understand the medical system
and how to access the correct resources for individuals. So
it's definitely been great experience, a learning experience for all
and a great experience of how we're working together to
really support the individual I love that.
Speaker 1 (08:42):
So, Patrick and Christina, what does success look like for
this kind of work? And can you share some examples
of what this looks like for you? Make it kind
of life for us? Give us some examples.
Speaker 2 (08:56):
So I'll let Christina give a great case example that
she doesn't want to job of summarizing, but really, in
my opinion, not only is success based on patient or
participant outcomes, where somebody who is street homeless and frequenting
the emergency department for their medical care, for their addiction care,
for their behavioral health care. In some cases ultimately gets
(09:20):
set onto a path of appropriate utilization of services. On
the outpatient side, somebody who says, yes, I'm ready, I'm
ready to move to the path of independence, and I
am trusting this team to move forward with the path
that they've described to me. In some cases multiple times,
(09:43):
in multiple settings, they allow the team to work collaboratively
with the participant to get them on that path. But Christina,
I'll pass it to you to provide that case example.
Speaker 3 (09:56):
Sure, So we did have an individual referred to the
collaborative from the hospital with very complex medical and behavioral
health history. She was living with end stage renal disease
requiring dialysis. She had experienced multiple digit amputations and was
managing opiate use disorder, mental health challenges, and obviously homelessness.
(10:19):
Due to the unstable housing and her active substance use,
she couldn't be referred to an outpatient dialysis clinic, and
what that meant was she relied on the emergency department
for a routine dialysis, so she was often spending up
to thirty six hours a week in the er for
this dialysis, and then when leaving there, she didn't have
(10:39):
anywhere to go to recover from her dialysis treatment. She
was going back to the streets and just surviving the
next day. So once she came to the collaborative program,
with the support from her hospital care team and the
increased stability due to her housing, she began to receive
dialysis at an outpatient clinic. They came and picked her
up daily, took her to her and returned her to
(11:01):
the site. That reduced her weekly treatment time from thirty
six hours a week to just nine which obviously this
dramatically improved her quality of life and freedom time to
really focus on her recovery and long term goals. You know,
she had a bed to recover in after her treatment
and she could focus on her opiate use disorder and
those treatment avenues that were offered to her by the
(11:22):
support team. She eventually signed a lease for a permanent
bed within our housing sites, and she's maintained her recovery.
She continues to attend her medical appointments and engages with
the community. So her journey really highlights the critical role
of housing and achieving the stability, recovery and improved health outcomes.
And before entering the collaborative model, you know, her medical
(11:45):
conditions were unmanaged and definitely exacerbated by her housing and stability.
So the consistent support that was offered and the stable
living environment were really crucial to stabilizing her health. But
also like reclaiming her ENDO tendance and being able to
actually work on her recovery and her long term goals.
Speaker 1 (12:04):
Wow, that sounds so rewarding to be able to see
somebody's journey traveling through what essentially would have been a
death sentence for her having to constantly go to the
er to get that life saving dialysis to now having
a lease and a home a stable schedule of treatment,
which is really quite amazing. Now, finally, what's next for
(12:25):
Temple Health and Project Home. What would it take to
make housing integrated recovery this standard of care across Philadelphia.
It seems as though you are really a great example
of what is possible. So Patrick, let's start with you.
What's next?
Speaker 2 (12:40):
So, I think some of the things that we've alluded
to has been a learning process on both sides on
how to get into the in depth details of what
it takes to get somebody who is unhoused and not
engaged in appropriate medical care to get ahead of certain
issues to independence. I think what we've identified are two things.
(13:04):
Number One, this model works, being that this is fully
grant funded at the moment, Finding sustainable opportunities to continue
a model like this is certainly high on our priority
list as a collaborative. Secondly, we do know that there
continues to be an expansion of housing opportunities in the
city of Philadelphia. What we found in this collaborative is
(13:27):
folks that are coming off of the street may need
a little less structure to provide housing in order to
get to recovery. So what I mean by that is,
as I said earlier, it's not a straight line to independence.
Sometimes people will take a step or two back, and
(13:47):
we need those housing programs to understand that there may
be a slip up or two. This team will continue
to support them and we're going to do everything that
we can to get them through to the next stage.
But ultimately there needs to be a trauma informed understanding
that it is not a straight line. So we've identified
that level of housing and those types of beds that
(14:11):
need to expand in the city because there are limited
beds for that level of care, and then focusing on
the sustainability so that a program like this can continue
in twenty years.
Speaker 1 (14:23):
And Christina, what do you have to say, what's next?
Speaker 4 (14:25):
I mean Project Home.
Speaker 3 (14:26):
We are working to expand beds this year for this
program specifically, and we do have two permanent housing sites
in our pipeline which would also help provide permanent housing
for this program. But as Patrick said, this is grant
funded currently, and sustainable funding is really our goal. We
know in the work we do with people in recovery
that it is a process working when someone is not
(14:48):
a straight line and having the allowance within the funding
sources to be able to work with people individually as
their needs see fit. There's a lot of structure in
the funding sources that we receive from housing programs within
the city, state, federal government, so it's hard to really
work with people and work with them in the way
they need.
Speaker 4 (15:08):
To be supported to be successful.
Speaker 3 (15:10):
This program has allowed us to take that time and
work individually with each person, and when there are instances
that they are taking a few steps back, as Patrick noted,
we can still support them and work with them through
this process and having this team of hospital staff and
support of housing staff together working with the person. We've
seen a lot more success as we work with people
(15:32):
to get them back on track, as we like to
call it, so that they can continue working in their
goals towards independence. And I think it's also that trust
component with the individuals that they know that we're not
expecting perfection out of them, like we are working with
them and we understand the challenges that do arise and
will support them through it, and we are here as
a true support to them because we want to see
(15:53):
them be successful. You know, anybody returning to the street
is something that we are not wanting to do. So
that we can keep them housed in a stable environment
so that they can get all the care they need
is the overall goal, and I think this program has
allowed us to have some flexibility in how we manage that,
and we do need to see more of that to
really work with people coming directly from the street, because
(16:14):
their needs are different and they've been through a lot
in the time they've been out there and around their
substance use, and really needing to have that trust and
support is how they're going to be successful long.
Speaker 1 (16:25):
Term, and I'm going to give you both the opportunity
to say one more thing that perhaps was unset and
perhaps also just to acknowledge each other for the partnership
that you have been engaged in.
Speaker 2 (16:38):
So I think maybe a word that wasn't used yet
was dignity. I do feel like this program is a
blueprint for how to provide care that's focused on dignity
and a lot of the work what we're learning is
really about establishing the trust and treating people the way
(17:00):
they want to be treated, which what we're learning is
it may have not happened for a very long time.
So we have a large hill to climb in the
beginning stages of enrolling somebody in this program, and I
think that some of the small wins in the beginning
really build quickly for somebody who is a participant of
(17:21):
this program. Christina and I and Project Home and Temple
have learned.
Speaker 4 (17:25):
A lot together.
Speaker 2 (17:26):
It also hasn't been a straight line for us, and
I do believe we are in a rhythm now from
an operational standpoint where if there are things that need
to be corrected, this has been such an iterative process
because of all the learning on both sides, that we've
hit a rhythm that allows for extreme flexibility, extreme nudges
(17:49):
in one way or another in the way the program
is working. That I think that as much as staff
has built trust with participants, I think that leadership from
Temple and leadership from Project Home have built trust with
each other to understand, Okay, this isn't working and it's
nobody's fault. We just need to fix it. And I
think the most beautiful part about this is we've never
(18:11):
been to that point. It's always been Okay, we're done, now,
you take over, or somebody needs to come for extreme
medical care, you take over. It's not like that, and
it really is the model that needs.
Speaker 1 (18:23):
To sustain wonderful collaboration. And Christina, what do you have
to say.
Speaker 4 (18:28):
Yeah, echo Patrick's sentiments about working together.
Speaker 3 (18:30):
I think you know, in the beginning of this program,
it was learning for all of us of how we
work together, understanding everyone's processes and procedures, and especially.
Speaker 4 (18:39):
At the housing site.
Speaker 3 (18:40):
And I think our teams as well as our leadership
teams have learned working together, being respectful of each other's
roles and expertise, but also when we are having challenges,
being able to come together, talk about it, work through it,
and be open to.
Speaker 4 (18:55):
Each other's suggestions.
Speaker 3 (18:56):
I think in the housing world, I've been a project
home for almost twelve the year, and as I always say,
we all.
Speaker 4 (19:02):
Have to be flexible all the time.
Speaker 3 (19:04):
We shift all the time because something may no longer
be working, the population we're serving may have changed, and
we kind of have to shift how we practice. So
I think using that kind of thought process and model
as we've work through this collaborative has been very helpful
in us being able to work together in the way
that we do now and that our teams work together
as they do now.
Speaker 4 (19:24):
And I think just like.
Speaker 3 (19:25):
Having an overall understanding for the individuals that we are
working with, and you need flexibility in that too, you know.
I think the dignity piece of it is crucial and
a lot of the feedback that we've heard from people
that have been in the collaborative program. In our research
component of it, they do surveys and things with individuals,
and a high level feedback that we have received is
(19:46):
that people have been happy with their time and collaborative
because of the way they are treated, because of the
way they have been welcomed in and treated by the
hospital teams and the housing teams, and that is something
that they're not always finding when they're going into other
houses or shelter systems within the city. So I think
that also speaks volumes because we really at Project Home,
(20:07):
you know, it's our mission and values at the core,
and we are concerned about treating people with dignity and
respect at all times. And I think folks in the
collaborative that have given us feedback are really speaking to
that level of support and love that they feel when
they come in and they can come in as they.
Speaker 4 (20:21):
Are and we'll accept them and work with them.
Speaker 3 (20:24):
And the hospital is functioning in that same way, really
meeting people where they are.
Speaker 4 (20:28):
So I think that is something to be spoken highly
of too well.
Speaker 1 (20:32):
It's a beautiful thing. Certainly when we talk about the
issue of homelessness, so many people throw their hands up
and say there's no solution, but clearly there are solutions,
and you are creating a model that hopefully will be
expanded and replicated not only in Philadelphia, but across the
state and across the country. Temple Health and Project Home
building Pathways to lasting Recovery. Patrick Voldemore, who is with
(20:53):
Temple Health and Christina Fidenza of Project Home. Thank you
both for joining us today.
Speaker 4 (20:58):
Thank you
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