ON THIS EPISODE OF "CYCLE OF HEALTH," HOUSE CALLS FOR THE HOMELESS.

ACCESS TO HEALTHCARE IS A MAJOR PROBLEM IN SYRACUSE WITH OVER 30% OF RESIDENTS LIVING IN POVERTY.

STREET MEDICINE INITIATIVES LIKE HOUSE CALLS FOR THE HOMELESS, ARE POPPING UP ACROSS THE COUNTRY.

JOIN US AS WE TALK WITH FIVE COMMUNITY MEMBERS WHOSE MISSION IS PROVIDING CARE FOR OUR NEIGHBORS EXPERIENCING HOMELESSNESS.

COMING UP ON "CYCLE OF HEALTH."

HELLO AND WELCOME TO CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC, HOMELESSNESS AND HEALTHCARE.

ACCORDING TO THE LATEST CENSUS, SYRACUSE - OUR CITY - HAS A POVERTY RATE OF OVER 30%--14TH IN THE COUNTRY OF CITIES OF FIFTY THOUSAND OR MORE!

WITH SO MANY PEOPLE LIVING HAND TO MOUTH, MANY ARE PROBABLY NOT ONLY HUNGRY BUT ALSO NOT GETTING GREAT MEDICAL CARE, BECAUSE OF COST AND ACCESSIBILITY.

TONIGHT, WE'RE MEETING WITH FIVE COMMUNITY MEMBERS WORKING TO MAKE A DIFFERENCE FOR OUR NEIGHBORS AFFECTED BY POVERTY AND HOMELESSNESS.

THEY ARE: REV.

JOHN TUMINO, EXECUTIVE DIRECTOR AND CO-FOUNDER OF IN MY FATHER'S KITCHEN DR. DAVID LEHMANN, DISTINGUISHED SERVICE PROFESSOR AND MEDICAL DIRECTOR AND CO-FOUNDER OF HOUSE CALLS FOR THE HOMELESS AT SUNY UPSTATE MEDICAL MS. MIA RUIZ-SALVADOR, PROGRAM COORDINATOR AND CO-FOUNDER OF HOUSE CALLS FOR THE HOMELESS AT SUNY UPSTATE MEDICAL DR.

SUNNY ASLAM, ASSOCIATE PROFESSOR OF PSYCHIATRY AND BEHAVIORAL SCIENCES AT SUNY UPSTATE MEDICAL AND MS. REBECCA RUSNAK, A SECOND YEAR MEDICAL STUDENT AT SUNY UPSTATE THANK YOU ALL FOR BEING HERE.

LET'S START WITH YOU, Dr. LEHMANN.

TELL US ABOUT HOUSE CALLS FOR THE HOMELESS.

WHAT IS MEDICAL CARE LIKE FOR THOSE FOLKS.

>> A COMBINATION OF INTENSITY AND USUAL CARE.

THERE IS NOT MUCH DIFFERENCE BETWEEN THE TWO IN TERMS OF CARING FOR THE FOLKS.

BUT THEY'RE IN TYPICALLY A STRESSFUL SITUATION.

THE GENESIS OF IT REALLY, I WAS A HOSPITALLIST AT UPSTATE AND I WAS TAKING CARE OF A GUY WHO HAD BEEN AT THE EMERGENCY DEPARTMENT 17 TIMES IN THE PAST MONTH.

>> WOW.

>> AND HE WAS ADMITTED, NOT ADMITTED, SENT HOME.

TYPICALLY, BECAUSE THEY HAD GIVEN HIM A PRECIPITATION OR SAID TO FOLLOW UP WITH-- A PRESCRIPTION AND FOLLOW UP WITH A PHYSICIAN, HE DIDN'T HAVE A PHYSICIAN OR A WAY TO GET TO THE PHYSICIAN.

THE GAP IN THE MEDICAL CARE WAS INTENSE SO I REMEMBERED THE WORD OF ST. AUGUSTA WHO SAID HOPE HAS TWO BEAUTIFUL DAUGHTERS AND THE FIRST ONE IS ANGER AT THE WAY THINGS ARE.

SO I GOT PISSED OFF AT THE SITUATION AND I CALLED MY CO-FOUNDER MIA AND SAID WE HAVE TO DO SOMETHING DIFFERENT WITH THIS.

SO I STEPPED AWAY FROM HOSPITAL MEDICINE AND BEGAN TO JUST SERVE THE PEOPLE ON THE STREET IN THEIR BROKENNESS.

THE KEY THING IS THE PROVIDING OF DIGNITY THROUGH HEALTHCARE.

THAT'S REALLY THE GOAL OF THE WHOLE PROGRAM TO TRY TO LIFT PEOPLE UP FROM THEIR BROKENNESS AND TO MEET THEM WHERE THEY'RE AT AND TO TREAT THEM EXACTLY LIKE EVERYBODY ELSE.

>> WHAT ARE SOME OF THE COMMON AILMENTS YOU RUN INTO ON THE STREET?

>> I FOUND MYSELF PERFORMING BASICALLY, FULFILLING TWO CENTRAL AREAS.

ONE IS GAP FILLING WITH THE MEDICAL SYSTEM BECAUSE NONE OF THESE GUYS HAVE DOCTORS, 80% OF THEM ARE FULLY INSURED ON MEDICAID.

>> THAT'S A SURPRISE.

>> THEY DON'T HAVE A DOCTOR TO PRESCRIBE THEIR MEDICINE.

WHAT I WAS SAYING WHEN I WAS DOING HOSPITAL MEDICINE, THEY WOULD COME INTO THE HOSPITAL AND GET ADMITTED FOR HYPERTENSIVE EMERGENCIES AND OTHER THINGS THAT ARE PREVENTIBLE THROUGH MEDICATIONS BUT THEY HAD NOBODY PRESCRIBING THE MEDS FOR THEM.

I GAP FILL IN THAT SENSE TO PROVIDE THAT SERVICE ON THE STREET, HAVING A HOT SPOT WITH ME, I JUST PRESCRIBE MEDICINES.

THE OTHER ISSUE IS GENERALLY BECAUSE OF LIVING ON THE STREET, THE UNCEMENTNESS OR-- THE UNKEPTNESS OR THE DIRTINESS, ET CETERA THAT THE STREETS CAN BE, IS WELL AS SOME FOLKS THAT USE INJECTION DRUGS, A LOT OF SKIN AILMENTS.

I WILL DO PROCEDURES, DRAIN ABSCESSES, OTHER THINGS ON THE STREET, AND THEN PROVIDE IMMEDIATE ANTIBIOTICS TO THEM SO THAT THE INFECTION DOESN'T GET SEPSIS AND NEED HOSPITALIZATION.

I TRY TO AGGREGATE THAT AT THE POINT.

THOSE ARE THE TWO MAIN AREAS.

>> YOU ARE A PSYCHIATRIST, AND WHAT PERCENTAGE OF FOLKS ON THE STREET HAVE SOME KIND OF MENTAL PROBLEM?

>> IT'S EXTREMELY HIGH.

WE ARE TALKING ABOUT A GROUP, A TEAM HERE THAT WORKS WITH PEOPLE THAT ARE IN TERRIBLE DISTRESS.

THEY'RE IN EMOTIONAL DISTRESS, FINANCIAL DISTRESS, THEIR HOUSING ISN'T STABLE AND SO THEY TEND TO DISRUST THE SYSTEM BECAUSE THEY'VE MAYBE HAD GENERATION RAITIONS OF POVERTY, EXPERIENCED DOMESTIC VIOLENCE OR OTHER TYPES OF TRAUMA.

THEY MAY HAVE DEPRESSION.

SO I ASSUME JUST ABOUT EVERYBODY IS TERRIBLY TRAUMATIZED AND MANY ARE ADDICTED AS WELL AND ABOUT A FIFTH HAVE A SERIOUS MENTAL ILLNESS LIKE SCHIZOPHRENIA BUT BEYOND THAT, HIGH LEVELS OF PTSD AND DEPRESSION AND WE REALIZE OUR JOB IS FIRST TO BE CARING AND BUILD A RELATIONSHIP.

IT'S NOT IN THE CLINIC WHERE SOMEBODY IS WALKING INTO A ROOM SAYING CAN I PRESCRIBE FOG ARE SOME DEPRESSION.

IT'S USUALLY CAN YOU GET AWAY FROM ME, PLEASE LEAVE ME ALONE.

WE OFFER THEM A SAND WITCH AND SOME SOCKS.

WE HAVE TO BUILD A RELATIONSHIP FIRST, REALIZING THAT THESE FOLKS HAVE A DEEP DISTRUST OF INSTITUTIONS THAT HAVE LARGELY FAILED.

>> WHEN I WALK PAST HOMELESS PEOPLE, I WILL OFTEN TAKE A MOMENT.

>> SOME OF THIS IS LINGO BUT WHEN I STARTED, SO PEOPLE ARE NOT HOMELESS.

THEY'RE NOT HOMELESS PEOPLE.

THIS IS REALLY COMMON.

IT'S PEOPLE ARE EXPERIENCING HOMELESSNESS BECAUSE-- >> PEOPLE FIRST.

>> IT'S ALWAYS PEOPLE FIRST.

>> THANK YOU VERY MUCH.

I WILL REMEMBER THAT.

>> EXPERIENCING HOMELESSNESS.

>> SO PEOPLE EXPERIENCING HOMELESSNESS.

WHEN I WALK PAST PEOPLE EXPERIENCING HOMELESSNESS, I WILL OFTEN SAY HELLO AND JUST, YOU KNOW, TALK ABOUT WHAT A LOVELY DAY BECAUSE THEY'RE ISOLATED.

I IMAGINE IT MUST BE PRETTY LONELY WORLD OUT THERE SOMETIMES LIKE YESTERDAY I WAS TALKING TO SOMEBODY AND I GUY STARTED TALKING TO ME ABOUT HEARING FROM THE RUSSIANS THROUGH THE SATELLITES AND I THOUGHT THESE PEOPLE HAVE SOME SERIOUS PSYCHOLOGICAL PROBLEMS.

AND WHAT COMES UP TO ME IS IT DANGEROUS TO TALK TO PEOPLE ON THE STREET?

>> THEY'RE MORE LIKELY TO BE VICTIMIZED THAN THEY ARE TO PERPETRATE VIOLENCE.

THERE ARE RISKS BUT THESE ARE EXTREMELY VULNERABLE PEOPLE WHO OFTEN ARE REPEATEDLY VICTIMIZED.

IT GETS INTO A LARGER DISCUSSION ABOUT CRIME IN OUR COUNTRY.

CRIME IS MOSTLY ABOUT POOR PEOPLE TAKING ADVANTAGE OF POOR PEOPLE IN THIS COUNTRY.

AND THESE ARE GREAT EXAMPLES.

SPECIFICALLY GETTING TO YOUR EXAMPLE DRUGS CAN CAUSE THOSE SYMPTOMS, FOR EXAMPLE, STIMULANTS CAN MAKE PEOPLE PSYCHOTIC AND MAKE THEM FEARFUL OR EXPERIENCE THINGS THAT THE REST OF US ARE NOT EXPERIENCING OR IT COULD BE SCHIZOPHRENIA WHERE SOMEBODY HAS SPECIFICALLY A DIAGNOSEABLE MENTAL ILLNESS THAT 1% OF THE POPULATION THAT AFFECTS 1% OF THE POPULATION, BUT MANY OF THOSE PEOPLE TEND TO DRIFT INTO LIVING IN TERRIBLE POVERTY BECAUSE THEY CAN'T MAINTAIN A JOB OR THEY HAVE A VERY DIFFICULT TIME MAINTAINING RELATIONSHIPS BECAUSE THEIR CONVERSATIONS ARE NOT LIKE WHAT THE REST OF US TYPICALLY HAVE.

>> REVEREND TUMINO.

>> YES, SIR.

>> TELL US ABOUT IN MY FATHER'S KITCHEN.

>> IN MY FATHER'S KITCHEN IS A FAITH-BASED ORGANIZATION CREATED BY MY WIFE AND I. I'M A FORMER RESTAURATEUR CHEF.

I HAVE A FAITH COMPONENT TO MY LIFE ALSO AND I HAD AN ENCOUNTER WITH A HOMELESS INDIVIDUAL STANDING ON AN OFF RAMP, CHANGED MY LIFE FOREVER.

I FELT THAT NO ONE WAS LOOKING AT HIM AND THAT HE FELT INVISIBLE AND I WENT OVER TO HIM WITH A LUNCH AND TOLD HIM HE WAS NOT INVISIBLE, INTRODUCED MYSELF TO HIM AND HE UNPACKED HIS LIFE STORY TO ME ON AN OFF RAMP.

20 MINUTES LATER I LEFT THAT ENCOUNTER A CHANGED MAN AND I FORGOT I WAS ON AN OFF RAMP.

I WAS HAVING LIFE IN RELATIONSHIP WITH AN INDIVIDUAL WHO WAS SUFFERING.

WHEN HE TOLD ME ABOUT THE TRAUMA FROM CHILDHOOD TO DROPPING OUT OF SCHOOL, ADDICTION, BROKEN FAMILY SITUATION, NOW HOMELESS, IT BROKE MY HEART AND I WENT HOME AND TOLD MY WIFE.

I SAID I KNOW WHAT WE ARE SUPPOSED TO DO.

WE ARE SUPPOSED TO FIND THESE INDIVIDUALS, TELL THEM THEY'RE NOT INVISIBLE.

BUILD A RELATIONSHIP WITH THEM AND START BRINGING OUT LUNCHES.

SO WE DO DIRECT STREET OUTREACH TO THE CHRONICALLY HOMELESS IN NEW YORK.

AT PLACES NOT MEANT FOR HUMAN HABITATION, UNDER THE BRIDGES, IN THE WOODS, ABANDONED HOUSES.

AND I'M CONNECTED TO THESE WONDERFUL GENTLEMEN AS WELL AS MIA AND MEDICAL STUDENTS THAT COME OUT WITH US AND NOW BECAUSE OF MEDICINE, A LOT OF THE ORGANIZATION GOES DEEPER OTHER THAN JUST HELPING THEM WITH CLOTHING AND HOUSING, AND PROVIDING MEDICAL SERVICES FOR INDIVIDUALS.

IT HAS BEEN A BEAUTIFUL THING TO EXPERIENCE OVER THE LAST FIVE YEARS WITH THESE TWO MEN.

>> I'M SEEING ON THE VIDEO, GIVING VACCINATION.

I'M ASSUMING THIS IS FROM THE PANDEMIC.

TALK TO US ABOUT THAT.

>> YEAH, SO WE STARTED DOING THIS SOON AFTER VACCINES BECAME AVAILABLE.

WE STARTED OUT WITH ONE SHOT AND DONE JOHNSON & JOHNSON WHICH WASN'T ONE SHOT AND DONE BECAUSE WE HAD TO GIVE BOOSTERS.

AND REALLY RAPIDLY IT WAS A PARTNERSHIP WITH THE MEDICAL STUDENTS WHO WERE REALLY CENTRAL IN PROVIDING THIS CARE.

IN ADDITION TO THAT, SO WE HAD AN UPTICK AS WE BEGAN ACTUALLY THROUGH OUR FOUNDATION, PAYING THE PEOPLE EXPERIENCING HOMELESSNESS TO RECEIVE VACCINATION.

WE WERE ABLE TO GIVE THEM A $25 CERTIFICATE WITH EACH VACCINATION AND SO IT'S BEEN A REALLY GOOD PARTNERSHIP WITH OUR MEDICAL STUDENTS.

THEY'VE REALLY RUN THE SHOW WITH THIS PROGRAM AND WE'VE DONE SEVERAL HUNDRED-- >> A COUPLE HUNDRED I THINK MANY.

>> IT IS.

>> PROBABLY MORE THAN THAT NOW, IN TERMS OF VACCINATIONS.

>> WHAT DO THE MEDICAL STUDENTS ACTUALLY DO?

>> WELL, WE LEARN HOW TO GIVE VACCINES.

YOU KNOW Dr. LEHMANN IS A GREAT TEACHER AS WELL AS THE OTHER PHYSICIANS THAT WE WORK WITH.

I WAS A FIRST YEAR MEDICAL STUDENT AND NOW I'M STARTING MY SECOND YEAR BUT IT REALLY WAS A GREAT OPPORTUNITY FOR US TO LEARN SOME OF THOSE PRACTICAL CLINICAL SKILLS THAT WILL BE NEEDED IN OUR FUTURE CAREER.

I THINK IT WAS A MUTUALLY BENEFICIAL SITUATION WHERE THE PEOPLE WHO NEEDED VACCINES WERE ABLE TO GET VACCINATED AND THEN FROM THE MEDICAL STUDENT PERSPECTIVE, WE WERE ABLE TO KIND OF LEARN, YOU KNOW, FROM OUR SUPERVISORS, HOW TO GO ABOUT DOING SOMETHING LIKE THAT.

>> WHAT'S BEEN ONE OF THE MOST SURPRISING THINGS TO YOU AS, YOU KNOW, AS A YOUNG PERSON GOING OUT ON THE STREET, I DON'T IMAGINE YOU SPEND A LOT OF TIME GOING AROUND TALKING TO PEOPLE WHO ARE HOMELESS, THANK YOU VERY MUCH.

I'M LEARNING ALREADY.

WHAT HAS BEEN ONE OF THE MOST SURPRISING THINGS TO YOU IN YOUR WORK?

>> YOU KNOW, I THINK THERE IS A LOT OF DIFFERENT THINGS THAT ARE SHOCKING AT FIRST WHEN YOU KIND OF START AND WORK LIKE THIS.

I WOULD SAY ONE OF THE INTERESTING THINGS IS THE BIG RANGE OF AGES WE SEE ON THE STREET.

YOU KNOW, I MIGHT BE TALKING TO SOMEONE WHO IS IN THEIR 20s LIKE ME OR WE HAD A GENTLEMAN WHO WAS ALMOST 70 THE OTHER DAY THAT WE TALKED TO.

SO IT'S NOT ONE AGE GROUP, ONE DEMOGRAPHIC WHO IS AFFECTED BY HOMELESSNESS.

IT REALLY CAN HAPPEN TO ANYONE AT ANY TIME.

SO I THINK THAT'S DEFINITELY BEEN SURPRISING TO ME TO SEE ESPECIALLY WHEN YOU ARE LOOKING AT SOMEONE WHO IS THE SAME AGE AS YOU BUT OBVIOUSLY HAS HAD A VERY DIFFERENT SORT OF LIFE EXPERIENCE TO GET TO WHERE THEY ARE.

>> CAN I SAY THAT I ALWAYS TELL PEOPLE IT'S SOMEBODY'S FAMILY OUT THERE.

RIGHT?

AND AS YOU LOOK AT YOUR OWN FAMILY CIRCLE, I'M SURE ALL OF US IN THIS ROOM COULD TALK ABOUT SOMEONE IN OUR OWN FAMILY WHO EXPERIENCED MENTAL ILLNESS OR ADDICTION.

YOUR MOTHER, FATHER, BROTHER, SISTER, AUNT OUT THERE, WOULD I SAY TO THE PEOPLE OUT THERE WATCHING IF IT WAS YOUR FAMILY MEMBER OUT THERE, WOULD YOU WANT PEOPLE LIKE US TRYING TO HELP THEM?

AND THE ANSWER IS ALWAYS YES.

>> SO ONE OF THE FIRST TIMES OUT IS PROBABLY WITHIN THE FIRST MONTH IN 2018 WITH JOHN, HAD A KID-- SORRY, WHO WAS AT THE TIME, WAS LIKE 22 OR SOMETHING.

>> THEY ARE KIDS.

>> I KNOW SO ANYWAY, HE HAD A ROLLOVER IN THE SNOWMOBILE AND HAD A TRAUMATIC BRAIN INJURY AT 19 YEARS OLD AND BECAME HOMELESS.

AND SO AT THAT POINT, HE CAME THREE YEARS LATER AND WAS WORRIED ABOUT SOMETHING ON HIS FACE AND SOME NUMBNESS AND HE WAS WORRIED ABOUT HIS T.B.I.

COMING BACK.

I TOOK HIM IN THE VAN, DID A NEURO A.M. AND REASSURED HIM HE WAS ALL RIGHT AND CHECKED HIM OUT.

THAT NIGHT, JOHN IS REALLY BIG ON MEDIA STUFF AND SO HE POSTED WHAT THE ENCOUNTER WAS A LITTLE VIDEO VIGNETTE ANONYMOUS BUT GAVE THE STORY ABOUT THE ROLLOVER ON HIS FACEBOOK PAGE THAT NIGHT JOHN GETS A CALL AND SAYS I KNOW THIS WAS MY SON THAT YOU WERE SEEING: I'M HIS MOM.

I THOUGHT HE WAS DEAD STHAING GOD HE'S ALIVE AND THANK YOU, ET CETERA, ET CETERA.

SO YOU JUST NEVER KNOW WHERE SOME OF THIS STUFF IS GOING GO.

>> RICH, I GET PHONE CALLS CONTINUALLY BECAUSE THE SOCIAL MEDIA FROM FAMILY MEMBERS WHO, CAN YOU HELP ME FIND MY SON OR MY DAUGHTER OR MY DAD IS OUT THERE AND IT'S JUST LIKE AMAZING TO ME THAT, YOU KNOW, IT DOESN'T DISCRIMINATE.

ADDICTION MENTAL HEALTH, HOMELESSNESS IS AN EXPERIENCE THAT SOMEONE FALLS INTO BECAUSE OF THINGS THAT HAPPEN IN PEOPLE'S LIVES BUT IT DOESN'T DISCRIMINATE ACROSS ECONOMIC LUNS, YOU KNOW, LINES OF COLOR, DOESN'T MATTER.

IT JUST HAPPENS TO PEOPLE.

IT'S LIFE AND WE ARE OUT HERE TRYING TO MAKE A DIFFERENCE.

>> TELL US ABOUT THE OTHER PROGRAM, HIGHER GROUND, H.I.R.E.

>> THAT WAS MY WIFE'S PLAY ON WORDS.

>> THE HIRE GROUND PROGRAM IS A WONDERFUL PARTNERSHIP BETWEEN ONONDAGA COUNTY, THAT PROJECT TOTALLY IS FUNDED BY THE COUNTY AND IT'S A DAY LABOR PROGRAM THAT WE ASSIST INDIVIDUALS THAT ARE EXPERIENCING HOMELESSNESS AND PANHANDLING TO GET IN A VAN FOR FIVE HOURS, TO DO BEAUTY ANY INDICATION PROJECTS IN OUR COMMUNITY BUT ALSO GET PAID AT THE END OF THE DAY AND IT'S NOT JUST ABOUT THE MONEY.

WE HAVE A CARE MANAGER ON THE VAN AND IT'S FIVE HOURS CAPTURED AUDIENCE INSTEAD OF A 10 MINUTE EXPERIENCE UNDER A BRIDGE.

WE HAVE FIVE HOURS WHILE YOU ARE WORKING, GIVING YOU DIGNITY WORKING BY THE SWEAT OF YOUR BROW OR WITH YOUR HANDS.

DIGNITY HAPPENS AND VACCINATION HAPPEN.

WE CALL THE DOC OUT WHO IS GOING THROUGH SOMETHING.

IT'S A BEAUTIFUL THING.

IT LAPSE REVOLVING AROUND A WORK SETTING BUT A DEEPER DIVE INTO SOMEONE'S LIFE TO FIGURE OUT HOW WE CAN HELP YOU GET OUT OF YOUR SITUATION.

>> OFTEN MANY PEOPLE DON'T WANT HEALTHCARE RIGHT UP FRONT FROM US: THEY MIGHT MEET US AND WANT EMPLOYMENT OR THE FOCUS IS HOUSING OR FOOD.

I THINK THE WORK DONE BY THE PEOPLE HERE HIGHLIGHTS HOW RECOVERY IS POSSIBLE FIRST OF ALL.

WE TRY TO BRING THAT HOPE TO PEOPLE.

RECOVERY IS POSSIBLE FROM MENTAL HEALTH ISSUES AND SUFFERING AND HOMELESSNESS AND EMOTIONAL DISTRESS BUT THAT IT HAPPENS IN ALL KINDS OF DIFFERENT WAYS THROUGH ALL KIND OF DIFFERENT ROUTES, MAYBE NOT THROUGH THE TRADITIONAL MEDICAL MODEL WHERE WE SIT, DIAGNOSE AND TREAT BUT WE MAY JUST BE BUILDING A RELATIONSHIP IN THE BEGINNING AND WE WERE JUST SHARING EARLIER THE SUCCESSES.

AND IT'S IMPORTANT TO CELEBRATE THE SUCCESSES BECAUSE THERE IS A HIGH MORTALITY RATE WITH THE FOLKS WE WORK WITH.

MANY DO DIE BUT MANY DO BECOME EMPLOYED AND HOUSES AND TO RECOVERY.

>> I SEE ON OUR VIDEO CLIP THIS IS PART OF HIRE GROUND HERE, THIS INTERACTION.

TELL US ABOUT THIS WHAT IS HAPPENING.

>> Y TEND, THIS IS JOBS PROGRAM HIRE GROUND.

AT THE END OF THE DAY, THEY DO 8:30 TO 2 CLOCK?

AT THE END OF THE DAY, WE-- JOHN HAS A CAPTIVE AUDIENCE FOR HE HELP THEM DURING THAT AND AT THE END, ANYBODY NEEDING MEDICAL CARE, I WILL BE THERE AT THE END WHEN THEY GET THERE, $50 BUCKS FOR THE DAY AND THAT'S WHERE OUR VACCINATION.

>> THAT'S WHERE MIA COMES IN WITH HIRE GROUND AND OUR CARE COORDINATOR WORKS WITH MIA.

CAN YOU EXPLAIN?

>> THERE IS A PROCESS IN GIVING THE VACCINATIONS SO WE CAN KEEP TRACK OF WHO IS GETTING VACCINATIONS.

THE HIRE GROUND CARE MANAGER SENDS ME THE LIST OF INDIVIDUALS ON THE VAN IN THE MORNING AND I GO THROUGH MY DATABASE THAT I'VE CREATED AND I CHECK THEIR MEDICAL RECORDS TO CHECK FOR THEIR VACCINATION HISTORY AND SO THAT I CAN SEE IF THEY HAVE BEEN VACCINATED AND FIND OUT IF THEY'RE ELIGIBLE FOR A FIRST DOSE OR A SECOND DOSE OR A BOOSTER.

>> SO LIKE RICH, WHEN IT STARTED, ME AND MY WIFE AND NOW I HAVE A TEAM OF SIX AND FOUR CARE MANAGERS.

THEY'LL COORDINATE WITH MIA AND OUR CARE MANAGERS WILL TRANSPORT, NOT JUST TRANSPORT.

WILL SIT THERE WITH YOU, WAIT WITH YOU TO MAKE SURE YOU DON'T HAVE A MELT DOWN IN THE MOMENT, MAKE SURE YOU DON'T BAIL OUT... >> IN THE WAITING ROOM.

>> THAT'S RIGHT.

AND SOMETIMES GOING IN FARTHER, WHETHER IT'S WITH A DENTIST GOING INTO THE CHAIR INITIALLY TO HOLD THEIR HAND.

>> I OFTEN HAVE A MELT DOWN AT THE DENTAL OFFICE.

>> WE BREAK THE ANXIETY BARRIER MAKING SURE WE STAY WITH THEM.

BACK TO SUNNY'S POINT HAVING A WONDERFUL RELATIONSHIP WITH OUR FRIEND.

>> YOU ARE TREATING PEOPLE WITH DIGNITY AND RESPECT.

TALK TO US A LITTLE BIT MORE ABOUT THE IMPORTANCE OF DIGNITY AND RESPECT.

>> TO ME IT'S WHEN SOMEONE IS FEELING-- >> JUST EVERYTHING.

EXUDES EVERY TYPE OF INTERACTION.

>> FOR US WE USE THE WORD BUILDING HOPE.

YOU ARE BUILDING AN EXPECTATION INTO SOMEONE'S LIFE WHERE THEY FEEL LIKE THEY HAD NO HOPE.

ONE OF OUR FIRST INTERACTIONS WAS WITH A GENTLEMAN THAT WAS HAVING A MELT DOWN I BROUGHT OVER TO THE CLINIC AND JOE AND FRANK, A SOCIAL WORKER SAT AND TALKED WITH HIM, BUT THE WAY THAT SUNNY AND JOEL TREATED THE PERSON WHILE THEY WERE HAVING A COMPLETE MELTDOWN SCREAMING AT THE TOP OF THEIR LUNGS AND ME SITTING BACK, NOT BEING A MEDICAL PERSON AT ALL, WATCHING THESE MEN DO THIS WORK WITH THIS GENTLEMAN, IT WAS ABOUT GIVING HIM DIGNITY EVEN THOUGH HE WAS HAVING A MELTDOWN IN THE MOMENT.

>> IS IT CHALLENGING, Dr. ASLAM TO BUILD TRUST WITH THESE FOLKS?

>> IT CAN BE EXTREMELY CHALLENGING.

OFTEN PEOPLE ARE UNAWARE OF WHAT THEY'RE EXPERIENCING, WHAT WE SEE THEM EXPERIENCING IS NOT WHAT THEY SEE AS AN ISSUE AT ALL.

THEY MAY BE ADDICTED AND THEIR BRAINING TELL CAN THEM TO GET DRUGS.

WE ARE TRYING TO OFFER THEM SOME KIND OF TREATMENT AND THEY'RE UNINTERESTED BECAUSE ADDICTION IS THE HIJACKING OF THE BRAIN BY THESE DRUGS: THEY'RE NOT EXPERIENCING THE SAME REALITY.

THAT'S WHAT SCHIZOPHRENIA IS FOR MANY PEOPLE.

THEY'RE HEARING VOICES UNDERSTAND AEXPERIENCING THINGS WE ARE NOT EXPERIENCING SO TRYING TO BUILD THOSE RELATIONSHIPS WHILE THEY'RE YELLING AT YOU, BEING ABUSIVE, THOSE KINDS OF THINGS.

YOU HAVE TO DECIDE WHERE YOU SET THE LIMITS AND WHERE YOU TRY TO CONTAIN THE BEHAVIORS, MAYBE OFFER MEDICATION OR ONGOING TREATMENT AND IT CAN BE AN ONGOING CHALLENGE.

>> HAVE YOU FOUND IT CHALLENGING, WHAT IS YOUR TYPICAL DAY LIKE AND HAVE YOU FOUND IT CHALLENGING TO CONNECT WITH THESE FOLKS?

>> I THINK IT DEPENDS.

I THINK I'VE LEARNED FROM THE BEST, JUSTED WATCHING HOW THESE INDIVIDUALS AROUND ME INTERACT WITH THESE PEOPLE AND SOMETHING I REALLY WANT TO HIGHLIGHT Dr. LEHMANN HAS SAID BEFORE, IS MEETING PEOPLE WHERE THEY'RE AT AND THAT'S A KEY FACET OF THIS PROGRAM AND HONESTLY A KEY FACET OF BEING A PHYSICIANING CIERCHED-- IS KIND OF JUST SAYING WITH INDIVIDUALS LIKE THIS, I UNDERSTAND THAT YOU ARE ADDICTED TO HEROIN BUT WE ARE IN THE GOING TO TRY TO TELL YOU THAT'S WRONG.

OBVIOUSLY THESE PEOPLE PROBABLY KNOW THAT FOR THEIR HEALTH AND THINGS LIKE THAT.

THEY WISH MAYBE THEY DIDN'T HAVE THIS ADDICTION BUT WE ARE NOT SITTING THERE LECTURING THEM TELLING THEM THEY NEED TO STOP THIS HABIT.

INSTEAD, WE MEET THEM WHERE THEY'RE AT AND SAY OKAY.

IN ADDITION TO THAT, THERE IS ANYTHING ELSE HEALTH WISE?

>> YOU ARE PARTNERING WITH THEM.

YOU ARE LISTENING, YOU ARE EMPATHIZING, TREATING WITH DIGNITY RESPECT AND PARTNERING.

WHAT CAN WE DO AS A COMMUNITY TO SUPPORT THIS WORK?

WHAT CAN WE DO?

THERE IS MORE THAT WE CAN DO AS A COMMUNITY.

>> I SAY FOR ME, WHEN I TALK TO FOLKS WHO WANT TO ENGAGE WITH THE WORG THAT WE ARE ALL-- WITH THE WORK THAT WE ARE ALL DOING, I CALL THEM SILOS.

YOU HAVE WEALTH, RESOURCES.

IF YOU WANT TO DONATE, WRITE A CHECK, WE'LL ALWAYS TAKE THE MONEY.

>> LET ME INTERRUPT A MINUTE.

>> DO WE GIVE PEOPLE MONEY?

>> ON THE STREET MY RECOMMENDATION OVER THE LAST SEVEN YEARS OF EXPERIENCE IS NOT GIVE THEM MONEY.

>> I'M CONFLICTED ABOUT THAT.

>> INSTEAD OF GIVING MONEY, GIVE SOMETHING.

>> I GIVE A PB & J SANDWICH.

>> OR A GALLON SIZE BLACK BAG WITH ITEMS IN IT THAT WOULD BE SEASONABLE.

WET WIPES, GLOVES, SOMETHING LIKE THAT.

SO THAT PEOPLE CAN GIVE FINANCIALLY OR GIVE RESOURCES LIKE SOMETIMES-- >> TO THE ORGANIZATION.

>> MATERIAL THINGS WE MIGHT NEED.

>> OR TIME AND TALENT.

MAYBE YOU HAVE EXTRA TIME AND YOU WANT TO VOLUNTEER.

IF THERE IS A VOLUNTEER OPPORTUNITY, MAKE THE HAPPEN.

>> THANK YOU SO MUCH.

THAT'S, UNFORTUNATELY, ALL THE TIME WE HAVE TODAY, BUT I WANT TO THANK OUR PANELISTS AGAIN FOR JOINING US.

REV.

JOHN TUMINO, EXECUTIVE DIRECTOR AND CO-FOUNDER OF IN MY FATHER'S KITCHEN DR. DAVID LEHMANN, DISTINGUISHED SERVICE PROFESSOR AND MEDICAL DIRECTOR AND CO-FOUNDER OF HOUSE CALLS FOR THE HOMELESS AT SUNY UPSTATE MEDICAL MS. MIA RUIZ-SALVADOR, PROGRAM COORDINATOR AND CO-FOUNDER OF HOUSE CALLS FOR THE HOMELESS AT SUNY UPSTATE MEDICAL DR.

SUNNY ASLAM, ASSOCIATE PROFESSOR OF PSYCHIATRY AND BEHAVIORAL SCIENCES AT SUNY UPSTATE MEDICAL AND MS. REBECCA RUSNAK, A SECOND YEAR MEDICAL STUDENT AT SUNY UPSTATE MS-2 AS THEY'RE CALLED.

BE SURE TO VISIT WCNY.ORG/CYCLEOFHEALTH TO SEE ADDITIONAL CONTENT, PRIOR EPISODES, AND OUR LATEST CHECKUP FROM OUR NECKUP.

FOR CYCLE OF HEALTH, I'M DR. RICH O'NEIL.

THANKS FOR CHECKING IN.

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