{"id":216359,"date":"2026-06-11T11:10:09","date_gmt":"2026-06-11T11:10:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-pa\/216359\/"},"modified":"2026-06-11T11:10:09","modified_gmt":"2026-06-11T11:10:09","slug":"phillys-25-million-lifeline-for-unhoused-drug-users-with-major-health-challenges","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-pa\/216359\/","title":{"rendered":"Philly’s $25 million lifeline for unhoused drug users with major health challenges"},"content":{"rendered":"

Love Philly? So do we. Let\u2019s be friends. Sign up for the Billy Penn newsletter today<\/a>.<\/p>\n

Four years ago, Joey Essinger was doing well, by his own account. He was off dope, renting a house in Frankford, and getting plenty of contracting work \u2014 drywall, flooring, tile, electric, plumbing, and whatever else clients needed.<\/p>\n

\u201cI\u2019m not a material person, but, like, I had a lot of material things,\u201d he recalled. \u201cI was making good money. I had money saved.\u201d<\/p>\n

He was still very much an addict, though.<\/p>\n

\u201cSometimes the addicts, see, when we\u2019re really down, and we go through things that are tough emotionally, we get high. And sometimes, we\u2019re doing so great, it\u2019s like, \u2018we deserve to get high.\u2019 And that\u2019s kind of like where I was,\u201d he said.<\/p>\n

Essinger is 41 years old, short, with a boyish, bearded face and a scratchy, occasionally slurring voice. Originally from Barnegat Light, New Jersey, he lived in Miami for 13 years before moving to Philadelphia in 2019.\u00a0<\/p>\n

\"\"Joseph Essinger spent three years living on the streets of Philadelphia before a foot injury in January 2025 put him in a wheelchair and he moved into Project Home\u2019s Sacred Heart Recovery Residence. He cares for a turtle named Rupert that a previous resident left behind. Feb. 24, 2026.(Kimberly Paynter\/WHYY)<\/p>\n

Three years ago, he lost everything when he returned to active heroin use \u2014 but then an unusual program helped him get out of homelessness and back into recovery.<\/p>\n

Sitting in an office at Sacred Heart Recovery Residence in Hunting Park earlier this year, he described his quick descent back onto the street.<\/p>\n

Using heroin once turned into using it twice, then every other day, then every day, he said. He burned through his rent money, got kicked out of the house he was renting and started sleeping on the streets\u00a0 near 30th Street, sneaking into the Amtrak station for a respite from the cold when he could.\u00a0<\/p>\n

He\u2019d often visit Penn Presbyterian\u2019s emergency room for issues like foot pain or a cold, or just to have a warm bed for the night. And the staff there remember him well.\u00a0<\/p>\n

\u201cAt least three times a month he would be there for, I would say more so minor things,\u201d said Madison Schmus, a Penn Medicine nurse who often treated him. \u201cHe\u2019s what we would call \u2018a frequent flyer.\u2019\u201d<\/p>\n

Twice a day Essinger would take the L to Kensington to buy and use drugs. He started having frequent seizures during withdrawal, and at one point suffered a minor stroke, he said. He entered drug treatment in late 2024, and the day after he got out, he got high again and took a hard fall at the Girard L station, shattering his right heel, he said.\u00a0<\/p>\n

An ambulance took him to Jefferson University Hospital, where doctors told him it was critical that he use a wheelchair for a few months.<\/p>\n

\u201cThey\u2019re like, \u2018If you don\u2019t stay off of it for at least 10 weeks, you\u2019re gonna do damage to it. We\u2019re not gonna be able to fix it. You\u2019re never gonna walk right again for the rest of your life,\u2019\u201d he said. \u201cI heard that, and I was like, that scared the heck out of me, you know?\u201d<\/p>\n

Limited access to recovery-centered housing<\/p>\n

Stories like Essinger\u2019s are achingly familiar to medical and shelter providers in Philadelphia who care for people who are living on the street and using opioids and other drugs.<\/p>\n

Many are caught in a vicious cycle of homelessness and declining health. Their lives are too chaotic to allow consistent care, which often leads to worsening medical issues. In turn, challenges like poor mobility, slow-healing wounds, or the need for kidney dialysis make it very difficult to find suitable housing.<\/p>\n

The Parker administration is spending hundreds of millions of dollars to create more shelter beds<\/a> and operate a \u201cwellness ecosystem<\/a>\u201d of drug treatment services and centers, and a variety of nonprofit and private organizations operate programs as well. But medically fragile people often can\u2019t take advantage of that network of resources.<\/p>\n

\u201cIf you\u2019re, for example, in a wheelchair, there\u2019s very limited options to access recovery-centered housing,\u201d said Gilly Gehri, a project manager at Penn Medicine\u2019s Center for Addiction Medicine and Policy. \u201cIf someone is on methadone, it\u2019s really hard to access a skilled nursing facility. Or if someone doesn\u2019t have a dedicated dialysis chair \u2014 there\u2019s just so many barriers.\u201d<\/p>\n

Instead, those individuals essentially remain homeless between disconnected episodes of medical care.<\/p>\n

People end up bouncing \u201cback and forth to the hospital, bouncing between hospitals and recovery houses, or skilled nursing facilities and rehabs,\u201d said Rosa Friedman, a medical case manager at Penn. For those patients, that results in \u201ca lot of turmoil, because of these systems not really having the resources to address everything going on with folks.\u201d<\/p>\n

The need for shelters that can accommodate people with serious health needs has grown along with the opioid epidemic, particularly as harmful new adulterants have become ubiquitous in the drug supply, providers say.\u00a0<\/p>\n

The animal tranquilizer xylazine<\/a>, or tranq, causes painful withdrawal and skin wounds that can lead to amputations, while another sedative, medetomidine, causes spikes in blood pressure during withdrawal and often requires treatment in a hospital intensive care unit.<\/p>\n

\u201cPeople were having increased medical complexity and increased hospitalizations and the need to interface more with physical health systems,\u201d said Judy Chertok, director of addiction medicine at UPenn\u2019s Department of Family Medicine and Community Health.\u00a0 \u201cThat is something that has changed, or has become more of a need and more apparent, in the last five-plus years.\u201d<\/p>\n

\u2018Trying to go bold and big\u2019<\/p>\n

Advocates often repeat the mantra that \u201chousing is healthcare,\u201d and cite the well-documented health and cost benefits<\/a> of finding beds in supportive housing for homeless individuals.\u00a0<\/p>\n

But such housing is costly to operate and in short supply, and places that accommodate active drug users \u2014 called low-barrier shelters \u2014 are particularly scarce. Add in a requirement that the facility be linked to high-touch medical care and intensive social services, and the number of options drops practically to zero.<\/p>\n

Project HOME has set up programs to partially bridge the gap. It offers shelter residents access to medication-assisted treatment such as methadone and buprenorphine, and has a street medicine program<\/a> for those with tranq wounds and other health problems. But the organization\u2019s co-founder Sister Mary Scullion wanted to do more.\u00a0<\/p>\n

She \u201chad this vision of really changing the trajectory and trying to go bold and big,\u201d Chertok said.\u00a0<\/p>\n

\"\"Project Home founder, Sister Mary Scullion, announced Project Home\u2019s Estadt-Lubert housing and recovery collaborative. May 31, 2023. (Kimberly Paynter\/WHYY)<\/p>\n

Scullion talked with her frequent collaborator Dr. Richard Wender, chair of Penn\u2019s Department of Family Medicine and Community Health, about ways to address the disconnect between housing and medical care. They also conferred with philanthropist Ira Lubert, a retired tech exec and investment firm manager who has been a longtime supporter of Project HOME, Thomas Jefferson University and other charitable organizations.<\/p>\n

In May 2023, Lubert and his wife Pam Estadt announced they would donate $25 million<\/a> to help create Project HOME\u2019s Recovery and Housing Collaborative along with Penn Medicine, Jefferson and Temple University Health. The goal of the roughly $100 million program would be to provide a \u201cunified ecosystem\u201d of services for people struggling with homelessness, substance use disorder and acute medical issues.<\/p>\n

\u201cIf we can create a framework that helps us put people on a better trajectory, this initiative will be a success,\u201d Lubert said.\u00a0<\/p>\n

Uber rides, cell phones, \u2018translation\u2019 services<\/p>\n

A central element of the collaborative is a team of physicians, nurses, social workers, advocates and administrators at each hospital system who look for emergency room patients who meet the program\u2019s guidelines \u2014 like Joey Essinger.<\/p>\n

\u201cWhen he popped up on our list, I\u2019m like, I know this person. He\u2019s here all the time. He\u2019s in the ER, and we love him,\u201d recalled Schmus, the Penn Medicine nurse. She and Friedman, her case manager colleague, found him in his emergency room bed. \u201cSo there he was, with his broken foot.\u201d<\/p>\n

After his fall in the L station, Essinger had spent two weeks getting fixed up at Jefferson Hospital \u2014 \u201cthey put a couple screws in a metal plate,\u201d he said \u2014 before ending up on the street yet again. Living outdoors, in his wheelchair, still using, he had another seizure and was taken to Penn Presbyterian.\u00a0<\/p>\n

Schmus and Friedman asked him if he was \u201csick and tired\u201d of being homeless, he recalled.<\/p>\n

\u201cSo I\u2019m like, \u2018heck yeah.\u2019 \u2018Well, what if we told you we got a spot for you?\u2019 I was like, \u2018oh my God.\u2019 I could not believe it. I hugged them both right there in my hospital bed,\u201d he said.<\/p>\n

\"\"At Project HOME\u2019s Sacred Heart Recovery Residence in North Philadelphia, registered nurse Madison Schmus, left, supports resident Joseph Essinger\u2019s recovery and medical needs. Feb. 24, 2026. (Kimberly Paynter\/WHYY)<\/p>\n

Once a patient agrees to enter the program, they\u2019re assigned to one of the 51 shelter beds reserved for the collaborative at Sacred Heart, Project HOME\u2019s Inn of Amazing Mercy<\/a>, St. Elizabeth\u2019s Recovery Residence or Prevention Point\u2019s Beacon House. From that moment on, staffers visit them frequently at their shelter, monitor their progress and needs, and provide a host of wraparound services, like Uber rides to doctor\u2019s appointments, help navigating insurance bureaucracies, and \u201ctranslation\u201d of medical talk, Friedman said<\/p>\n

\u201cOnce they\u2019re in the environment of the doctor\u2019s office, they can be feeling kind of pretty overwhelmed or overstimulated or anxious because of past experiences,\u201d she said. \u201cSo I like to be there to be a second brain and second set of ears to help them remember what they wanted to address.\u201d<\/p>\n

It\u2019s transformative for both patients and doctors to have someone like Friedman or Schmus with them during an appointment, Chertok said, for example when complex decisions are being made about whether to operate on a xylazine-related wound. A case manager can help explain how the wound has been treated and how their recovery has been going.\u00a0<\/p>\n

\u201cIt\u2019s hard to describe how valuable that is for our patients, but it makes just a tremendous difference, because it\u2019s very intimidating to go to these appointments,\u201d she said.<\/p>\n

The participants also get basic life skills help. They\u2019re given cell phones, they relearn how to make their bed and do their laundry, and at some point they typically visit a PennDOT office with Friedman or another case manager to get a new state ID card \u2014 a crucial step toward getting government benefits, permanent housing and possibly employment.\u00a0<\/p>\n

\u201cJust helping people navigate being in the world while not using [drugs], people who\u2019ve been very used to thinking in a very concrete, short-term way, because that\u2019s what they needed to do to get through the day:\u00a0 \u2018Where am I going to eat? How am I going to have dry clothes or whatnot?\u2019\u201d Friedman said. \u201cOnce you have some of those needs taken care of, then you have to figure out how to deal with everything else.\u201d<\/p>\n

Working hard to recover<\/p>\n

Essinger described his time in the collaborative as \u201clife-changing.\u201d<\/p>\n

\u201cThey gave me a phone, they gave me clothes. I had nothing. They saved my life, and they are so good to me. I\u2019m so humbled by the stuff they\u2019ve done for me. I feel almost like I didn\u2019t deserve how much they did for me,\u201d he said.<\/p>\n

He moved into a dorm-style room at Sacred Heart, underwent physical therapy and, almost four months after his accident, was able to step away from his wheelchair.<\/p>\n

\u201cWhen he first came in here, he couldn\u2019t even walk. [He] worked really hard to get where he\u2019s at,\u201d said Shannon Qualters, assistant program manager at the residence. \u201cYou still always see the ones that really want it. He\u2019s definitely one of the ones that really want it.\u201d<\/p>\n

\"\"Project Home\u2019s Sacred Heart Recovery Residence in North Philadelphia. Feb. 24, 2026. (Kimberly Paynter\/WHYY)<\/p>\n

His routine now includes regular visits to a methadone clinic, and once a week he spends much of his day in appointments at Penn Medicine, seeing a primary care doctor, another physician, and a therapist.\u00a0<\/p>\n

\u201cI just started talking to my family again. We hadn\u2019t talked in years,\u201d he said. \u201cThere\u2019s a lot of stuff going on in their lives too, but\u2026 Either way, I\u2019m back in their lives, and they don\u2019t gotta worry right now about getting that phone call that\u2019s every parent\u2019s worst nightmare.\u201d<\/p>\n

\u201cThe methadone really works with cravings and stuff like that,\u201d he added. \u201cJust the thought of using dope, it makes me cringe. It\u2019s so disgusting.\u201d<\/p>\n

He takes care of a tiny turtle named Rupert he inherited from a former Sacred Heart resident, and tries to keep himself occupied and avoid getting bored. He\u2019s waiting to be matched to housing by the city\u2019s coordinated entry system, and thinking about what he\u2019ll do once he has his own place again.<\/p>\n

\u201cI can\u2019t wait to get back to work. But I\u2019m gonna start off easy, like 20 hours a week or something. I don\u2019t want to stress myself out,\u201d he said. \u201cI\u2019m not doing any more labor. I\u2019m an old man now. But I\u2019ll find something that\u2019s good for me.\u201d<\/p>\n

\u2018Unbelievable\u2019 progress, but an uncertain future<\/p>\n

Other programs serve similar purposes to the Project HOME collaborative, but none appear to match its scope.\u00a0<\/p>\n

For example, medical respite programs<\/a> like those run by the Public Health Management Corporation in North and West Philadelphia offer a high level of medical care to people experiencing homelessness after they leave the hospital, but typically only for 60 or 90 days.\u00a0<\/p>\n

One direct precursor for the collaborative was Temple Health\u2019s Housing Smart<\/a> program, which launched in 2020 and initially offered housing subsidies to 25 people. It ran out of funding, but the launch of the collaborative led Temple to create what it calls Home Base teams comprised of housing advocates, community health workers, and recovery specialists, said Patrick Vulgamore, director Temple\u2019s Addiction Medicine Service Line.<\/p>\n

Temple\u2019s program has about 80 patients, he said. Some are part of the Project HOME collaborative, while services for others are funded by health insurance and Temple Health. Vulgamore said the Home Base teams do \u201camazing work\u201d breaking down silos between different health providers and community organizations, and working together to solve complex problems.<\/p>\n

\u201cI have never seen collaboration as close-knit and as patient-focused as this program. It is unbelievable,\u201d he said. \u201cEvery single day, it seems like mountains are being moved to get participants what they need.\u201d<\/p>\n

\"\"Olivia Quinn, right, coordinator at Project Home\u2019s Sacred Heart Recovery Residence, said she wears many hats for the residents. Feb. 24, 2026. (Kimberly Paynter\/WHYY)<\/p>\n

At the same time, the collaborative still faces challenges.\u00a0<\/p>\n

While the program has been gradually scaling up toward a goal of 150 beds, there still won\u2019t be enough spots to fully meet the need. Program managers regularly have to turn down hospital staffers\u2019 requests to enroll eligible emergency room patients, Friedman said.\u00a0<\/p>\n

Those who do enroll and stabilize their lives may then have to wait years until the city\u2019s homeless assistance system assigns them to supportive housing or other permanent accommodation.<\/p>\n

\u201cIt\u2019s very confusing, and there\u2019s a lot of different routes to achieve housing goals, all of which are slow and convoluted,\u201d Gehri said.<\/p>\n

The future of the collaborative beyond the five-year duration of the Estadt-Lubert grant is also uncertain.\u00a0<\/p>\n

Managers are exploring whether health insurers will pay for the home nursing supports Schmus and others provide at shelters, which could help fund the program long-term. The federal and state governments could eventually cover more costs, if Pennsylvania follows the example of several other states that have Medicaid waivers allowing providers to bill for home- and community-based services \u2014 although the Trump administration has moved to make waivers harder to obtain.<\/p>\n

Gehri noted that while the program provides social benefits to the participants and the community, from a healthcare perspective it\u2019s \u201cjust really expensive,\u201d spending large sums on a small number of patients. A study is under way to see whether the collaborative cuts emergency hospitalization costs, which could provide an argument for sustained funding of the program.<\/p>\n

In the \u201cideal dream state,\u201d Chertok said, \u201cwe could come up with a hodgepodge of grants, as well as billing mechanisms \u2014 that would be our goal to sustain what we\u2019re doing.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Love Philly? So do we. Let\u2019s be friends. Sign up for the Billy Penn newsletter today. Four years…\n","protected":false},"author":2,"featured_media":216360,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[14672,1057,94634,5725,4736,3806,36683,14673,36854,69,71,70,59350,94635,10869,15084,4347],"class_list":["post-216359","post","type-post","status-publish","format-standard","has-post-thumbnail","category-philadelphia","tag-addiction","tag-health","tag-hospital-of-the-university-of-pennsylvania","tag-hospitals","tag-housing","tag-jefferson-health","tag-jefferson-hospital","tag-opioids","tag-penn-medicine","tag-philadelphia","tag-philadelphia-headlines","tag-philadelphia-news","tag-project-home","tag-substance-abuse-recovery","tag-temple-university","tag-temple-university-hospital","tag-university-of-pennsylvania"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/216359","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/comments?post=216359"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/216359\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media\/216360"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media?parent=216359"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/categories?post=216359"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/tags?post=216359"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}