- Associated Press - Sunday, March 6, 2016

CASSELBERRY, Fla. (AP) - Donald Testa had just had three surgeries, part of one foot amputated and a fresh diagnosis of Type 2 diabetes when an Orlando hospital discharge planner announced he was well enough to go home.

There was just one problem: Testa had no home.

The 49-year-old had been living out of a motel and working day-labor jobs when blisters from a new pair of boots led to a nasty infection. An initial trip to the emergency room turned into repeated hospital stays and, at discharge, he was in a wheelchair, on intravenous antibiotics and taking 10 prescription medications plus insulin, which had to be refrigerated.

The hospital found him a bed at Pathways to Care - a rare place of respite for the homeless.

“If not for this place,” he says of the Casselberry medical assisted-living facility, “I’d have been on the streets. And God only knows what would have happened to me there.”

One of only a handful of such facilities in the nation, Pathways is a 50-bed program for people like Testa - with no home, no family to take them in and no one to dote on them with chicken soup and crossword puzzles while they recuperate from surgery, chemotherapy and other major medical procedures.

“I had seen people being discharged to the streets, discharged to the woods, as soon as the hospitals could get them out,” says Father John Bluett, Pastor at St. Stephen Catholic Community in Winter Springs and the program’s founder. “I just said, ‘We’re better than this.’”

That was 15 years ago, when health-care outreach workers were regularly finding people in the woods with IVs, unhealed surgical openings, oncology ports and even the occasional feeding tube. Bluett initially tried to find a facility near downtown Orlando but ran into political opposition - as he did in Sanford, Lake Mary and Winter Springs.

Finally, in 2003, Pathways found financial and administrative support from Catholic Charities of Central Florida and its current home in a Casselberry warehouse district, where it just added a second-phase program to help medically stable patients get off the streets permanently.

It is open to all faiths.

“It’s not a plush facility, but what it does is absolutely unbelievable,” says Rabbi Maurice Kaprow, a retired U.S. Navy Chaplain who serves on Pathways board of directors and last month donated a wheelchair-accessible van. “If Pathways didn’t exist, a lot of the people would die.”

In fact, people were dying.

“As hard as it can be to recuperate in your own home, imagine trying to recuperate in the woods,” says Karen van Caulil, president and CEO of the Florida Health Care Coalition. “There’s no sterile environment, no running water, no electricity.”

One patient, for instance, was referred to Pathways when his oncologist discovered he was riding a bicycle from a camp in the woods to chemotherapy treatments.

“The people who work here - they’re passionate about wanting to help,” says Ken Heim, a semi-employed golf pro and musician who was living out of his car last summer when his heart began to fail. “This place has been wonderful.”

Heim, like all the residents here, had no insurance at the time he went to an emergency room, barely able to walk. Doctors discovered severe blockages in his arteries. A week and one quadruple bypass later, the hospital put him in a cab to Pathways, where he has been for six months. He has since turned 65 and qualified for Social Security.

Pathways relies on the hospitals for about a quarter of its $1 million a year budget. They’ll pay for whatever they deem medically necessary - whether it’s two days or six weeks - and provide at least 30 days of medication. The rest of the budget comes from Catholic Charities (part of the Diocese of Orlando), various churches, the Jewish Federation of Greater Orlando, small government grants and private donors.

A contract with the Department of Veterans Affairs covers former service members, and a recent $100,000 two-year grant from Dr. Phillips Charities allowed Pathways to open the 10-bed second-phase unit in December, which gives residents time to get on their fee financially by applying for disability benefits or saving up Social Security income for rent.

The unit had been built more than five years ago but was sitting vacant, awaiting the money to run it.

Funding is an ongoing struggle, says Pathways administrator Dawn Zinger. When she arrived five years ago, the place was losing $150,000 a year and only last year did it finally cover the deficit.

It has helped, she says, that hospitals are improving their discharge planning to cut back on readmissions. Having patients recuperate at Pathways - at $85 a day - is a fraction of what a night in the hospital would cost. People are still being discharged to the streets or shelters, Father Bluett says, but not as often.

Representatives from both Orlando Health and Florida Hospital called Pathways a “great partner” but noted that the facility can only accept patients who are fairly independent. It is not, after all, a skilled nursing facility, though a full-time nurse is on staff to supervise. But Pathways case workers do help educate the residents on how and when to take their medications, shuttle them to doctor appointments, and ensure they get regular nutritionally balanced meals.

They also try to reconnect them with family or government benefits so they’re not homeless again when they leave. Nine times out of 10, the case workers succeed.

Dennis Kamasinski, a 62-year-old Marine Corps veteran, hopes to live long enough to have a place of his own through a VA program. Diagnosed with advanced colon cancer last May, he was initially given four months.

“I’ll take whatever time God gives me,” he says. “And meanwhile they show me tremendous love here - more love than I’ve had in a long while.”

___

Information from: Orlando Sentinel, http://www.orlandosentinel.com/

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