SARATOGA SPRINGS —Saratoga Hospital Community Health Center (CHC) physician assistant Samuel Halajian, MPAS, PA-C, traveled a circuitous pathway to his career. Pivoting away from his success in film and TV production, Halajian now renders medical care both in a clinic setting and in the street to those with medical needs, regardless of their ability to pay.

A Briarcliff, New York, native, Halajian, a husband and father at 38, describes his early life as “an artist, always.” But even as a student at New York University, he found himself drawn to train as an emergency medical technician (EMT) and, once certified, he volunteered in Ossining, New York. Soon, despite making a professional mark in visual media, he yearned for more responsibility in medicine and became a paramedic, “physically and emotionally demanding work,” he recalls, in busy urban settings, like the Bronx, where he was exposed to a range of serious and stressful situations and problems, including violence, accidents, and injury.

“I loved it, but it was wearing me down,” says the Ballston Spa resident. “I couldn’t imagine doing it for 30 or 40 years. Then I learned about opportunities as a physician assistant, and it was definitely attractive to me. I knew I wanted to be in medicine, but I didn’t want to spend years and years in medical school. Being a P.A. was the answer.”

A physician assistant (P.A.) is a mid-level health care provider who may diagnose illnesses, develop and manage treatment plans, prescribe medications, and serve as a principal health care provider.

After researching his options, Halajian discovered that one of the best P.A. programs in the United States is through the military. In exchange for his extensive medical education, he committed six years of service after completing the training to the Army Reserves; he has two left to go. 

“It’s definitely not ‘free’ schooling,” he points out, adding, “The training was fantastic. The Army program is among the top 10 among about 300 in the United States.” Last year, Halajian was temporarily deployed as an Army medical officer to Eastern Europe.

“I love my work for both the Army and the Saratoga Hospital Community Health Center,” he enthuses, “The people I work with in health care are passionate about what we’re doing.”

Although anyone is welcome to use the Community Health Center, Halajian notes that he works extensively with the homeless population, both in the office and in the field, utilizing his special skills in addiction medicine and mental health.

“I go into motels, into the streets, the parking lots, the woods – where the homeless are, I go,” he says. Halajian explains he is part of “street outreach initiative” that relies on a network of partners, including Captain Community Services (the lead agency), Shelters of Saratoga, The Salvation Army, Healing Springs, and RISE Housing and Support Services. Other involved ar agencies include Veterans & Community Housing Coalition, Inc. and Wellspring, which serves individuals experiencing domestic violence. He is part of a weekly video conference with the network partners.

Halajian’s goal in the field is to establish trust with unhomed individuals via consistent, direct engagement outside the office, including to diagnose and treat acute and chronic medical concerns, including splinting a limb, binding a wound, diagnosing diabetes, COVID-19 testing and much, much more. The job is a perfect fit for Halajian, who is dedicated to working with mental health and addiction issues often found in this population.

“It’s a chicken-and-egg question,” Halajian says. “Do people become homeless because they are alcoholic or have mental illness, or does being homeless lead people to drink?” Either way, he tends to those who are struggling. “There are routine places I go,” he notes, “or I might get a call to check out a location or a specific person. I bridge the gap between the doctor’s office and the emergency department, because that’s often where the homeless end up. However, they may get immediate care and then not follow up once they’re on their own again. With me, there’s trust built over time and they’ll hopefully come to the office for help or see me again in the street. Not all, not everyone I see, obviously, follows up, but I would say I now have more than 20 office patients who are unhomed. The situation is improving.”

He says, “There is much I can do in the field and in the office, write prescriptions, order tests that people need to get into detox programs and expedite the results, interact with a case manager from social services, and more.”

Some homeless people depend on Medicaid or Medicare, acknowledges Halajian, but some, such as those who live in a woods encampment, for example, have commercial insurance through a job. Also, social services, disability insurance, and other supplemental income programs are set up to help fill prescriptions.

“When we combine our inter-agency skills, the care team is very resourceful at getting people what they need with discretionary funds from drug companies, for example,” Halajian points out.

Halajian is quick to point out that there is “no one response or reception” to his presence in the field. “It depends on the individual, or even a mood that can change day to day. But I am not there to judge, I am there to love and help them all.”

Some of the homeless want nothing to do with Halajian and his services, he admits, but he rarely gets “right down to business. We do a little dance of getting to know each other to build trust. Some of these people, when sober, are intelligent, funny, and warm. I love talking to them, whether we’re in the street or the office. More and more, enough of them know who I am to begin to believe I’m there to help. There are folks I encounter who start out very suspicious, people with mental illness, and they’re really challenging to treat, they’re very guarded, but the vast majority are willing to engage and want me to be their provider.”

Halajian observes that there are fluctuations in the volume of the homeless population and that “They seem to come in waves – in the summer there are many homeless near the train station in the woods, but then some end up in jail or in the hospital or another mental health program, and many are gone when it gets cold.”

“Everyone individual is different,” underlines Halajian. “There is not one single factor that drives people into the street; if we talk to 50 people, we get 50 stories. Looking at human beings as ‘trends’ is not useful. What is productive is asking what we can do.”

Halajian disagrees with those who claim there aren’t enough services for people who are unhomed. “We have services, what we also have are barriers to access, for example, a lot of people don’t have transportation to service agencies or doctors and that’s the problem: barriers to care.”

He also says that mental health problems are another barrier, as it may make patients non-compliant. “If I see someone with high cholesterol and treat them, but they insist on living on pizza and hamburgers, that’s not my fault,” he points out. “We can offer assistance, but we can’t make people accept it. But, it’s really important not to paint the homeless population with a broad brush. While a lot of my patients have the tragic disease of alcoholism, we do have some success engaging them for detox, mental health services, and employment. It helps to find out about the individual’s unique history and how he or she got to a place of being homeless and alcoholic, or to abusing other substances, to support them in making good progress. I put my hand out – it’s up to them whether to take it. Sometimes, people with addiction issues make bad choices. Unfortunately, that’s when they become visible to the public. I try to give people the help they need so they can do better, do well.”

Halajian notes that the Community Health Center is a patient-centered medical home which offers behavioral health, addiction medicine, dental, and primary care services.

“This is complex work,” Halajian says. “We have to keep these people safe. Nobody should freeze to death in Saratoga – I think we can all agree on that. People get uncomfortable and unhappy with the idea of unhomed people being around them, so I’m grateful that my role is focusing on health care, but I can’t do it all by myself. That’s why we have a network of partners. We are there for each other and the people we serve. I get to build all these relationships with people who live with barriers. I get to talk to people about how to take care of themselves – and that’s a privilege. There’s a lot on my plate, but it makes me grateful to have a home, food on my table, and a family to love.”

SARATOGA SPRINGS — A new market in downtown Saratoga Springs is preparing to open soon.

PDT Market is “six to eight weeks” away from opening its new location at 55 Railroad Place, said owner Adam Foti, who described PDT Market as a “specialty grocery store,” with many other offerings.

“There are seven aisles of a grocery store,” Foti said. “So as far as people being able to come in and grab things like eggs, butter, milk, flour, the sort of staple things, as well as specialty things, like brands and things you may not find at other places.”

PDT Market will feature deli, seafood, and produce areas, along with a grab-and-go station, charcuterie station, flowers, personal items, and more. The market will also have a full-service bar with beer and wine on tap.

Foti said the new location, “just seemed like the right kind of space and time for us as a brand.”

“When we saw that Price Chopper announced last year in February that they were leaving, we thought this was a great space for all the things we wanted to bring together in the manifestation of all the things that I am and we are as a brand,” said Foti. “All the food bits and pieces, but also a space where people can be immersed in our brand, and transported, hopefully, to some other place.”

Foti said the store has been designed to be “really aesthetically pleasing.”

“Our brand lives in this sort of French and Italian-inspired place, and specifically our ques that we take from a design and food perspective are more like Provencal and Tuscan,” said Foti. “What that means to us is upscale comfort food, in a way. It’s not fussy, but it’s food made really well from scratch ingredients with a limited amount of things in it.”

Foti said the grab-and-go section will offer prepared sandwiches, salads, protein bowls, and more. The deli area will sell sliced meats, paninis, and custom sandwiches, while a hot bar will also be available with items such as macaroni and cheese.

The meat and seafood area will feature “super fresh” seafood, said Foti.

“Out of the ocean and into the store in a day to two days max,” Foti said. “Other prepared foods there, by the pound, things that you would find at a normal deli area, like macaroni salad, potato salad, pre-made entree things that people can just go home and heat up.”

PDT’s full-service bar will offer beers on tap, craft cocktails, and wine. Foti said the bar has a limited menu, and said they will also sell their own private coffee blend, pastries, and baked goods. The bar area can also be rented out for private events.

The store will also feature a build-your-own charcuterie station, and offer cooking classes to the public. Foti named regions of Italy and France as possible themes for the classes, and said they typically run about 90 minutes. Classes through June are open for registration on www.pdtmarket.com. 

“We do all the chopping and cutting. You come in and do the fun part, which is cook,” Foti said. “Then you can get drinks from the bar, hang out with friends, and have a good time. So it’s sort of our version of Paint and Sip, but you get to eat and sip.”

PDT began as a catering company, and Foti said they will continue to offer catering services. The company formerly had a physical location in Ballston Lake, where they offered what Foti described as “lifestyle products.” 

Now, in Saratoga Springs, PDT will be able to offer much more.

“In this case, there’s so many different types of food experiences that you can have in this space,” said Foti. “Whether it’s truly need-based, where I just need to get eggs, milk, and bread or whatever. … There’s that piece, but there’s so many other components to it.”

PDT is currently in the process of hiring employees, Foti said. As the store gets closer to opening, he said it is “really exciting” to see his vision come to fruition.

“I’m a super passionate person about the things I do,” Foti said. “Nothing fulfills my soul more than to have people smile and laugh while they’re eating, and just enjoy themselves. … That’s what sort of drives me, and why we do what we do every day.”

Foti said he hopes PDT will be an inclusive space “where everyone can come and enjoy us in whatever way they want to.”

“We hope, and we know, that there’s a community here already that will like what we have to put out there,” said Foti. “We feel that this type of concept is missing right now in this market, so we feel like this could be a great space where people could come together.”