When Karlo first came to Zufall Health, he was unhoused, struggling with alcohol use, and hoping for a fresh start. His primary care provider, Family Medicine Physician Douglas Bishop, MD, began treatment with Vivitrol, a monthly injection that reduces alcohol cravings. But Karlo wasn’t ready—he continued drinking and missed appointments.

In 2023, he was hospitalized with advanced liver failure and cirrhosis. Ineligible for a transplant, doctors didn’t expect him to survive the summer. Around the same time, he lost Medicaid coverage due to missed renewal notices sent to an old address.

After discharge, Behavioral Health Case Manager Shirly Sanchez helped Karlo appeal the Medicaid lapse, made repeated calls to the state, and successfully reinstated his coverage. She also connected him to external counseling to support his recovery. With his coverage restored, Karlo resumed Vivitrol treatment with Dr. Bishop—lifesaving medication he couldn’t have afforded without Medicaid.

“Now, when I have extra money, I don’t think about spending it on alcohol. I think about what I can do for my kids,” Karlo says.

Today, Karlo is active in the recovery community, plans to pursue a career as a certified peer recovery specialist, and has 50% custody of his children. He still sees Dr. Bishop regularly, not only for Vivitrol but also to manage other chronic conditions including asthma, allergies, and diabetes.