Marielle McKenna (Yulia Tsarenko-Carey/Catholic Charities)
Marielle McKenna (Yulia Tsarenko-Carey/Catholic Charities)

Neatly stacked boxes and plastic tubs flank Sherrié Janz in her small Southeast Portland apartment. Formerly homeless, the 53-year-old now has a place to put her modest assortment of clothes and household items, which she’d kept in storage for years.

Janz is savoring her new space — the bathroom is already color-coordinated — and the safety and stability it provides.

Yet a small possession she carries everywhere has been as transformative as her new home.

This past fall, Janz received a smartphone through Catholic Charities of Oregon. It came with a charger, a cover, earbuds, a free data plan, and a range of potential ways to improve her overall well-being.

The phone is one piece of a telehealth project funded by a three-year grant of more than $600,000 from Providence Health Plan and administered through Catholic Charities. By increasing access to reliable technology, health education and outreach support for homeless women, the initiative aims to improve mental and physical health, increase income and housing stability, and deepen social connections for homeless individuals or those at risk of homelessness.

Virtual care, or telehealth, has been used in the Oregon region previously but typically not for the homeless population.

“This is bridging the digital divide and making health care more equitable,” said Father Tim Bushy, chief mission officer for Providence Health Plan. At its core, the effort fulfills Providence’s mission to serve all, especially the poor and vulnerable, as an expression “of God’s healing love,” he said.

A recent report by researchers at the University of California at San Francisco found that homeless people in their 50s have physical health conditions typically seen in 70- and 80-year-olds. Nearly 47% of homeless women meet the criteria for a diagnosis of major depressive disorder — twice the rate of women in general, according to a study cited by the American Psychological Association.

“Homelessness has devastating impacts on health,” said Rose Bak, who oversees a number of services at Catholic Charities, including housing and homeless-outreach programs.

Barriers to care include uncertainty about where to receive treatment, a lack of insurance and limited transportation. There’s also fear.

“For many people who’ve been on the streets for a while, especially people of color, an authority figure like a doctor can cause a certain anxiety due to past experiences,” said Bak.

And without preventative care, homeless individuals’ contacts with medical professionals are relegated to an emergency room after a crisis. “If you associate a doctor with a really horrible event, even a wellness visit can seem traumatic,” Bak said.

The Providence-Catholic Charities project, called Technology Access Now (TAN), addresses these health care challenges by giving women the technology they need to receive routine, preventive care remotely.

“It’s a proactive approach to health,” said Father Bushy.

Since its launch last year, TAN has focused on three populations served by Catholic Charities: homeless women living on the streets; residents of Kenton Women’s Village, a cluster of transitional housing pods in North Portland; and women dwelling in the agency’s permanent supportive housing units.

To be eligible for a phone, a woman must not possess a reliable alternative and already have had contact with the agency. In the first year of the program, 10 women have received smartphones; the goal is to expand to 20 clients this year.

Most studies indicate a majority of homeless individuals have a phone, but they typically are free government-sponsored devices that “often break, have customer service that’s difficult and cause a high level of frustration,” said Catholic Charities outreach worker Marielle McKenna. The government-issued phones have only a small amount of data — “not enough to get anything important done,” added Bak.

Janz, introduced to the telehealth initiative while living at Kenton, said she’d be working on her government phone and all of a sudden lose her work. Or the phone sometimes became hot to the touch before eventually petering out.

“There were times I’d cry it was so frustrating,” she said.

Janz said the smartphone from Catholic Charities has been snag-free thus far.

In addition to distributing a limited number of phones, TAN helps people access the Oregon Health Plan — a program that pays for low-income Oregonians’ health care ¬— and once they have insurance, teaches participants how to use it to receive primary care.

Women learn to log in to their providers’ health apps to make appointments, refill prescriptions and view test results. Certain digital technologies allow doctors to provide virtual appointments, during which they might analyze blood sugar levels, examine a patient’s throat or discuss flu symptoms.

For the street outreach portion of the project, staff connected with around 500 people last year. They distributed blankets and food when needed, then shared ways individuals could access medical care, even while living on the streets.

Laptops for Kenton and supportive housing residents and a group texting plan also were purchased for the project.

Recently a cohort of women were moving out of Kenton into permanent housing, and a text informed residents “about a celebration to send off their sisters,” said Jennifer Lucena, who manages the TAN program for Catholic Charities. “It’s an example of how the phones can create community.”

Janz, who has scoliosis and a mix of other health problems, regularly uses her smartphone to make medical appointments and communicate with her doctor. But the phone made securing housing less daunting, as well. She was able to scout for apartments online and then submit applications via email.

“I would have had to ride a bus way out here to bring the paperwork, so the phone saved me a lot of time,” she said.

TAN participants learn how to save documents on the cloud — remote servers that can be accessed online. Simple features like a Google calendar, an alarm and the phone’s flashlight improve people’s everyday lives, said Lucena.

As with most technology-related projects, there have been glitches. Staff also needed to consider a range of mobile device proficiencies.

“Technology changes quickly, and the trauma from homelessness means not all participants may be tech savvy,” said Bak. Additionally, there’s a growing number of elderly people who are homeless, and not all are comfortable with the newest devices.

No matter one’s smartphone skills, it is difficult to maintain a phone while living on the streets. It can be tough to keep it charged and it might get stolen or wet.

McKenna recalled how one client’s phone was thrown into a bag of wet clothes when police officers asked a group of homeless individuals to dissipate quickly.

The client came up with a solution for future incidents. She’s wrapped it in a plastic bag, which allows her to still use the touchscreen, and keeps it in her bra.

TAN offers peer mentors, women who’ve known homelessness firsthand, and they provide emotional support throughout the program. They are available to attend appointments and serve as advocates.

“We are a relationship-centered program, and that seeps into all that we do,” said Lucena.

Father Bushy said a key motivator for the Providence grant was to provide hands-on help, not simply technology. “There needs to be people to walk with these women on their journey,” he said.

Plans for the second year of the program include an expanded street outreach effort, added trainings for TAN participants and additional peer support specialists.

Catholic Charities is looking for ways to extend the most successful portions of the initiative beyond the three-year grant. It already has started incorporating some of the health and technology related questions into regular services outside of TAN, such as in the nonprofit’s Housing Transitions Program.

Participants are finding answers to hurdles “and shaping our process for the next stage,” McKenna said.

Even after one year, McKenna’s seen how the program fulfills a spectrum of need.

For some, the need is simple and vital.

McKenna recalled how during a recent street outreach she heard a desperate-sounding voice coming from inside a tent. “Can someone call 911?” the person asked.

The individual didn’t have a phone or it wasn’t charged, “and they were worried they could die alone without anyone knowing,” said McKenna. “All this person needed was the ability to call 911 on a phone.”

Janz said she hopes the phones and related support become more widely available.

“There are a lot of women out there who are alone and who don’t have a phone or don’t own one that works properly,” she said. “A phone can be a lifeline.”

 






The Feb. 21 print issue of the Sentinel will contain the annual special insert on Catholic Charities of Oregon.