Fort Worth Star-Telegram
FORT WORTH, Texas — Cynthia Lynn Logozzo was doubled over with severe abdominal pain when she called 911.
She was rushed to a hospital where she was diagnosed with colon cancer. On Jan. 16, doctors removed the cancerous portion of her colon.
After leaving the hospital, and because she had recently lost her apartment, she stayed in a low-budget hotel room for a few days. Then she ran out of her money, most of which came from her Social Security check.
The homeless district became her next address.
Logozzo took up residence in a tent at a makeshift campsite in a wooded area near East Vickery Boulevard and South Riverside Drive, where the nights are cold and the days long and hard.
Logozzo, 57, says she is fighting to stay alive.
“I am going to die in the streets… ,” she said. “I can’t even do the treatments that I need because I am homeless.”
The surgery left her with an opening in her abdomen, called a stoma, which requires care to prevent infection. She also has to routinely change a colostomy bag.
In late February, outreach workers found Logozzo and pledged to help her.
“I’m sick and homeless,” Logozzo told Joel Hunt, a physician assistant with the JPS Care Connections outreach team. “I have colon cancer.”
Hunt took notes, asked more questions and tried to ease her worries. A week later, several outreach workers from several organizations combined forces to find her housing.
Hunt feels a deep connection to the homeless and quotes a friend while describing this calling:
“It’s not about fixing them. It’s about walking alongside them,” Hunt said.
‘There is a lot of need’
In Tarrant County, emergency personnel, healthcare workers, outreach teams and social service advocates are working to identify people in the homeless district who need medical care. These efforts have helped find people who need help with many health conditions including asthma, diabetes, injuries and cancer. Their work aims to keep the homeless healthier and out of emergency rooms.
6,706 people experienced homelessness in 2015, according to the Tarrant County Homeless Coalition, which released its annual report last month.
“Tarrant County is large and there is a lot of need,” said Jay Semple, program manager for Catholic Charities’ Street Outreach Services.
In 2015, more than 6,700 people experienced homelessness in Tarrant County, according to a recent homeless count.
Experts say the homeless are vulnerable to sickness and injury. Homeless people die 30 years earlier than those with homes, and they suffer more injuries, according to the National Healthcare for the Homeless Council.
Many homeless people don’t know where to get help when they don’t feel good. Others don’t realize how sick they have become. Often, they end up calling 911 from a campsite or street corner.
Resources are available for the homeless, “but often people don’t know about it,” said Matt Zavadsky, spokesman for MedStar Mobile Healthcare.
Very often, the homeless end up in emergency rooms.
From Oct. 1, 2014, to Sept. 30, 2015, JPS Hospital spent $7.8 million on homeless patients who arrived at its emergency room. During that time, homeless patients stayed an average of 5.8 days, compared with 4.9 for patients who weren’t homeless. Additionally, homeless patients at JPS were two times more likely to be readmitted within 30 days of a procedure.
Homeless people die 30 years earlier than housed counterparts, according to the National Health Care for the Homeless Council.
Treating the homeless
Richard Turner lives under the Allen Avenue overpass, or “the Allen bridge.” His living quarters, made up of blankets, tarps and cardboard, are about a block away from JPS Hospital.
Turner, 50, is pleased when Hunt and Edna Frade, a JPS community heath worker, drop in for a visit.
Hunt and Frade are a team.
They have laptops that allow them pull up health histories. Hunt checks Turner’s blood pressure and asks if anything is ailing him. He takes notes with a pencil and paper.
“I was never diagnosed with high blood pressure until I saw Joel,” Turner said. “Joel comes down here to check on me — he takes our temperature and all that.”
Turner said being sick and not having a home “is really bad.” He said he relies on the help of Hunt and outreach groups.
“We try to work ourselves out of the job with each patient,” Hunt said.
Homeless people can find health and medical support in a variety of ways. Hunt’s outreach teams are on the lookout for people, like Turner, who are living at campsites, under bridges or on the streets. Hunt works with outreach teams from Catholic Charities, MHMR of Tarrant County, MedStar and the Tarrant County Hands of Hope.
“I love working with the homeless population,” Hunt said. “The need is extreme.”
Many resources available
Homeless people often call 911 when they are sick, but they also call when they are scared, nervous, in pain, worried about missing medications or feeling too cold, MedStar’s Zavadsky said.
“They will call us from camps and we do respond,” Zavadsky said, adding that they have also responded to calls at shelters.
MedStar created a program that helps target people who frequently call the 911 service. “EMS Loyalty” program members are those who frequently turn to 911. Homeless people enrolled in the program get access to a 10-digit number that allows them to call mobile health paramedics who already know the patients and their medical histories.
These paramedics work day and night so they can meet a homeless person on a street corner anytime, Zavadsky said.
6,706 people experienced homelessness in 2015, according to the Tarrant County Homeless Coalition, which released its annual report last month.
He said these paramedics can ask themselves, “Is it really appropriate for this person to go to the emergency room again?”
Catholic Charities SOS team also treats the homeless with medical services offered by a registered nurse, nurses and doctors in training. A mobile unit takes the clinics to the streets, Semple said.
The homeless also have access to medical care at area shelters. For example, Union Gospel Mission has the Healing Shepherd Clinic, which allows clients to see a registered nurse. Medical students at the Texas College of Osteopathic Medicine treat the homeless at clinics held at the Day Resource Center and Presbyterian Night Shelter.
“It would be my hope that as long as there is a homelessness problem, that TCOM will be able to and will continue helping,” said Amy Owen, 26, a medical student who participates in the school’sHomeless Outreach through Medical Education program.
Building a healthy future
Homeless people have a long history of chronic health and mental health problems, said Scott Walters, professor of behavioral and community health at the UNT Health Science Center. About three-quarters of the homeless have chronic health issues such as chronic obstructive pulmonary disease and diabetes, Walters said.
About two-thirds of the homeless have a history of substance abuse.
The solution to keeping the homeless healthy is finding them housing, Walters said. But homeless people need help managing their health so they don’t become homeless again.
“It’s not simple. It’s not that you are just working on one thing. You might be working on three or four things,” Walters said.
The health science center developed a tool that helps homeless people start on a healthy path once they find rental assistance and are living in an apartment. The tool is a health coaching program calledm.chat. It has been used by 300 people since it was started three years ago.
Walters said there are signs that people prone to homelessness are moving toward healthier living with m.chat. In the first year, depression among clients went down by a third, and of those who used substances, a quarter quit using them, he said. Also, there was a 50 percent reduction in criminal justice interaction, he said.
Clients of supportive housing services — offered by organizations such as the Center for Transforming Lives, MHMR and the Salvation Army — are matched with a health coach, who also serves as a role model. Together they set goals in six areas: diet, exercise, social support, recreation and leisure, medication compliance, and substance use.
“We are trying to provide not only a friend and advocate but also somebody who is going to model good behavior,” Walters said.
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