“People who experience homelessness are often treated as though they are invisible. Healthcare is about trust, about relationships. It’s up to us as healthcare workers to show they aren’t invisible, that they matter.”
Nurse Practitioner Mary Tornabene has been with Heartland Alliance Health (HAH) for 29 years. As one of Chicagoland’s preeminent healthcare providers for the homeless, Mary has treated thousands of people in the last three decades – giving her a unique understanding of the experiences and needs of our city’s most vulnerable population. That level of expertise is unique, and her knowledge of infectious disease and the social determinants of health have been quite valuable for shelters all across Chicagoland.
For years, she’s been a go-to expert, alongside epidemiologists and public health officials, in addressing infectious outbreaks of all sorts that spring up in homeless shelters. In recent years, her expertise in reducing tuberculosis spread has been invaluable to homeless service providers.
Today, at the forefront of the COVID-19 crisis, her expertise is more valuable than ever.
“This pandemic is changing everything. The nature of this disease is so different from most other outbreaks we’ve dealt with, and many shelters just aren’t equipped to respond. It’s a lot of work to change not only your healthcare system, but your entire shelter.”
At least two days a week, Mary is helping providing services through the new tele-health model for HAH’s three health care centers on Chicago’s North, South and West Side. The team has ramped up our tele-health technologies, and is only doing direct visits with folks in urgent need. Mary has connected with all of the folks in her case load to arrange calls or conferencing services for regular visits.
It can be difficult, building a new system out of the blue, for both the practitioner and the patient. Today, there is no physical exam, and stethoscopes cannot cross over the internet.
“It has certainly been difficult. I ask if they can touch a certain point on themselves, to see if something hurts. We get a lot of laughs that way, it’s a goofy process,” Mary said. “Ultimately they’d much rather be in person, and so would I.”
Outside of the city, Mary & HAH have been the health partners for Journeys: The Road Home – a shelter system in the northwest suburbs. They go up once a week for primary healthcare and health screenings for anywhere between 100 to 150 people in the shelter system.
The program’s emergency-shelter system was based on a rolling schedule, with participants moving from one location to the next every week. That system changed completely once the pandemic struck, with some government funding to place people in a local hotel.
Mary has been tasked with surveilling the participants at the hotel for COVID-19. She has been working with many of these men and women for years – helping them with mental health or substance use issues. Masked up and covered in PPE, the hotel rounds have given Mary the chance to connect with some of her long-term patients in a more personal manner. The changes she’s seen in her patients has been just as dramatic as the changes in the shelter system.
“I was struck. I was having conversations with people that I never would have had before. They seemed so much more lucid, readier to connect,” Mary said. “Just today, I had a conversation with a woman that was so fact based, so direct, so honest – and she advocated for herself in a way I’ve never seen before. I’ve been working with this woman for 14 years. The only thing that’s changed is a key. She has housing.”
Mary and the entirety of Heartland Alliance Health believes that housing is healthcare, and we’re seeing that more than ever as shelters shift to this new normal. With any luck, this silver lining during the pandemic will prove to others that the real solution to homelessness is supportive housing.
Whether at shelter sites in the suburbs or at the health care centers in the city, Mary has been sure to send her patients off with a self-screening program she created based on CDC guidelines. In it, she has people check themselves daily for runny nose, body aches, fevers, loss of taste, respiratory symptoms, and so on. That same piece of paper has a phone number that leads directly to Mary.
“We have a responsibility to these people. They’re scared, and they have questions about this pandemic. These interactions empower them to take care of themselves, and make sure they have the medications and tools that they need to continue to stay healthy.
