Jonathan Kumar and Samaritan

[00:00:00] Making Waves in Health Tech is a podcast about health, equity and innovation.

[00:00:06] The cost of living has skyrocketed, leaving many people unable to afford a place to live.

[00:00:12] Being unhoused can dramatically impact health and well-being. People who experience homelessness

[00:00:18] have higher rates of illness and die on average 12 years sooner than the general US population.

[00:00:25] Today on Making Waves in Health Tech, we meet Jonathan Kumar of Samaritan.

[00:00:30] Samaritan tackles one of the most complex problems that face cities,

[00:00:35] the rising number of people experiencing homelessness and the health problems that arise as a result.

[00:00:43] And I'm Hilda Martinez from the California Healthcare Foundation.

[00:00:46] The Foundation's Innovation Fund is a strategic investor in tech-enabled healthcare

[00:00:51] delivery startups. Everyone is deserving of healthcare, but not everyone has a fair chance at it.

[00:00:57] We are looking for innovations that make healthcare accessible and affordable.

[00:01:02] We want to inspire other health tech entrepreneurs, and on a deeper level,

[00:01:06] we're seeing how tech is solving some of the most complex issues.

[00:01:10] So without further ado, let's get into it.

[00:01:19] Jonathan!

[00:01:20] What up, Janet girl? I'm going to see you or hearing your voice again.

[00:01:24] It's great to hear your voice. Thank you so much for joining us.

[00:01:28] We're super excited to have you talk to us about you, your work with Samaritan,

[00:01:35] the work that you've been doing in California and across the country.

[00:01:38] So tell us a little bit more about your work and tell us a little bit more about Samaritan.

[00:01:44] Samaritan is a support platform that helps people who don't have a stable home access

[00:01:51] the financial capital as well as the social capital needed to enter a stable home as quickly as possible.

[00:01:59] Walk us through the platform, say for example, if I were to be a user of Samaritan,

[00:02:04] what would my journey look like using the platform?

[00:02:07] Yeah, absolutely. So people on the street or near the street will get invited to become a

[00:02:13] Samaritan member and they get invited by our health and human services partners.

[00:02:18] So Samaritan will contract our license, like our financial and social support platform to

[00:02:24] health and human services that are serving this population. Medicaid plans, hospitals, clinics,

[00:02:31] traditional social services who get to use Samaritan to better support last mile populations

[00:02:38] that they're serving that have experienced chronic homelessness and other traumas,

[00:02:42] other conditions. We provide these smart wallets, these physical smart wallets to these

[00:02:47] organizations who then use them as a resource on the street, in street outreach or in case

[00:02:54] management or shelter settings often in hospital and clinic settings to offer as a resource for

[00:02:59] someone who is in great need. I want to make it clear that we're not solving homelessness.

[00:03:06] We don't own any buildings or not constructing any apartments and the solution to homelessness

[00:03:11] is in the name itself. It's a home, it's housing. But we see a couple of things. One,

[00:03:19] if you provide cash and social support to people directly, we think of them as raw materials.

[00:03:28] People often know how to build something for themselves. They have aspirations, they have

[00:03:32] goals, they have families they want to reconnect to, dependents that they want to claim or

[00:03:38] grant children they want to live next to and get ice cream with after school.

[00:03:45] There's regular people. We just want to get behind them and we're excited to be aligning

[00:03:52] massive healthcare industry and the dollars behind that into this population. However, we can.

[00:03:59] I'm going to give you a hypothetical scenario based on a story you told me once.

[00:04:03] Let's say someone is experiencing homelessness. She was recently injured and the injury got

[00:04:08] infected. She did get help. She was admitted to a hospital who treated her, but on discharge,

[00:04:14] didn't know what to do or where to go. Is her stuff where she left it? How would she get there?

[00:04:22] On discharge, someone might invite you or talk about you taking a Samaritan membership card

[00:04:29] or becoming a Samaritan member. They'll show you this fancy looking credit card thing that

[00:04:34] my team designed. It carries $10 on it to start and then if you want, you can get signed up and you

[00:04:41] can basically share some top level goals that you have for your own life and then break those goals

[00:04:46] down into immediate action steps and needs based on your situation, based on maybe

[00:04:53] what that social worker at the hospital is helping you figure out. One of those action

[00:04:59] steps might be for you to establish care at this really awesome community center called St. John's.

[00:05:06] In St. John's case, they offer both ongoing longitudinal care for your wound that you came

[00:05:13] into the hospital with, but they also offer social care, things related to how you're

[00:05:18] connecting to your community, to housing, to employment. You'll get $10 just for

[00:05:25] becoming a member and then you'll get $10 more by checking in with Esther, let's say, at St. John's.

[00:05:32] Once you have a Samaritan card, you start to earn bonuses, five, ten, $20 bonuses for taking

[00:05:39] positive action steps related to your own housing journey, your health journey, your

[00:05:43] journey to access income. If you have needs that are barriers to those action steps,

[00:05:50] you just need to share them with Samaritan and we have a network of philanthropic

[00:05:57] good Samaritans who will often fund those things and provide financial support, but also just

[00:06:04] wards of encouragement that you'll get through text or email or your case manager at St. John's.

[00:06:09] The sum total is that you'll be able to access this financial support and this social support

[00:06:15] connected to your own goals and your weekly or daily journey to reach those goals.

[00:06:24] One of the cool things about having founders here with us is that we get to learn about how

[00:06:29] the companies were founded. For those who are listening, could you please tell us how you

[00:06:34] started your company Samaritan? Was there a particular point in your life that you thought,

[00:06:39] okay, this makes sense or there's a need that I want to address?

[00:06:44] Yeah, definitely. It goes back to even before I was born really. My parents got a chance to

[00:06:52] immigrate to the States from South India in the late 80s and they went to Buffalo, New York

[00:07:00] of all places. Basically my dad was there, a study, my mom wasn't working and I was around so

[00:07:05] the three of us were very much in a position of need. We were living off a student's type

[00:07:09] and of about $600 to $800 a month, we were in public housing or on Medicaid and all of that stuff,

[00:07:14] food stamps. It was a position of vulnerability. We were never homeless, never on the street.

[00:07:21] We basically had a group of people from a local ministry, adopt my parents and they

[00:07:28] sort of brought them in almost like they were their own kids and provided friendship and also

[00:07:34] financial resources, legal support for us and it was just so catalytic for us being able to make it

[00:07:40] and be successful in those first five years or so while my dad was finishing up school and

[00:07:45] applying for jobs, etc. Once my dad got a job, things were mostly on the easy street for my

[00:07:50] family, moved to the Midwest. I studied at the University of Michigan, studied design

[00:07:56] and user experience design specifically but you never really forget what that experience

[00:08:01] was like and so fast forward 25, 30 years I'm in Seattle, Washington at a startup and I'm thinking

[00:08:07] about what my next step might be and as I'm puzzling through that career process just

[00:08:13] notice how pervasive homelessness, human suffering was in this beautiful city around me.

[00:08:20] As someone deep into product and user experience design, wanted to better understand that user

[00:08:25] experience so I just started spending time with people on the street talking to them,

[00:08:29] understanding a couple basic questions like how do you lose your housing, where have you come from,

[00:08:34] where are you trying to go, what's keeping you from getting there. Just learned a ton from these

[00:08:49] conversations and there's one conversation in particular that stood out to me. He was a guy

[00:08:55] flying a sign at a street corner downtown Seattle and the intersection that he was at was about

[00:09:01] 50 yards away from a lunch spot and so I was eating this outdoor, rare sunny day in Seattle

[00:09:07] I was outdoor lunch looking across the street kind of watching this guy while he's eating my

[00:09:11] sandwich or whatever and so I finished the sandwich and 15 minutes later 20 minutes later

[00:09:15] he's still there and as far as I could tell not a single person had even acknowledged that he

[00:09:20] existed. A bunch of cars drove by, a bunch of people walked by and just no one really responded

[00:09:25] with or engaged with him. So I went up to him. I want to again better understand that

[00:09:30] user experience like so I asked him like excuse me do you mind if I ask you what you feel

[00:09:35] your challenges are in terms of raising this money. So he had a sign out that read I need

[00:09:41] medication for the diabetes in my feet. He's standing there gingerly and he's asking for this

[00:09:47] help and I'm asking him what do you feel like quite a few people aren't supporting you.

[00:09:53] And he basically said well I've got the wrong look for this, the wrong clothing,

[00:09:59] the wrong skin color, nobody actually believes me. Nobody actually believes I am who I say I am.

[00:10:07] And you know it was like hard for me to hear for sure when he said that.

[00:10:13] You know my next question after kind of receiving that for a second was if you don't

[00:10:18] have any money you shouldn't have to pay for your medication. Do you have access to a doctor

[00:10:23] or something you know that could give you this for free, this medication? And he said

[00:10:28] yes I have a doctor through the shelter I'm staying at but he only trusts me with about a

[00:10:35] fifth of what I need on a monthly basis to manage the pain. He doesn't want to give me more because

[00:10:46] he thinks I'm either going to sell it or get addicted to it. And so you know just like a really

[00:11:08] stark conversation that showed me the lack of social capital this individual had and you know

[00:11:15] both from a community sense as well as from a professional provider standpoint.

[00:11:19] It wasn't the only conversation I had that led me to want to really take a shot at solving for it but

[00:11:26] it was a critical crucial one. Just started taking steps forward to address not just a

[00:11:31] financial poverty but really the relational poverty that this person had to the extent that he

[00:11:36] had felt like he had to go beg strangers on a street corner for the help that he needed.

[00:11:40] And I don't think we need to have people doing that. I've been working to put teams of

[00:11:47] volunteers as well as professionals around each person, each Samaritan member so that they can

[00:11:53] access the financial and also the in kind resources they need to be healthier, be housed

[00:12:00] and you know be self-sufficient. You mentioned something that really

[00:12:03] cut my interest and that was the relationships connecting people and how that is sometimes

[00:12:10] missing and is really important particularly when you're dealing with people experiencing homelessness.

[00:12:15] I think one thing that gets tragically forgotten around homelessness is just

[00:12:20] you know how isolating and depressing that that state can be and how often you know it's

[00:12:28] reinforced that this is who you are and you're not going to be anything better

[00:12:34] and you might as well accept that. This is how little you matter you know to society.

[00:12:41] You know your stories of people being looked through, sped upon and it's just awful and it's

[00:12:47] really I think hard to keep positive and it's really easy to get kind of shaken off of

[00:12:53] your point and fall into depressive or you know dangerous states. You also look at research that

[00:13:01] shows that for foster youth actually that hopefulness is you know as you're able to measure it is one of

[00:13:09] the greatest predictors of outcomes or success for foster youth. It has the most impact on outcomes

[00:13:15] than the other variables they were testing with idea that hopefulness is an emotional

[00:13:20] well-being is so critical for people to actually make it out of their situation which takes concerted

[00:13:25] effort you know for weeks or months, 26 steps you know to get in this table housing.

[00:13:32] The impact that social support from strangers, from everyday people who are not being paid to be

[00:13:40] their friend or their case manager, it makes such a big difference when we started testing

[00:13:45] this in 2017 long time ago. We were giving people 50 bucks and this 50 wasn't coming from some

[00:13:50] like government office it was coming from 10 people who chose to give that person $5 and

[00:13:57] that had significance you know the fact that it was coming from Martha and Jonathan.

[00:14:02] Our members get text messages or emails or if they don't have a phone or email they get it

[00:14:07] through their case manager they see the names and they see the words of our Samaritans who

[00:14:12] who are giving at least first names. We hear time and time again that that you know makes a difference

[00:14:17] you know the fact that these people want to invest in me makes me want to invest in myself

[00:14:23] that's what I would share to someone who's not sure about the necessity of addressing some of those

[00:14:28] social needs. People need more than their physical needs taken care of they are some

[00:14:32] deep emotional needs as well. The same thing goes for rich people too right it's like

[00:14:38] whether you're rich or poor yeah you need a team you don't have that as a serious problems again it

[00:14:44] applies for both poverty and prosperity you know we see the repercussions of that and it's harder

[00:14:50] hard for people in the street it's harder for people off the street to access that all the time.

[00:14:54] You've talked a little bit about the impact on people who are experiencing homelessness what

[00:14:59] about the impact on the providers those that are providing the care have you seen an impact

[00:15:05] there as well? Yeah I mean would love to be able to have them speak on their own accord but yeah we

[00:15:13] see that in the data we see that you know when you give people a Samaritan membership when they

[00:15:20] start you know receiving these tangible benefits or rewards you know these action step bonuses

[00:15:26] or the dollars or these words of encouragement around meeting you know very real needs like

[00:15:31] people's capacity just increases and people are able to be more proactive around accessing care

[00:15:39] whether it be you know social services or primary care the word proactive has come up

[00:15:43] several times in our work when we hear a back from our the front line partners using Samaritan

[00:15:50] in outreach or hospitals or clinics it's a really cool tool for them to use in their work to

[00:15:58] help you know drive outcomes. It sounds to me that there's something about the words of encouragement

[00:16:07] and also the community support would you say that's one piece of you know the Samaritan platform

[00:16:12] that's very valuable for some of your members? Yeah the message support you know incredibly

[00:16:18] meaningful for some of them and I think it's important yeah to distinguish that it is

[00:16:23] you know a portion but not all of them because you know folks are so different some people they don't

[00:16:28] need words of affirmation. Some people need you know structure and bonuses some people just need

[00:16:35] cash in their hands some people don't really need the money it's about being reminded that they

[00:16:41] matter and are worth something you know to help them choose to take steps forward.

[00:16:47] Curious about what have been some of the biggest challenges that you've faced with Samaritan and

[00:17:06] how have you overcome them? One challenge has been like you know the members themselves they don't

[00:17:12] have a lot of things that are designed for them and so pretty quickly we're able to see like okay

[00:17:16] this is making a difference that they appreciate they want to use and they're engaged with

[00:17:21] but making sure that this is not only a win for the members but a win for the front line

[00:17:26] organizations where they're like seeing a significant value add was you know a challenge for us

[00:17:33] and still is sometimes but learning how to you know deliver a unique value a compelling value

[00:17:39] proposition again not just to the user but like the frontline caregivers to align the intervention

[00:17:48] with their own goals and their own needs and their own initiatives and their existing

[00:17:55] workflows it has been a challenge and is now I would say is an area of strength for us if you talk to

[00:18:01] you know our frontline partners and so that was a big challenge that took you know years to

[00:18:07] that has taken years and will continue to take years to figure out how to do the right way in a

[00:18:11] way that not just benefits again the user but the implementing partner the case managers so forth

[00:18:17] the second big challenge is like we've iterated through a lot of business models again we kind

[00:18:21] of had our user figured out and we knew that we could create value for them and it's just like

[00:18:25] okay how do you get paid for that is it as a nonprofit you know I think most service is targeted

[00:18:30] towards this population of nonprofit we are technology based and so we decided to be a

[00:18:37] benefit corporation that had a social mission but could raise capital to build technology

[00:18:42] it's hard to build technology based nonprofits access to capital is limited when you know

[00:18:47] you're asking donors to pay iPhone developers versus you know provide food or clothing or housing

[00:18:54] directly I guess our mission at the front was you know we want to deeply impact people without a

[00:18:59] home at scale we wanted to reach more than 100,000 lives we needed to find partners that we could

[00:19:06] create incredible value for and and we wanted to do it for more than just you know donors

[00:19:13] we wanted to do it for a customer someone who had a repeatable problem that we could help solve for

[00:19:19] and that we felt we could scale faster through solving customer problems than versus solving

[00:19:26] only donor problems who that customer would be whether it be you know city governments or

[00:19:34] individual nonprofits delivering care or you know downtown I mean we went through a lot of

[00:19:40] business models our target customers you know downtown business associations or real estate groups

[00:19:46] or yeah the city county government like we've been through a lot of things and so

[00:19:51] how did we overcome that you know we were able to survive long enough to get enough you know

[00:19:56] contracts put together with hospitals and and and Medicaid plans to now give us a really good

[00:20:03] shot at scaling to reach that 100,000 number we have served about 2,000 people so far

[00:20:09] who have been on the street you know help them you know take an action step or to meet a need

[00:20:14] and that's something I think I mean yeah 2,000 people it's a lot of people

[00:20:19] you know something we're proud of but also it's just you know a starting point

[00:20:26] let's talk a little bit about your business model how is it that Samaritan gets paid

[00:20:33] so our customers are Medicaid plans and also hospitals like any any

[00:20:39] healthcare entity or government entity that's serving this population or is you know bearing

[00:20:45] financial responsibility for them could be a customer of ours typically when you're on the

[00:20:52] street it's really really hard for you to engage with resources healthcare services social

[00:20:57] services just so many different things that you're supposed to be doing and and and like very

[00:21:02] little capacity to do any of them consistently just because again you're not sleeping well

[00:21:07] you're you're fearing for your safety you may not have a place that's for your belongings

[00:21:12] may feel like you can't go anywhere because you haven't been able to bathe in the last week or

[00:21:19] you don't have clean clothes and there's just so many reasons that can enter a progress

[00:21:25] and so you know our customers have a really tough time getting resources that are available

[00:21:31] adopted by these individuals these these last mile patients or members and so they'll

[00:21:37] essentially contract Samaritan you know hey give us a list of a thousand folks that they're having

[00:21:43] trouble reaching or helping or you know just constantly seeing in the hospital and it's

[00:21:48] sort of this revolving cycle and of you know degrading health and increasing costs and

[00:21:54] they'll just say you know hey see if you can get 200 of these folks off of this list of a thousand to

[00:22:01] you know find a way to get them the Samaritan membership and get them financial social support

[00:22:06] that they can leverage to a survive and b you know make strategic progress towards their goals

[00:22:12] we could pay either monthly fee per person that's using Samaritan or an annual fee

[00:22:17] that covers our costs I think one of the biggest things about creating a solution for people

[00:22:25] experiencing homelessness or Medicaid is that when you try to get funding people get so well

[00:22:31] traditional venture capitalists sometimes they get so weary they're like oh Medicaid ooh you know

[00:22:36] because they're so focused on financial return right I'm hopeful that you know in the future

[00:22:42] that there are more environments created to enable social entrepreneurship I know that like

[00:22:48] venture philanthropy is you know newer and there may be some growth but you know how do we

[00:22:55] help people start nonprofits with capital that you know that grows over time as milestones are

[00:23:01] achieved how do we help you know startups that choose a for-profit tax status to access

[00:23:08] the capital that they need to test their ability to scale for the founders themselves

[00:23:14] spending as little time building as possible and as much time you know selling as possible

[00:23:22] so you know like sticking with the basics around interviewing folks validating problems

[00:23:28] validating markets so less time building 30 page business plans more times spent with

[00:23:34] the user spent with your customer getting pre-orders getting commitments and then as it relates to

[00:23:40] financing and fundraising and stuff just being focused on milestones for your organization and

[00:23:48] trying to show hey you know for us to get to this seed financing where we could raise $2 million

[00:23:57] we need to do these three things or we need to do these five things

[00:24:00] I like to ask this next question of founders that we have on our podcast because I think that

[00:24:07] it gives us insight from founders about what makes them tick and they always provide such

[00:24:13] interesting and motivational responses what excites you about the work that you do

[00:24:21] the things that have excited me most in terms of the work the last couple years I mean I

[00:24:26] remember very distinctly getting our first dollar delivered from a Samaritan to a Samaritan member

[00:24:33] and just how amazing that was and you know seeing it you know not just the dollar a few more you

[00:24:39] know redeem for something meaningful and then seeing our first life changing outcome

[00:24:44] hearing that a member went because of a relationship they built through Samaritan

[00:24:49] they they you know connected like there's so many cool stories on our website of people who

[00:24:54] have taken these action steps and as a result have met people you know develop a relationship

[00:25:00] with a case manager or an employer that ended up leading to a housing entrance or a job or

[00:25:07] something like that like just seeing that first life changing outcome and then the 50th life

[00:25:12] changing outcome and now more those stories as people those situations like truly excite me and

[00:25:19] excited our team and you know we start to see it now not in just Seattle where we started but

[00:25:25] in Baltimore or in Jacksonville or in Louisville or in LA or in you know we're launching in Oakland

[00:25:33] and Sacramento and San Diego and you know seeing the first like the first second city or you

[00:25:40] know the third city or now we're in eight markets that's you know exciting and again

[00:25:46] now having enough proof points enough outcomes to justify these partnerships with national

[00:25:53] organizations that are serving tens of thousands of people that don't have housing that are

[00:25:59] struggling with poverty mental illness substance use the justice system and just seeing like this

[00:26:07] wide sea of people that we can that we can serve and will serve with enough time that is

[00:26:13] exciting so it's like the life changing outcomes for one person and thinking like man we really could

[00:26:19] we could really do this we could really grow to serve 100,000 people and see that type of impact

[00:26:24] multiplied those are exciting things wow oh my goodness thank you so so much Jonathan not

[00:26:34] only for you know joining us today but all of your work because you know for people who

[00:26:39] are experiencing homelessness that is a population that not a lot of people really you know develop

[00:26:45] solutions for and you know you are one of the few entrepreneurs that we've seen that really addresses

[00:26:52] you know how we can be more helpful to them and so you know we're really appreciative again for

[00:26:58] you being really open with us sharing your story and sharing the stories of some of your

[00:27:04] members and sharing the stories of some of you know the partners that you work with and so

[00:27:09] again thank you so much the evidence is pretty clear that social determinants of health like

[00:27:19] safe housing significantly impact health outcomes one of the aspects of Samaritan's work that really

[00:27:26] sticks with me is that we know people are experiencing homelessness and that they're

[00:27:31] struggling with financial poverty but perhaps what we don't think about enough is what Jonathan

[00:27:37] calls relational poverty they lack the connections to people and resources who can provide the help

[00:27:44] and the support that they need and that's really a critical piece in developing hope

[00:27:50] and the structure needed to find a stable home I really appreciated how Jonathan said that we

[00:27:55] all need a team regardless of what our situation looks like and the cool thing is is that with

[00:28:00] all of our founders it's awe inspiring to see how much humanity can exist in tech startups

[00:28:05] that is what's needed another big takeaway for me is how Jonathan is bridging healthcare with the CBOs

[00:28:14] you know one thing I want to emphasize on is that there aren't a lot of tech solutions designed

[00:28:18] for people experiencing homelessness now Samaritan alone cannot solve all the problems but what's

[00:28:24] interesting is that Samaritan is the first mover in the space you know they're building

[00:28:28] the blueprint and another entrepreneur can come in and build on top of that foundation and to

[00:28:34] add to that because Samaritan is centered on health equity the company attracted funding from a wide

[00:28:40] range of sources including venture capital corporate giving and philanthropy in addition to their

[00:28:47] contracts with Medicaid plans and hospitals it could be that diversifying income sources helps

[00:28:52] a purpose-driven company like Samaritan withstand an economic downturn like the one we had during

[00:28:58] the pandemic I invite you to check out Samaritan at samaritan.city and look forward in your favorite

[00:29:05] app marketplace it's an important service and it's a fascinating model that straddles the worlds of

[00:29:11] innovative technology and helping others and that's all we wrote I look forward to our next

[00:29:16] conversation ill-deck igualmente likewise until next time making waves and health tech is

[00:29:25] brought to you by California healthcare foundation's innovation fund it is created

[00:29:29] and hosted by Ilga Martinez and Janet Boatjie today's program was produced by Zosia Warpale

[00:29:35] and Grace Norma of Mission Boom audio engineering by Zosia Warpale music composed and performed

[00:29:41] by Cameron King Horne the California healthcare foundation helps Californians with low incomes

[00:29:46] get the health care they need learn more at chca.org