Community Services Agency Overview
Target demographics: low income, working poor, homeless and seniors in Mountain View, Los Altos, Los Altos Hills, CA.
Direct beneficiaries per year: 5000+
Geographic areas served: Mountain View, Los Altos, Los Altos Hills, California
Programs: We fulfill and accomplish our mission through the following core programs that address the issues around the working poor and unemployed, the homeless, and the elderly.
The working poor and unemployed are provided assistance through two programs:
1) EMERGENCY ASSISTANCE. Our Emergency Assistance (EA) Program provides one-time help with rent and/or utility bills for those with economic hardships whether through unemployment or medical crisis. Vouchers are available to meet some of the very basic necessities of life such as clothing, and transportation. Emergency Assistance includes limited dental, vision, and prescription assistance for uninsured adults and their children. Families with school-aged children are also helped with vouchers for shoes and backpacks and other back-to-school supplies. Our Food and Nutrition Center provides free groceries (with culturally relevant foods), along with nutrition and health education to feed the hungry and minimize food-insecurity for almost 3,000 individuals in Mountain View, Los Altos, and Los Altos Hills, 37% of whom (1,052) are under the age of 18.
2) HOLIDAY SHARING. Food, toy, and clothing drives are held throughout the community to provide clients with extra groceries and small gifts to make the holiday season a little brighter for both those who give and those who receive.
The homeless are helped through the following program:
3) ALPHA OMEGA. Using the Housing First model, our Alpha Omega program works with homeless individuals and families linking them to services such as employment, mental health, substance abuse treatment, and government benefits. The goal is to shorten stays in emergency shelter and assist people?s move into permanent, affordable housing thus providing stability so they can rebuild their lives. Homeless individuals are also provided food through our Food & Nutrition Center.
The elderly are assisted through the following programs:
4) SENIOR CASE MANAGEMENT. Senior Case Management provides in-home assessments, counseling and referrals to community resources by one of two Community Services Agency senior case managers. In addition our volunteer manager coordinates a Senior Volunteer Outreach Program to provide escorted transportation and shopping assistance for the elderly to help them maintain independent living status.
5) SENIOR NUTRITION PROGRAM. The Senior Nutrition program offers subsidized lunches every weekday to those in the community over the age of sixty. These lunches at the Mountain View Senior Center break the barriers of isolation for many elderly and provide opportunities for health education, disability prevention, and disease management presentations.
THE NEED: Nowhere is it probably more difficult and challenging to be poor than in Silicon Valley. Thousands of people live in poverty even though they earn more than the official 2008 federal poverty level ($17,600 for a family of three) or the Department of Housing and Urban Development (HUD) level ($28,650). The “self-sufficiency standard,” which measures how much income is needed for that family of three to adequately meet their basic needs without subsidies of any kind in Santa Clara County, is $65,598. Yet, almost 30% of the new jobs created in Silicon Valley pay less than $30,000.
If you are poor in Silicon Valley you are really poor.
A SOLUTION: The purpose of our Emergency Assistance Program is to provide safety-net assistance and services for low-income individuals and families with a financial emergency to stabilize their situations and prevent any further financial erosion or downward spiral in their lives. The program encourages and supports self-sufficiency of the working poor, elderly, and/or homeless in Mountain View, Los Altos, and Los Altos Hills.
• Financial assistance is available for rent, utility, housing, dental care, and eye exams.
• Back-to-School assistance in the form of backpacks and school supplies are provided for grades K-12.
• Our Food & Nutrition Center provides essential and basic food items to minimize food insecurity for low-income individuals and families.
• Our Holiday Sharing program engages volunteers and community on a large scale with toy, clothing and food collections to make the Holidays brighter for low-income families with children.
After a period of relative decline and stabilization of client numbers this past year we experienced a 20% increase of people in need. This year: 3915. Last year: 3310.
We distribute one ton of food every single business day to 1 out of every 35 people in our service area, based on the population of Mountain View, Los Altos, and Los Altos Hills. This year: 3068 people shopped the Food & Nutrition Center (40% of them or 1,240 under the age of 18). Last year: 2,845.
Our Food & Nutrition Center is the most wide-reaching program under Emergency Services in terms of numbers served offering perhaps the greatest stability in the lives of low-income families and individuals. Money not spent on food can pay for clothing, education, school supplies, medical bills, etc. The Food & Nutrition Center is a critical safety-net for many people in our community to help them survive on low-paying and/or minimum wage jobs in a high cost of living area
The Food & Nutrition Center is set up like a mini-grocery store where our clients “shop” for the food items they need: breads, dairy products, canned goods or even fresh produce.
While appreciative of all food donations, we often receive food that is close to the end of its shelf life or of a nature that does not provide for a nutritious and healthy diet. The long term health impacts and benefits on the individual and community need to be considered, too, while minimizing food-insecurity, moving beyond “just giving them any food” with a more holistic approach.
We strive to provide nutritious and healthy food options with fresh fruits and vegetables through partnerships with local Farmer’s Markets, Village Harvest and Hidden Villa whose organic produce is probably fresher than even the Farmer’s Markets. Dairy and protein products however need to be purchased.
A NEW APPROACH: We will be implementing a new case management strategy pilot program this coming year for Emergency Assistance clients to explore additional programs and services that will enable them to achieve greater financial stability and thereby decrease the need for any future emergency financial assistance.
THE NEED: Starting in just four years, 10,000 Americans will turn 65 every day; the total number eligible for Medicare will double to over 70 million within this generation, while the population of “senior” seniors, over 85, will increase five-fold. The “baby boom” is fast becoming the “senior boom.”
Aging is a process, unlike poverty and hunger, which we are not trying to eradicate.
A SOLUTION: We can report that case loads have remained fairly constant for the past 5 years, with an average of almost 200 seniors per year, taken care of by three full-time case managers. This is not for lack of seniors in need of case management care but rather, the consistent number reflects the human capacity of our case managers. This past year we did add a full-time case manager which brought the client counts per case manager to a more reasonable and standard 60+.
Case management for seniors becomes increasingly complex as seniors live longer. Multiple medical and mental health issues, together with dementia, present challenges to case managers as they strive to educate and empower seniors in navigating the health care system. The number of hours per senior spent by a case manager increase as the senior gets older.
Our internship programs with the San Jose State University School of Social Work and the University of San Francisco School of Nursing bring us much needed case management relief and support as we train younger social workers and nurses in geriatric care and issues. They also provide incremental hours of case management without a budget commitment for an additional salary with benefits position.
A NEW APPROACH: This coming year we will be implementing 2 new programs focused on keeping seniors out of the hospital and living independently on their own:
• Hospital to Home Transition Management: Currently 18% of Medicare patients admitted to the hospital are readmitted within 30 days of discharge, adding billions to health care costs. The frequency of readmissions for this age group is shown by research to be often related to difficulties in the management of symptoms in an outpatient setting; e.g. management of disease and medications, lack of adequate support systems, inadequate assessment of caregiver or patient ability to carry out discharge instructions.
We will provide hospital discharge assessment and planning, along with one-on-one medical and health education to assist with management of any chronic disease or illness in addition to providing referral and case management to ensure all community resources are available and utilized.
• Senior Fall Prevention Program: A 1998 Tufts University article states that people over the age of 65 who experience a fall and fall related injury are “10 times more likely to enter a nursing home than others of the same age and general health.” Approximately one-third of older adults over the age of 65 reports one or more fall each year. Reported falls increase annually to 40% of persons over 75 and 50% for those 80 or older.
Case managers will assess risk factors and refer clients to their primary care doctor to diagnose and treat any underlying fall risks, such as taking four or more medications, or impaired vision. Other risk factors that cannot be mitigated will be monitored on a more regular basis for any signs of deterioration that would then warrant medical intervention: increased dependence for activities of daily living, dependence in transferring, the use of assistive devices, cognitive impairment, and problems with incontinence
THE NEED: Poverty and homelessness are inextricably linked. With low-income or minimum wage jobs, the working poor face difficult choices every day with their limited resources. Pay for food? Pay for childcare? Pay for education? Pay for housing? Pay for healthcare? Pay for bus fare? Pay to put gas in the car?
It’s housing, which requires the largest proportion of income that takes the hit.
A SOLUTION & NEW APPROACH: Two years after transitioning from a rotating shelter program, which limited the number of people assisted at any one time, to one of providing homeless services, our Alpha Omega Homeless Services program has seen a frightening rise in the number of people who have come to us for help. From an average of 39 homeless people assisted annually in the rotating shelter program, we helped 162 in the first year of full homeless services case management and 241 last year, 50 of whom were under the age of 18.
The majority of homeless that we assist are provided information to locate and secure housing, information and assistance with transportation services, along with food supplies from our Food & Nutrition Center. Others need help with benefits, employment, and health services, which can be quite labor and time intensive.
But, perhaps the greatest challenge we face with homeless services is dispelling the myth of the homeless person as a drug user or just lazy. People can be homeless even with a job. More of homeless individuals and families live in their cars, or motels when they can, or with family and friends (on couches) than actually live on the streets.