County program aims at reducing emergency visits

Through departmental collaboration, Whole Person Care works to help clients gain independence.
Edward Hernandez waits for the bus outside county offices. Photo provided by Cyrena Salinas/Whole Person Care.
Edward Hernandez waits for the bus outside county offices. Photo provided by Cyrena Salinas/Whole Person Care.

Twenty years ago, with seven children to take care of, Gloria Hernandez had no choice but to keep working after her husband abandoned her and her children. Unable to speak English, she lived with her sister and did seasonal agriculture work. She relied on government programs to pay rent and provide food.

After her kids matured and moved out, she went to live on her own. Though successful following that transition, she eventually lost her home and spent five months in the Housing Opportunity Meals Empowerment (HOME) Resource Center. She later slept in her car.

Last November, one of Hernandez’s daughters told her about Whole Person Care, a San Benito County Health and Human Services Agency pilot program started in July 2017 to improve client well-being through coordination of appropriate departments in health, behavioral health and social services.

With the help and guidance of Whole Person Care, Hernandez now receives financial aid to help her pay rent for a room. The program also helps her make and attend doctor appointments, as well as drinking education classes and court dates for her probation.

Having a place to call home now is a huge difference, Hernandez said, because it’s where she can always shower, cook and sleep. She also said she doesn’t have to worry about getting wet when it rains.

“Si no hubiera encontrado este programa, pienso que todavía viviría en la calle,” Hernandez said.

(If I had not found this program, I think I would still be living in the street.)

Whole Person Care collaborates with different San Benito County programs to ensure their clients have access to resources so they can meet the program’s goal to improve physical and mental health. It works to reduce emergency room visits, as well as acute inpatient and psychiatric inpatient hospitalizations.

The program targets adult Medi-Cal beneficiaries who are either homeless or at risk of being homeless and meet at least one of the following criteria:

  • Have repeated incidents of avoidable emergency department use and hospital admissions
  • Have two or more chronic health conditions
  • Have a behavioral health condition

Eligible clients go through a series of assessments to identify their needs and set up short- and long-term goals, social worker Cyrena Salinas said.

Program Manager Kimberly Allen said 36 clients enrolled in the first year of the Whole Person Care program. When comparing the data between the first six months of 2018 with the last six months, she said there was an 18% reduction in emergency department use, and an 80% reduction in hospitalizations in the same period. In both cases, they anticipated a 5% reduction.

Though the program focuses on the chronically ill and frequent users of emergency room services, Salinas said they also do outreach to the homeless community.

Social worker Noemi Perez said when she and her colleagues do outreach, they first try to build a rapport through several visits and don’t push the program on people.

“Initially it’s just getting to know them, building trust and letting them know who are those familiar faces that are coming to work with them and help them,” Perez said.

Edward Hernandez has been homeless off and on for about four years. He currently stays at the HOME Resource Center, San Benito County’s year-round homeless shelter, at 1161 San Felipe Road in Hollister.

He said in the past four years, he’s learned how avoid people who take advantage of the homeless. It takes people like Perez and Salinas to win over homeless people, because the homeless have a hard time trusting others.

“Their staff is very well picked,” Edward said. “This job is not easy. It takes a lot of caring, respect and compassion.”

That is what’s missing toward the homeless community, Hernandez said.

“It gave me the hope that I needed and it got me to think positively about myself,” he said.

Following an increase in referrals, the Whole Person Care program has grown since its adoption from three employees to five. As it expands, Allen hopes that it will continue as a county program after its pilot phase ends in 2021.

Whole Person Care hosts an open house for their new location at 1161 San Felipe Road on Thursday, May 23 from 11:30 a.m. to 1:30 p.m.

Noe Magaña

Noe Magaña is a BenitoLink reporter. He also experiments with videography and photography. A San Benito High School alumnus with a bachelor's in journalism from San Jose State and a Liberal Arts Associate's Degree from Gavilan College. Noe also attended San Jose City College and was the managing editor for the City College Times, the school's newspaper. He also was a reporter and later a copy editor for San Jose State's Spartan Daily.