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April 8, 2020

Care for the whole person

When Sharon Hill bought her motorhome for $400, she thought that she would live there for the rest of her life.

Then one day 64-year-old Hill tripped and fell getting out of her vehicle in Thousand Trails park in San Benito. She could no longer get up to get food, and she thought to herself, “I’m going to die.”

Whole Person Care San Benito learned of Hill’s situation when the local Social Security office referred her case to them.

Before long, caseworker Cyrena Salinas from Whole Person Care in Hollister and another caseworker took Hill to Taco Bell in Hollister for their first meeting. From that point on, Hill said, she finally felt like things were going to be different. 

“It was two months later and I had my housing,” said Hill. “I mean, it’s just unheard of.”

When Hill first met the women of Whole Person Care San Benito, she was nearly blind, wheelchair-bound and homeless. Now she’s had cataract surgery to improve her eyesight and knee surgery to get her out of a wheelchair, and she rents her own apartment, all thanks to referrals by the caseworkers at Whole Person Care.

Whole Person Care is a statewide Medi-Cal pilot program that coordinates health, behavioral health, and social services for needy individuals. The program is funded through 2020, with no firm decision on funding beyond that. The San Benito program is one of 25 in the state.

Whole Person Care’s motto is, “a pathway to independence and wellness.” Under the program the caseworkers help with everything from booking appointments and going with clients to the doctor’s office to referring clients to housing programs and helping him or her to create and maintain a budget. 

The program’s goal is to reduce emergency room visits, with most client referrals coming from surrounding hospitals. The case workers at Whole Person Care San Benito meet with a potential clients approximately eight times before enrolling them.

San Benito program manager Kim Allen said this builds a relationship, and identifies goals for each client.

Caseworker and client

Hill said she had teetered on the edge of homelessness for about 40 years, living in Santa Clara County for most of the time. She moved to San Benito County two years ago. She had been to shelters and tried other county and state programs, but she always felt judged. Hill said she left every appointment feeling overwhelmed and with a laundry list of tasks she didn’t know how to accomplish.

When Hill was living in Santa Clara County, she was scheduled for a long-awaited knee surgery. Just as she was hooked up to an IV and about to go into the operating room, Hill said, she was notified the surgery could not be performed. The caseworker who had been handling her operation had left on vacation and had not filed the paperwork for Hill’s outpatient care. 

Through tears Hill said she had felt hopeless before meeting Salinas. Hill is recovering this month from knee surgery in an outpatient facility, preparing to return home to her apartment obtained through a reference made by Whole Person Care.

“They show up,” said Hill. “They just want to get you help.”

When Hill first moved into her apartment, she couldn’t stop baking cakes for Salinas and the other employees at Whole Person Care. It was the first time in her adult life that she had her own kitchen. It’s clear when Hill talks about Salinas and her journey through the program how close she considers herself to the caseworkers. She calls them family and reaches for Salinas’ hand when talking about all the ways her life has changed.

According to Allen, there have been 44 clients enrolled in the program in San Benito County.

Salinas, who is currently a masters student at California State University Monterey Bay, said the first week she started as a caseworker she began reaching out to people who are homeless in San Benito County. She knew someone who worked with the Hollister Migrant Center and she got extra food from an event donated to Whole Person Care. 

Salinas and the other caseworkers helped distribute the donated food, which she said this created an instant connection with the community. To this day Salinas said people still refer to her as “burrito girl.”

The Whole Person Care team said it’s their engagement with people who are homeless in the county that has resulted in successful outcomes for their clients. The caseworkers don’t have a singular measure of success, but said they listen to the needs of clients and help them reach their  goals. The goals could include anything from paying off fines to getting a hip replacement or finding permanent housing. While Whole Person Care does not offer any of these services itself, its caseworkers help clients plan their lives and refers them to other county or state agencies. 

Coming together

“Our program’s the glue,” said Allen when talking about Whole Person Care’s place in San Benito County.

Now that the program has success stories, Allen said the referrals have come rolling in. “When it started out it was a bit tough,” confessed Allen. “It wasn’t until our partners saw progress, then the next thing you know, you’re getting phone calls from the hospital on a daily basis.”

When Allen first came on as the program’s project manager in October 2017, Whole Person Care was still working out its kinks. As Allen and the team began to identify the community they needed to help and how they could best do that, everything seemed to come together. 

The team at Whole Person Care San Benito is currently all-female: Allen, two full time social workers, a temporary social worker and an office assistant. Two vocational assistants will join them in July. 

A new state law, SB 1152, boosts Whole Person Care’s role in the community, said Allen, because it requires hospitals to have a discharge plan for each homeless patient. The health care providers turn to Whole Person Care to find a place for their patients to stay the night.

Whole Person Care uses motel vouchers or calls the San Benito H.O.M.E shelter, which sometimes leads to enrollment in their program and a long-term housing solution.

As the program has progressed, Salinas and Allen said the caseworkers have built relationships with doctors in the area who understand their clients’ circumstances. This was key to helping clients be successful, said Salinas, because the doctors knew what was realistic to request from their clients and did not constantly require the client to explain his or her housing situation.

The caseworkers also help clients navigate these relationships, giving them the confidence to ask for what they need. Salinas said she can tell the program is working for the client when they start booking appointments and coming into the office on their own.

The future

Much of the first two years of the Whole Person Care program was spent building trust with the community and ensuring people that this program was different, that the caseworkers would really be there, said Allen.

As of now, the program’s funding runs out June 30, 2021. If the program ends in three years, Allen said, “I really do think that the clients would be very upset. People are making progress, and not everyone can progress in a few months.”

Even after finding housing, Hill continues to work with Salinas. The caseworker would like to find Hill a new apartment that’s more accessible for her after her surgery. “It’s just wonderful to know you mean something to somebody,” said Hill.

Although its long-term fate remains uncertain, Whole Person Care has moved into new offices next to the H.O.M.E shelter, with big plans for movie nights, Alcoholics Anonymous meetings and possible cooking classes. 

Carol Sloan, public information officer with the California Department of Health Care Services, said in an email to the Free Lance, “The goal is that WPC pilots will have created a local infrastructure and built strong collaborative relationships among public and private entities so they can continue to identify the most vulnerable in their communities and meet the needs of the ‘whole’ person. … Additional funding is being proposed to continue efforts begun through the pilots.”

For Hill, the program is a beacon of hope for people who are homeless in San Benito County. She said she continues to refer friends to the program and that Salinas and the caseworkers have given her a new lease on life.

She told her doctor that in a year she plans to walk the San Francisco Marathon. In an interview with the Free Lance, Hill held Salinas’ hand, and said, “When I couldn’t fight, they fought for me.”

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