Policy & Practice February 2018

and social services staff, Gertrude is now receiving much needed care to improve her quality of life. Creation of HUMAINS Based on the success of Gertrude’s case, combined with the need to address the high use of 911 services for nonemergency services among older adults, the task force formed the HUMAINS project—High Usage Customer Resource Network. The group’s charter is: “.. to work collaboratively to provide resources to individuals that are frequent utilizers of the EMS system and have needs that cannot be met by the current system. This would include in home care, in home equipment or mate- rials as well as external resources. Using all community resources available to aid in the betterment of the individual’s quality of life and personal safety.” The resources exist and oftenneed only connectivity to thrive. the genuine needs of customers ina community has resulted inamore integrated service deliverymodel. The genesis of such programs is rooted in ourwillingness to empower employees to seek atypical solutions to common challenges. This approach to holistically examining

The HUMAINS group has expanded the team to include mental health resources and home health care. The group’s caseload has expanded signifi- cantly, beyond its ability to address all needs. Long term, the strategy is to establish a sustainable program with full-time staff to help coordinate the efforts. In the meantime, Gertrude and other Albemarle County older adults are benefiting from a group of dedi- cated staff focused on helping their community. Vulnerable citizens who do not possess the ability or desire to seek added resources for their impedi- ments are afforded the assistance of knowledgeable agencies genuinely dedicated to helping. The HUMAINS project is an out- standing example of first responders projecting far beyond their typical service delivery model. The fire fighters, while willing to answer Gertrude’s many calls for service, recognized that this defenseless little lady’s needs exceeded their ability to truly solve her essential chal- lenges. This approach to holistically examining the genuine needs of cus- tomers in a community has resulted in a more integrated service delivery model. It also frees the fire fighters to respond to more pressing emergen- cies. The genesis of such programs is rooted in our willingness to empower employees to seek atypical solutions to common challenges. The resources exist and often need only connectivity to thrive. The next time your agency identifies a need or challenge, take a look at the resources that already exist. Develop relationships with other agencies and determine if there is an opportunity to combine and create a force multiplier for problem solving. The future of service delivery is not likely to hinge on creating something new, rather on investigating the extant systems and thinking beyond your current vision. Dan Eggleston is the Chief of the Albemarle County (VA) Department of Fire Rescue. Trish Suszynski is the Adult Services Supervisor with Albemarle County Department of Social Services.

In Virginia, self-neglect is consid- ered a form of adult abuse and is the most prevalent. Often the lack of social capital leads to isolation among older citizens. As a result, many individuals are reaching out to public agencies to fill in the gaps where natural support systems (social capital) such as rela- tives, faith-based organizations, and neighbors could ideally meet their needs. As with many social problems, sustainable solutions require an ecological and strengths-based per- spective. Outside of a family system, public service programs should be encouraged to collaborate and develop innovative solutions to meet the needs of their communities. One of Gertrude’s significant chal- lenges is that her closest family member, a brother, lived on the West Coast and they did not have a good relationship. She did not have local friends and rarely interacted with neighbors. Gertrude suffered from social isolation and did not generally trust anyone, especially officials that represent government or affiliated agencies. Gertrude refused to follow up with DSS or JABA for assistance and would always default to calling “her boys” when she needed care. The task force realized that the trusting rela- tionship between Gertrude and the fire fighters could be used to help bridge a relationship with other agency staff. Therefore, the fire fighters would take on the role as the patient’s advocate and slowly, but deliberately introduce DSS and JABA staff as their “trusted friends.” Results The process of putting the fire fighters in a role as the trusted friend proved to be very effective. The fire fighters spent generous time intro- ducing Gertrude to the social workers and options counselors and often stayed during the initial assessment to help address questions and concerns. It turns out that Gertrude had sig- nificant health challenges, including undiagnosed mental health issues that exacerbated her declining living condi- tions. There was no doubt that gone unchecked, Gertrude would have con- tinued on a downward spiral. Thanks to a group of dedicated public safety

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February 2018   Policy&Practice