An Intensive Case Management Program
New Directions is an innovative hospital and community-based case management program for individuals with complex medical and psychosocial needs. A program of the Healthcare Foundation of Northern and Central California, New Directions is dually focused on both business concerns and patient care. The business focus is to reduce the impact of frequent users of the emergency departments at Santa Clara County hospitals. The patient care focus is to improve the quality of health and lives of frequent users of ED services through improved access to medical care and social services.
Since its inception in 2002, New Directions’ intensive case management services have helped stabilize the lives of more than 250 of our county’s most vulnerable patients- those who have complicated medical conditions or are at risk from the medical complications resulting from homelessness, lack of primary care or a medical home, lack of financial or health insurance benefits, lack of transportation, addiction to drugs or alcohol and/or untreated mental illness.
New Directions’ philosophy is to do “whatever it takes” to stabilize and support these patients. Services are provided by culturally competent, Masters level social workers and include: individualized assessment and care planning; meeting immediate needs for food, shelter and clothing; assistance with accessing medical care, income or benefits, housing, mental health services, drug and alcohol support, assistance with legal issues, transportation, and ongoing supportive services.
Funding for New Directions originally came from the generous support of the Heath Trust, the California Healthcare Foundation and the California Endowment. In recent years local hospitals recognizing the positive return on investment, have funded the project on a case rate basis. Additional funding from community organizations such as Kaiser Foundation, and Pacificare has enabled New Directions to provide case management services to patients utilizing the Medical Respite program at EHCLifebuilders, while funding from Destination: Home has enabled services for referred clients from Santa Clara County’s One-Stop Homelessness Center. Strong collaborations with community and county agencies ensure comprehensive services and reduce the duplication of efforts involved in meeting the needs of these patients.
Future goals include potential expansion to other sections of the Hospital Council of Northern and Central California as well as stabilization of funding sources. For further information, contact the program offices at (408) 272-6509 or Sholm@hospitalcouncil.net