Awards

The San Bernardino County Department of Aging and Adult Services – Public Guardian (DAAS-PG) is the designated Area Agency on Aging (AAA). This designation makes the Department eligible to receive Older Americans Act (OAA) funding to provide Long-Term Services and Supports (LTSS). DAAS-PG offers various programs to help seniors, disabled, and at-risk adults in San Bernardino County, and strives to ensure options are easily accessible where anyone can go or call for help, information, or referral. With the number of available resources but no one specific location to connect the available resources, DAAS-PG recognized a need to have a single coordinated system for the seniors, disabled, and at-risk adults to obtain access to services. The Aging and Disability Resource Connection of San Bernardino County (ADRCSB) was initiated in November 2019. It was based on a collaboration between DAAS-PG and the designated Independent Living Center (ILC), Rolling Start, Inc., to provide a single, coordinated system for individuals seeking reliable information and access to LTSS. This service was not previously available within San Bernardino County. As a result of this collaboration, the ADRCSB has served approximately 12,600 clients by helping them navigate resources and access services through locally contracted agencies.

The Department of Aging and Adult Services – Public Guardian (DAAS-PG) Age Wise Program serves older adults aged 59 and older to help maintain the best possible behavioral and physical health, by increasing their ability to sustain independent living and well-being. In 2017, Age Wise identified an increase in poor ambulation among their clients due to aging-related disease, which in turn led to a significant increase in injurious falls. In 2018, the Age Wise Fall Prevention Program was developed and implemented by Age Wise Occupational Therapist staff, with the support of DAAS-PG management to assist with mitigation of this high-level concern and begin assessing for fall risks and the subsequent need for reasonable accommodation and/or home modification of client’s living environments, primarily focusing on those housed in apartment dwellings.

The San Bernardino County Department of Aging and Adult Services – Public Guardian (DAAS-PG) Age Wise Learning Collaborative with Lifestyle Medical was established in April 2021. The collaborative focuses on building an innovative and effective community partnership to improve depression care for older adults and reduce mental health disparities. This collaborative partnership improves access to care, patient engagement, patient experience and quality of care by bridging access to direct resources and services. The learning collaborative is dedicated to serving San Bernardino County adults aged 59 years and over with an array of professional service and resource offerings, including: • In-Home Behavioral Health Counseling, • Telehealth, • Access to licensed clinical therapists available by telephone 24 hours a day, seven days a week including holidays (Age Wise 24/7 Senior Hotline), • Full-Service Case Management, and • Assistance and referrals regarding: o Feelings of isolation, o Food insecurity, o Transportation, and o Peer and family advocacy. This learning collaborative resulted in patients making healthier lifestyle choices and an increase in patients’ levels of resiliency toward daily challenges as their depression is addressed. All patients entering the learning collaborative were screened with the Patient Health Questionnaire (PHQ-9) for depression; the average entry PHQ-9 score was 17, moderately severe depression. Engagement with patients was bi-monthly for three months and resulted in an average leaving PHQ-9 score of 12, a movement from moderately severe depression to moderate depression.

In California, Adult Protective Services (APS) is a social services program focused on helping elderly adults and adults with disabilities live with dignity and respect by investigating allegations of abuse, neglect, self-neglect and exploitation. As this program has grown, the number of cases increased, using significant office space and causing other issues concerning hard copy document tracking and maintenance. San Bernardino County’s Department of Aging and Adult Services – Public Guardian (DAAS-PG) implemented the APS Imaging Project to address issues such as office space use, security of Personally Identifiable Information (PII) for APS clients, ease of provision of case documents to Law Enforcement (LE) as well as other necessary entities, and prevention of document loss via the use of a secure document imaging and storage system. By increasing efficiency and security in accessing documents, more staff hours are available for case management, which results in improved service delivery to APS clients. Through the implementation of the APS Imaging Project, paper cases have been imaged and stored as electronic soft copies, effectively addressing storage problems and allowing for staff to focus more efficiently on APS client needs.

The San Bernardino County Adult Protective Services (APS) – a major program of the Department of Aging and Adult Services-Public Guardian (DAAS-PG) – developed the APS Strike Team comprised of five specialized APS workers to respond to mass level eviction or displacement of seniors, 60 or older, and disabled adults. The program aims to address the complexity and time sensitivity of assisting multiple clients at once experiencing an unexpected event putting them at risk of homelessness. Collaborations with various local agencies enhance immediate placement. Tangibles are also provided, including, but not limited to: motel vouchers, gas cards, and food cards. Stabilization is provided through crisis intervention and long-term intensive case management, optimizing outcomes and long-term success. Other services include assistance with establishing eligibility to Medi-Cal/Medicare, transportation to medical appointments, assistance obtaining legal identification, and obtaining and sustaining permanent housing.

San Bernardino County established the Collaborative to Prevent Homelessness of Gravely Disabled Adults, which includes the Department of Aging and Adult Services-Public Guardian (DAAS-PG), the Sheriff’s Department, Arrowhead Regional Medical Center (ARMC), Department of Behavioral Health (DBH), and County Counsel. The Collaborative advocates for the proper mental health treatment, placement and transportation arrangements with ARMC for individuals who are found Incompetent to Stand Trial (IST) by the Superior Court of the State of California and are placed under Conservatorship with the San Bernardino County Office of the Public Guardian under the guidelines of the Lanterman-Petris-Short (LPS) Act (Welfare and Institutions Code Sections 5000 et seq).This program strives for best practice and prevention of homelessness for this susceptible population through appropriate treatment and placement and enhanced communication.

The Department of Aging and Adult Services-Public Guardian (DAAS-PG) Community Resiliency Model (CRM®) – Trauma Informed and Resiliency Focused Approach is an evidence-based, wellness skills model focused on promoting resiliency, regulation and recovery to Department staff and the individuals they serve. DAAS-PG is a San Bernardino County agency dedicated to helping seniors and disabled adults improve or maintain choice, independence, and quality of life in the least restrictive environment. The DAAS-PG CRM® initiative is a Train-the-Trainer model that certifies staff as CRM® Teachers who are provisionally certified through the Trauma Resource Institute (TRI) of California to teach the six wellness skills of CRM® to organizations and the community at large. This Department initiative provides training for staff in the use of CRM® skills and encourages staff to regularly practice these interventions that promote wellness in order to promote well-being and resiliency. To further support and normalize the Department’s wellness initiative, weekly practice sessions held on ‘Wellness Wednesdays’ are hosted by leadership members trained in CRM® which brings staff together on a voluntary basis to spend fifteen minutes practicing the use of the skills and promoting regulation in a group format.

The San Bernardino Department of Aging and Adult Services – Public Guardian (DAAS-PG) developed and implemented the DAAS-PG Adult Protective Services (APS) Call Center in order to transition most APS calls received during core business hours from the Child and Adult Abuse Hotline (CAAHL), minimizing wait times and reducing abandoned calls. The APS Call Center is staffed with English and Spanish speaking social workers. An email feature was added to allow county employees to bypass the wait times and submit a referral electronically to an inbox. The DAAS-PG APS Call Center operates Monday through Friday 8:00 am – 5:00 pm excluding holidays. As a result of this implementation, DAAS-PG has improved customer service to its vulnerable and at-risk population by providing a more efficient means of submitting referrals regarding alleged abuse and neglect among this population.

San Bernardino County’s Department of Aging and Adult Services-Public Guardian (DAAS-PG) developed the Nursing Model to Enhance Service Delivery Systems program to provide an intradisciplinary team approach in providing personal in-home care to its recipients that enhances their ability to remain in their homes safely and for as long as possible. DAAS-PG assists vulnerable individuals who are aged and/or disabled remain in their homes by providing services aimed at promoting health and safety. The DAAS-PG Nursing Model provides in-home nursing services to eligible high-risk and underserved seniors who reside in urban and rural communities within San Bernardino County that require assistance monitoring their health due to their impeding social, economic, emotional and/or physical limitations. Implementation of the DAAS-PG Nursing Model to Enhance Service Delivery Systems fills a health education and screening gap by sending qualified nurses out to visit aged or disabled clients in their homes to instruct them on how to conduct proper self-assessments that may identify potential life-threatening health issues.

San Bernardino County Department of Aging and Adult Services-Public Guardian’s (DAAS-PG) collaborated with the Inland Empire Health Plan (IEHP) to initiate and implement a Fans and Heaters program that mitigates health risks to Adult Protective Services (APS) clients due to extreme temperatures. The San Bernardino County APS program, administered by DAAS-PG, provides services to vulnerable seniors and dependent adults. The population served includes the elderly and dependent adults with medical issues which can require temperature stability and control. San Bernardino County is subject to extreme temperatures throughout the year, putting this population at risk of health complications resulting in hospitalization and, in some cases, loss of life. The Fans and Heaters program provides fans and heaters through the APS program directly to clients at risk while assessing for additional needs to not only prevent the impact of extreme temperatures to client’s health but also maintain client independence and prioritize self direction.

The San Bernardino County In-Home Supportive Services (IHSS) Onboarding Program was implemented to provide a comprehensive training program for new IHSS Social Workers (SWs) and support staff to orient them to the IHSS program and enable them to obtain the knowledge, skills, and abilities to provide accurate and helpful service to IHSS clients. In addition, the program promotes consistent and uniform training for new IHSS staff to develop core competencies in IHSS in order to improve employee performance and reduce Quality Assurance (QA) errors. The IHSS Onboarding Program includes online eLearning modules and on-the-job training. The IHSS Onboarding Program was rolled out to staff in September 2020 with the online IHSS onboarding eLearning modules launched in January 2021.

The Department of Aging and Adult Services-Public Guardian (DAAS-PG) In-House Implementation of Staff Development Leadership Training Initiative is a peer-led training developed for department leadership to evaluate and enhance their leadership qualities. The six-session training course is facilitated by volunteer coaches in leadership positions within the department. The training is designed to engage new and experienced DAAS-PG leadership in discussion of different scenarios while exchanging ideas on how to address department issues.

The San Bernardino County Department of Aging and Adult Services – Public Guardian (DAAS-PG) introduced the Internship Program for Behavioral Health Focused on Older Adults in September 2021 in response to the needs of the older community. A collaborative initiative between DAAS-PG and California State University San Bernardino (CSUSB), this program serves San Bernardino County older adults aged 59 years and over whose quality of life would be improved through the additional professional services to be provided by university students pursuing a Bachelor’s or Master’s degree in Social Work. The Internship Program provides a rare opportunity for students to pursue their degree, earn required internship hours and synchronously serve this vulnerable population. The Bachelor of Social Work (BSW) and Master of Social Work (MSW) interns are supervised by state-licensed DAAS-PG professional staff within the DAAS-PG Age Wise program. The interns provide a vast number of supervised professional services that may include in-home services, case management, peer and family advocacy, behavioral health, wellness and resource services tailored to assist older clients in navigating a healthy life and combat social isolation and food insecurity.

One of the most horrific worldwide public health problems is elder and dependent adult abuse. Elder abuse is defined in California as a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person or dependent adult. Although older and dependent adult abuse remains a hidden phenomenon, it has been recognized as a serious concern in the United States. To address this terrible issue, the San Bernardino County’s Department of Aging and Adult Services – Public Guardian (DAAS-PG) Adult Protective Services (APS) program, District Attorney (DA), Superior Court, and County Counsel have developed an innovative collaboration model to protect elderly and dependent adult victims of crimes, known as the Multi-Disciplinary Team (MDT). The MDT is the collaboration of experts who organize and coordinate health and care services to meet the needs of individuals with complex care needs. The MDT meets once a month to bring together the expertise and skills of different professionals to assess, plan, protect and manage care of the most difficult cases jointly, through proactively supporting individual care goals.

The Office of the Public Guardian Multi-Disciplinary Team and Collaborative Approach is a result of the Department of Aging and Adult Services – Public Guardian (DAAS-PG) Office of the Public Guardian recognizing the essential need for all San Bernardino County staff and community partners involved in conservatorship to be part of the conversation and development of care plans that protect conservatized individuals. This method maximizes the resources, knowledge, and perspective that each stakeholder brings to the table and ensures the most appropriate care is provided for individuals referred to the Office of the Public Guardian for conservatorship and probate services. This comprehensive meeting serves as a mechanism that demonstrates that, from an interdisciplinary perspective, conservatorship is the last resort and identifies the most suitable line of services for the client.

San Bernardino County’s Department of Aging and Adult Services-Public Guardian (DAAS-PG), in collaboration with the Human Resources (HR) department, developed a Recruitment Enhancement Initiative, known as Information Sessions, to assist in the recruitment and retention of staff. The Information Sessions are a one-hour presentation conducted by employees from DAAS-PG and HR to provide potential applicants with a detailed overview of the position for which they may be applying. The Information Sessions are held while the official job announcement is published to give prospective applicants a better understanding of the job duties. The Sessions are advertised internally and externally by HR on the County website. Implementing Information Sessions for prospective applicants has proven successful by having a more significant number of qualified candidates applying for open positions. In addition, hired employees are retained longer and are more successful in their position. Due to the success of the Information Sessions, other programs within DAAS-PG started utilizing this technique, and other County departments have also begun implementing the program.

The San Bernardino County Department of Aging and Adult Service-Public Guardian (DAAS-PG) is an agency dedicated to helping seniors and at-risk individuals to improve or maintain choice, independence, and quality of life. DAAS-PG employs Registered Nurses (RNs) to provide services to its clients, including conducting home visits, checking vital signs, and providing outreach and education. In 2018, DAAS-PG partnered with Loma Linda University (LLU), a Seventh-day Adventist coeducational health sciences university which compromises eight schools and the Faculty of Graduate Studies, including the Registered Nursing program, to implement the DAAS-PG Registered Nurse Internship Program. The internship program was designed to promote and provide experience to RN students at LLU by offering limited hands-on nursing experience to DAAS-PG clients. Through this program, LLU students work side-by-side with San Bernardino County RNs to observe and perform supportive activities for DAAS-PG seniors and at-risk clients. This collaborative effort provides student interns with valuable exposure to the unique aspects of working with adult and aging populations while providing assistance to DAAS-PG professionals in caring for this population.

San Bernardino County’s Department of Aging and Adult Services-Public Guardian (DAAS-PG) implemented the Robotic Pet Initiative in September 2022 to offer a new service and improve the emotional well-being of its senior and disabled adult population. DAAS-PG is an agency dedicated to helping seniors and at-risk individuals, one of the most vulnerable and underserved populations, in order to improve or maintain choice, independence, and quality of life in the least restrictive environment. In addition to physical challenges, the senior and disabled adult population frequently experiences social isolation and emotional challenges unique to bring an aging or disabled adult. Through the Robotic Pet Initiative, staff from Age Wise program and Office of the Public Guardian (programs administered by DAAS-PG) evaluate their clients who may benefit from this initiative, and if eligible, issue them a robotic dog or cat. These robotic pets serve as companions that provide the emotional comfort of a real pet, without the financial or physical requirements of caring for a live animal, helping to overcome barriers associated with monetary and mobility constraints often experienced by DAAS-PG program participants. The goal of the Robotic Pet Initiative is to provide comfort and, in some instances, therapeutic intervention for those experiencing behavioral health-related anxieties. Robotic pets can reduce levels of agitation and loneliness and are a stimulus for conversation. The pets can help with cognitive ability, including clients with Alzheimer’s and forms of dementia.

The San Bernardino County Department of Aging and Adult Services-Public Guardian (DAAS-PG) Age Wise program introduced the Telehealth Home-Based Behavioral Health Care for Older Adults to close the digital divide by enabling mental health clinicians to conduct outreach and provide ongoing services to older adults isolated by living in rural areas, especially those who isolated during the Coronavirus 2019 (COVID-19) pandemic, and other limitations. This program provides equipment and connectivity for qualified older adults to support establishing and continuing behavioral health case management services.