This care coordination program is offered by the Sonoma County Area Agency on Aging in the Human Services Department Adult and Aging Division.
Linkages is available to frail seniors and adults with disabilities aged 60 and older who are at risk of being placed in a skilled nursing facility or other institutional setting.
Linkages care managers provide case management services as well as information and assistance services that connect clients with available community resources to assist them to remain safely at home and independent in the community.
Who is Eligible?
For Linkages services, an individual must meet the following criteria:
- 60 years of age or older
- Resident of Sonoma County
- Requires assistance due to illness, injury, or disability in order to live independently
- Need support in managing care and obtaining services that are not available through other resources
- May not be receiving case management from:
- Department of Rehabilitation
- Department of Mental Health
- Department of Developmental Disabilities
- Multipurpose Senior Services Program (MSSP)
Income level is not a determining factor for participating in and receiving services. Clients who can afford to pay are requested to contribute a share of the cost (co-payment).
What kind of help is available?
The client and care manager work together to determine what services the client needs in order to stay at home as safely and independently as possible. The care manager may refer the client for additional services or the Linkages Program may purchase a limited amount of additional services for clients. Type of help available include:
- Medical equipment purchases (ramps, bath benches, grab-bars, etc)
- Housing Assistance
- Adult Day Care Programs
- Home Repairs
- Telephone Reassurance
How does it work?
Applications are taken by telephone interview.
After the application is accepted, a care worker will schedule a home visit. At the home visit, the client is evaluated and a care plan is developed with the client and family. Services are arranged or purchased to assist the client to remain independent.
The care manager will call regularly and visit clients to monitor and re-evaluate their needs on at least a monthly basis. The care manager visits each client at least every three months.
Make a referral online by clicking here, or call (707) 565-5970 to apply. There is usually a waiting list for Linkages.