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PAGE 59 One community member described trying to navigate health care services after moving from another county: “There’s a year-long wait for dental at Axis Community Health and they’re like, “oh, no, you have to call Alameda County and you have to disenroll from that. And then you have to re-enroll… and I’m like, ‘How long does that take?’ And they’re like, ‘oh, it’s between 30 and 90 days’… I trust absolutely nobody. I can’t get a hold of Alameda County Alliance. Because all the things I’m told, it just spiraled out of control. It’s like, can somebody please just tell me something that’s simple to do? I don’t have the money to pay for all of this stuff. But I would if I could, just to avoid it, because it’s so heartbreaking.” A provider also mentioned the knowledge and skills needed to navigate human services and how difficult it can be for community members: “Being able to get to health care is one issue. The other issue is just having the resources to know where to go, how to look for it, and to the ability to get it…to call their insurance or a primary health care physician, and they will direct them to whatever resources they need. Without that kind of access, a lot of people really struggle and don’t know where to go. And we still have people who have insurance but struggle to know where to start—how to begin to get health care, mental health care.” Individuals with disabilities also have unique service navigation needs. One service provider noted frequent calls about housing, programs, and other resources for people with disabilities. The provider was overwhelmed by the number of requests and limited capacity to serve as a resource navigator. The provider said that the 2-1-1 line and the Regional Center of the East Bay do as much as they are able but are overwhelmed, too. Just under half (174 of 352) of the 2-1-1 callers indicated having a disability. 12 Unhoused individuals also have specific needs for service awareness, navigation, and centralized services (e.g., assistance with document access and retention and housing application support). One focus group participant highlighted the many complex contributing factors to becoming unhoused, and identified the near-impossible task for those in crisis to recognize and access the right services: “There’s a number of different solutions…are you getting ready to be kicked out of your apartment or evicted? Are you losing your job? Did your car just break down, and your car is the key to getting your kids to school and getting you to work so that you can pay the rent? I think there are services that address crisis mode… and (a need for) getting people connected with those services and making them aware of the services.” Focus groups participants in a John Muir health report said that services for unhoused veterans were insufficient or even non-existent in the Tri-Valley, forcing people in need to travel outside the area.9 Participants identified immigrants and refugees as sub-populations that could benefit from efforts to increase awareness of services and strategies to provide service linkages. “A lot of them know about their refugee status and they know that they can get free medical, food stamps, low-income housing. Some of them know about it, some of them don’t. I think that could be something that they could be more aware of. But then again, there’s a long waiting list for those as well.” Participants also said that older adults need navigation support services. This is made more complex by their need to navigate insurance types for health care and medication coverage. The John Muir report also indicated that transitioning to telehealth care is a significant challenge for older adults.9 Racial/Linguistic/Cultural Responsiveness RACIAL AND CULTURAL RESPONSIVENESS Participants from the community and nonprofits expressed a desire to have more individuals from various communities and cultures in paid service provider provisions. This was particularly acknowledged in light of the changing demographics within cities and across the region. Individuals acknowledged that having service providers who are from the communities being served enhances client comfort and trust in the care. EASTERN ALAMEDA COUNTY HUMAN SERVICES NEEDS ASSESSMENTSS Page 117 of 554