Challenge: Older adults face chronic health conditions, falls and emergency room (ER) visits. In Riverside County, 71 percent of repeat 911 callers are seniors, often due to illness and falls. 

Solution: Riverside County Area Agency on Aging, 911 and Riverside University Health System expanded efforts to target seniors age 60 and over with three or more encounters in one year. Data sharing endeavored to track high users of emergency services, enabling timely interventions such as managing health conditions, medication adherence and connecting to the Jurupa clinic hub for nonemergency care. 

Results: Outreach to seniors with repeat ER discharges yielded a 9-percent engagement rate, with 36 percent agreeing to services and 25 percent attending multiple clinic visits. Participants received resources such as food, transportation and utility assistance, along with access to behavioral health and housing supports.

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