Interview with Miriam Rivera, Intensive Case Manager with New Directions

Miriam Rivera is an intensive case manager with New Directions who is working with Housing 1000 clients. That means she advocates for some of the sickest, most chronically homeless men and women in the county. This week we spoke with her about her experiences.


Q: Have you noticed anything unique about homeless clients in particular?

Miriam: My homeless clients have been so humble. Some of my clients work, but their income is just not enough to afford housing. Media portrayals are so deceptive—my clients have never tried to take advantage of the system, they really don’t feel entitled. They appreciate anything you can do for them. Something that you and I take for granted, like a photo ID, can help them take a step towards reclaiming their dignity.

I think some of these folks have lived on the street for so long that they don’t really believe they deserve a better life. It’s just heartbreaking. As a result, they won’t speak up for themselves enough. For example, they might not appeal a benefits decision.

They also might not understand the process of finding a place to live, or getting General Assistance. My clients tend to be quite ill, and underserved by the medical system; six clients of mine this year couldn’t remember the last time they’d seen a doctor—it might have been 30 or 40 years ago, when they were children. A couple of my clients were among those institutionalized in the 80s, before the state mental hospitals closed down, and there was just no follow-up care and they became homeless because of their illness. These men and women need advocates, and that means they need a case manager.

I’ve housed six Housing 1000 clients so far, and they are like different people now than when I first met them. Their demeanors are totally different after being housed, far more relaxed, optimistic and focused. They say they’ve never had so much rest—my clients sleep ten or twelve hours a night, those first few days in a new place. It’s because they’re no longer worrying about being attacked, or having their stuff stolen while they sleep.
I continue working with them after they’re housed, on whatever they need—we work on setting healthy boundaries, budgeting, sometimes even setting up a payee account to help them maintain their housing.

Q: How did you first get involved with serving homeless clients?

Miriam: I got my masters from SJSU, and did an internship with New Directions. New Directions works with people with complex medical issues, including people in medical respite—that’s a program for folks recovering from surgery or other medical procedures, who have no place to go, so they’re housed in the Boccardo Reception Center shelter for 4-6 weeks while they get better. Medical respite and New Directions work together to fill an old gap in the system—it used to be that homeless people would get very ill, wind up being hospitalized, and then have no place to go after being discharged. It’s not the compassionate thing to do, or even the cost-effective thing to do, to put someone out on the street after a medical crisis. So now these patients are able to recover in a safe, clean, dorm-style living environment and access case management.

Q: We in the “biz” throw around the phrase “case management” a lot like it’s a magic bullet. But what does that actually mean? What do social workers and case managers actually do all day?

Miriam: That’s a great question. Basically what we do is advocate for people in society who might otherwise fall through the cracks. We do a ton of different things on a daily basis, from helping clients get photo IDs, to hooking them up with the benefits they qualify for, to helping them find housing. We provide for their basic needs, and in some ways we act like family—a lot of my current clients, for example, are pretty isolated individuals. A case manager is a consistent person who provides support. We find out what they need, and help them get it. Whatever it takes. If you’re a case manager, you’re the intervention that could change a life.

I’m usually at the Boccardo Reception Center during the day, but I also do some home visits. This morning for example I went out to Gilroy to meet a client who’s living in a park. The first two or three times I meet a client, I’ll bring coffee or a Subway giftcard—something to convince them I’m trying to help.

I also advocate for clients with landlords. For example there are all these ridiculous barriers to ending someone’s homelessness—landlords will run credit checks, and of course someone who is homeless may not have a perfect history. That’s why they’re homeless, because they couldn’t afford to pay the bills, for whatever reason. So I talk to landlords, I talk to people from board-and-care places—those are facilities for folks who can’t care for themselves in independent living situations. I advocate with the Social Security office, benefits, insurance companies— I just do whatever I can to make sure my client can get healthy and housed.

Q: If you could change the system, what would you do differently?

Miriam: I’d institute shorter waiting times. General Assistance needs to work more smoothly, and the process should be faster. I’d make sure everyone has medical coverage. There’s so much waiting right now, waiting and applying and submitting medical records that might be impossible to obtain. Homeless men and women can’t afford to spend months waiting on the streets before they get benefits or medical insurance they need to survive!
Evictions and inaccurate records are another problem. I have one client who’s been homeless for years, but she had been married and when she was divorced in the 80s, he got the house. Well, that home ownership is still coming up on her records, and it has been a barrier for her in getting services! There also just need to be more shelter beds, and more mental health programs. The system is overloaded and there’s not enough resources.

Q: What has it been like, working with Housing 1000?

Miriam: It’s just been wonderful. It’s a little chaotic because it’s a new program, and there’s so much new stuff to learn, but I love the work I’m doing with my clients. I love it. There’s just something about my bunch of clients, they’re just awesome!
There’s so much collaboration between different agencies. There’s funding for post-move-in worries, like kitchen starter kits and cleaning supplies, which clients need in order to be successful. The patients aren’t in the shadows anymore. The people we’ve housed are so happy. The bottom line is, we’re getting results.

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About K.A. Erickson

I worked with Housing 1000 (http://www.housing1000sv.org/) from August 2011 until July of 2012 as an Americorps VISTA member. I am the ghost of Katherine past! I wrote a couple interviews to post automatically even after I left--from beyond the grave, as it were. ;) My current blog talks about fiction writing, world travel and other adventures: http://feistynotes.wordpress.com/
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One Response to Interview with Miriam Rivera, Intensive Case Manager with New Directions

  1. Pingback: Interview with Lorena Collins, Senior Program Director of South Bay Mental Health and Men’s Services with InnVision the Way Home | Housing 1000 Official Blog

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