Human Services Needs Assessment
City of Palo Alto Office of Human Services
CITY OF
RDA 4 YEARS
PALO ALTO
CONSULTING
Human Services
Needs Assessment 2024
City of Palo Alto Office of Human Services
This report was developed by RDA Consulting
under contract with the City of Palo Alto Office
of Human Services.
CITY OF
PALO ALTO
RDA 4 YEARS
CONSULTING of Systems Change
RDA Consulting, 2024
Table of Contents
Executive Summary 2
Introduction & Methodology Overview
Limitations
Definitions 6
Profile of HSNA Participants 7
Community Needs & Existing Services =
Barriers to Service Participation 13
Essential Services for High Needs Groups 14
Community Connection, Isolation, & Inclusion 22
HSRAP Funding Alignment with Needs & Recommendations 25 Areas for Further Consideration 29
Appendix A: Community Member Snapshot 33
Executive Summary
Introduction & Methodology
In early 2024, the City of Palo Alto Office of Human Services The FY24 HSRAP budget (OHS) engaged RDA Consulting to conduct a Human is just over $850,000 and Services Needs Assessment (HSNA) to identify and prioritize distributed amongst human service needs, gaps, barriers, challenges, and twenty-two service resources to guide future funding priorities and service grant programs run by twenty- allocations, with specific emphasis on the Human Services one community-based Resource Allocation Process (HSRAP), through which the City organizations (CBOs). has been allocating human services funds since 1983.'
To guide the 2024 HSNA, RDA—in partnership with OHS-developed a community engagement and assessment plan to assess human service needs, existing services, and gaps.
To this end, RDA and OHS identified three overarching questions: (1) What human services needs are Palo Alto residents experiencing? (2) What are the strengths and gaps in existing services available to Palo Alto residents? (3) What are the opportunities for HSRAP to better fill gaps in services? Primary and secondary qualitative and quantitative data gathering activities conducted between May and July 2024 included focus groups, surveys, and interviews as well as secondary data gathering and review.
Profile of HSNA Participants
HSNA community survey participants reflected diverse demographic characteristics that align with those of the City of Palo Alto with respect to age and to some degree race/ethnicity.
Community Needs & Existing Services
Overall, the areas of greatest need resulting from this mixed methods assessment include (A) essential services for high needs groups-including, primarily, (1) individuals experiencing housing insecurity and/or homelessness, (2) individuals with disabilities, and/or
(3) older adults; as well as
(B) community connection, isolation, and inclusion.
Barriers to Service Participation
The most common barriers to service participation included the inaccessibility of services, waitlists or lack of capacity, long or confusing application processes, and service costs.
Additional barriers identified include location and transportation to services as well as not knowing what services/resources are available.
HSRAP Alignment & Recommendations for Funding Priorities Overall, based on the findings from this needs assessment and human services best practices, we recommend that OHS sustain and narrow HSRAP funding priorities to primarily include
1. Homelessness services & housing 4. Food & nutrition services
2. Services for individuals who are disabled 5. Mental health services
3. Services for older adults
https://www.cityofpaloalto.org/Departments/Community-Services/Human-Services City of Palo Alto OHS: Human Services Needs Assessment 2024 | 2 Introduction
The City of Palo Alto Office of Human Services (OHS) assists with providing a safety net of services, and works toward enhancing the quality of life in Palo Alto in a variety of ways.2 The OHS team oversees the Human Services Resource Allocation Process (HSRAP), a Human Services grant program open to organizations who deliver direct safety net services to Palo Alto residents, through which the City has been allocating human services funds since 1983.3 The 2024 HSRAP fiscal year budget is just over $850,000 distributed amongst twenty-two service programs run by twenty-one community-based organizations (CBOs).
In early 2024, OHS engaged RDA Consulting to conduct a Human Services Needs Assessment (HSNA) to identify and prioritize human service needs, gaps, barriers, challenges, and resources to guide future funding priorities and service grant allocations, with specific emphasis on the HSRAP program. RDA collaborated with OHS to carry out a variety of robust community engagement, research, and analysis activities. Data gathered via these activities, which took place throughout the spring and summer of 2024, directly inform this report's findings and recommendations.
Methodology Overview
To guide the 2024 HSNA, RDA—in partnership with OHS-developed a community engagement and assessment plan to assess human services needs, existing services, and gaps. To this end, RDA and OHS identified three overarching questions:
What human services needs are Palo Alto residents experiencing? a. What are the most pressing human services needs in Palo Alto? 1 b. Which needs are being met? Which needs are not being met? c. Whose needs are being met? Whose needs are not being met? What are the strengths and gaps in existing services available to Palo Alto residents? a. In what ways do services meet community needs?
2 b. In what ways are services not meeting needs?
c. To what extent does HSRAP funding align with community needs? What are the opportunities for HSRAP to better fill gaps in services? a. What potential service improvements may be needed (e.g., refinements, additions)?
3 b. Which population subgroups would benefit from more investment (e.g., more or expanded services)? In which specific areas of need? c. Where can HSRAP funds have the most impact?
2 https://www.cityofpaloalto.org/Departments/Community-Services/Human-Services 3 https://www.cityofpaloalto.org/Departments/Community-Services/Human-Services City of Palo Alto OHS: Human Services Needs Assessment 2024 | 3 The community engagement and assessment plan identified and informed the development and implementation of multiple primary and secondary qualitative and quantitative data gathering activities:
• Qualitative Research (Focus Groups & Interviews): A total of four focus groups with 21 participants, interviews with four community stakeholders, and 26 intercept interviews were conducted virtually and in person between June and July 2024, with a combined total of 51 community participants. 4 Topics covered by the in-depth one- on-one and small group interviews and focus groups included consumer needs and service strengths, weaknesses, and opportunities for improvement to better meet needs of community members. These qualitative data gathering activities allowed for deeper dive discussions and exploration of questions relating to the objectives of the HSNA. Note: All 453 community members and service providers who completed a survey (see below) were invited to participate in a focus group with RDA. Only 21 of these individuals both (a) volunteered to participate and (b) ultimately showed up to participate in one of the virtual focus groups held by RDA staff. • Survey Research (Community & Provider Survey):
To learn about community needs and experiences in To ensure equitable services, a survey was administered electronically via access to the Alchemer (an online survey platform) and via paper form community member between May 28, 2024, and July 9, 2024. Altogether we survey, RDA partnered received 419 unique survey responses from 385 with JR Language community members and 34 service providers. Overall, Translation Services to the number or community member respondents provides translate the survey into a statistically representative sample of the broader a total of five languages:
population of Palo Alto residents.S Furthermore, the English, Spanish, Russian, sample population of community members is largely Traditional Chinese, and representative of the broader population of Palo Alto Simplified Chinese. residents with respect to age and to some degree race
(see 'Profile' sections below).
• Secondary Data: In addition to the primary data gathered for the 2024 HSNA, RDA partnered with the Office of Human Services to gather data on HSRAP grantees and on service providers in the City of Palo Alto and the County of Santa Clara more broadly. This data included agency names, service areas and descriptions, and HSRAP award allocations (if applicable). RDA also utilized data from the 2020 Palo Alto Census to assess the representativeness of the HSNA community survey sample. 4 Includes duplicate participants (e.g., community members and providers who participated in a focus group and completed a community survey).
5 The community member survey sample of n=385 is considered statistically representative of the overall population of Palo Alto, 68,572, given a 95% confidence interval and 5% margin of error.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 4 Limitations
RDA leveraged varied data sources to prepare this report in alignment with best practices for rigorous community research and analytical methodologies. Key limitations include (1) overrepresentation of perspectives from more service-aware and engaged consumers; (2) overrepresentation of viewpoints from HSNA participants who shared feedback via more than one method (e.g., community survey and focus group) as well as those who received the survey via a specific service provider who directly administered the survey to clients; (3) limitations in number of HSRAP grantees that participated in this research (only six of 21 FY24 HSRAP grantees completed a survey); and (4) limitations with respect to community member demographic data—(a) nearly one-in-five (19%) community member respondents did not report their race/ethnicity and a similar proportion did not report their household income and other important demographic variables; (b) certain demographic groups were overrepresented (e.g., individuals 75 and over, females) while others were underrepresented (e.g., Asian only residents), (c) the community survey included the new Middle Eastern and North African (MENA) category introduced by the U.S. Census in April of 20246, but failed to provide specific subcategories that would allow participants to self-identify with one or more of the diverse and more nuanced racial categories included within the broader MENA category (e.g., Egyptian, Iranian, Iraqi, Israeli/Jewish, Lebanese, Syrian), which is particularly important given the current socio-political climate.
Nonresponse Bias & Steps Taken to Minimize Bias
Multiple forms of nonresponse bias may be present with a voluntary community survey, including community members who are unwilling or unable to respond to the survey as a whole or unwilling or unable to respond to specific survey questions.* Individuals may choose not to answer a specific question because it feels too personal (e.g., income, race/ethnicity), because they are unsure how to answer, or because of some other reason.
In developing and administering the community and provider survey, RDA took multiple steps to minimize nonresponse bias including but not limited to:
• Avoiding simple 'yes'/ 'no' questions and including a wider range of response options • Including 'not listed - please specify:', 'unknown', 'prefer not to state' and 'N/A' options • Leaving demographic questions to the end of the survey to minimize stereotype threat** • Ensuring all open-ended questions were optional (vs. required) • Providing assurance that all information shared will remain confidential • Multiple communications and reminders to complete the survey • Providing an incentive to complete the survey
Sources:
*https://www.qualtrics.com/experience-management/research/response- bias/#:~:text=Voluntary%20response%20biases%20in%20surveys.have%20a%20highly%20opinionated%20sample. **https://isotl.sites.olt.ubc.ca/files/2019/03/eio-general_guidelines.pdf https://www.census.gov/newsroom/blogs/random-samplings/2024/04/updates-race-ethnicity- standards.html
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 5 Definitions
• Accessible: Resources, facilities, or services that consider and are responsive to the needs of people with disabilities (e.g., facilities or services that are built or modified so that they can be used by people of all abilities). "
• Endorsed Needs: For the purposes of this report, "endorsed" needs including any needs identified by community members or service providers as an area of need (including "top" area of need as well as additional areas of need). • Essential Services: Programs or facilities intended to meet the basic health, welfare, and other needs of community members with the goal of promoting self-sufficiency and well-being.®
• High Needs: For the purposes of this report, "high needs" refers to individuals who fall into demographic categories that have higher rates of unmet need (e.g., unhoused individuals, older adults, individuals with disabilities) relative to other demographic subgroups.
• Human Services Recipient: For the purposes of this report, "human services recipient" includes any individual who identified as a human services recipient or a behavioral health recipient per the HSNA Community Survey.
7https://www.cdc.gov/ncbddd/disabilityandhealth/disability-strategies.html https://www.dictionary.com/browse/human-services#google_vignette:
https://www.humanservicesedu.org/definition-human-services/ City of Palo Alto OHS: Human Services Needs Assessment 2024 | 6 Profile of HSNA Participants
HSNA community survey participants reflected diverse demographic characteristics that largely align with those of the City of Palo Alto with respect to age and race, however Asian only residents are slightly underrepresented and female residents are overrepresented within the survey (see Table 1). With respect to age, survey respondents generally mirror the population of Palo Alto, apart from individuals 75 and older who are overrepresented (see Table 1). Additionally, as with the overall population of Palo Alto, approximately half of all survey respondents identified as White (48%). Hispanic / Latino/a/x residents are also proportionally represented (6% vs. 7%). In contrast, Asian residents are slightly underrepresented (28% vs. 35%) while other minority subgroups including Black / African American residents (6% vs. 2%) are overrepresented (see Table 1).
Dissimilar to the overall population of Palo Alto, which is nearly evenly split by sex (male, female), approximately two-thirds of survey respondents (63%, 128 of 203) identified as female.
Respondent household income varied; over half of respondents reported a household income of $120,000 or less per year (54%; 209 out of 385) and approximately two-in-five reported a household income of $60,000 or less per year (21%, 81 out of 385).
NOTE: For the purposes of this report, we examined trends for those reporting a household income of $120,000 and below, given that the American Community Survey indicates about 25% of households in Palo Alto have an annual income of $100,000 or less. Additionally, we examined trends for those reporting a household income of $60,000 and below, particularly with respect to rates of unmet need.' Beyond these demographic characteristics, most community survey respondents resided in the following three Palo Alto zip codes: 94306 (25%; 96 out of 385), 94303 (20%; 78 out of 385), and 94301 (17%; 67 out of 385).
Approximately one-third of community survey respondents identified as a human services recipient (36%; 139 out of 385) and a similar proportion identified as a parent (37%; 142 out of 385). A minority of survey respondents identified themselves as an individual with a disability (9%; 34 out of 385), and a small proportion identified as an individual experiencing homelessness (4%; 17 out of 385) (see Appendix A for a more detailed demographic breakdown).
9 https://data.census.gov/profile/Palo Alto city, California City of Palo Alto OHS: Human Services Needs Assessment 2024 | 7 Table 1. Palo Alto HSNA Community Survey & Census Demographics1° Highlighted rows indicate demographic groups that are proportionally representative of (i.e., not statistically different from) the overall Palo Alto population.
Category Community Community Palo Alto 2020
Survey Survey Census
Count Percentage Percentage'
Age (n=331)
44 and younger 165 50% 53%
45-59 55 17% 21%
60-74 50 15% 14%
75 and older 61 18% 11%
Sex / Gender (n=320)
Female 203 63% 51%
Male 105 33% 49%
Another Gender Identity!2 12 4% N/a
Race/Ethnicity13 (n=312)
White only 149 48% 49%
Asian only 88 28% 35%
Hispanic or Latinx (of any race) 20 6% 7%
Native American or Alaska Native only 19 6% 0.1%
Black or African American only 18 6% 2%
Another Racel4 18 6% N/a
10 In accordance with data de-identification guidelines, demographic categories that represent fewer than 11 individuals have been rolled up into a larger combined category (e.g., 44 and younger). 11 Palo Alto 2020 Census: https://data.census.gov/profile/Palo_Alto_city._California?g= 160XX00US0655282. These data are inclusive of American Community Survey (ACS) updates.
12 Community survey respondents selected gender identity categories that were unavailable in the 2020 census. 13 In the Community Survey, respondents were able to select all categories that applied. For the purposes of comparison to the census data, RDA recoded data to determine who identified as 'White only,' 'Asian only,' etc. 14 This category includes race/ethnic groups representing fewer than 11 respondents in each of the following groups: Native Hawaiian or Other Pacific Islander only (Not Hispanic or Latinx), Multiracial (Not Hispanic or Latinx), Jewish only (Not Hispanic or Latinx), Middle Eastern or North African only (Not Hispanic or Latinx). Census data could not be retrieved for comparison because Community Survey respondents selected racial categories that were not available in the 2020 census data (i.e., Jewish, Middle Eastern or North African) City of Palo Alto OHS: Human Services Needs Assessment 2024 | 8 Table 2. Community Survey: Frequency of Respondent Race/Ethnicity by Household Income
Race/Ethnicity Unknown $0-$30k $31- $61- $91k+ TOTAL
Income $60k $90k
White only 20 11 21 25 72 149
(Not Hispanic or Latinx)
Non-White* 40 27 14 45 37 163
(Including Hispanic or Latinx)
TOTAL** 60 38 35 70 109 312
*Non-White Race/Ethnicity categories include Asian, Native American or Alaska Native, Black or African American, Hispanic or Latinx, or another unspecified race. ** Race/Ethnicity: Unknown/Not Reported not included given n<11 for multiple income categories.
Table 3. Community Survey: Frequency of Respondent Primary Language by Household Income
Primary Language Unknown $O-120k $121k+ TOTAL
Income
English 29 172 43 244
Non-English* 28 35 12 75
TOTAL** 57 207 55 319
*Non-English language categories include Mandarin, Cantonese, Spanish, American Sign Language, Hebrew, Korean, Russian, Vietnamese, and another unspecified language. ** Primary Language: Unknown/Not Reported not included given n<11 for multiple income categories.
Table 4. Community Survey: Frequency of Respondent Age by Household Income Age Group Unknown $0-$30k $31-$60k $61-$90k $91-$120k $121k+ TOTAL Income
44 and younger 14 9 16 57 47 22 165
45 and older 53 35 21 13 11 33 166
TOTAL** 67 44 37 70 58 55 331
** Age Group: Unknown/Not Reported not included given n <11 for multiple income categories.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 9 Provider Snapshot
A total of 34 providers, completed the Provider Survey. Additionally, nine providers participated in one of two focus groups with RDA staff. Overall, providers perspectives' on pressing community needs aligned largely with community members, with slightly greater emphasis on mental health needs.
Areas of greatest need (i.e., top needs):
• Mental health supports for adults (15 of 29)
• Housing assistance (13 of 25)
• Food and nutrition services (11 of 24)
• Homelessness outreach and services (11 of 25)
• Older adult services (11 of 19)
• Community engagement/connection (13 of 22)
• However, most providers indicated this need was mostly or completely met.
Areas of greatest unmet* need:
*"not meeting or only "somewhat" meeting
• Housing assistance (20 of 27)
• Homelessness outreach & services (18 of 27)
• Mental health supports for adults (18 of 27)
• Transportation assistance (18 of 26)
• Emergency financial assistance (16 of 26)
• Supports for individuals with disabilities (15 of 26) • In-home care (assistance with daily living) (15 of 26) • Older adult services (14 of 26)
• Medical/physical health care (14 of 26)
In their own words:
Reflection on housing assistance needs & services
"There is currently a lack of shelter and affordable housing for Palo Alto residents." "Temporary housing for those working towards permanent placement is not available." Reflection on mental health needs & services
"In the context of mental health of youth, 50% are receiving support. Stress and academic progress are impacting the mental health of students. There are not enough resources.
Families who are receiving basic needs support are unable to advocate for their children." Reflections on needs & services for adults & individuals with disabilities "Senior services are not adequate for seniors with developmental disabilities." "Individuals with developmental disabilities are not fully included in services and activities." "Many disabled people need direct support from trained professionals, like support workers who are trained specifically on how to support the medical diagnosis and disabilities." City of Palo Alto OHS: Human Services Needs Assessment 2024 | 10 Community Needs & Existing Services
Overall, the areas of greatest need identified from the The most common barriers to triangulated results of this mixed method (qualitative service participation identified and quantitative) needs assessment include by community survey (A) essential services for high needs groups-primarily, respondents include limitations (1) services for individuals experiencing housing to or inaccessibility of services insecurity and homelessness, themselves (e.g., eligibility, (2) services for individuals with disabilities, and capacity, cost) as well as (3) service for older adults; as well as location, transportation, and awareness of services.
(B) community connection, isolation, and inclusion.
Figure 1. Community Member Survey: Most Important Areas of Need (N=298-338) Community engagement/connection (n=338) 67% 21%
Cultural services or affinity spaces (n=331) 60% 21%
Medical/physical health care (n=315) 58% 20%
Leisure/recreation (n=319) 56% 29%
Older ad uit services (n=320) 55% 21%
Emergency financial assistance (n=316) 53% 20%
Mental health supports for adults (n=316) 51% 23%
Food and nutrition assistance (n=320) 47% 24%
Housing assistance (n=320) 47% 22%
In-home care (assistance with daily living) (n=316) 46% 21% Transportation assistance (n=319) 46% 27%
Child/youth programs and recreation (n=330) 46% 16%
Elder abuse prevention (n=315) 43% 22%
Supports for individuals with disabilities (n=309) 43% 17% Legal aid/support (n=311) 42% 26%
Childcare assistance (n=327) 42% 14%
Services for adults with disabilities (n=315) 42% 15%
Workforce development/employment assistance (n=304) 41% 20% Mental health supports for children/youth (n=313) 41% 23% Sexual and reproductive health care (n=306) 40% 18%
Substance use services (n=308) 40% 17%
Tutoring (n=298) 39% 24%
LGBTQ+ resources and support (n=302) 38% 12%
Homelessness outreach and services (n=312) 38% 11%
Maternal and infant health care (n=306) 33% 20%
Services for children and youth with disabilities (n=306) 32% 18% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
• Top need (%) • Need but not top need (%) •Not a need (%) City of Palo Alto OHS: Human Services Needs Assessment 2024 | 11 While needs for community connection, isolation, and inclusion are largely met, essential services for high needs groups are largely unmet. This is especially true for: (a) individuals experiencing homelessness, (b), adults with disabilities, and (c) those who identified as Hispanic or Latino/a/x, another race (including multiracial), and those who did not share their race/ethnicity.
Figure 2. Community Member Survey: Unmet Need (N=116-269) Services for adults with disabilities (n=135) 34%3 41%
Emergency financial assistance (n=180) 30%6 52%
Housing assistance (n=181) 30% 40%
In-home care (assistance with doily living) (n=172) 28% 429 Homelessness outreach and services (n=117) 26% 38%
Legal aid/support (n=180) 26% 41%
Services for children and youth with disabilities. (n=116) 26%6 34% Mental health supports for adults (n= 195] 26% 49%
Food and nutrition assistance (n=200] 25% 42%
Transportation assistance (n=194) 25% 50%
Older adult services [n=220) 25% 39%
Supports for individuals with disobilities (n=147) 24% 49% Workforce development/employment assistance (n=151) 23% 38% Maternal and infant health care (n=135) 23% 42%
Mental health supports for children/youth [n=151) 23% 42% LGBTQ+ resources and support (n=124) 21% 42%
Tutoring (n=149) 21% 60%
Elder abuse prevention (n=151] 21% 41%
Cultural services or affinity Spaces (n=238) 20% 47%
Community engagement/connection (n=269) 19% 51%
Sexual and reproductive health care (n=146) 18% 53%
Substance use services (n=138) 17% 44%
Medical/physical health care (n=214) 17% 42%
Leisure/recreation (n=247) 1788 47%
Childcare assistance (n=155) 16% 38%
Child/youth programs and recreation (n=181) 15% 54%
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
• Not met (%) •Somewhat met (%) • Mostly met (%)
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 12 Barriers to Service Participation
Community survey respondents who need services experience a variety of barriers to service participation. The most common barriers to service participation included ineligibility (or uncertainty regarding eligibility), waitlists or lack of capacity, long or confusing application processes, service costs, as well as location and transportation to services.
Additionally, most community members indicated that they "do not know where to learn about services/resources to help meet their needs" at least some of the time. Throughout qualitative activities, providers and community members alike noted a need for greater awareness and knowledge of existing services in Palo Alto and surrounding areas. Multiple stakeholders note that greater marketing of available services and resources would be a valuable resource to the community.
Figure 3. Community Survey: Barriers to Service Participation (N=328-339) I am not eligible (or i am not sure if 1 am eligible) for services "Spreading [n=333) 34% 40%
the word
I do not have adequate transportafion to and from services (n=332) 30% 33%
about
Services are not located in neighborhoods where I con
participate in them (n=329) 30% 37% available
Services are not welcoming and respectful to people from my services 28% 27%
culture or background (n=332
needs some
Services are already full and /or have a long waitlist (n=333) 28% 48% work. It's
Services do not accommodate my disability (n=330] 28% 37% definitely a
Application processes for services are too long and/or priority for us 27% 48%
confusing [n=333)
lam concerned people will judge me for participating in to get more 25% 35%
services (n=331)
exposure so
lam concerned that participating in services will negatively affect my immigration status or that of my loved ones (n=333) 24% 27% that the Services cost too much money (n=328) community
24% 52%
knows we
I do not.know where to learn about services/ resources to help meet my needs in=339) 23% 45%
are here
Service provider staff do not have a similar cufture or 21% 38% and what
background as me (n=332]
services we
Services are not available in my language (n=332) 19% 28% are
I do notknow where and/or how to access needed services 49% (like food assistance, healthcare, housing) (n=338) 18% providing or
lam concerned about my safety when traveling to and/or need to participating in services (n= 330) 17% 37%
I am not able to use technology to participate in services provide." 16% 37%
[n=331)
- Service
2095 409 6096 8095 1009
Provider
• Always or almost always true (%) •Sometimes true (%) = Not at all or rarely true (%) City of Palo Alto OHS: Human Services Needs Assessment 2024 | 13 Essential Services for High Needs Groups
While high needs groups, such as unhoused individuals, adults with disabilities, and older adults, benefit in part from existing services within Palo Alto and neighboring cities within the County, they still lack comprehensive safety net services. Additionally, long waitlists for critical services and resources including shelter, along with the high demand for mental health services, remain pressing issues. Individuals who are currently unhoused, have a disability, or both, had the highest rates of unmet need overall.
Housing Assistance & Homelessness Services
The most pressing need identified by participants across community engagement activities for this assessment was accessible housing and shelter. Individuals experiencing homelessness, low-income individuals, and more affluent community members alike consistently named affordable housing and safe and accessible shelter as one of the most pressing needs facing Palo Altans. The complex housing challenges in the Bay Area, driven by various economic and social factors, have a significant impact on the Palo Alto community members-particularly unhoused individuals, adults with disabilities, and individuals identifying as human service recipients.
Most respondents endorsed housing assistance as an important area of need (68%; 219 out of 320 who responded), and nearly half endorsed homelessness outreach and services as an important area of need (49%; 154 out of 312 who responded). Overall, however, most community survey respondents indicated that they personally could access and/or afford housing or rent, while more than one third of respondents indicated that they can only sometimes or rarely if ever are able to (see Figure 4). In contrast, only a small proportion of survey respondents (4%) identified as experiencing homelessness.
Figure 4. Community Survey Wellness Indicators: Housing
54.4%
51.7%
22.7% 24.0%
16.0% 14.9%
I can access and afford safe and adequate I am able to afford my rent or mortgage housing (n=375) (n=375)
i Not true or rarely true • Sometimes true •Always or almost always true While housing and homelessness related services were common needs among survey respondents overall, specific subgroups endorsed these needs more frequently than others.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 14 Most notably, all respondents who were currently experiencing homelessness endorsed housing assistance and homelessness outreach and services as needs (16 out of 16 each).
Additionally, most respondents identifying as human service recipients endorsed housing assistance (81%; 107 out of 132 who responded) and homelessness outreach and services (71%; 88 out of 124 who responded) as needs. Additionally, most individuals experiencing homelessness indicated their needs for housing assistance (9 out of 13 surveyed) as well as "homelessness outreach and services" (7 out of 12 surveyed) were unmet. Qualitative data illuminated that these individuals have experienced long wait times and short stays at shelters.
Additionally, some individuals interviewed indicated that they feel unsafe at local shelters, including those who identify as LGBTQ+.
"I was on the (shelter) waitlist for two months.
Usually, you can only stay 90 days."
"The overnight shelter doesn't work for me because I am perceived as gay — (the other guests) will start harassing me."
- Community Members Experiencing Homelessness
Other specific subgroups, including individuals who identified as having a disability or being an older adult also reported higher rates of unmet needs with respect to housing assistance (disabled: 60%, older adult: 47%) compared to full sample of community members surveyed (30%). Individuals who did not report their race/ethnicity, those who identified as "another race" (including multiracial), and those who identified as Hispanic or Latinx also reported higher rates of unmet needs with respect to housing assistance (unknown race: 71%; another race: 50%; Hispanic or Latinx: 50%).
Additionally, most provider survey respondents endorsed housing assistance (80%; 20 out of 25 who responded) and homelessness outreach and services (80%; 20 out of 25 who responded) as needs among their client populations. Additionally, most respondents who were disabled indicated services did not meet their needs for housing assistance (60%; 9 out of 15 who responded). Additionally, disabled community members encounter difficulties accessing in- person services from providers who could support them within the community. "The unhoused can't do anything. Waitlists are long. Everything is difficult to navigate including the city website."
- Service Provider
The limited availability of below-market multifamily units and diverse housing options exacerbates needs for not only unhoused individuals but also low-income Palo Altans, making it increasingly difficult for young families, working professionals, and essential workers to secure housing within the community. The lack of affordable housing forces essential workers into long commutes, complicating employer efforts to retain talent, while families struggle to find suitable living arrangements.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 15 Families and other community members who can't afford traditional housing increasingly turn to alternative living arrangements, such as RV homes or residing in neighboring cities. These realities further highlight the urgent need for more comprehensive and accessible housing solutions within the community.
While projects like Mitchell Park Place, an affordable housing complex with plans for inclusive community spaces, offer a promising step toward addressing housing needs, these are not enough to meet the full scope of the need. Moreover, the affordable housing shortage poses a critical barrier to individuals living and participating in their community.
Services for Individuals with Disabilities
More than half of participants (57%, 180 of 315) identified services for adults with disabilities as a personal need. Overall, this is fewer endorsements relative to other areas of need. However, adults with disabilities reported higher rates of unmet need in several categories relative to most other community members. Notably, approximately two-thirds (65%) of individuals with a disability indicated that their emergency financial assistance needs are unmet and a similar proportion reported that their needs with respect to elder abuse prevention (60%) and housing assistance (60%) are unmet-highlighted the intersectionality of needs among adults with disabilities, older adults, and individuals who are low-income. This subset of the population also identified unmet needs around sexual and reproductive healthcare (57%), mental supports for children/youth (57%), maternal and infant health care (50%), services for adults with adults with disabilities, and legal aid support (47%) at higher rates than their counterparts who did not identify as having a disability (apart from unhoused adults). Additionally, among human services recipients, a greater proportion identified services for adults with disabilities as an unmet need (30%) compared to all other areas of unmet need (14-27%), indicating that of those who do access relevant services, there may be a greater gap in services in this area. "Many disabled people need support from trained professionals, but it's really hard to find the personnel to support those disabled members, including children and adults."
- Service Provider
For many disabled individuals in the community, accessing consistent, affordable support from trained professionals is difficult in Palo Alto and the Bay Area overall. Both children and adults, require professional support workers trained to address specific medical diagnoses and disabilities. However, finding such specialized disability support staff locally is often challenging.
The high cost of living in Palo Alto has led to a shortage of healthcare providers, therapists, and direct support workers within the city. As a result, individuals with disabilities find that they must travel long distances to receive services. Relatedly, multiple HSNA participants noted that there are limited transportation options for individuals with disabilities (as well as older adults).
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 16 Older Adult Services
A considerable proportion of service providers and community members named the sustainability of older adult services as an area in critical need of additional funding, resources, and attention countywide. Older adults feel increasingly isolated and find it harder to access essential services.
A majority of those who responded to the community member survey endorsed older adult services as a key area of need (76%; 244 out of 320 who responded). Further, most service provider survey respondents (79%; 15 out of 19 who responded) endorsed older adult services as a need among their client populations. Despite the pervasiveness of the need for older adult services, there were no respondent subgroups for which the majority of respondents indicated that this need was completely/mostly met or unmet by existing services 5 with one exception: the majority of respondents whose racial identity was not reported (or unknown) indicated their older adult service needs were unmet (54%; 8 out of 15 who responded).
However, many respondents who participate in activities at the Avenidas Chinese Community Center reported that it has played an essential role in meeting their needs. Other older adults surveyed appreciate recreational opportunities including Pickleball Club and YMCA. "Avenidas provides classes and activities which are part of ancestral heritage.
These experiences are important support for my emotional and mental health." - Community Member
Some older adults who do not have family nearby and are not aware of where to access support, turn to their local library for support with relatively minor needs, including support with various tasks or challenges related to technology. This phenomenon may be due to libraries being more accessible and familiar, the helpfulness of individual staff at local libraries, a lack of awareness or familiarity with the senior center, or some combination of these factors (and possibly others).
"A lot of seniors need five minutes of help from someone. Usually with tech stuff but a large range of tech stuff. Like the only way to pay for a ticket was online or calling from a phone..."
- Service Provider
Service providers expressed concerns about the growing population of older adults outpacing allocated resources, leading to longer wait times and other barriers to participation. Providers note that there are significant limits to what local agencies can provide with respect to transportation, social activities, medical services, and counseling for older adults. 15 For all Community Survey respondent subgroups, responses for this specific need was distributed evenly across "not met", "somewhat met", and "mostly or completely met", such that no single category constituted the majority of responses.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 17 "Adequate funding for senior services countywide is the biggest challenge for us.
We cannot charge fees for services under the Older Americans Act. Our level of staffing and availability of services is directly related to grant support we receive." - Service Provider
Adding to these concerns, a community member highlighted the precarious situation many older adults face in Palo Alto, emphasizing the critical role of safety net services such as affordable housing, income programs like Social Security and SSI, healthcare, and case management. This perspective underscores the broader challenge of aging in Palo Alto, where a sudden change in circumstances can lead to a crisis, further straining the already limited support systems available.
Mental Health Supports for Adults & Youth
Both adult and youth mental health emerged as areas with moderate levels of unmet need from the needs assessment.
Nearly all provider survey respondents endorsed adult mental health support as a need among their client populations (86%; 25 out of 29) and a majority of those who responded to the community member survey endorsed adult mental health support as an important area of need (75%; 236 out of 316). Additionally, one-in-ten community members (9%) indicated that they are rarely if ever able to access the mental health supports they need while nearly one third reported that can personally access the mental health support they need only "sometimes" (31%) (see Figure 5).
Figure 5. Community Survey Wellness Indicators: Mental Health Service Access
49.7%
30.9%
8.9%
I am able to access the mental health
support I need (n=372)
• Not true or rarely true •Sometimes true Always or almost always true Some community survey respondent subgroups indicated that adult mental health support was unmet by existing services more often than other subgroups. Namely, most respondents who were experiencing homelessness indicated their needs for adult mental health support were unmet (8 out of 12 who responded). Additionally, more than half of respondents who City of Palo Alto OHS: Human Services Needs Assessment 2024 | 18 identified as "another race" (including multiracial 6) indicated their needs for adult mental health support were unmet (53%; 9 out of 17 who responded).
Approximately two-thirds of community members (65%) and some service providers also named youth mental health as a specific area of unmet need. The extent of the unmet need among youth may be underrepresented in the quantitative survey findings given the community survey was not administered to school age youth (under the age of 18). However, several participants who engaged with the qualitative research indicated that the stress associated with academic performance and other pressures is impacting many students from an early age. Simultaneously, they noted that resources are often insufficient to meet this growing demand particularly for lower income families who are impacted by the disparity in access to resources. These accounts underscore the need for a more comprehensive and accessible (geographically, financially) mental health support system that spans all stages of youth development in Palo Alto, from early childhood through adolescence. "Youth and teen mental health [services and supports] will definitely be needed in this community. It connects directly with some of the tragic suicides and the high pressure in the education system."
- Community Member
"When we think of mental health, we think of adults and teens. We need to think about elementary students. And then we also need to think about 0 through 5." - Community Member
Food & Nutrition Services
A majority of those who responded to the community member survey endorsed food and nutrition services as an area of need (71%; 228 out of 320). Although this need was common among survey respondents overall, specific subgroups endorsed it more frequently than others. Most notably, all respondents who identified as Native American or Alaska Native only (Not Hispanic or Latinx) (19 out of 19) and nearly all who identified as Black or African American only (Not Hispanic or Latinx) (18 out of 19 who responded) endorsed food and nutrition services as a need. Further, most provider survey respondents (17 out of 24 who responded) endorsed food and nutrition services as a need among their client populations.
Despite the pervasiveness of the need for food and nutrition assistance, there were no respondent subgroups for which the majority of respondents indicated that this need was 16 For this analysis, "another race" included: Middle Eastern or North African only (Not Hispanic or Latinx), Jewish only (Not Hispanic or Latinx), Native Hawaiian or Other Pacific Islander only (Not Hispanic or Latin), and Multiracial (Not Hispanic or Latinx).
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 19 completely/mostly met or completely/mostly unmet by existing services.' However, a statistically significant larger proportion of individuals with a household income of $60,000 or less indicate their food and nutrition needs are either not met or only somewhat met relative to those with a higher income (74% vs. 60%). Additionally, among human services recipients, a greater proportion identified food and nutrition services as an unmet need relative to other areas of need (apart from services for adults with disabilities), indicating that of those who do access relevant services, there may be a greater gap in services that meet the need in this area.
"The [food bank] is only open Monday to Friday."
- Community Member
Some unhoused community members reported traveling outside of the City of Palo Alto for higher quality and quantity of food, as well as the ability to access free food on Saturdays and Sundays when local Palo Alto based food and nutrition services are closed. Other community members noted a lack of transportation to food pantries. 17 For all Community Survey respondent subgroups, responses for this specific need was distributed evenly across "not met", "somewhat met", and "mostly or completely met", such that no single category constituted the majority of responses.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 20 Additional Areas of Unmet Need for Specific
Demographic Subgroups
Medical and Physical Health Care
A majority of Palo Alto residents who responded to the community member survey endorsed medical/physical health care as an important area of need (78%; 245 out of 315 who responded), however medical/physical health care needs are somewhat or mostly met for nearly all respondents (88%), with one exception: the majority of respondents who were experiencing homelessness indicated their needs for medical/physical health care were unmet (58%; 7 out of 12 who responded). "Palo Alto citizens cannot get the appropriate medical therapeutic services, or they have to commute too far away."
- Community Member
Immigrant populations reported facing further challenges in accessing medical care, particularly when language barriers are involved. One participant highlighted, "If you speak a language outside of just Spanish, Cantonese, or Mandarin, it can be really hard to navigate the healthcare system." This adds another layer of difficulty for non-English speaking residents in obtaining the care they need.
Emergency Financial Assistance
A majority of those who responded to the community member survey endorsed emergency financial assistance as an important area of need (73%; 229 out of 316 who responded), however specific subgroups endorsed this need more frequently than others. Most notably, the majority of respondents who identified as Black or African American only (Not Hispanic or Latin) (100%; 19 out of 19 who responded) or Native American or Alaska Native only (Not Hispanic or Latinx) (100%; 19 out of 19 who responded) endorsed emergency financial assistance as a need. Most respondents with a household income of $120,000 or less (72%; 200 out of 279 who responded) also endorsed this need. Additionally, most service provider survey respondents (70%; 16 out of 23 who responded) endorsed emergency financial assistance as a need among their client populations.
Some community survey respondent subgroups indicated that emergency financial assistance was unmet by existing services more often than other subgroups. Namely, the majority of respondents who were experiencing homelessness indicated their needs for emergency financial assistance were unmet (64%; 9 out of 14 who responded).
Additionally, approximately two-thirds of respondents who were disabled indicated their needs for emergency financial assistance were unmet (65%; 11 out of 17 who responded).
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 21 Emergency financial assistance was not identified explicitly as a need by qualitative research participants, however the need for (non-emergency) financial support was implied in community members' reflections on the wealth gap and affordable housing issues plaguing the community.
Intersectionality of Identity & Needs:
Unhoused Individuals, Individuals with Disabilities, & Older Adults Additional findings specific to needs and services for Individuals with Disabilities and Older Adults can be found in the sections that follow; in contrast, additional findings for individuals experiencing homelessness can be found in the section above.
Elder abuse prevention
Most respondents experiencing homelessness and the majority of respondents who identified as disabled indicated that elder abuse prevention is an area of unmet need (63% and 60% respectively). This area of need was not mentioned in qualitative research activities nor open-ended responses in the community survey and would benefit from further exploration in subsequent assessments.
In-home care assistance
Overall, individuals who identified a need for in-home care assistance had greater rates of unmet need relevant to all other categories of need. Individuals experiencing homelessness had the highest rates of unmet need in this area (63%) followed by older adults (40%).
Community Connection, Isolation, and Inclusion
Community connection and engagement, along with leisure/recreation, and cultural services or affinity spaces were the most widely shared needs identified by needs assessment participants, crosscutting all demographic subgroups. However overall levels of unmet need with respect to these service areas were relatively low.
Nearly half of survey respondents indicated that they sometimes or almost always feel isolated and/or lonely (48%; 175 out of 365 who responded). Nearly half also indicated that they sometimes or rarely/never feel included and welcome in their community (45%; 166 out of 366 who responded) (see Figure 6). However, overall, this need is relatively well met across most subpopulations, apart from individuals experiencing homelessness and individuals with a City of Palo Alto OHS: Human Services Needs Assessment 2024 | 22 disability who experience the greatest rates of unmet need around community connection and belonging (30% and 24% respectively).
Figure 6. Community Survey Wellness Indicators: Connection & Belonging
48.4%
42.5%
35.6% 33.3%
12.3% 12.0%
I feel isolated and/or lonely (n=365) I feel included and welcome in my community (n=366)
• Not true or rarely true •Sometimes true • Always or almost always true A vast majority of community member survey respondents endorsed community engagement and connection as an area of need (87%; 295 out of 338 who responded). Similar proportions of respondents endorsed other engagement-related needs, including leisure and recreation (85%; 271 out of 319 who responded) as well as cultural services or affinity spaces (81%; 269 out of 331 who responded). These respondents reflected varying background characteristics (e.g., income, race, age, gender, sexual orientation, zip code), suggesting that community engagement and connection may be a broad and common need. This finding is further substantiated by the fact that an overwhelming majority of provider survey respondents also endorsed community engagement and connection as a need among their client populations (20 out of 22 providers who answered this question).
"It feels like the community is not engaged with each other. Very individualistic and it can be very lonely. We are closed in our little, small groups- religious, cultural, or other affiliation, rather than having neighborhood connection." - Community Member
Many qualitative research participants expressed appreciation for Palo Alto's local amenities, finding it a good place to raise a family, with high quality libraries and parks, however, many others also felt that opportunities for community connection and engagement were limited.
High needs groups such as unhoused individuals, individuals with disabilities, and their caregivers as well as immigrants and those who work but do not live in Palo Alto (because they cannot afford to)-stated that they have limited opportunities to engage with other community members. The significant disparity between community members impacts not only the well-being of those whose needs are not met but also plays a role in undermining the community's overall sense of belonging and connection.
Despite the pervasiveness of the need for community connection and engagement, more than half of respondents (51%) indicated that these needs were "somewhat met" by existing City of Palo Alto OHS: Human Services Needs Assessment 2024 | 23 services18. This was largely true for most subpopulations, with one exception: nearly all respondents identifying as Native American or Alaska Native (Not Hispanic or Latinx) indicated that their cultural service or affinity space needs were "mostly or completely met" by existing services (95%; 18 out of 19 who responded).
Qualitative research activities provided some insight into specific ways in which specific subgroups with the community experience needs pertaining to community engagement.
Some adults with disabilities, for example, stated that they struggle with isolation and limited community engagement due to a lack of recreational programs, trained support staff, and reliable transportation. Caregivers for disabled adults in the community often face significant challenges due to the lack of support services. This absence of adequate support can quietly contribute to feelings of isolation, which might make it more difficult for these families to feel fully connected to the broader community.
This sense of isolation also affects immigrants and working adults who encounter barriers in accessing essential services. For many immigrants, limited language support and a lack of resources tailored to their needs present significant challenges. One participant shared, "In the communities that I have served, there are no resources to help immigrants if they're not in the school district." This issue is particularly pronounced for immigrant groups who face additional difficulties due to limited English proficiency and the need for affordable housing. "Outside of the school districts there are no services catering towards immigrants. There are many Latino/a/x centric services, but the community is divided along lines of disparities in race."
- Service Provider
Working adults, especially those in lower-paying jobs, experience similar challenges due to the high cost of living and lack of affordable housing. Multiple services providers noted that they themselves and their employees cannot afford to live in Palo Alto. "We do not live in Palo Alto. We cannot afford to live in Palo Alto. We're spending an hour to two hours driving to work and home. Some of us are up to four hours a day in cars. The amount of commute required for low-paying jobs is ridiculous, and without housing solutions, we are just going to continue to struggle to have employees come to Palo Alto."
- Service Provider
These accounts illustrate the interconnected challenges faced by different groups within the community, highlighting the compounded impact of limited services and resources, and affordable housing on the feasibility of low-income and high-needs community members and service providers alike to remain connected and supported. 18 For all Community Survey respondent subgroups, responses for these specific needs were distributed evenly across "not met", "somewhat met", and "mostly or completely met", such that no single category constituted the majority of responses.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 24 HSRAP Funding Alignment with Needs &
Recommendations for Future Funding Priorities
Approximately three-quarters of all
current HSRAP funding (FY24) goes Human Services Best Practices toward services for individuals Recommendations
experiencing homelessness, children
» Limit priority areas of funding to four or five.
and youth services, and services for
disabilities and special needs. There is › Develop guiding values* **. Specifically, significant alignment between FY24 • Improving Accessibility HSRAP funding and some areas of • Focus on Equity
greatest need identified by this • Cultural responsivity & centering those most impacted • Strength in partnership & communication
assessment, including • Sustainability
homelessness/housing and services
for individuals with disabilities, and to » Lean into-and align funding—with key frameworks. a slightly lesser extent the need for Specifically,
services for older adults as well as • Social Determinants of Health***:
food and nutrition services. However, • Economic Stability (e.g., housing instability, food some areas of need identified by this insecurity, poverty). • Neighborhood & Built Environment (e.g., access to
assessment including food and food, quality of housing). nutrition services would benefit from • Health Care Access & Quality greater prioritization. • Social & Community Context (e.g., social cohesion) • Education Access & Quality
Some areas of need identified by • Consider also: Community Engagement, Power Sharing, community members as part of this & Capacity Building**** assessment are available in Palo Alto,
» Identify overarching strategic priorities. Specifically, in other North County cities (Mountain
• Health & wellbeing of the most vulnerable individuals View, or Los Altos), or both. This is (e.g., ensuring food, shelter, healthcare, supportive especially seen for those who have services & community connection; especially services housing and emergency financial aid for older adults and/or people with disabilities* **, ***; needs as well as food and nutrition • Equitable, inclusive, & accessible services (e.g., services needs. However, those who need to encouraging diversity, equity, and inclusion in marginalized communities, including access to
access physical health or mental language services) *, ***; health services often must travel to Sustainability of grantee organizations****; outside of the City Palo Alto to find • System Collaboration, Communication & Integration:
the nearest provider. Additionally, promote effective practice, advance collaboration & there are very few providers offering reduce the number of silos*, **. services to older adults and "Fully sustaining systems [require] significant individuals with disabilities in the Palo collaboration.... Ongoing trust and communication...are key to successful human service contracts and
Alto Area. For this reason, greater
implementation. 4344'****
emphasis on funding for these three
Sources: *https://www.sfhsa.org/partnering-sfhsa
areas—older adults, individuals with **https://www.chhs.ca.gov/guiding-principles-strategic-priorifies/ **https://health.gov/healthypeople/priority-areas/social-determinants-health disabilities, and individuals with
mental health—is strongly suggested
files/Strengthening-the-Human-Services-Sector.pdf
in the coming year.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 25 Overall, based on the findings from this mixed method analysis as well as human services best practices (including tailored recommendations pertaining to guiding values, frameworks of relevance, and strategic priorities), we recommend that OHS emphasizing the following five service areas in the coming year:
1. Homelessness services & housing
2. Services for individuals who are disabled
3. Services for older adults"9
4. Food & nutrition services
5. Mental health services
A brief rationale for these recommendations can be found in the 'Recommended Areas for Sustained or Additional HSRAP Funding' below (far right column in Table 5), along with a snapshot of the total number of HSRAP grantees and total dollar amount awarded to each service area. For additional insight regarding these recommendations, please reference the findings corresponding to each service area in the 'Community Needs & Existing Services' section of this report (e.g., Figure 2 and narrative discussion of unmet needs). Additionally, areas for further consideration with respect to each of the priority service areas identified can be found in the following section of this report.
Table 5. Frequency of Existing Service Programs by Service Area & Recommendations Service Area Total # of Total # of Total $ Level of Recommended Area for Local, HSRAP HSRAP Unmet Sustained or Additional
City, Grantees Funding Need HSRAP Funding
and/or (FY24) (FY24) Overall (2024 HSNA)
County (2024
Programs HSNA)
Homeless- 12 7 $392,306 High High: Overall homelessness ness/ services (including shelter) and
Housing access to affordable housing is
the most significant area of
need for Palo Altans - and
individuals experiencing
homelessness have the greatest
rates of unmet need in all other
service areas. As such, this
service area could very much
benefit from sustained if not
increased funding from HSRAP.
Children, 12 6 $175,975 Medium Low: This is an area of
Youth, proportionally lower rates of
19 lt is important to note that while services for older adults appear to be less resourced based on HSRAP funding alone, older adults receive the more funding from the City of Palo Alto than any other demographic subgroup. The City of Palo Alto has long been funding Avenidas at approximately $550,000 per year as a professional services contract for a variety of programs that is decided upon by the City and Avenidas.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 26 Family, & unmet need relative to other
Community areas-across all population
Services subgroups
Older Adults 5 5 $159,309 High High: Given concerns about the growing population of older
adults outpacing allocated
resources and higher rates of
unmet need (e.g., housing
assistance), services and
supports for older adults could
be a service area where HSRAP
could have a more significant
impact in the future
Disability 13 420 $187,654 High High: The rate of unmet need with respect to services for
individuals with disabilities is
higher than any other service
area; this is an area where
HSRAP could play a greater
role in supporting high needs
community members
Food & 321 $174,493 High High: Individuals who access
Nutrition services identified this as their
second greatest unmet need,
only surpassed by services with
adults with disabilities; there is
opportunity for HSRAP funding
to make a greater impact in
this service area
Mental 13 322 $43,216 Medium Medium: Additional targeted, Health investment in this area would
be appropriate to ensure that
community members can
readily access services locally
Medical/ 15 223 $113,759 Medium Low to Medium: Although there Physical is substantial unmet need in this
20 Vista Center for the Blind is a program for the visionally impaired and is also counted under services for Older Adults.
21 La Comida is a senior nutrition program, and the Health Trust runs the Meals on Wheels program; both programs are also counted under services for Older Adults. 22 Adolescent Counseling Services ASAT is a program for youth addiction counseling and the Children's Health Council is a mental health program for youth; both programs are also counted under services for Children, Youth, Family, & Community Services.
23 Peninsula Healthcare Connection and Ravenswood help low-income/homeless individuals with Medical/Physical healthcare needs.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 27 Health area, this is an area that is
seemingly largely beyond
HSRAP's sphere of influence
and one in which there are
numerous providers (including
large institutions like Stanford)
where service improvements
would make the greatest
difference-including
improvements to wait times
and affordability of care
Emergency 14 0 N/a Medium Low to Medium: While there is Financial certainly need in this area,
Assistance there are numerous service
providers in the area and there
many other areas where HSRAP
would have a greater impact
by providing sustained funding;
if nothing else, OHS' could help
raise awareness of existing
services (vs. direct investment in
this area
ommunity Unclear N/a Low Low to Medium: Although this is naaaemer (depends the most common area of
on how need, overall needs are largely
this met and intensity of need is
category lower than in other areas.
However, it may be worth
concept considering tailored resources
valized) and funding for low-income
families and older adults
Legal 11 124 $20,500 Low Low: This need is mostly met
Services and was not identified as a
need in qualitative data
gathering activities
Employment 6 125 $38,473 Low Low: This need is mostly met and was not identified as a
need in qualitative data
gathering activities
24 Senior Adults Legal Assistance (SALA), also counted under services for Older Adults. 25 Downtown Streets Team (also included under Homelessness Services) City of Palo Alto OHS: Human Services Needs Assessment 2024 | 28 Areas for Further Consideration
This section highlights service improvements needed pertaining to the main findings of this report and is paired with considerations for OHS, HRC, the City of Palo Alto, service providers, nonprofit partners, community members, and other stakeholders. These considerations are informed by evidence gathered and presented in this report as well as values of improving accessibility, cultural responsivity, and strength in partnership and communication.
Barriers to Service Participation
Service improvements needed: Overall, there is a need for a greater number of free services with minimal eligibility requirements and barriers to participation. In addition to greater capacity, greater visibility and awareness of local services-including types of services offered, eligibility requirements, application processes, location, and hours-is broadly needed.
Additionally, there is a need for more culturally responsive and inclusive services that meet the needs of subgroups living and/or working within the City of Palo Alto, particularly unhoused and low-income individuals and families in need of human services, individuals with disabilities, older adults, immigrants, individuals who identify as Hispanic or Latino/a/x and multiracial, LGBTQ+ and those who identify as more than one of the previously mentioned.
For consideration: Identify opportunities to strengthen partnerships, connectivity, and messaging regarding available services. Specifically, leverage and strengthen partnerships amongst service providers within the City of Palo Alto and across the County to expand the online resource directory26 with additional information about service offerings and program eligibility for each service. Additionally, consider opportunities to strengthen or more creatively leverage partnerships with private or philanthropic entities to extend the network of resources and support within the community. Furthermore, diversify modes of communication regarding available services to meet various populations and consider ways to strengthen partnerships that can provide a foundation for stronger messaging, awareness-building, and in turn service connection (e.g., a formalized partnership with local libraries).
Additionally, strengthen service provider capacity to deliver culturally responsive, intersectional, and inclusive services that better meet the needs of diverse consumers with intersectional identities and needs-especially unhoused and low-income individuals who are also older adults, individuals with disabilities, or both, as well as those who identify an immigrant, Hispanic/Latino/a/x, LGBTQ+, or some combination. "We often work in silos but there are many challenges that are similar." "In larger cities there are point people to bridge resources/ideas and so on to create a more robust safety net. A convener or a system that makes convening more appetizing is a great opportunity for the city."
26 https://www.cityofpaloalto.org/Departments/Community-Services/Human-Services/Information-and-Referral City of Palo Alto OHS: Human Services Needs Assessment 2024 | 29 "It would be fabulous if the Office of Human Services was located at the Library. [The Downtown Library] is the end of line for two counties - San Mateo and Santa Clara County. It would be great if we advertised services and places where folks could access services. Advertising regionally would be easier than each city... all the services besides housing could be better coordinated." "Public private partnerships are critical, there is a lot of capital/influence in the tech community, and it would be important to align the siloes to move collectively to solve the problem."
- City of Palo Alto Stakeholders & Service Providers
Housing Assistance & Homelessness Services
Service improvements needed: While some needs are addressed through local resources for the unhoused food pantries, and other community assets that support those at risk of homelessness, these efforts are unable to meet the broader demand for services and supports relating to housing assistance and homelessness. Improvements are specifically needed with respect to affordable housing and more consistent shelter to meet the basic needs of individuals experiencing homelessness.
Services for Individuals with Disabilities
Service improvements needed: Greater quantity and improved capacity of services is needed to better meet the needs of adults and youth with disabilities. Specifically, improvements are needed in housing, health care, transportation, and recreation and after-school care for youth with disabilities, among others.
For consideration: Increase resources and training (e.g., disability competency training) for providers working across these areas (e.g., health care, transportation, recreation, etc.) to strengthen the capacity and quality of services for individuals with disabilities.
Older Adult Services
Service improvements needed: Funding for essential services for low-income older adults and those that live alone or do not have family nearby is limited and does not meet current needs.
For consideration: Consider initiating peer support models (where older adults can provide support to one another) as well as intergenerational socialization activities. Expand access and capacity for service opportunities for older adults and improve service connections for consumers who live alone. This may include expanding access (physical space and financial accessibility) for older adults to connect. Additionally, provide resources to formal and informal community groups to facilitate creative ways to engage people (e.g., outdoor classes, group walks in a park), coordinate and implement wellness checks and outreach activities, and increase awareness of existing relevant services.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 30 Mental Health Supports for Adults & Youth
Service improvements needed: An increase in the availability of free or otherwise affordable mental health support for all Palo Altans is the primary improvement needed in this area, along with increased supply (and accessibility) of services to meet the significant demand.
For consideration: Revisit resources and funding as well as communication strategies to ensure those with the greatest need and greatest barriers (financial, transportation, etc.) can more easily access and receive mental health services within the City Palo Alto.
Food & Nutrition Services
Service improvements needed: Greater and more consistent availability of food and nutrition services within Palo Alto.
For consideration: Extend hours to include at least one weekend day (e.g., Saturday) and increase funding to specifically improve accessibility and availability of food and nutrition services within the City of Palo Alto.
Areas of Unmet Need for Specific Subgroups
• Emergency Financial Assistance for Unhoused & Low-Income Individuals Service improvements needed: Additional services and resources needed to support Palo Altans in need of emergency financial assistance.
Medical/Physical Health Care for Unhoused & Low-Income Individuals Service improvements needed: More timely (shorter or no waitlist), affordable, accessible (local) and comprehensive care.
For consideration: Increase the availability and capacity of programs that support people's ability to access and maintain safe and affordable housing. Consider expanding support to unhoused and low-income community members with shelter and housing search and application processes as well as search processes for identifying needed medical/physical health care.
Community Connection, Isolation, & Inclusion
While this assessment illuminated a variety of needs and gaps unique to specific subgroups of the community, it also highlighted that the most common need-although largely met-is a sense of community connection among community members from all backgrounds.
Opportunities for inclusive and accessible community connection and engagement that attract and bring together a broad cross section of community members would lend itself to strengthening the social fabric and sense of community within Palo Alto.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 31 For consideration:
• Identify new, localized, and culturally relevant opportunities for community members to connect and socialize. Given the lack of awareness of services, a well-publicized community fair hosted by the Office of Human Services in partnership with providers and the City Manager's office could be uniquely helpful in bringing a broad swath of community members together. Such opportunities could simultaneously encourage community volunteerism, raise awareness, and provide ways for community members in need to identify and seek needed services and resources available in Palo Alto and in Santa Clara County.
• Leverage and further expand opportunities and resources connected with the local library would maximize a local and known community hub. Qualitative research highlighted the local libraries and library staff as a strength and key resource for the community as well as older adults who seek community and support from libraries in the absence of other options.
• Expand affordable and accessible offerings for low-income families, caregivers, and youth with disabilities to fill specific community engagement needs of the community.
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 32 Appendix A: Community Member Snapshot
Table A1. Palo Alto HSNA Community Survey & Census Demographics Category Community Community Palo Alto 2020
Survey Count Survey Census
Percentage Percentage?
Age (years)
44 and younger 165 43% 32%
45-59 55 14% 21%
60-74 50 13% 14%
75 and older 61 16% 11%
Unknown/Not Reported 54 14% N/a
Gender
Female 203 53% 51%
Male 105 27% 49%
Another Gender Identity 28 12 3% N/a
Unknown/Not Reported 65 17% N/a
Race/Ethnicity
White only 149 39% 49%
Asian only 88 23% 35%
Hispanic or Latinx (of any race) 20 5% 7%
Native American or Alaska Native 19 5% 0.1%
only
Black or African American only 18 5% 2%
Another Race29 18 5% N/a
27 Palo Alto 2020 Census: https://data.census.gov/profile/Palo Alto city, California?g= 160XX00US0655282 28 Census data could not be retrieved for comparison because Community Survey respondents selected gender identity categories that were not available in the 2020 census data. 29 This category includes race/ethnic groups representing fewer than 11 respondents in each of the following groups: Native Hawaiian or Other Pacific Islander only (Not Hispanic or Latinx), Multiracial (Not Hispanic or Latinx) lewish only (Not Hispanic or Latinx), Middle Eastern or North African only (Not Hispanic or Latinx). Census data coul not be retrieved for comparison because Community Survey respondents selected racial categories that were not available in the 2020 census data (i.e., Jewish, Middle Eastern or North African) City of Palo Alto OHS: Human Services Needs Assessment 2024 | 33 Unknown/Not Reported 73 19% N/a
Primary Language
English 244 63% N/a
Unknown/Not Reported 66 17% N/a
Mandarin 34 9% N/a
Another Language 16 4% N/a
Cantonese 14 4% N/a
Spanish 11 3% N/a
Sexual Orientation
Straight/Heterosexual 270 70% N/a
Unknown/Not Reported 97 25% N/a
Another Sexual Orientation 18 5% N/a
Zip Code
94306 96 25% N/a
94303 78 20% N/a
94301 67 17% N/a
Unknown/Not Reported 45 12% N/a
94304 31 8% N/a
Another Zip Code 29 8% N/a
94302 18 5% N/a
94305 21 6% N/a
Household Income
Unknown/Not Reported 121 31% N/a
$0-$30k 44 11% N/a
$31-$60k 37 10% N/a
$61-$90k 70 18% N/a
$91-$120k 58 15% N/a
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 34 $121-$200k 22 6% N/a
$201k 33 9% N/a
Other Roles/Identities
(not mutually exclusive)
Parent 142 37%
Human Services Recipient 139 36% N/a
Behavioral Health Services Recipient 106 28% N/a
Caregiver 73 19% N/a
Disabled 34 9% N/a
Homeless 17 4% N/a
TOTAL 385 100
City of Palo Alto OHS: Human Services Needs Assessment 2024 | 35