SSCC Grantees
Track 1: Program Replication/Expansion
Ardent Solutions, Inc.
Program: PEARLS
State: NY
Organization Type: Community-Based Organization
Ardent Solutions will lead the implementation of the University of Washington’s PEARLS program to support homebound, isolated or depressed older adults and caregivers residing in Allegany, Cattaraugus and Steuben Counties. Delivered through their Uniper Cares’ interactive technology platform, PEARLS will use problem-solving treatment to reduce depression and improve quality of life. The goals are to 1) reduce depressive symptoms in underserved populations, 2) expand access to mental health care via virtual delivery and 3) enhance social connectivity and engagement. The objectives are to 1) enroll and support 35 participants annually; and 2) measure improvements in mood, social interaction and quality of life.
Fallon Paiute-Shoshone Tribe
Program: Memory Cafe
State: NV
Organization Type: Title VI program
The Fallon Paiute-Shoshone Tribe will implement the Memory Cafe Initiative to strengthen social connection, reduce isolation and enhance well-being among elders experiencing memory loss and their caregivers. The program will offer twice-monthly, culturally rooted Memory Cafe gatherings at the Stillwater Senior Center that incorporate traditional storytelling, arts, music, cognitive-stimulating activities and caregiver support. The initiative will address rising dementia-related needs, reduce stigma and increase access to meaningful engagement in a rural Tribal community. The project builds staff capacity, promotes cultural identity and establishes a sustainable, community-centered model to support families affected by memory loss.
Hearts and Hands: Faith in Action
Program: Wits Workout
State: NY
Organization Type: Community-Based Organization
Hearts and Hands provides free volunteer-delivered support to older adults and those with disabilities, including transportation, in-house support and companionship. Part of its mission is to combat isolation prevalent in older adults without a support system. Hearts and Hands will use the Wits Workout as a program offering for care receivers to stay mentally active, enjoy the company of others and connect to the community. The Wits Workout will be offered four times during the grant period, moving the location across the jurisdiction, with a participation goal of 40 to 50 people at each session.
Jewish Community Center of Greater Pittsburgh- AgeWell at the JCC
Program: Wits Workout
State: PA
Organization Type: Community-Based Organization
AgeWell at the JCC will introduce Wits Workout, an evidence-informed social connection program, at its two senior centers to reduce isolation and increase social engagement among older adults. The program will deliver 20 sessions over 10 months and aims to engage at least 200 participants (duplicated). Goals include increasing social interaction, strengthening peer relationships and enhancing cognitive stimulation. Key objectives are to train three staff and two volunteers as facilitators, implement a consistent delivery model across sites, achieve a 70 percent improvement in participant-reported belonging, and establish a sustainable program structure with opportunities for expansion in Year 2.
Native American Community Services of Erie and Niagara Counties, Inc.
Program: Circle of Friends
State: NY
Organization Type: Community-Based Organization
The Native American Community Services of Erie and Niagara Counties’ project, The Good Mind Circle: Haudenosaunee Peer Connections, addresses critical social isolation among Native elders. It uses the Circle of Friends intervention, adapted into self-sustaining "Wisdom Circles" centered on the cultural teachings of the "Good Mind." The primary goal is to foster long-term social bonds and enhance community well-being. Key objectives include achieving a 20-percent reduction in social isolation scores for 70 percent of participants, ensuring 75 percent of Circles attendees achieve independent sustainability, and enhancing access to virtual and traditional resources through five culturally significant social outings and technology training workshops.
Pima Council on Aging (PCOA)
Program: Memory Cafe
State: AZ
Organization Type: Area Agency on Aging
PCOA will enhance social connections and support for older adults and caregivers by expanding the community’s Memory Cafe network. Building and improving the existing framework using a community-informed approach, we’ll engage existing Memory Cafe collaborators, caregivers, program participants, key representative community stakeholders and new partners, launching one new Memory Cafe over a 12-month period. This project will establish a long-term, sustainable, evidence-informed program that is grounded in community engagement. It will reduce social isolation, expand support networks and enhance quality of life for individuals and caregivers on the dementia journey, fostering broad, collaborative partnerships and deepening collective impact.
SeniorsPlus
Program: Opening Minds Through Art; Memory Cafe
State: ME
Organization Type: Area Agency on Aging
SeniorsPlus, an Area Agency on Aging serving three counties in western Maine, will expand its social connection programming through a two-pronged approach to increase organizational capacity. The first goal is to expand the established Opening Minds through Art program to two additional counties, training three new staff members to provide sufficient program capacity. The second goal is to launch monthly Memory Cafes in three counties to provide regular opportunities for older adults and their caregivers to connect and engage in health-promoting activities. This proposal instills the capacity to sustain expanded programming to serve older adults in rural western Maine.
Trustees of Indiana University
Program: Circle of Friends
State: IN
Organization Type: University/Area Agency on Aging
CICOA In-Home Solutions, Indiana’s largest Area Agency on Aging, identified loneliness and social engagement as the greatest needs in a recent community needs assessment. We seek to implement the evidence-based Circle of Friends program to address loneliness. Our objectives are to 1) train up to two staff to implement Circle of Friends, 2) implement the program at two meal sites in Marion and Hendricks Counties and 3) deliver the program to 40 participants. Outcomes will be measured using the UCLA Loneliness Scale, Lubben’s Social Network Scale and quotes from participants’ experiences. Findings will inform future program implementation at CICOA’s 21 meal sites.
Track 2: Cross-Sector Partnership
CHPcommunity, Inc./Iowa Community HUB
Program: Referral Process/Social Prescribing
State: IA
Organization Type: Community Care Hub
CHPcommunity, Inc., will address social isolation among older adults and caregivers in rural Iowa by integrating social prescribing into clinical care and community outreach. Through the partnership between the Iowa Community HUB and Primary Health Care (PHC), at-risk individuals are connected to tailored social programs using the HUB’s Navigator model. PHC identifies older adults for social prescriptions, and HUB Navigators complete comprehensive screenings, including PRAPARE, to further assess needs and provide personalized support. Both organizations will receive Age-Friendly Care training. The project aims to reduce social isolation, enhance rural engagement, improve well-being and create a replicable statewide model.
Community Living Campaign
Program: Social Prescribing
State: CA
Organization Type: Community-Based Organization
Community Living Campaign’s Neighborhood Buddies is a community-driven social prescribing program in San Francisco that pairs older adults and people with disabilities with trained local volunteers for weekly connection and support. Designed in collaboration with Sutter Health, the program features a community-driven, participatory design process; a hospital care team referral system; culturally aligned volunteer matching; and a focus on building participants’ long-term social health through connection to broader community activities. It combines peer-based companionship and link navigation, shared activities and warm hand-offs to community resources, helping participants connect with others, access services and maintain independence while reducing loneliness and isolation.
Sid Jacobson Jewish Community Center
Program: Social Prescribing
State: NY
Organization Type: Community-Based Organization
This project expands an approved social connection intervention—social prescribing—through a partnership between Sid Jacobson Jewish Community Center (SJJCC), a CBO, and Glen Cove Hospital, part of the Northwell Health system. Before discharge, hospital staff will use a standardized Social Determinants of Health (SDOH) screening to identify older adults experiencing isolation or unmet social needs and refer them to SJJCC’s Social RX social worker. This social worker will assess needs, co-create a personalized care plan, and provide warm, mutually accepted referrals with ongoing follow-up to reduce isolation and strengthen connection. Caregiver support will also be offered by SJJCC.