Board directs phased fee increases for senior daycare, OKs public guardian fee updates and annual CPI adjustment

The El Dorado County Board of Supervisors on March 4 directed Health and Human Services (HHSA) staff to implement phased increases to senior daycare fees and to pursue recommended fee changes for the Public Guardian, while adding an annual inflation adjustment.

HHSA Deputy Director Lynette Engelhart Stott presented a fee study from MGT Consulting covering the county’s senior daycare program and public guardian services. The county operates two adult day services, in Placerville and El Dorado Hills, serving an average of about 7.5 participants per site. HHSA noted the program’s current general fund subsidy is roughly $666,000 and estimated a subsidy of about $170 per participant per day based on fiscal-year 2024–25 participant days.

On senior daycare, MGT offered two options: (1) a one-time increase that would recover about 87% of costs and raise the daily fee substantially, and (2) a phased approach the department recommended (option 2) that would spread increases over three years (roughly a 33% increase year-over-year under the consultant’s example). Under both options the study recommended raising the enrollment fee (currently $50) toward a figure shown in the consultant’s tables and eliminating a client shower-assistance fee. Engelhart Stott told the board that staff recommends option 2 to moderate the impact on families.

On the Public Guardian program, Nathaniel Houston, program manager for protective services, explained the office is a court-appointed conservatorship and representative-payee service. Public Guardian fee collections are constrained by court approval and by state probate code limits; Houston specifically cited Probate Code sections (identified in the meeting as 62640–62641) that limit collections from clients receiving public benefits. Houston said moving from an hourly structure to a revised flat-fee structure and charging for previously unbilled work (initial investigations and fiscal work) could increase revenue; MGT estimated the proposed public guardian fee changes could raise about $587,000 in potential revenue if allowed by the court.

Board direction and votes: After public comment and discussion about affordability, alternatives and sites, a motion was made and amended on the dais. The board removed an instruction to “explore alternating site locations” and instead asked staff to study the possibility of consolidation or a single-site study; the board added an instruction to include an annual consumer-price-index (CPI) escalator for both public guardian and senior daycare fees. The motion directed staff to return with resolutions to increase the senior daycare program fees in phased increments over three years and to return with a resolution to increase public guardian fees as recommended by staff and MGT. The consolidated motion was seconded and approved by voice vote.

What supervisors and residents asked: Supervisors pressed staff on participant ability to pay and whether families use private alternatives or long-term-care insurance; staff said the department does not currently collect income data from members and that some participants may use long-term-care plans or other short-term funding sources. Several board members and commenters asked staff to analyze consolidation (one site vs. two), private-sector availability and transportation challenges for residents who live far from the sites. The board asked staff to return with more information on participant income, comparative private options, and a clearer cost/revenue analysis before finalizing a fee resolution.

Next steps: Staff will prepare fee resolutions for senior daycare and public guardian incorporating board direction (three-year phased increases for senior daycare, the public guardian fee schedule changes, and an annual CPI escalator), to return to the board. For public guardian fees, implementation requires court approval in conservatorship cases and must comply with probate-code limits on collections from clients receiving public benefits.

Why this matters: The county subsidizes senior daycare and conservatorship services from the general fund. Staff framed the recommended fee changes as a step to reduce general-fund subsidy and to better recover the actual cost of service; board members cautioned that increased fees could reduce participation or price out lower-income families without additional subsidy or alternative funding.