Committee advances multi‑year nutrition and community‑living funding for older adults and approves CalAIM partnerships

The Budget and Finance Committee on July 23 forwarded a package of Department of Disability and Aging Services (DAS) items to the full Board with a positive recommendation. The measures include multi‑year grant agreements with Self Help for the Elderly to continue congregate and home‑delivered meals and amendments to the Community Living Fund (CLF) administered by Institute on Aging, together with two agreements with San Francisco Health Plan that bring CalAIM revenue to support community supports and enhanced care management.

Self Help for the Elderly, a long‑standing community partner, would receive four‑year grants to provide congregate meals (Item 12) and home‑delivered meals (Item 13). DAS staff reported strong program performance: in fiscal year 2023–24 Self Help met or exceeded client and outcome targets and delivered a high percentage of contracted meals. The department highlighted culturally appropriate meals and outreach: Self Help operates 15 meal sites across seven neighborhoods and delivers meals tailored to older adults’ dietary needs and cultural preferences.

Budget and Legislative Analyst (BLA) staff noted two policy considerations: the congregate‑meal grant (Item 12) represents a substantial reduction in service relative to FY23‑24 levels (a 61% reduction in meals and a 30% reduction in clients, reflecting HSA budget constraints); and the home‑delivered meal contract (Item 13) has a per‑meal cost about 50% higher than a separate Meals on Wheels contract discussed previously, in part because Self Help is smaller and specializes in culturally specific Chinese cuisine. BLA recommended examining whether economies of scale or procurement approaches could lower per‑meal costs amid constrained federal and local funds.

DAS also presented Item 14, an amendment extending and increasing funding for the Community Living Fund (CLF) operated by Institute on Aging. The CLF helps support transitions out of skilled‑nursing facilities and prevents unnecessary institutionalization by funding case management and purchase‑of‑service supports. HSA/DAS and the BLA reviewed recent database transitions that temporarily limited outcome tracking; DAS said the database retooling is expected to be completed in August and that outcome monitoring will resume.

Items 15 and 16 are agreements with the San Francisco Health Plan to bring CalAIM‑funded community supports and enhanced care management payments into the CLF program; DAS forecasted approximately $9.9 million in revenue through these health‑plan agreements across the contract periods to offset program costs and stabilize the general‑fund portion of the CLF. The BLA recommended reducing the CLF amendment by approximately $2 million to reflect prior underspending; DAS accepted the recommendation and the committee adopted an amendment to lower the not‑to‑exceed amount from $27,630,868 to $25,676,683 before forwarding the package to the Board.

Committee members praised services for reducing isolation and meeting culturally specific needs and asked DAS to return in the fall for a broader discussion about workforce, portfolio‑wide risk and strategies to improve cost efficiency. The committee voted 3‑0 to forward the amended package to the full Board.

Key quotes from the record: “At least 97 percent of older adults reported increased consumption of fruits, vegetables, and whole grains,” DAS nutrition lead Tiffany Kearney said in reporting program outcomes.

“Should we get additional funding…those costs do go down,” BLA and committee members noted when discussing potential economies of scale for culturally tailored providers.

Ending: The committee forwarded the DAS package, including Self Help grants and CLF amendments with the BLA‑recommended reduction, to the full Board with a positive recommendation.