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DAS director warns HHS reorganization could disrupt Older Americans Act funding; Medicaid cuts would risk local services
Summary
DAS Executive Director Kelly Dearman told commissioners that a federal HHS reorganization and possible reductions to Medicaid and Administration for Community Living programs create uncertainty for services funded by the Older Americans Act and for locally administered programs serving thousands of older adults and people with disabilities.
Kelly Dearman, executive director of the San Francisco Department of Disability and Aging Services, told the DAS commission on April 2 that a proposed U.S. Department of Health and Human Services reorganization has created uncertainty about federal programs that support older adults and people with disabilities.
Dearman described HHS plans to reduce staffing from about 82,000 full-time employees to roughly 62,000, consolidate divisions and reduce the number of regional offices from 10 to five. She said the Administration for Community Living's (ACL) critical programs would be redistributed across multiple offices and that it is not yet clear whether positions such as the Assistant Secretary on Aging or specific ACL programs would continue in their current form.
"It is unclear at this time if any specific programs currently administered by ACL will be cut or eliminated," Dearman said. "We really want to know how this reorganization ... is going to affect the people that we are charged to serve."
Why it matters: San Francisco relies on Older Americans Act (OAA) formula funding and Medicaid-funded services to support in-home and community programs. Dearman said the city receives about $7,760,000 in OAA funding for older-adult services and had claimed just over $6,000,000 so far in the fiscal year, with roughly $1.5 million remaining to claim. She warned that deep federal cuts or reorganization could slow responses and create gaps in service delivery.
Local Medicaid exposure Commissioners pressed department staff about the potential impact of Medicaid reductions. Dearman said the Human Services Agency receives roughly $450 million in Medicaid funding annually and that significant cuts would force difficult local decisions.
"If Medicaid gets totally cut ... at the end of the day, obviously some hours for people would have to be cut so that we can make sure that everyone who needs hours gets hours," Dearman said, adding that the department serves about 28,000 people who receive those services.
Commission response and advocacy Commissioners and staff said they are tracking developments, coordinating with the state association of aging programs and planned to discuss a coordinated city response at an upcoming department-head meeting. Commissioner Sasha Buettner and others noted that national elected officials had publicly raised concerns about the regional-office consolidation.
Ending Dearman and commissioners said they will monitor federal and state developments and keep the commission apprised of any impacts on local program funding and operations.
