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Aging and Adult Services proposes tiered wage pilot for IHSS and Dignity Fund allocations
Summary
Shereen McSpadden presented DOS’s IHSS caseload and workforce challenges, proposed a tiered‑wage pilot to retain IHSS caregivers, and outlined initial allocations from the Dignity Fund including caregiver support, access, transportation and legal services.
Shereen McSpadden, executive director of the Department of Aging and Adult Services, told the Budget Committee IHSS serves roughly 25,000 unduplicated people per year (about 22,400 per month), with clients receiving an average of 22 hours of care per week. She said DOS is facing a severe workforce retention problem in contracted IHSS services—HomeBridge, a contract provider, is losing about half of its workers within three months of hire—and the department is proposing a small pilot to test retention incentives.
The proposed IHSS pilot would cover approximately 150 clients and pay participating caregivers $1 per hour more in the first year and potentially another $1 in the second year, tied to training and performance metrics. “They’re losing approximately half their workers after 3 months on the job,” McSpadden said, describing the training investment and turnover that undermines continuity of care. The department told the committee the pilot would be evaluated for retention effects before broader expansion or changes to IHSS rates.
McSpadden also reviewed Adult Protective Services (APS), which serves roughly 4,800 people and receives about 650 new reports of abuse or neglect per month—an increase of 26 percent compared with four years earlier. She highlighted the department’s clinical and quality assurance unit, and described a Dignity Fund allocation plan (Prop I): a baseline of $44 million in 2017–18 including $6 million of new spending to be distributed across caregiver support, community access, transportation, legal services for seniors and adults with disabilities, and nutrition/wellness programs.
Public commenters representing long‑term HIV survivors, Open House and community providers urged coordination to serve marginalized seniors—particularly LGBT seniors and people aging with HIV—and asked DOS to fund housing navigation and targeted outreach. McSpadden said housing advocacy and counseling are part of DOS budgets and that cross‑departmental coordination with homelessness and housing offices will be important to reach those populations.
The committee filed the DOS hearing without objection. DOS said it will monitor pilot results and continue coordination with providers and other city departments to address workforce and housing‑access gaps.
