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Human Services Agency warns of potential IHSS cost shift and federal funding risk
Summary
Trent Rohr described HSA’s program mix and funding sources, emphasized that most federal funding is entitlement‑driven, and warned the governor’s proposal to change IHSS county financing to a 30% share could expose San Francisco to about $43 million in new costs.
Trent Rohr, executive director of the Human Services Agency, presented a high‑level overview of the agency’s three‑department structure and program priorities, including family and children services, in‑home supportive services (IHSS), CalWORKs, and cash assistance programs. Rohr summarized the funding breakdown—federal, state (including realignment), and local—and explained how the Affordable Care Act enrollment increased Medi‑Cal caseloads and enabled operational efficiencies by co‑locating eligibility for Medi‑Cal and CalFresh.
Rohr described HSA’s progress on child welfare reforms and the statewide Continuum of Care Reform (CCR) to reduce reliance on congregate care. He discussed programmatic reforms in the county adult assistance program (CAP) and outcomes from CalWORKs welfare‑to‑work strategies, noting CalWORKs caseloads have declined from the 1990s and that HSA continues workforce supports for families.
On funding risks, Rohr told the committee that while an outright, program‑by‑program cut tied to sanctuary‑city status is unlikely because most HSA funds are federal entitlement dollars that flow through the state, a structural federal change such as a move to Medicaid block grants could shift costs to states and counties. Rohr’s more immediate concern was the governor’s January budget proposal to alter IHSS financing by replacing the fixed county maintenance‑of‑effort with a 30 percent county share of program costs—an approach he estimated would cost San Francisco about $43 million. Rohr said county and city staff are negotiating with the governor’s office and CAO groups to mitigate impacts and that budget drills are underway to model scenarios.
Rohr also highlighted concerns about the governor’s proposed recalculation of CalWORKs funding on caseload decline, which could reduce San Francisco’s allocation by roughly $6.5 million. He said HSA is preparing alternative proposals and working with the mayor’s budgeting staff to examine reserves and contingency plans.
The committee filed the HSA hearing without objection. Rohr said HSA will continue to provide updates as negotiations and state budget processes evolve.
