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Aging and Adult Services flags IHSS uncertainty, highlights Community Living Fund and integration planning
Summary
DAAS Deputy Director Shereen McSpadden told the Budget & Finance Committee the Community Living Fund has helped about 1,500 clients and that the department is planning for possible state‑level changes to IHSS, including a governor proposal to move long‑term services into managed care; one 20% cut proposal was struck down but a cut to domestic‑related services remains possible.
Shereen McSpadden, deputy director for the Department of Aging and Adult Services, told the Budget & Finance Committee the department’s Community Living Fund (a $3 million general‑fund program) has served more than 1,500 clients since 2008 by funding intensive case management and services to help seniors and adults with disabilities stay out of skilled nursing facilities.
McSpadden said the department is closely watching the governor’s proposed coordinated care initiative, which would shift some long‑term supports and services into managed care. She said the state is still developing the approach, including which services will be in the managed‑care mix and how dollars would flow, and warned that local maintenance‑of‑effort and service delivery could change under a managed‑care model.
McSpadden outlined San Francisco’s local effort to plan for possible changes: the department has hired a consultant and is coordinating with Human Services Agency, the Department of Public Health and community partners on an integration plan that aims to preserve services while evaluating costs and delivery models.
On In‑Home Supportive Services, McSpadden said a proposed 20% across‑the‑board reduction in hours was struck down and backfilled for the current year, but that a proposed cut to domestic and related services remains under discussion; the department’s slide warned the domestic‑services cut could affect over 12,000 clients and reduce more than 128,000 hours if enacted. She said the department and commissioners expect that state legislators will be cautious about such a politically sensitive cut, but that final action was uncertain.
Supervisors raised questions about data collection and services for LGBT seniors and people aging with HIV. Supervisor Wiener said a task force is forming to identify policy recommendations; McSpadden said DAAS is working to improve data collection and programming and is willing to collaborate with the task force on implementation and training for providers.
McSpadden closed by noting the department is monitoring trends in IHSS caseloads and other long‑term supports and will report back as the state provides guidance and as local planning proceeds.
