Transcripts For SFGTV BOS Budget And Finance Subcommittee 4616 20160412

Okay good morning, everyone. Welcome to the budget finance subcommittee for wednesday, april 6, 2016, my name is mark farrell im joined by supervisor katie tang and supervisor yee want to thank linda as well as Jennifer Lowe and charles kremack madam clerk, any announcements . Yes. Completed speaker cards and documents to be included should be submitted to the clerk. Items acted upon today will appear on the april 12th board of supervisors agenda unless otherwise stated. Okay. Thank you madam clerk will you call item one. An ordinance amending the planning code for the establishing fees. Okay thats correct colleagues at the request of the depended after Public Comment to continue this item for a week unless other comments by the Board Members comment anyone wish to comment seeing none, Public Comment is closed. Colleagues, can i have a motion to continue to the april 13th budget meeting well take that without objection. Madam clerk item 2. Item 2 resolution approving the issuance of tax revenue obligation i the California Authority for the principle not to exceed 10 million for the facilities owned by the school of San Francisco. Okay. Thank you do we have the gentleman. Im from the Controllers Office Public Finance thanks for considering the item in attention camilla the tax responsibility with the Tax Exemption on issues for the tjpa in this case, the city issues the citywide authority or c s da the Transbay Joint Powers Authority San Francisco is a member the authority is issuing the bonds for participation and other forms of indebtedness the resolution before you today because federalist tax law in which the project is located approve the project and after the Public Housing is it can be issued on a tax exempt basis city and county of San Francisco is not general Obligation Bond for payment on the embodying bond and published a notice in about San Francisco chronicle the public hearing was held and no comments if any members of the public assuming all the riders approvals are objected they will issue an transaction not to exceed 10 million the cancel is seeking to 10 million in taxexempt obligations to refinance an existing loan the amount of approximately 9 million plus which was used to acquire and install and rehabilitate equipment at 645 broadway in San Francisco and to pay issuance of financing an approval of this legislation wouldnt have an impact to the city and county of San Francisco any fiscal impact it is a Jewish School for k through 8 the school is established in 1963 to inspire the students to lead lives of purpose and an welcoming Community Deeply enriched by jewish tradition and an brochure enrollment of 4 hundred students in supervisor yees district. Thank you very much colleagues, any questions i appreciate we have no budget Analyst Report anyone wish to comment on item 2. Sir, can you step up to the microphone everyone has 2 minutes. Well, i just dropped in one thing id like to say that means when someone gets very upset it is a jewish word every Independent School sha show have the right inform different languages needs specific people to keep specific languagess so when it comes down to funding specific language type of schools i think San Francisco, california do that should be able to give an extension i was coming by the Supervisors Office you guys know me quite well the governing board is like the federal board your supervising each individual district if youre district has a school that teaches specific languages or things i think San Francisco should be able to come up with some process where they can do that as Tax Exemption whatever over and over a bay is a good word sometimes, i get anger and say that word it is a different language and different skills you work put together i think San Francisco, california afford to help a Jewish School my name is lee and you have a good day thank you. Any publion item 2 seeing none, Public Comment is closed can i have a motion . Sorry supervisor yee. I want to say i had the chance to visit that school it serves as a mentioned 4 hundred students and it is providing a Great Service not only in district 7 but for those who are coming throughout the city to attend the school i hope youll be supporting this id like to make a motion. Motion by supervisor yee well take that without objection. Madam clerk item 3. Ordinance amending amending the administrative code for the finance repairs and improvements needed to abate vision of inspecting. This was sponsored by supervisor wiener who sponsored this im going to turn it over to him. Thank you, very much mr. Chairman this legislation is part of a broader effort ive been working on with various city departments as well as advocates the community to try to improve Code Enforcement and ramp up the Code Enforcement effort in San Francisco to address a serious code visions with delipidated buildings and issues that really impact many tenants as well as neighborhoods when you have a building that is delipidated are falling apart and violating codes it is a health and safety and quality of life issue we need to do more to address our Code Enforcement deficiency if San Francisco on monday, i had legislation a few piece of legislation that came out of the Land Use Committee to next tuesday to reform expand and streamline San Francisco approach to Code Enforcement so that we our city departments are enforcing the law the goal is not to be punitive the goal so bring buildings into compliance and have safe healthy surrounding for people that live in those buildings and live around them and so in that spirit we know that there are pertains in the city particularly open spaces that h small Property Owners that want to be in compliance but not to have the resources last year, i was able to thank you, colleagues for your support approximately 4 million split between two fiscal years that you are think requires to create a Code Enforcement resolving loan funds the idea this 4 million would form the basis of a fund where a small Property Owners in particular could receive low interest loans to help them correct code deficiency theyll pay the money back and replenish the fund that approximately 4 million sits in reserve and once we pass the legislation the item before you it can be loaned out the legislation creates the resolving loan funds it will be funded later youre going this reserve money i hope as part of budget process that is coming up we are working the clerk will take the roll with the department of building inspection and the Mayors Office of housing and Community Development to come up with policies and procedures for this loan fund. The funding that is sitting in reserve comes from building inspection fees useless recall that last year the dbi proposed we accepted a reduction in building fees because dbis reserves were getting large what we did he with made the reductions somewhat less and that went into too this reserve that whether fund the loan because it comes down from that building inspection fees it can only be used for building inspection related issues so the Building Code the electrical code, the green housing code and the housing code and the mr. Flanagan code those are broad categories in terms of bringing the buildings up to standards and all expect in terms of safety and health, i ask for your support and skoovd is r Sophie Hayward here in the Mayors Office of housing and Community Development if there are any questions thank you thank you, supervisor wiener colleagues, any eggs he questions okay opening it up for Public Comment anyone wish to comment on item 3 seeing none, Public Comment is closed okay supervisor wiener tutor bringing this forward can i have a motion . To send that forward. So moved. Motion by supervisor tang well take that without objection. Madam clerk item four the distribution of common stoke and authorizing the durability to into enter into agreement to accept the distribution of shares with the stakeholders architecture in order to amend it with the stakeholders agreement. Mr. Wagner from dpw. Good morning cfo department of Public Health the resolutionblast before you relatives e re89s to the membership and an Group Organization that was formally University Health care to pool the purchasing power with other Health Systems for materials and metal supplies a year ago u h c merged with another organization and under the new Corporate Structure for the organization which is now called busy u h c members receive common stock shares in the organization on a perforate 83 based on the membership were authorized to accept those shares of stock at the this time there really on asset on paper only closely Held Corporation but having those shares will allow us is a say in the governance of the organization that is helpful we do a lot of purchasing and has a potential financial upside for the city at sometime in the future and i think their really very little identified Going Forward were asking for your acceptance of those stocks that are held in trust. Thank you, colleagues any questions okay calling names any Public Comment on item 4. Seeing none, Public Comment is closed. Colleagues if no other questions love to entertain a motion. Ill make a motion to move forward i move we send it to the full board with a positive recommendation. Madam clerk item 5. Ordinance 30 years the execution of the participation in an aggregate not to exceed 95 million to provide fund to assist in the development, acquisition, construction or rehabilitation of affordable renting housing project. Good morning jane i didnt with the Controllers Office of finance the item before you to execute and discover in an agency gate amount not to exceed 95 million for the housing projects ill including phase one and phase two known as rad and construction for the Affordable Housing on city owned parcels the state will be borrowing and repaid the Housing Trust fund and the approval of this ordinance the board will approve all dloush documents in the form including a supplemental to the property lease and supplemental property lease and other markets to the prior sale this ordinance approves the preliminary official statement back to the board prior to the sale the certifies are delivered to the supplementals again, a trust agreement property lease all which were dictated may first 2009 there leased property is secured and related agreement are in the laguna honda implementation that serves as a seat for outstanding series 2009 ab and 12 a which is why their supplementals to the original document the lease property is located on laguna honda an evaluation of 5,001,934,000,000 and has a capacity of three hundred plus Million Dollars to, available and the proposed authorization not to exceed 95 will be the remaining capacity the laguna complex this authorized total of 95 million is a 6 million that allows for flexibility and counts for interest experiences between the issuance and is use of funds the co p are not to be sold until 2017 it allows mohcd to move quickly to respond to marking conditions as the this allows the office of Public Finance to authorize the paper prior to the issuance and a authorized the kropz depending on the housing projects fund the Mayors Office of housing and Community Development will only allow the specified expenses ill be happy to answer any questions you may have. I have benjamin here with mohcd to provide more background on the project. Good morning, supervisors my name is benjamin the cfo for the Mayors Office of housing and Community Development were going to do go over a few slides to highlight some of the items that jamie mentioned as you may know the Housing Trust fund is set aside for housing approved by the members in 2012, the allowance are multiple single families and down payment and the assistance in order to address the housing crisis the last two budgets approved by the board have included borrowing against the transfused as loud the 20142015 and 20152016 aa o have appropriated money from the trust fund leveraging with an additional 25 million for 20162017 total of 75 million for housing uses as jamie mentioned the repayment will be from trust Fund Allocations this shows the summons with the cost of issuance and the marketing conditions bringing the total to 95 million approximately 70 percent of revenue is appropriated for the rental program in partnership with the hubbed for four promotions in those multi family piling e pipeline and Treasure Island and a portion of hope sf even though the rad project is underway the investment is not needed until rehab of each building because of that the phase one is the cropping fund is needed with additional cropping revenues in early 2018 or 19 those projects are underway and the ability for the office to move quickly and respond to the changes the market potential trick or treaters and borrowing costs were asking our approval so we can begin work on the projects ill be happy to answer any questions you may have. We have kate hartley director of housing to answer any questions. Okay. Thank you very much colleagues, any questions right now for staff okay mr. Rose, can we go to your report. For item 5 please. Yes. Mr. Chairman, and members of the committee on page 5 of our report we note summarized in table 3 which is on page 7 of the report the total Affordable Housing project development or estimate at one billion dollars plus of which the Housing Trust fund be contribute one and 79 million plus that includes 75 million from the cropping freerdz to construct a total of 3 thousand plus Housing Units on page 8 of our report we report that the requested not to exceed 95 million will be issued for thirty years assuming a one 83 million plus issuance and a converting 7. 5 Interest Rate the this will result in a total estimated design team service 200 million over a thirty year period the 200 and 13 plus total includes a one and 29 million of interest and 83 million in principle that is based on estimated afternoon annual design team service of 88 thousand plus we replacement not to exceed 95 million of cops will be from future housing fund we recommend you approve the ordinance. Thank you, mr. Rose colleagues, any questions. Mr. Rose question in your naufs you have a conservative 200 plus figure. That was an estimate by the Controllers Office. Okay real quick what are we seeing on todays market the cops. So most recent cops were around 3 and a half percent so 7 and a half percent is a conservative amount were allowing a buffer in the market over the course well decide. Colleagues, any questions for mr. Rose or the staff can we opening it up for Public Comment anyone wish to comment on item 5 seeing none, Public Comment is closed. Colleagues motion to send i move we send it to the full board with a positive recommendation to the full board. Mirena burns call items 6 and 7. Item 6 resolution approving the figure it out amendment for the probation and the leaders in alternative for the reoperation of the Community Assessment and Services Center to increase the policies monument to 500 million plus and located on 6th street for the adult probation at 71 thousand. Okay. Thank you very much i know we have a number of people to speak on the item. Barbara on behalf of supervisor kim the experience of items six and seven i want to give you a little bit of background in regards to the cardiac as you recall the board of supervisors approved the realignment in the communities supervision Implementation Plan part of the plan to develop a onestop shop or center for individuals with criminal histories and the collaborative practice two r between probation and Community Services you know that are models ballistic the Mental Health and we have the department to provide Details Details on that contract one of the reasons we want to go ahead and sponsor those two items was for the most part make sure there is a reliance on the Cast Services we believe the authorization of those two items will do that i want to share im sure our budget analyst will address this that since the budget legislative report coming out came out since that time to now real estate and the provisions have been working with the analyst to make sure that the maementd the analyst proposed are incorporated we come to respectfully request that body entertain the amendments and hopefully their acceptable those amendments speak have to me in regards to Good Governance giving the city the opportunity to leave the lease should they find consolidating the properties the city is getting an out if necessary the second component better loin this to the Capital Improvement plan that we have that is substantially being going through the process of figuring out the next steps in looking at added real estate and how we use to sufficiently. Just to be clear a request to amend item 7. Yes. File 1602 and should hopefully have a copy of the draft with underlying the changes before you. Okay great mr. Rose, can we go to your report. For items six and seven and. Yes. Mr. Chairman, and members of the committee on page 12 of our report we note as shown in table 2 the citys rent payments under the proposed lease are 8. 7 percent less than the citys reimbursement to the Administration Fees under the current lease in table 28. 7 percent reflects a reduction of 80,000 plus the first year on page 13 of our report the report that the proposed amendment that is under file 1608 not to exceed 802 million plus from the Million Dollars plus to 11 million plus and thats for the one year extension as shown in table 3 on page 14 of our report on the bottom of page 14 we note to the rent to be paid by the city to pb b for 6th street over the 10 year lease is 9 million plus that is shown no table 4 on page 15 and in addition the citys Real Estate Division estimates one Million Dollars plus in operating costs including the securities for others costs over the 10 years the total cost is 10 million plus on page 15 of our report we report to you that previously we submitted a report to the budget and finance committee this was on april 30th, 2014, that the Adult Probation Department provides programs at the 6th street that or similar to the programs provided by i did Sheriffs Department on oak grove street so for that reason we have made recommendations proposed amendments for our consideration on page 16 of our report first, we recommend you approve the figure it out amendment between the Probation Department and lc a and thats file 160782, and, secondly, we recommend you amend the file approving the lease between the city and d b d for 464, 6th street in that represents to amend we request that the Capital Improvement Plan Committee evaluate the alternatives to the probation long term lease for the facility as part of evaluation of the Sheriffs Department and Adult Probation Department and incorporate those with the city Capital Improvement plan open capital plan and the second part of the amendment to states the Real Estate Division and pb b the landlord have arlgd to add a cost providing the city with the right to terminate the lease with one weeks in inspiring on june 30th, 2018, finally we recommend you approve that resolution that is file as amended ill be happy to respond to questions. Just to be clear the sponsor is everyone accepting of those recommendations okay supervisor yee. Yes. Thank you thank you, mr. Rose for your report. Im glad that you rent will be reduced i just have a question in regards to the existing structure before the new lease theres on page 12 of our report i dont know who is going to be able to answer that but im looking at the chart of table 2 and dollars the rent page of the landlord and then the city Administrative Administration freeing fee which looks like a close to 15 percent he guessed guess somewhere around there im curious is that a typical structure where the city the fee and whats the fee do i mean who what does it pay for. I will or i want to clarify for the committee the real estate low respond supervisors this is a the lease between the landlord and the nonprofit so this never came before the board of supervisors the budget analyst never analyzed that previously i want to clarify that and let the department of real estate. So as state the administrative fees although a city lease is the Service Provider and the landlords master lease between themselves we did reimburse that our leases dont have administrative fees sometimes they do it is rare when we 2340r7 one it is usually because tenant improvements for the capital plan and lead certification they have to help the department or the firm get to that point it is based on the ti cost or the improvement costs 19 it can, an onsite manager that is required by the department to be there to either for the Service Provided or manage the building in those cases it is rare in my short temple you are or my assistant to real estate ive only seen one administrative fee a 5 percent fee for ti and recertification that the department will have handed. In this particular contract i guess what does it pay for the prior, the prior again there is no administrative fee in the current the prior i can only guess i dont know what their negotiations were about back then but assume since tis that pertains to them. And can you oh, we have someone from the department. So i can understand the ti. I thought it was Treasure Island. My name is learning the director of reindustry for the adult probation i want to clarify as part of professional Services Contract an indirect rate the indirect rate for the rents 24 7 l cac and the landlord was 15 percent youre seeing under 21,000 is the indirect rate for the tlc. Okay. Interesting. Im sort of so glad were not seeing this anymore it is seems odd the indirect rates we just pay basically a monthly rent or whatever how you pay 2 i cant see charging 15 percent. Sure it was part do you want to speak it was part of original negotiation were looking forward to the next phase that a much more favorable lease and taught department of real estate. Thank you and again, i would question is more if this were an ongoing cost i hope that real estate will look at more the clerk will take the roll with other structured leases unless people can explain why their charging in this case one and 20,000 a year to receive point of privilege e pay rent. Im diane the director of finance currently the lease resides in the Service Contract and excuseme. The Services Contract pays for administration of lease and so it was a past due and were currently trying to separate the lease which will at this point not have an administrative fee and a service of 80,000 as a result of the change moving forward well no problem not have an administrative fee for the rent. So im uncomfortable why would were moving forward and not charging the one and 20,000 fee also you dont need it i really not understanding i ran nonprofits and got money from grants and we pay our lease im not sure we ever did that i understand so basically l t d was charging to administer the costs of services so, now were moving forward with removing it from the Service Contract it will not be an administrative fee. Okay. I mean again, this is sort of past history at the point we need to go look at that piece more closely with other types of structures and not discover is after the fact thank you very much and again, people i want to make sure that has nothing to do with with me not wanting to support this. Thank you. Okay. Colleagues any questions or comments okay kansas Public Safety Emergency Services anyone wish to comment on item 6 or 7 okay seeing none, Public Comment is closed so colleagues, we have amendment in front of us and amendment by mr. Rose like to entertain a motion. Through the chair i believe the amendments are for item 7; correct . And i want to make a motion to send forward item 6 i move we send it to the full board with a positive recommendation thank you very much colleagues item number 8 is sponsored by supervisor mar who is a few minutes away so well go into recess for possiblyarri all right. Everyone welcome back were out of recess i want to announce that supervisor mar that is replaced supervisor farrell on the committee and hopefully joined by supervisor yee and madam clerk call item 8 please item 8 a hearing on affordability of health care for people with disabilities a sfbz and requesting the Adult Services and the longterm report. Thank you and since this is a hearing called by supervisor mar im going to turn it over to him. Thank you chair tilly chang. Thanks to mark farrell for allowing this hearing to move forward im working with a geo of seniors and disabled organizations and this hearing an sfooblt of home care for seniors and senior disabilities it is a need for Better Home Care for thousands tens of thousands of what we call upper poor seniors and disabled people i want to acknowledge this is out of 5 years of analysis organizing and advocate for senior and Domestic Workers organizing a number of us gathered with thousands of seniors and Health Care Workers in Million Dollar in 2011 and we kicked off a campaign and the best frame from a gentleman the authors of dignity preparing for the elderly boom in changing america last year 33 she visited San Francisco and many cities around the country i think she advocates for a holistic that is transformational she talks about the aging boom and the senior boom not only in San Francisco but cities throughout the country and advocates for helping the sick and people with disabilities in a way that transformers policies not just locally but nationally so we improve the quality of life as people age and people get sicker at different time and people with disabilities as you may know the baby boomer like me and others it is rapidly our population is angling over the next 25 years we will double the senior population in San Francisco the association of the area government estimates that the San Francisco bay area the senior boomer population is double to be by 2010 to 2050 double the senior population is 21 percent according to the dos and the Controllers Office report and association of area government our senior population and disabilities will increase from thirty to 40 percent over the next decades our challenge is creating an aging Friendly Center and 80 a strategic to keep up and transformational policies that addresses the needs of growing seniors in our population in our city we need institutions that nonprofits and grassroots to help to create more amp in process to call ourselves a friendly city this is a growing issue not only here but nationally hawaii has subsidize home care for thousands in that state and relieve the burden on many families and well hear public testimony if seniors and people with disabilities and families how they grapple with the demographic change and the stresses on many of the community so similar i directed the budget analyst to conduct an analysis for helping seniors and people with disabilities keep pace with the private home care and as our friends across jaushgsz coalition and jobs for judges and many others are fighting for living wage protection for Home Care Provider and make sure that everyone that needs care has access to home care many dont have the funds but to acknowledge that our challenge in San Francisco amidst the rapidly growing senior and disabilities popping to create programs that keep with the boom and especially with people with disabilities that are poor and unable to afford home care and others needs well hear from dos the Budget Analyst Office as well as the Controllers Office who will present findings from their report and reports if our amazing Long Term Care coordinating council dos will present on the services for seniors and people with disabilities who need home care hss for the dos Needs Assessments for the homebound seniors and senior disabilities as a distinct population with a great unmet needs and 1234rz will live alone according to a report the budget analyst will present today, the status. Options for health care with people w people with disabilities and the figures of how many have need for home care and currently not receiving that gap is huge in our city and the Controllers Office will present on their report for the long term coordinating council is the routines if focus groups what the seniors quote upper seniors not eligible for i hss are in need cant afford their care before we call the different departments ill acknowledge the Grassroots Coalition with worked on that program well proposing at the end of this hearing it is really key the work of senior disabilities action the care council the new Grassroots Coalition and is members of dedicated Fund Coalition that are advocating for a ballot measure in november that includes a steady and healthy stream of funding for seniors and people with disabilities programs also, we have been striving to be a friendly city ill say this one hearing and this program were promoting is one part of big bite to make us an aging friendly city in San Francisco the board of supervisors and the Budget Committee knows weve delivered the home meals to end hunger over the years and lots of other promissory notes programs we need to do more and late last year, i had the pleasure of going to with the meals on wheels one and 8yearold woman named ms. South gate shes twice my age and living alone bus of amp in pl e meals on wheels and there are tens of thousands of seniors and people with disabilities in our communities that currently need and cant afford home care this is what had hearing is about one of the recommendations about this hearing especially from the budget analyst an idea for a Pilot Program my office has been working with the longterm care council to follow up with this recommendation youll hear a proposal for a home supported program weve identified the council has made that a top Budget Priorities and finally thanks for the seniors and people with disabilities and caregivers the room and speaking and telling their stories on we as a city can meet the challenges and opportunity before us i want to start first if there are no remarks from my clearances and sherren with the department of aging adults. Good morning, sherry and supervisor mar i want to thank you for the opportunity to speak at this presentation for our bringing up this important issue i think dos has focused on protecting population of seniors and people with disabilities but due to your Needs Assessment sea at fact as we the department on aging are responsible for preparing for senior disabilities were aware that people live below our population who are really in need of Home Care Services so weve been paying attention be a little bit more attention to the upper core weve had studies we been involved with that the longterm coordinating council we started to Pay Attention to this group and part of our concern is why wet in addition to the Long Term Care coordinating office at the Mayors Office to look at the needs of upper core today, our presentation will focus primarily on the departments current role and then following me the Controllers Office will present its study on the dos request that will be focused on the report in general the majority folks higher their own home caregivers theyre in the dependent prior mode they hire their own caregiver our current caseload is 2 three hundred thousands clients a total active caseloads we saw more the 2000 but we can also is that San Francisco has a very high penetration rate our percentage of clients ref hss services in San Francisco a percentage of the total population higher than any other county on average the clients receive 22 hours of care each week the maximum is 200 plus a week the 420 million the cost is primarily wages and benefits and the citys share of the hfa is 79 million about 1 percent of total cost so you defined seniors as 65 years old and old or 60. For in home people with requirement regardless of age yes seniors are 60 and older but this is a program for people at any age. So i was asked to talk about a pilot we did as i said before in home support is focused on the medical population and people that dont qualify for the in Home Services without a share of costs so individuals can opt to pay a share of costs for the program if theyd like most people opt out because it fairly expensive so a number of years ago i think the early 2000s there was an advocate group that came together and said we have people above the threshold that need home care cant afford to stay in San Francisco we may not be able to stay at home or forced into a nursing home facility we start a Share Program to see if it will work for people above that threshold to get in home support with a little bit of help from the city to share the costs the promotion the budget for that share was that hundred thousand dollars we didnt have a huge amount of money but again, a pilot we served 75 clients in that program during the existence except for 08, 09 with an increase we middleincome out in that pilot we had certain Eligibility Criteria not serving just the total but people that had less than one thousand dollars a month had to have a need for personal care assistance and not just you know they didnt have to have help with getting to the Grocery Store but a personal caregiver in the home and not receiving a subsidy one of the key barrier is rent so also the client had to meeting met auto other medicals and had to qualify for medical we subsidized 70 percent of share of costs and the client was asked to pay the remaining thirty percent unfortunately due to budget cuts we were unable to continue the program were hoping to turn a lot it to an Ongoing Program we hit the budgeted issue we remember there we were forced to pope move people into the other situations we were fortunate it the Community Living fund absorbed some and unfortunately, some we were having to tell them well not share the costs anymore. When did the share Pilot Program end. In fiscal year 9, 10. So the main lessons we leader was rent was the main barrier to preventing cries to pay for their share of costs developing the Eligibility Criteria and the prior system was really challenging we had a huge wait list i think of seven hundred and 50 people for this share of cost program we didnt have is that so figuring out who had a higher need was challenging i guess the other thing we did we end up doing a first come, first serve well have to do a better way of compromising and the program is complex there were administrative issues there were reconciliation the subsidy was confusing and these weight loss management was confusing if we put something in place in the future well have to figure out i think supervisor mar mentioned he was having an ethical problem first come, first serve well have to figure that out first i want to switch to the Community Living fund it prevents unnecessary institutiontion and helping those in long term facilities as you may know it a mix of Case Management that sweet spots people it would be a variety of other services that hope people stay at home im not going to go over what the Community Living fund but the eligibility threshold it serves people that hundred percent of poverty people up to 35,000 for a single individual the asset for 9,000 for a couple it was trying to get at the you upper core population and the needs that have that population in addition the individual has to be at risk of imminent institution so just focusing on the home care purposes clients per year in d o fs it three hundred and 56 people and total sorry ill talk about home care so the total with a purchase of service is one 70, 48 percent of clinic tell in that program and three hundred and 50 clients with in a Program Every year for the home care purposes co f covers the ineligible while theyre waiting to get it in Home Services on average 17 clients get home care each month and 40 percent it every year it is the cost is about private pay is 30 an hour and the afternoon month per client is 2,300 annual spending 432,000. Could you repeat that amount. Three or four hundred and 32 a year for those clients that receive oscar so those are basically the two we have 23 thousand people and co if is smaller the two basic home care programs that dos has i want to highlight some of the Caregiver Support Programs we have i dont have the details i only want to make you aware the first is family care caregiver support that has for Informal Caregivers so 3 program can send people out to homes with caregivers they can talk about things for conditions and the Respite Program is small but important another caregiver is a big deal so being able to assess that respite is important for caregivers we have the village model supervisor mar i know your familiar but basically a Membership Network that provides peer support to the members and obviously volunteers support is really important for People Living at home for caregivers who may need to get out and get a break or cant get away from their caregiver diets go to the pharmacy and things like that home delivered meals are important often this is a really important addition to Home Care Services especially someone didnt have enough home care hours it is helpful to know theyre able to get access to the home delivered meals and medical has a resource hub this is because one of the things a big issue for people aging out of the new architecturally they can assess the in Home Services when they turn 65 no assess for people under the 65 Affordable Health care medical but when they turn 65 that asset kicks the thought well, people get medal; right . But the problem that didnt make up for the care giving that was not taken care of in legislation and people say that was done for a reason but it is an issue people age out and all of a sudden their 65 and cant assess home care we have medical counseling staff which is at 2 golf i have to say that were also having our grand opening april 13th at the 10 00 a. M. Were excited about that but one of the things were doing is helping council as they age out of the medical benefit we can help them figure out their assets and apply for and assess Health Insurance and then the last slide i wanted to point out to you that i know youve probably had a chance to look at the new assessment it is dense i want to point out one slide the San Francisco seniors are likely to live alone in all thirty percent of our seniors and thats people 60 plus live alone so that has to do with with the need for home care in San Francisco i think thats the end of my presentation unless anyone has any questions. Supervisor yee. Thank you for your presentation and we do have quite a range of Services Even though it is inadequate one thing i do i dont know. I had to go be a caregiver for several members of my family thats not here anymore but the one of the things that was crucial for a lot of us out there that are not working and trying to figure out just want people qualify for it didnt work for me trying to figure it out i eventually had to work with selfhelp or people that were counselors to guide you know the people that we have to care for whats available to them and assess this i think i wanted to mention that i think that is an Important Service that sometimes doesnt get mentioned so i know i agree i think one of the things weve tried to do to integrate the Public Services together with one number to call thats why i mentioned 2 golf the hub for seniors and people with disabilities it is complicated we have la jolla it is hard to get information out were 123457b9 trying to find ways to communicate with people and get out the word to come to one place to get information it is hard an ongoing struggle. And it is and i appreciate the complexity of the notion we want to keep our people in their homes as long as we can as most of the people know this already but for lioners one of the worst thing to lose move a senior from one place to another they get disoriented and theres a loss of you know selfi guess that happens versus and then the complexity of that is that youre trying to keep them there but we need to do isolation so sometimes those to things are a relationship between the two i dont know what a the balance is for home caregivers i dont know the solutions or ingredients that can help that balance i think that was supervisor mar mentioned the meals on wheels and i also was able go to do a delivery that is another element or as people are delivering theyre actually become friends to these people that recipes of the news and i realize that a lot of time many of those folks are isolated they appreciate talking to anyone. Thats one of the key exponents of the meals on wheels the delivery people are the eyes and ears for the podium they help to mitigate some of that isolation. Thank you for all you do and thank you. I really appreciate the assessment and but focused on the numbers and by 2030 adding more seniors graduating into that program and the programs what we can do to fill the gaps thank you. The next speaker is from the Controllers Office i forgot to mention i want to thank you for all your hard work rachel from my staff and kate meier. Mr. Reilly. And thanks to the Controllers Office for really focusing on the numbers as well. Thank you very much my name is mike reilly a project manager the city performance unit of the Controllers Office a section within the City Services let me boot that up. So weve been involved that the l t cc by marie and joe a number of years ago when living with dignity report came out putting numbers on some of the fiscal monuments citywide across the city and the issue was what else can use analysis and Research Work it took a year or two through the policy working group of the l t cc our Stakeholder Group we autopsy u came up with the idea of middleincome what is the size of this group first get our arms around the demographics might be before moving on to the needs of the group we framed the question we did 65 and older how many seniors over 64 and younger deputies with disabled were ineligible for medical and our at risk not being able to afford the home based care ill be using the term l t c but for the purposes of home care this is broadly how we framed the question so we went about trying to describe the lower bounds it was a little bit easier the medical threshold including the income disallowance that allows a slightly higher than for poverty but 14 thousand plus and a couple higher the upper bound we find a discussion and ended up using the economic index which is for many years accepted as a good way to say what are the real costs to San Francisco not just users the Poverty Level it is a National Figure we utilized the shorthand called the elderly index that has minimum income needed in San Francisco and sometimes Health Sufficiency by a couple or two households available then we looked at turns out the inside center the elderly index with usa so we looked at those packages and tried to update the numbers our methodology was to get it as closed to the current we used the 2013 elderly index and the 2007 elderly long term consider packages and used our own jauflt to get it up to the 2015 costs im not go through all them but this is at upper the medical and the that he bottom this is the upper bound and we actually were able to get it to 6 different categories with a single couple or an owner or renter those categories matched the elderly index and matches the contents data we were able to have benchmarks and an example is one of the categories is renter would need 30,000 and plus on top of an additional 9 thousands to 55 thousand to pay for the Long Term Care costs depending on the level of need what i mean dont think on the level this is this low level, memoranda and highlevel of care we looked at our own 0 local model but use the index model the low level is 6 hours a week of personal care for a homemaker and 16 is the lower and the higher is 36 hours the Service Packages there is a health aid and a monitoring device, there is a couple of lower costs services in those packages theyre not just be personal care but the permanent care is the biggest dollar item so that was our upper and lower than we applied to the population consensus and the budget analyst used the same source of the data the American Community survey we used the 2012 and the 3 year sample a data set called i promise. Supervisor yee has a question. Im sorry. Im listening going back to the income thresholds like the upper bound ones the lower lovely care for renter is 39,000 what did that represent sort of the upper. Yeah. As you can see on the renter line the elderly index is thirty thousand and add another 9 thousands if they need l t c care the thirty plus 9 a 39 thousands plus thats the number one needs to survive yeah. And we worked about how to frame this the way we framed it if you dont have that level of income youll have trouble paying yourself for the 39 thousands youre a renter with a low level of needs people that make 39 can afford outofpocket. Mr. Reilly just to be clear the lower level is lows care and medium at 16 hours is roughly 2 hours a gay dda of care and the higher is 36 maybe, 4 hours a day those are those are the various levels of care. And sometimes 6 it is split between two hours at a time every other day or Something Like that. The situations are different actually, i worked on lining up an agency for my parents 5 days a week back to 3 days a week but coming everyday or 34 or 4 days a week. Mr. Reilly can i ask any reason why the Controllers Office cant add in disability into the numbers i know the dos numbers are higher but 65 years and older is there a reason the dos numbers are higher and we included the disabled we did everyone over 65 thats the defense in the report senior disabilities we did everybody over 65 and the disabled other 60 we have disabled in our disabled and over 65 youre in the larger group. Okay. Thank you. So again, we pulled the consensus data the key data matched our 65 and over and 18 with anyone or more disabilities the housing situations are the renters and if theyre not institutionalized a smaller amount that is institutionalized Human Resources heres results from the data pull we did so the total population of San Francisco adults again, this is 2012 data is 6 hundred and 99 thousand senior disabilities this is old not just our study group is one and 1 we do note of the one and 44 thousand plus are one to two person households that is a number ill explain in a moment and lastly the end results of the data users the upper and lower bounds we have for lack of a better term senior disabilities or upper poor the amount that are at the low level of care not need the care but who are at risk of not afford it and incremental if people need a memoranda level of care 4 hundred thousand plus and the higher level of care 4 thousand plus at risk of not being able to afford that cost. So in a way we use the europe bound as a on top of the upper range but it is regretting who is at risk of not paying for this care the grand total is 45,000 depending on the level of care as you can see on the different shades of blue back to the senior disabilities how does that group look and in the total did you want population this is the key end results people are get our heads around so the gray up above people with the methodologies will will be able to afford the cost of care. Youve seen the abag demographic for the bay area moving up to 2015 whats your assessment of the growth of people in San Francisco. I think dos had that the early population it is continuing to grow and the over eight hundred 4 proportion let is growing the faster but the younger population is growing fast people with disabilities under 65 was also has healthy growth in that area. Supervisor yee. I think this percentage is one thing but as the population grows it is deceiving to talk about the percentages it the actual numbers that are important to me. This is how the two different groups the largely and the steady population distribute in terms of income see it is not a surprise that most of caregivers need most of population on the lower income range the gray bar is all senior disabilities and the blue is in our upper category so the greater st. Jude the 4 to 10,000 range the steady population slightly it is a higher memoranda income in the 10 to 15,000 range and the tail that going out goes to the distribution. A couple of teachers rendered make up 47 percent for the upper memory income between the equal mortgage 25 percent and those who own their homes with no mortgage is 28 percent. Age and gender having a charger showing the ages not streeps when you get to 64 this is the aging 64 disabled and jumps up at 65 which the methodology is everyone 64 and older so naturally jumbled up the gender is slightly higher for males and where women outnumber men are 60 percent of the population over 65 on race and again, this is using what we have it is different then the consensus categories it is how the study Group Population end up in terms of race white 50 percent and others africanamerican at 9 and latino at 11 i think nativeamerican is the gray dot not legible compared to the greater std it is less Asian Pacific islanders and slightly less latino on the next slide with languages we wanted to show the full delay i made copies english is the largest language and chinese 16 percent and stacey pen percent and a variety of other languages again, some of the same trend it race the middleincome or upper part is slightly higher it is a greater proportion of english in an the greater population. One of the limbs of our study is elderly age doesnt have 3 person incomes we found did analysis on 3 plus households the strategic is more language diverse so those statistics on the last two pages are one or two possible households. So the asian and latino may have more one or two people the households with an elderly. It got tricky so make assumptions so a family relationship theyre supporting poem i think it is 3 people outlining together that may not have a connection so we had we thought about the assumptions of the 3 person relationship we stayed away from that for now. Our conclusion the size at risk of unable to afford the care and not quality is between 45 plus depending on this level of need this is a high estimate with the households who is at risk because we know not everyone will need Long Term Care that is everyone is that at risk one figure that in the deducting and Human Services uses up to 70 percent once you reach age 65, 75 person of those people will need Long Term Services this might be high in that regard more surveying or modeling will be required to get a specific population that needs the care and try to predict this services this is something were talking about doing more work on we do supervisor mar i mentioned the focus groups the report and analysis i just wanted to give you a brief overview using the l t c weve had the fitness groups 7 groups held in december and january 51 participants the average size is 7 and simply the groups chinese and spanish translations one sneak peak the consultant has given us so far not related to home care but a majority dont have l t c insurance Long Term Insurance to supervisor yees point they struggled where to get credible information and sherren talked about the one stakeholder source who can guide them on medical it was interesting that came up especially in a group i participated in their common niece is a list of things that came up with help around the house and transportation and socialization and daily living and housing took up a lot with access to health care i stop here to say both of the people in the groups were okay. Right now in stable situations but that on of the scenarios we didnt talk about think about the future and what might happen a section on interrogating scenarios of what theyre concerned approximately, one third go with a spouse or relative for the income categories they have friends and family and theyre in relatively good health who will take care of later the common theme were not expecting Food Services theyre willing to pay a sliding scale i think that is a key issue people are willing to pay but whats the appropriate level for the share of costs and that recorded is coming out will be presented at the 12 council. Thank you. I was going to comment the majority not having Long Term Care insurance i think this is the awareness of cost home care and grapple with that with my mother and others the family not having Long Term Care Insurance Company but this is really helpful im looking forward to the final results thank you now we have pa ma toyota followed up by a short comment from the Mayors Office on disability i want to thank those from the budget analysts office. Good afternoon supervisor mar and supervisor tang and supervisor yee im from the Budget Analyst Office we want to point out that Julia Metcalf is one of the analysts but la toya will give an overview. Thank you. Supervisor mar and members of the Commission Many thanks for having us to present our findings of care for the seniors project so supervisor mar asked your office inform a key question what are it in home options available for seniors how many seniors are assessing home care and unable to assess the services. What is the impact of the minimum wage increase on the affordability of inhome skewer in order to answer the questions we had to estimate who are the seniors that could need in home care in San Francisco we used the American Community survey to estimate the number of people who are 65 years or older and recorded one or more disabilities including health care and independent living difficulties and through that we leader there were 37 thousands plus seniors who are at risk of institutionalization if they didnt get adequate home care that is an conservative estimate trags the researchers uses the selfhealth care but this conservation of conservative estimate will talk about how many seniors the population the first question with what are are options for in Home Care Services in San Francisco there are a variety of onramps options and range from family and friends to the most expensive options Long Term Care insurance or formal private care and then the two local programs are the in Home Supportive Services hss as well as the Community Fund im going to go through the next slide talking about them in depth but the medical program and is aging services is a big program are 419 million budget with 78 million the city funds and the rest is by the federal and state there are eligibility requirements in addition to being enrolled in medical you have to demonstrate a fundamental needs for in home care and assigned Health Certification so quite a few of the steps for the seminars to access those resources, however, we know that quite a number of seniors have been participating as of june 201522 thousand complies and seniors were 44 percent of that client population the i hss has a visual program that people are making use of the Community Living fund is a much smaller program it is administrative code by the Department Department of San Francisco aging Adult Services commission and the 3 housing unit 6 million was permitted by city funds it is narrow the focus is specifically geared towards people of premature institutionalization you have to demonstrate those financial things that lend to the i recollect medical needs this one interesting aspect of this gram we found was that the income eligibility threshold is for march genus up from the Poverty Level and slightly over 35,000 in 2016 and it is the cut off look at a lot of 14,000 per year we are the key vmd and home care is go expensive and to answer the question we assigned a benchmark to figure how much income do you need to live in San Francisco and mit has a living wage they estimate the minimal average he need to live in cities kugs it is 30,000 a year thats a bare bone and adding it in home care at the minimum wage it is 11,000 plus dollars together those two costs will get to you 42,000 per year thats the amount of income to be able to afford in home care at the minimum wage if you look at the red doted line the average annual income of senior disabilities in San Francisco that you can see that you know the cost of inhome care at the minimum wage rate is well beyond the need of seniors if you compare the average income of senior disabilities for the private care it is more out of reach so that is clear again that the coz cost of inhome care is high we know a number of seniors that need this type of resources and many that can afford it within the low income population a portion of poem that can access local government in order to help them but a group of at risk seniors that are at protecting but not qualified for Government Support for those services those are the red bars 14 thousands at risk seniors low income not poor enough to qualify for services so the city has a number of options that they could pursue to address this issue the most sort of you know natural declination for a subsidy for the entire population of over 14 thousand seniors that costs the city Million Dollars per year those costs were estimating users the administrative costs of providing i hss this is exactly the cost structure of the program our recommendations will be that the citywide either target resources to either the poorest first weve divided the population into different incomes 20 percent depending on the Financial Capacity or another targeted mechanism will be to give resources to those who need it the most those who have the medical urgency we do that that hsa and the practitioners the city will be best suited for this strategy in terms of other options we think a Pilot Program will allow the city in addition to providing in home care for options for and that could include in home modifications where maybe you can install a grab bar just to modify the homes so a senior can live independently without having a caregiver go to the house each week another point to set annual target and evaluate the process that is important to know how many seniors are at risk and how many of those seniors are the city servicing e serve this way to have a yearly target a way to measure platform we at this time that the Community Living fund was a great option for a Pilot Program we have expertise in this area and flexibility implementation option especially in terms of the income goikt a very big barrier and then beyond the boards review we think that is important to reach the advocacy at the federal and state it advocates for tax credits for people that are taking care of the seniors so thats the general overview of our project and our finding ill be here to answer any questions you might have thank you. Supervisor yee. Thank you for your report is there a reason ive i guess thats not the purpose of study is it difficult to have information to the cost of if you dont have enough help at home the next thing urge have to go into the institution necessarily and so i guess what im trying to get at the cost of helping people stay at home versus the cost of being institutionalized id like to see some numbers in terms of the costs of being institutionalized and so my guess we can make an argument what is cheaper to help people at home with this program rather than institutionalized them for the report to be complete that would be helpful to say look at this. Question have that comparison in our report i can i cant find do number now but the cost of a institutionalize is far beyond the cost of inhome care. We do that does the city is there city funding that is effective when one is institutionalized. We didnt cover that was one of the questions we were asked to address we didnt cover the institutionalized care i think that is, you know, there are maybe people from dos can better answer that question than we can. Yeah. Again, it is just i realize this is not part of report but it would it would be nice to have that information it is going to cost a lot more institutionalized the second question how much it mr. Cost the city i guess it will cost the city more it makes logical sense to have a greater urgency and im talking about pure monetary cost is is also the costs of what it does for it senior to be institutionalized. I think the dignity Fund Coalition to the care council to care across the coalitions have good stories and data on the cost of institutionalization but the worst Health Outcomes on institutionalization versus other tech supportive systems hopefully that comes up in Public Comment i want to thank the budget analyst and for fuller information the future thank you so much i think we need to move to the comments and report from the Long Term Care coordinating council and ask if cynthia and others are here. Looks like marie will present with jessica. Thank you yes youre right im marie im representing the longterm care council and doing it along with another member. Jessica im wondering im not sure our presentation is up. Mroung. Thanks to the coalition ladies. Thank you very much so as you may know the issue of home care is a major point of discussion with the longterm care council for a number of years we were really pleased that the coalition that formed to really look at this Program Support at home brings the coalition together we look at how it works and bring it to the council tor for supportive question voted to make that a priority in other words of budget for the current year a lot of discussion why home care is important so it allows the seniors and people with disabilities to live denting it keeps us healthy and active and people mentioned isolation is an increasing reflex bad for our health and keeps people from being isolated and helps. To care and leave home with support the other thing the law of the land is the americans with disabilities act it requires that government provide options for people to get the care the most integrate setting in their homes and community and home care is a critical piece of making that happen so what is the need well, this board of supervisors and the mayor for the last 20 years worked with the community to approve the hss program there is benefits and Additional Support and consumers have options and can get mental support and use the registry the i hss program is a model but it is only a model that is available to the lowest income people in San Francisco and for that next group the upper core and beyond their locked out of that assessing what is a model system so i think what were talking about today is being able to open the door wider to provide for assess and support for the low income seniors and senior disabilities to stay in their home a and it will take people are bare barely hanging an and at home tens of thousands of dollars more if they dont have it little hope for folks we want to bring that to the city it is a Great Coalition is formed is to get us to the point there are the names and some of the groups are members of the Council Groups representing the disability and the disabled and the Employment Opportunities and ongoing so w a very Impressive Group of folks thats an partial list im pleased that you mentioned the initial share Pilot Program planning for the elderly was the group that got it started many years and ms. Hale was the strongest advocate im proud the senior and disability successor has helped to lead this campaign im going to turn it over to jessica now to talk about what were asking for thank you okay so we are very excited to tilt present a proposal for a program that we think does address this need and based on the coalition we think we have a lot of great heads at the table with decades of experience and talked with individuals effected and included are government bodies and last week to present what that program will do the basic idea to subsidies the cost of home care for upper poor senior disabilities and a big question who will be eligible for this and so we talking about looking at both the needs for personal care and financial needs thats been mentions to prioritize well look at those two pieces together were thinking people that benefit dont say home care or only able to afford a few hours a week the upper income there be 60 or 65 thousands that is based on the figures youve seen about the income that is needed for an average amount of home care or make sense to tie to the medium income that number can say worked out and a sliding scale respond that makes 50 thousand a year and may only need a few hours a week modest pitch in a few dollars for home care with other help theyll get the care they need and like to to be a simple assessment for the administrative cost load and recognize the economy how does that work were proposing to serve two groups the first group is those who quality for i hss but have a high share of costs they cant afford youve heard from sherry rev rethat many people that have this opt out of the program altogether so this assisting the people to help with the share of costs tap into many hours of hours from i hss that the stated fund and the second group is the middleincome people that want to pay privately that is a splitting scale based on the rents or mortgage they have to pay and so this program will be opportunity through the is it fair to say so to get this program started we have estimated that we need 2 million in each of the first two years and a positive typo i realized we stemmed that will coffer one and 20 to two hundred and 40 people were hoping to get a big enough group in the first couple of years to see how that works to have a benefit the communities and so this is why we need 2 million not a huge amount but enough to launch the program and a key part of projecting program is a key evaluation component we see how to prioritize and who is benefiting we know how to expand it the future we now have clear data on the huge need for the home care substances with seniors and people with disabilities we have a plan weve prepared we have broad consensus from stakeholder that Something Like this is necessary and beneficial so we ask the board of supervisors and the mayor to take action to allocate funding for this supported home program in 20162017 thank you. Thank you. Any questions supervisor tang. Thank you, thank you for that presentation and you shared on the details of that proposal i think there is talk supervisor mar about the creation of a dignity fund so im wondering how it relates to each in terms of the funding and your thoughtful. Marie or jessica. Board Mayors Office whoever. So as you may know the Dignity Coalition is working hard to put a ballot measure that will create a baseline budget with the dos related to and will call for an appropriation currently were asking for 2 percent of property tax thats the way to fund what everyone has pointed out a growing need for services for seniors and people with disabilities home care is an important part of that i see no way to do this unless the city expand the money available for home care youre talking about hunger and a host of programs that people need as they try to find their way out of poverty in the city does that answer your question. I guess the proposal is obviously still pend but a thought if it passes or something that is supported and ignores forward it will fund this april program the funds. As we know with first, we have to make the pot bigger and have a good profit that is fair and open and transparency as you can see that home care is a big priority for folks so im not sure it will be considered by the board and everyone makes recommendations it is a twopart process. I guess i might be speaking out of turn here but in the discussions that has taken place around the funds supervisor tang you, your suggesting i dont believe there is any conclusion at this point there will not be i think it needs more discussion but you trigger a guarantee is another question for me ill ask it after. I see the the mayors director is here i dont know if you have anything to add. So we need the microphone. Im melissa from the Mayors Office weve worked closely with marie and andy and the rest of the coalition around the dignity fund and supervisor mar and supervisor cowen and looking forward to getting resolution in the coming months this the first time ive heard about the call for this hearing as a relates to the District Fund but i have the same questions and love to have further conversations on that. I the president to add as ive seen the drafts of the dignity fund not supposed to supplant programs but adding on top of existing programs and not back phil the existing programs if there were a Program Tobacco funded seen as an existing program but hopefully as a pilot there are ways to look at sports and expansion of Something Like that this pilot ill say there is an upgrade need for care at home this Huge Population of 14 maybe over 20 thousand people that need it we cant wait were here in the Public Comment in a few minutes. So with that, we have a couple of comments and a short presentation from the associate director of the Mayors Office on disability and go to Public Comment we have 10 speakers. Good morning, supervisors joann with the Mayors Office on disability the director for the public assess and frankly its my pleasure to speak with you on this important issue and allocation professionally and personally personal care at home is a civil right not a luxury not mean that a person who needs assistance getting in and out of bed, using the bathroom and getting dressed or meals prepared or cleaning their home actually entitled it is a matter of survival that is what civil rights are about; right . In addition the a. D. Under the home instead mandate specified that federal, state, and local governments have to provide services the most integrated setting possible that means ones home and for the past hour weve been talking about seniors who are fined as age 60 and older ill tell you a huge other demographic that is perhaps not as vocal or visual we think about the seniors contributing many years into society their left without assistance, however, their young people people with disabilities and many of them working in society right now and have to choose how many times a day they need to go to the bathroom something as simple as that or whether theyll be able to do their laundry or clean their homes in a particular day of the week those are no, not just the upper poor but sometimes the working poor the federal government and our social services and have not catch up with the demographic changes people with disabilities even gender disabilities live longer they age too in addition people are hiv ladies and gentlemen, lifesaving problems live to the age of 60 and recent studies show over thee quarters of people aging with hiv are over the age of 50 or so which means there be additional impairment and an additional function a person it goes through a lifesaving treatment often comes up with a beverage of side effects that limits their function ability folks with balance and difficulties with selfcare and those are folks not your typical 60 and over population now i think supervisor yee you asked about the cost of home care versus the costs of institutionalization and there are plenty of studies the primary focus why i hss was fund we dont have well take into consideration is actually that middleincome or that above the poverty line the exceptions has been if you need such a severe amount of home care youre not able to produce an income thats not true but there is currently no single credit allocated to a person with a life iconic intimidate outofpocket pays for disabilities expenses that is a case of a Family Member had a exact as well as being a breadwinner so for that and many more reasons we fully support this program and challenge the administration and your body to actually be on the cuttingedge of disability and on the cuttingedge of home care and services and support for people who need them regardless of age or income set example for the federal government i know that you had the opportunity to do that when you in 2006 i said the feed money of 30 millions for the living fund because this is body has understood for a very long time that staying at home saves a lot of money at the future about institutional tuesday costs but the Emergency Services engaged e6r789 that a person didnt have are support at home because of a fall or they simply cant get out now that i finished this formal modus operandi part of my presentation id like to take two minutes if possible to speak about my own personal experience and put a face to what were talking about i have at t at the for the for the most part that effects all parts of my body i am unable to hold my head or turn over in bed or use the restroom i know that is funky to talk about that in a public setting but i work 50 hours a week you are two children under the age of 10 im married and stay at home i make a middle manager City Employee living and yet after they take out the home care expenses for myself and some basic hours cleaning or laundry duties that i have to have services for other people to do or my poor husband our family will qualify to a belowmarketrate unit in San Francisco just take into consideration this is very real my personal supportive expenses go for about 20,000 a year for which you can deduct it as part of your taxes but not always easy oftentimes i use the minimum amount of care because i have the good fortune of having a partner but my duties as a mother, as a homeowner, as an employee severely gambled by my ability to care for myself and pay for the services i need you guys tell me thank you for sharing our story now if the chairperson allows me open up for Public Comment im going to call 5 names at that time, 10 names calling names for jobs for justice and from the hss and pam and also bentley if hes here and ashley from hand in hand and others from hand in hand and from the living resource center. Hello. Thank you everyone im juliann im representing just a for justice in the council two broad based organizations coalitions of labor and community the care in home program is incredibly important to support seniors and people with disabilities to live is dignity in their homes with the extreme housing crisis impacting our communities 90 in San Francisco this program whether help to ease some of the Financial Burdens of hundreds of families the communities that require home care this program has an Important National significant were in the mist of a huge baby boomer we have 4 millions american per year by 200050 some of us will double to 27 million but right now the system to support our aging parents and grasps is outofdate and out of touch that is costing everyone seniors are torn away from their homes and community, families are spending down generations of saves and the home Care Workforce that we rely on to care for the people we love make an average of 13,000 a year living many dependent on public assistants with our elderly boom Small Business should be a blessing we learn from each other and the question is how do we want to live as we age the time now is to invest in a Care Institution constitutional care force so our parents and grapples can age the communities now it 9. Is time for our government so support the realities of the 21st century the care at home is an important step to address those issues thank you. Thank you. Next speaker. Thank you can you hear me cool. Im the Community Organizer at dpirnt resource selfcenter San Francisco we strongly support of care at home im here to speak about many of the consumers that use home care our mission at the independent center is to insure that our customers live independently as possible home care is fundamental to that ability for most of your consumers but for most of consumers they have too often choose whether to pay their rent or go without food to pay for their home care nobody should have to choose between their personal assistance and theyre other essential functions of their living i want to second what joanne said about this effectively the working population many of our salaries were not for other programs will go directly for paying for our Home Care Services because that will be our major outlay and expectation so this program will give a lot of seniors freedom from having to worry about what to do and how to spend use their income necessarily and it will give a lot of the younger folks some flexibility in terms of choosing to go back to work or in order to put money into a 6th district at large we urge the board of supervisors to be in is cuttingedge of this issue and support this program. Thank you. Next speaker. Ill call a couple more names michael for the panthers and sarah for h. R. And marie. Good afternoon and 2u78d im the executive director of San Francisco in Home Supportive Service Public Authority i i want to echo everything everyone said we represent a broad organization to support this program and working hard and recognize the need for the gap of who needs to live at home and not meet the i hss requirement San Francisco supports all the people i urge you to take action and pit u put funding behind this fundamental program. Thank you, ms. Lee. Gamechanger my name is pam im today here to talk about being the parents of my parents years ago any father became ill and was not limited to to San Francisco General Hospital and after two my goodness months returned home frail a different man while i was away my mother showed signs of dementia impossible to care for him my father made it clear to me i want maine and me to stay at home we want to be together this is his request ive struggled to honor by being at home they remained a vibrant part of neighborhoods with the mailman dropping by to say hi home care made this possible the beginning their home care costs were 45 thousand dollars a year their combined income it 48,000 over time their needs i have no speaker cards with the assistance with walking and medical and administration cognitive care costs went up and remaining at home was no longer an option i had to move them to an assisted living facility outside of San Francisco where the quality of life is much less today both exhibit signs of depression she asks where am i when am i going home it is sad i failed to honor their wish i share so youll understand why San Francisco needs this program any struggle to keep my parent safe has taken a toll that will take another 3 minutes please support this program so elderly in their that Twilight Years can receive the quality care they both deserve. Thank you pam next speaker. Ill call more names. Next speaker. Im the person and im proud San Francisco and a member hand and hand organization. Im sasha a proud San Francisco residents and im a member of hand in hand the domestic employer organization. Ive lived in supervisor yees district for about 27 years. Ive lived in supervisor yees district for about 27 years. And im a member of the community and im a very active member of the community and went to uc berkley. Im from i may have not that i quality for when i had had math and i actually for me to be mobile volunteer. I have actually not taken jobs im qualified for when i do the math it makes a lot of sense to be a volunteer. Are along with any rents will make me poor. So with all my costs and my rent that will my home care. Sorry my home care costs and rent will make me fundamentally poor. I totally support can you repeat that. I know mine retired but it still effects my quality of life. And im heartbreaking i know my story. My story im sorry, im sorry my story is not as heartbreak as other people but it effects my quality of life. And if you want people with disabilities phobia fully the Community Something really good first step. If we want people with disabilities to be fossil fuel a part of community i think this supported home program is an important first step. Thank you very much. Thank you very much. Thank you. Next speaker. I think ive calls everyones names if people can come forward. Hi its me, im speaking for someone else again my name is sarah i work at senior disabilities action but today, im speaking on behalf of a gentleman that works with us who agreed to let me share his story hiss hes a caregiver for his husband he says i am a 45yearold out of work disabled man and a full time caregiver for any 73yearold husband with a Long Term Disability on top of that he was diagnosed with dementia two years ago my income from ssi sisters and my husbands income if is we receive a small monthly defend different. Current home was nearly foreclosed from mortgage payment we asked hope from the keep our home and negotiated refinance with the lender we last spring paid off the back mortgage thanks to the Government Program and get a lower Interest Payment our combined monthly income is 48 thousands from the medical and medicaid gap premium after those premiums our monthly income is roughly 44 hundred with the current wregsz your income level an amount of the retirement account this is more than we can quality for medical then we have other expenses home expenses and Prescription Medication were also working with the state it pay back late payments to the irs in addition, we have payment of Adult Diapers and cost of food he mentioned hes physically and emotionally exhausted hes his only Home Care Provider he fits into the upper poor. Thank you. And thank you. The gentleman. Next speaker hi, im michael from the california reliance of retired americans were a statewide organization and looking at it as a state thing it is obvious there is real, real programs with home care there is huge numbers of people needing is and not getting it perhaps youve seen carol louis crazy quilt of several agencies which administer in this very fragmented program a huge amount of work needed statewide in order to be able to give people what they need for Long Term Care, however, you have the opportunity to being able to do something locally that is easy, simple and could be very, very effective and giving services to people who really, really need it and dont qualify for it it is particularly appropriate San Francisco should do Something Else it is a tradition of healthy San Francisco and also necessary, of course, in San Francisco because of the living examiners are so high and people that need Long Term Care are in so much danger of losing their contract with their friends and department of Human Resources and other medical providers so this is a very serious issue and it is also one because if you get more people who would qualify for medical and hss but cant afford the share of costs if you get assistance to them they can get medical think of all the money the city will save. Thank you. Next speaker. Gamechanger supervisors my name is donna im from senior disabilities action were we appreciate our calling this hearing and you know debating taking action on that right problem were very strongly supported at home we hear stories consistently in our Office Members and People Associated with us that cant meet or not able to pay for home care people before me have testified eloquently about how expensive home care is and the depths and extent o extents of need for a program like this i want to take a second to read something short from a member of fda she falls into the category we quality for hss but as a high share of costs i believe i am portability by the end of the month i pay may 500 no rents a thousand plus i hss and pay for my medications and that heaves me with less than three hundred and month i forego necessities and spend less on food and not eating much and eating poor food that is cheap at the market and entertainment and a movie ive not done that for years so we feel like this is a program that can keep people from being completely impoverished if they have to meet a high share of costs and want to support this program and thank you for considering it. Thank you. Next speaker good morning, supervisors im a senior here mick my own plea to you for those persons who are going to try to represent myself as a senior im Beverly Taylor 84yearold ive been struggling over 11 years trying to keep my head above the waters financially and file number i takeover of my husband figure out added home because he didnt want to go into an institution and promised him when he passed i tried to get help you couldnt get it im still not getting it im still pleading and begging i cant get my medication and cant pay my utility bills most of times my house note is higher than my retirement owe worked 423 years Teaching School and 43 years taking care of the seniors i think ive earned more than im getting he plead you recognize what those persons to help seniors who paid their dues and give them more than you have been giving them. Thank you, ms. Taylor. Next speaker. Good afternoon, supervisors my name is my name is elizabeth im a client advocate i work for golden gate regionals i wear many hats im coming to you today because i want you guys to think about something we all get older each and every one of us and some day you guys might become disabled and might need those same services as were asking for you to support. So put yourselves in our shoes how would you want your quality of life to be would you want to be in an institution where your places are taken away would you want somebody to tell you when to go to bed and when to wake up would you want to lay the soiled diaper everyday and have to beg a nurse to change you and while hearing them as a you got to wait until my soap opera is over then ill change you no, when people got a right to live in their own homes just put yourself in new year and people with disabilities i tell everyone that i do we didnt ask to be disabled none of us wood chip the morning and said yeah, im so happy being disabled it is what i always minded in my life hell, no but since we are we want to clog our lifelike every one of you guy is im asking you today to please support this because it is really means a lot to a whole lot of people he live in my own apartment but i dont im lucky i have two when you talk about us hss i dont know if theyre coming or not they get paid so this you shouldnt put a price on how much people get paid it is about quality of life thank you very much. Thank you i see other speakers sandy and dignity Fund Coalition anyone else that wants to speak were going to end Public Comment. Good afternoon supervisors. Thank you im here to support the 2 million for this project post homes it very important that the group that put this together look at the different priorities within this program and were looking at people who live alone the fact that thirty percent are seniors in San Francisco live alone this year many families who have people who are often friends or families but some people dont have Family Members here some people are people who left the city so the seniors are left here alone i think this whole issue of the fact this particular program was fund at a period of time previously the city but were stopped this particular program had been reshould learn what what happened before so we can build upon those lessons from that ill hope the Department Look at that and compares what we can do different that program has an evaluation it is important to include the budget request i ask the budget people to really seriously look at that with the numbers growing x toshl the next years. Can i ask supervisor kim ask do about the dignity fund and whether this could be a program to be funded im not sure if you have a response my understanding it operationally is that the exact type program to be funded by a dignity fund we need the supportive home and the dignity fund will be brother voters later this year so thats one of the responses i gave you wonder if you want to respond to supervisor tangs question. I want to address that supervisor mar and supervisor tang the way i understand 24 your request your requesting for this particular upcoming fiscal year the Mayors Office and the board of supervisors decide to include that thats great that that be included in the baseline budget for any future particular funding for the dignity fund if this is on the bloovlt ballot it will sedate e set aside x dollars for the dignity and this bathroom, will will be the based on budget it is an giggle service were working together with the City Attorneys Office this type of services is included in the District Fund eligible services. Thank you. Next speaker good afternoon. Im marla if i can ive meaningful a senior i strongly support 24 Equity Program that feels like healthy San Francisco was a furious when medical was enacted the san jose 70s people were not living longer than and no component im a city College Teacher my income is 401k a year i dont qualify for i hss i had a comment the industry controller his average was really low that 25 thousand a year i think at least 10 higher than that thats really all i want to say i guess i represent a lot of seniors not just in north beach and San Francisco thats an Excellent Program ive read through that a couple of times it is simple obviously got to work out kings the pilot but i know that is wonderful and i want to thank all of you had worked so hard many, many people will thank you thank you. Next speaker. And. Im teresa and today, im speaking as a tenant who was one of the 8 other tenants in the building that takeover of her 90yearold landlady to live in her home between 95 between the commercial part of building the 88yearold that helped to take care of her we each had a job to have her remain in her home since age 4 she could die at home at age 96 because of the evictions and reminder that communities are destroyed Building Society and Building Communities are also been dismantling so the need for this kind of assistance subsidy is going to only get greater and grammar because over the last few years as you may know the evictions are up so people are needing to put more money into residence and will not have that money in order to take care of their physical and emotional needs keep in mind the needs will only grow not only because of baby boomers. Next speaker yeah. Good afternoon and thank you for having us. Im with the senior and disability action but speaking from any personal experience from 2010 a 2014 my wife and i took off of my motherinlaw we had to she couldnt take care of at that time, because of dementia type 2 diabetes and other Mental Health and other issues we had it set up we thought we had enough mou money but as her health deteriorated we went through her salesforce and our savings but the fourth year developed cancer and passed away but that was increasing with the rent and the health costs that was getting to be almost impossible but four years we managed to get through that my own person ive been diabetic for 46 years and averaging the appointment and my medical has gown up thats one of the reaps with the rents and everything thats why we moved out of the city we cant afford it im 62 but it will be costly ive been having problems lastly so thats why im out of the city fortunately, i have a job but getting to the point i can see someone like me and dealing with Health Issues for years it is getting to be a crisis thank you anyone from the public wish to comment then maam, chair Public Comment is closed. Public comment is closed. Supervisor mar. I want to thank everyone for the stories told and the data gathering and the report i want to say this is a great opportunity for San Francisco to lead the country again with an important policy implementing a program that addresses a need we know is there the reports show us how severe and timely to support and others addressed the high cost of living and the potential of displacement people seniors and people with disabilities so the emergency before us supported in home program at 2 million to launch a program to begin to meet the need you look forward to work working with the Mayors Office of budget and the coalition that is represented here this Important Program can help our city truly b be an aging friendly city but an inclusive city people with disabilities can remain in their home are these and helping their communities as though their lives i want to thank chair tilly chang and supervisor yee and especially the coalition that was here i think that is was a great hearing and proud of work the people accident and hope we can make history in San Francisco again. Thank you clapping. supervisor yee. Yeah. I want to join supervisor mar in threatening the public for coming out and sharing their stories the stories that personally are very near to myself i know there is a great need when some of the advocates came in my office to describe this i get it because again those are types of things when it happens to be personally 19 it means more than oh, this happens to others thank you. I wanted 0 echo any thaengz supervisor mar i may look like someone that didnt understand the difficulties of what youre going through my family took off of my grandmother and prior to that another grandparent and watching them into or go through the things youre going through i share in the sentiments ive expressed and all the stories many of them sounds like familiar i look forward to the conversation with the topic with all the people involved and supervisor mar do you want to take an action. Ive move we table or yeah or file the hearing and thank you from the policy in terms of my office and well continue with the coalition and looking forward to the upcoming Budget Discussion thank you. Well take that without objection. Im sorry file the hearing and mr. Clerk, is there any additional business to come before this body . That completes the agenda thank you. The meeting is