affordable housing. the loss of redevelopment funds means we do not have as many resources to construct affordable housing, and the cost of living in san francisco continues to skyrocket in the for-profit sector, driving people that are marginally house, into the street. want to lose housing and become homeless -- homeless. , your mental health needs become much more complex. now is not the time to cut funding, now is the opportunity to invest in san francisco's future and create jobs by supporting community-based services and construction. now is the time to freeze -- from the housing needs as is the right. supervisor all lolague: thank you. ann hinton.

>> good morning. thank you for the opportunity to have a hearing and discussed the issues that are important to all of us and give the community as staff -- a chance to speak to their individual and community concerns. i want to thank them for his great coverage of the issues in terms of demographics and poverty levels and who lives and our community, because it really sets the stage for the comments i am going to make. i handed out to you supervisors, a brief description of the department, but for the audience purposes, i would like to talk a little bit about that. department of aging and adult services is what i refer to as an integrated department. many years ago the comptroller's office did a report and found things might be better in san

francisco if we were to poll the various programs together and departments together that serve younker adults with disabilities and older adults, so we became an integrated department. we're made essentially of four divisions. we have ihhs, the largest single program areas serving over 22,000 older adults and young adults with disabilities by providing home care in people's homes. local government shares in the cost of the program, and this is one of the ones the governor has targeted for reductions in the coming year's budget. there is also 18,000 workers and that program. some of those are the folks that dan talked-about better over 65- years-old. the next division is protective

services. this is where we have an adult protective services, which is there to focus. these programs are there to serve people, regardless of their income. our protective services programs are available to anyone, regardless of income. our public guardian, public administrator's office, public conservatives office, and re pae. they help people manage the income so they can actually remain living in the community. doing investigations on reports of neglect and abuse, and that is an ever-rising problem in our

community. the third division of the department is long-term care operations where we have seen some of the most innovative and creative program development, largely due to the mayor and the board of supervisors. this is where the community living fund resigns, a fund that helps people leave nursing homes to come back to the community, or to help them stay in the community and not enter institutional care in the first place. this is where the diversion and community integration sits in the first place, which is helping people leave institutional care, or if they are at general hospital, to move them back into the community. the fourth division and our department is community services and intake. i am going to be read preferring a lot to my -- i am going to be referring a lot in my comments

to this today. this is the area agency. this is where the county veterans' offices reside and have developed it over the past seven years, an integrated intake unit. i want to focus a little bit on that section by starting to say that all of the service, whether they are means-tested it or not, are targeted for the entire community. we have a lot of folks in the community that are modeling many different languages. our staff are specifically hired for the languages and the understandings of the community, because we are here to serve everyone, not just specific people. we know of discrimination, biased, and poverty make things more difficult to people.

although we have a specific concern about the middle-class person that is on the lower end of the economic scale finds themself in a situation where they cannot purchase services and do not qualify, that is the difficulty we see on an ongoing basis and is a problem in our office. although some of the programs can target people, regardless of their income, a lot of the services that are key to staying at home are there specifically for the low-income per cent. discrimination, biased, and poverty make things much more difficult for anyone, regardless of age or circumstance in the community. partnerships have proven to be a critical component to our department over the many years. partnerships with community- based organizations, as well as partnerships with all of the various assets of city and county government. we have had a good working relationship with the disability

council. the health department as well. we know it would help the partnerships. we could not embark on the new initiatives, nor could the programs like the protective services functioned well in the community. >> san francisco has a long history of strong non-profit community. it also has a long history of the board of supervisors -- board of supervisors and mayor's being committed to making sure it can remain at home and be successful in the environment. this is really seen in the fact that unlike many communities across the state and across the country, we've received general funding better > the match requirement for most of the federal funds. you did not see that before the downturn in other communities,

and you do not see that now. the downturn has hit communities very hard. it is not that we have been untouched, but we started at a place that was a lot better than a lot of communities are. that is really the advocacy that has been done by the cb'o's, but also because the officials have been committed to funding as best they could at that time. i was going to talk a little bit about the budget over the past few years. i have been ahead of the department for about seven years. my first year in the budget was doing well and the economy was doing well. there was a $160 million budget. that includes all the programs i was talking about. we received $6 billion over a

new general -- over the course of two years due to a lot of advocacy, and due to the fact that there was this commitment to try and work to keep people at home, and also these institutio deinstitutionalize aa honda hospital. we were also then able to provide greater support to things like legal services and immigration services and naturalization and other kinds of programs. as the downturn came, we were hit just like other departments were. on the whole, we have survived well, although we have lost about 30 positions in our

department, and we know contractors have faced reductions, just because costs have gone up. there is no way to get away from that. if you stay flat, something is still hurting you. in terms of dollars that we have lost in the past few years, if you think theabout the 6 million that came four years ago, and then you look back at our history, you will see that we probably lost about 2 million. we are still ahead in the key area of community services. that is good news for us. and we have lost money in key areas. we have tried things we thought would work with resource centers. we got new federal money in, so we used that. we got a new design. we also did rate reductions in nutrition and other things. as of the population moves and

grows, and the needs of the population growth, we will see over time what happens is the key programs. those were things that we decided to do at the time. that lost us a couple of million. the deputy of the department has been incredible at looking for new resources, either to go after match money on things we might have been doing using general funds seven or eight years ago. we may be did not think at that time was worth all the work we would have to do to get it, but now we match every dollar that we can possibly match. providers have been doing the same thing with us. they have become partners in that area as well. we have had some new

initiatives that are important to us. the conversation about planning and what are we doing for the future, dan referred to the area plan. you can find at some of this online, but it is a pretty big document. i brought one along so that everyone can see it as a star road document. it is required in order for us to get the administration on aging money. but is also a practical document, because it helps us determine what it is we're going to fund. it is always changing and always doing updates. in addition to that, we're part of the long-term care council. the council has developed a second one, so we are in the midst of implementing the recommendations at this time. a couple of years ago, because

we recognized -- you might go back to the fast-growing population is at 85 +. we decided a couple of years ago that we would take on the issue, and this document, wises -- which is a 10-year plan, and we will be doing an update to the plan in the fall so we can make sure any new things that have happened since we first did it will be in the plan. and anything new we have undertaken is in one of these plans. the plans reference each other and have many crossroads between them. whether or not it would be it would be the grant of about 7 million to the city and county

of 3 million to us, we have been working on transition from hospital to home for a very long time we are now in discussions about the centers for medicare and medicaid to talk about contract with them, so that we can have federal support for the work being done in the community. we have sought designation and funding for adults with the stability resource centers. we have really focus our money on evidence-based health the aging, because we have seen that evidence on those program shows it regardless of income and ethnicity and all those things we talked about earlier, people do better when they're able to get involved in one of those programs, and we are using to programs, one from stanford and

one from usf, and now we are managing around drug and alcohol in the future. we of undertaken of long-term care integration investigation. we know the state, many states are moving to managed care, so we sought outside funding to bring in a consultant to form an expert panel that can delve into the issues, and so that sanford says go can pull together a plan that really speaks to the issues that people have in our community, so when the state moves into managed care, we are ready for that. the lgbt task force, we're providing support to the work that is going on there. we were probably one of the first area plans to have that as an issue or addressed the population's issue in that document. one of the new things the long-

term coordinating council has taken on our local communities. how do you create communities where people can stay? i think when it comes to challenges in our community, i think there are two. one is the middle-class, low- income population and how you get these services to them? or how you help them access that when money is pretty tight? that is one issue. the other one is neighborhood planning. how you create livable communities? how what do you do that in older cities with a lot of hills when there is a lot established? we know we have some specific districts and our city where

there is not as much service as we need. part of that is around the planning. i think part of that we will take up and livable community work, but it is still something that bothers some -- that is bothersome in terms of where our stores located? where is transportation? where are services and how does that all work? i will end there. supervisor olague: thank you for that. when we did the study, we found that access to food, healthy food and things like that, was something that some neighborhoods were lacking. eventually it may be that -- there was a transportation and effectiveness planning to look at some of these issues, but there were some senior disabled

voices at the table, but it seems to me we still have to fight our way to be heard, sometimes in the discussion around planning issues in general. maybe as we move forward in this, maybe in the next year or so we can look at establishing some sort of a planning effort with the city planning department to look at where people are aging and what the department of public health has done with community health impact assessments, which looks at how you create healthier communities. i think there is some movement in the different departments bringing that conversation to the senior and disabled community. to the community. >> i should mention that the planning department has joined with the long term council in network group. one of the really interesting things about that is that it has

attracted people that we do not normally come into contact with. we got a couple of architects interested in this issue. people from different parts of the city. yes, we need all of those people involved. " supervisor olague: i will save my comments for later, but i have become more familiar with seniors in public housing and how they have been exposed to those nuances. i am sorry, supervisor chu? of supervisor chu: taking a look at the report earlier and the demographics of where seniors are living, there is a dark green in the district. we have talked about this before. i spoke to you about the

different communities that have different structures. many seniors are living in their own homes and the services that we provide in things we might want to look at might be different from the other things. what are the plans for these hard to reach areas? traditionally, we have not had very large spaces. there are limited commercial spaces. how do you anticipate facing the challenges, given that we have what circles around this over and over again and seem to be making no progress? >> community work popped up. over the years i have been here, one of the things that has been very clear to me is that every district needs to own retirement

process. the sunset is one of those key areas where we have a lot of older adults and key services in their. we have day care, relatively close by. there are key providers very much dedicated to raising additional dollars on self-help for the elderly. the provider community has been working hard on it. each district is very different. it is a lot of single-family homes with stairs up and down -- of course, stairs are up and down, but you know what i mean. the conclusion that the only way to deal with that that i have concerns about is to sit down with key players in the work

group at the sunset might be one of those districts they look at. taking all the key players and people from the business community, those are key issues for them. park in iraq as buildings in -- part in iraq -- park and rec has buildings in there, as well as independent contractors and the business community. if the work does not proceed along those lines, i think we will have to do it ourselves, because the issue is not -- the demographics are not changing in a way that make it less of an issue. supervisor chu: thank you. supervisor olague: now we will hear from [unintelligible]

from meals on wheels. >> good afternoon. just one minute, apologize for the technical difficulties. i do have a power play to put up. [whispering]

perfect, ok. i think we're all -- no? it looks just perfect from here. oh, it is. ok, good. in the senior director of programs and operations at meals on wheels of san francisco. i am also a member of the task force and am also on the long- term care coordinating council. good afternoon to you all. thank you so much for the opportunity. we have worked together for years and this is an amazing place to gather to hear updated reports. i am excited to tell you about the struggles seniors have been having around attrition.

i look forward to doing a presentation on both groups or the long-term care coordinating council in july. as you have heard with the large baby boomer generation, demand for senior meles has risen substantially. they're likely to need services well into the future. private fund-raising but continued to be required to meet these critical needs, putting our safety net at risk. 12%, 19,000 people, are living below the poverty line. 27% of our seniors are living below 150% of the poverty line.

can you imagine? painful choices of rent, food, medications are amongst the san francisco seniors every day. defined as access for all people of all times, including worrying about food that will run out, found it cheaper, rationing meals, which is what most seniors do every day, or skipping meals completely. that is the reality of our seniors who are living 150% of the poverty line or last. -- or less. food becomes that non-essential item, though it is the most

essential, in choosing between fixed expenses, like rent, and buying food, as we know, is something they wilma worry about. to complicate matters, access to food can be a complicated process. is there a rush restore nearby? is the senior able to get to the store? to a pantry or meals site? is there a kitchen facility? there is lack of kitchen facilities for so many seniors. meals on wheels, we do provide two per day, seven per week. most providers to not. the programs are really designed to be supplementary.

most are often at capacity and people are waiting to come on the program through attrition. there is no entitlement program for nutrition at all for seniors. >this graph shows that there are over 700,000 meals that people are accessing. in the fiscal year we are doing over 1.2 million. we quickly want to point out the percentage at this fiscal year, looking at about 11%. each year there are approximately 15,000 seniors going to these websites. there are over 2800 seniors accessing home delivery programs. organizations that serve meals are raising additional funds to support that need.

it is not sustainable. it is just not keeping pace. for seniors living below the poverty line, most of the time they're able to access the food stamp program. for the seniors receiving ssi, just under the federal poverty line, be cashed out of allowing people want ssi to allow for food stamps in the early 1970's. we have looked at those agents as opposed to the blind and disabled. it favors the folks who are blind and disabled and we have seen it continue to favor folks who are not agents. we would be looking at the average grant of $140.