times $700,000, in other words, 350,000, with a total coming out to $450,000. a similar program is also available for prepping transfers fl interest r from grandparents to grandchildren. if you're interested in learning more visit our website

>> we're going to recognize erik wong. [applause] hi, erik. congratulations. it's very exciting. so, i had a chance today. erik's program director can't be here today. because she had to attend another meeting and she really she was glowing about you, erik. i'm going to read what people said about you. i wanted to say i had a chance to talk to sandra. she said, i'm sorry i can't be here and i want to see him get his award. we're going to have fun later. she also said -- [laughter] she also said, you know, you are so patient and you are h elegan. you have an elegant way of being

aa you are a team player. i wanted to make sure to mention that because all of your colleagues feel the same way -- >> erik joined the office of the public in january of 2018 and he is quickly become an integral part of the team. he goes out of his way to support his colleagues with possible his kindness is the care and services he provides to his clients. he has effectively collaborating with mental health partners with the goal of ensure tag his client needs and goals are met. he is patient. he takes the time to assess each situation and applies thoughtful

intervention. he is not easily discouraged. when faced with challenges he examines the problem with a compassionate lense to reach a resolution. erik has proven to be an essential member of the office of the public conserve ter. he has been collected as employee of the month. erik is a delightful colleague and exemplary conservetor. congratulations. [applause] erik, on behalf of the dos commissions, you are employee of the month for the month of february. [applause] >> i want to say a quick thank you, especially sandra, our fe

fearless leader. of course, all special people that make up our public conservetor's office and i want to say how much of a privilege it is working with my clients. it ithey've shown a willingnesso work together and they've caught taught me about values, humility and respect. again, i appreciate this recognition. thank you. [applause] >> the next item on the agenda is the advisory council report. dianne lawrence. >> good afternoon. i actually have two reports to

give. i am going to go into them together if that's ok. >> sure. >> the advisory council had its first meeting of the 16th of january. the executive committee met to discuss our plans for the year. just get familiar since we have new officers. the members are surveyed for the years so we can prioritize them. we're copying from what tack did, that's what they did back in september and i'll address that in a few minutes. [ please stand by ]

. >> -- that they were developing a hybrid pace program mainly for the lgbt community. after discussion with director mcspadden in early january, michael zog, the director of the office on ageing, will be attending our meetings. he'll be attending our meetings

and will be the liaison between the department and council. and we have our -- >> miss zieglar comes to us from calpers, which i thought was an interesting combination. they prioritized the topics for this year's meeting, and we'll focus on one of these topics at each of the meeting, fielding california master plan information, the effects of ageing, and the effects of isolation, and that was the results of studies done in september. we had perspective on the

information on studies without walls. the department participates in spanish courses are being started in california. looked at the s.s.i. cashout, where s.s.i. recipients may also receive calfresh benefits on an e.b.t. cart beginning this summer. the benefits will increase $10 per person, per month, to be equitiable with s.s.i. and s.s.p., and most s.s.i. recipients will need to apply for calfresh. excluded members of current calfresh households need not apply, and all households are gearing up for increase -- increased applications. and i will send bridget a

flier. -- what they're looking at is side by side data across all states. beginning january 1, counties started collecting data, and this is to provide more information regarding the client and the abuser. and within california alone, there are eight different databases. so you can imagine the challenge that we will have nationwide. adult protective services, the california welfare director's association, is asking -- directors association, is asking for more public access and guardian training funding. we have california universities

that are doing some research in these areas, so one thing that struck me is the partnership with the university system, both the cal state and the u.c. system. they're -- thornton thomasetti state of adult -- the state of adult daycare services in california, that's a quite complicated system. it was a victim of the 2011 recession, and they pointed out that 25% of millennials have caregiver responsibilities, so millennials are very interested in this topic. and there's -- it takes about two years to start-up a new center, and new york university is doing a pilot study on the effects of nutrition on hospitalization, and it'll be interesting to watch, and ucla is doing a study on mental health. we had an update on the older

californiians act, and cal state university bakersfield has identified a group of students who would like to help with updating that legislation. this'll be discussed at our meeting at the end of this month. they're discussing that point -- there was a post election update. there was discussion of a long-term care -- long-term support and services, just figuring out where it would fit in. and then also, again, the idea of a california master plan on ageing, and there's a 20-year history of trying to get something like that going, and respite care is one issue. and then, there is senior rally day is scheduled for may 7, 2019.

i'll get more information the end of the month. and then, all of the area agencies gave their reports. so we meet again february 27 and 28, and on the 28, we'll be attending the c-4-a capital day, so i'll report on that at the meeting. >> thank you very much, diane. does anyone have any questions? >> hi, diane, could you tell me, the meeting at the rally, was that the 7th? >> the 7th. >> okay. any more questions? any other comments from the public? okay. thanks, diane. >> thangsz. >> n >> -- thanks. >> next term is the long-term jobs. >> like most of the meetings, it starts with announcements. mark burns provided a reminder that there was a forum with the

mayor scheduled for the following day at the public library, hosted by the dignity fund coalition, which, by the way was very successful and can be viewed on the coalition's website, which is sfdignityfund.org. the other announcement was about the long-term system care and policy recommendations that the council has been working on the last few months. executive director sherreen had a discussion, and it actually came back around at yesterday's meeting for priorities. so you'll just have to wait till next month, like the cliff hangers of old, to find out what those priorities were. we had two very weighty reservations. one was from the mayor's office of housing and urban development, their analysis of impediments to fair housing, and the hiv housing plan.

and that overview really provided sort of high level about the issues, the timelines for the plan's development, and particularly focus on issues from the perspective of long-term care. again, that powerpoint presentation is also on the l.t.c.s website, which is ltcsf.org. the mayor's office of housing and urban development stated they'd like to partner and come back in either june or july to provide an update. the second sort of weighty presentation was a result of all the hard work from the assisted living work group, and the highlights of that report was provided, and the group voted and approved the draft report as it was, and it's been present does to the mayor hopeful -- presented to the mayor hopefully for action.

the next meeting is coming up soon, and if you're interested about anything we've talked about today, it's on the website for the long-term council, which is ltccsf.org. any questions? >> thank you, maria. any comments or questions? thank you very much. case report. >> good afternoon, commissioners and executive director mcspadden. greg moore, cochair of case. our 2019 is off to a very busy start. we've had a couple of presentations at january and february meetings that were excellent. elizabeth london in january from the hub talking about the hub and its resources, which was particularly helpful as we have a good handful of new case members, so good to educate them and increase their

knowledge of resources out there. and then, this month, we had benson and adele speaking, presenting on the ombudsman program, so excellent, excellent learning experience for all of us. next month, we will be having dr. jilleen johnson from ucsf talking about her findings. last month, we also had our annual elections and all of the officers were reelected, so myself and sue horsh will be cochairs. we also have ramped up our advocacy campaign starting much earlier. we've already gun scheduling and holding meetings, individual meetings with supervisors to present our

2019-20 budget year ask that was sent to director mcspadden in december. the reason that we've done this is to allow additional time during the budget process for follow-up meetings so we can do additional advocacy work. we'll also be scheduling a meeting with budget director kelly kirk patrick and hopefully with the mayor. we'll see how far we get with that. and then, we continue to work on a proposed celebration of ageing event which we've tentatively slated for september. we now have begun looking for funding sources, and hopefully in the very near future we'll be able to present in more detail on that. questions? >> thank you very much. any comments or questions? >> i have a quick question. could you say a little bit more

about the celebration on ageing. what is that? what is it historically -- what is that historically have bun? >> this is an event that the case board began talking about 1.5 years ago or so. a significant citywide event to celebrate ageing and persons with disabilities to not only -- as a celebration but also as a resource event where agencies and for-profit companies could meet with the public, performances of different type -- types, yeah. the idea came up actually based on a conversation when we talked about many, many years ago an annual event that was held for several years, citywide event called bay to breakfast. so we that you with efforts that are in the works and still in the works for -- around

reframing ageing, we thought that this tied in nicely with that. >> thank you. any other questions? >> yeah. just on that topic. it sounds like a great event. i know that the jewish center does something similar to it. i know this event has similar aspects to it, but are you working with them on that -- are you aware of that, first of all, what the jewish community center does? >> we are aware, and we're not because we're still trying to get planted in terms of funding for the event. so before we -- before we put the cart before the horse. >> it's a good resource fair. it goes on for a day, and it would be sort of the hub of what you're doing, but it sounds like what you're going to be doing is much broader. >> yeah. we want to not only attract our seniors that are currently participating and enjoying the

resources out there, but draw in new clients. and not necessarily all seniors. we'd love to have younger come and learn about the joys of ageing. and also something that we would particularly like to have part of it is using technology to bring in satellite locations. >> all that sounds great, so good luck with it. >> exciting. >> thank you. any other comments or questions? thank you very much. >> thank you. item five, any old business? item six, new business. we'll begin with item a, and that is a review and approval of the daas fiscal year 19 and 20 and 21 budget. daniel. >> thank you. okay. i'm going to start off asking for your help. so thank you, commissioners. i'm here today to present to

you and ask for your approval on the daas budget. the process of developing a budget is something that takes many people, so some of them are -- [inaudible] >> john, can we have you talk into the microphone. >> thanks for the reminder. i'm good. >> okay. >> so emily gibbs, ruth levine, are the ones who focus mostly on the daas budget. but there are many, sherreen, certainly, and we kind of work through it together. so we're at a point now where we're ready to present. we will be sending this with your blessing -- assuming with your blessing -- to the mayor's office on the 21st.

and after that, we'll go through a long period of discussion with the mayor's office which will ultimaty lead to the mayor's budget which will be transmitted to the board of supervisors on june 1. and after that, we'll go through a six-week period where there'll be discussions back and forth between the mayor's office and agencies and the board and the budget and legislative analyst's office. and by going through that process, we will ultimately get to a budget that the board will pass and the mayor will sign, and that'll happen by mid-july. so that's the rough schedule. as this first slide shows, we have some budget reduction targets in the budget for this year. they are relatively small in

the grand scheme of things, and they relate not only to the daas budget but to the entire h.s.a. budget. so there's $750,000 in the first year and $1.5 million in the second year. and i should say to staff or, those are re -- start off, those are reductions in general funds. those are local funds, state funds, general funds, and realignment funds, which i'll talk about in a moment. a reduction of this size at least in this year is small enough for us to meet with new revenues. so we've had ib creases in revenues. in -- increases in revenues. if we look at our budget as a whole, we've had decreases in the calfresh, we are we've had

increases in the ihss and the medicare allocations. re-review, which i'll talk about in a moment, has gone up. so if i put it all together, there's new revenues that will offset those reductions although we will have a little less upfund in our budget. -- little less general fund in our budget. so we tend to look at the budget in terms of three views. the revenue view, the program view, and the -- and then, the expenditure-type review. so what i'm actually going to do is i'm going to jump ahead one slide and then jump back.

so this is the program view, and as you can see, the budget grows by about $35 million, but -- but most of that growth, about three-quarters of it is in what we call the ihss maintenance of effort budget. and so the ihss program, as you know, is a large program, 20,000-plus clients, and it provides -- and it provides personal assistance services to all those clients. and it does that primarily through the use of independent providers, many of whom are relatives or friends of the folks they care for who are paid a wage and who have access to health benefits as a result

of their work as ihss workers. and the way counties contribute to the cost of the ihss program has changed a number of times over the years. if we go back eight years ago, there was a county share of costs on individual hours of service. then, we moved to what was called a maintenance of effort payment, which was very generous to counties compared to previous ways of contributing to cost. and then, in 2017, the state passed sb-90 which rebased the maintenance of effort to counties and rebalanced the effort to counties about $600 million a year. and introduced inflation factors that were much greater than what counties had

experienced before, and also introduced two changes that specifically affected san francisco county. one was a change that required increases in the maintenance of effort for wage increases that were occasioned by voter-approved initiatives like our minimum mwage increases, ad increase in mode services. those hadn't been covered in the previous m.o.e. law, and san francisco had not been paying increases on those increased costs. so we have a situation now -- and i will talk about this in a little bit more detail as we move forward where our maintenance of effort costs are growing relatively rapidly, and they're growing relatively

rapidly primarily because wages in san francisco for the ihss program are growing relatively rapidly. they're not high wages, by any means, although they are the highest wages in the state. so when the minimum wage ordinance was passed several years ago, it quickly caught up to the wage that was being paid in the ihss program. and since then, up until a couple of weeks ago, we've been paying the minimum wage as the ihss wage. so the ihss wage increased from $14 this last fiscal year to $15 this fiscal year. and then, in the autumn, the board passed a new minimum compensation ordinance, and the minimum compensation ordinance set a new higher wage for

community-based organizations and ihss workers, and those schedules are phased in -- increases are phased in in different schedules. the first increase phased in on february 1 of this year, and the wage moved from $15 to $16 and hour. and then, in july it will move to $16.50 an hour, which will be the c.b.o. minimum compensation wage. the basic idea is to get them both to 16.50 on july 1, and then, the c.b.o. wage will increase by the c.p.i., and the ihss worker wage will actually increase a little bit faster than that over the next few years.

so suffice it to say because of that change, and other ways of the working of the m.o.e., our increase of the m.o.e. between 18-19 and 19-20 is currently estimated to be $26 million. that's the biggest change in this budget. there are also some changes related to the ihss program that i'll mention, as well. benefits costs are going up by a little over $1 million. those are mainly because of a higher uptake rate for benefits for ihss workers. and then the cost of the contract mode worker benefit is going up, as well. and there's wage growth in there, as well. and then, the last item is

the -- what's labeled here as the office of ageing slice of the pie. that is mainly dignity fund growing. and i'm going to go back one. you'll see that the biggest slice. the ihss is paid through a combination of funds and 1991 realignment revenue growth. the controller's office will

actually come along and they will reestimate this number before they finalize the budget, so we will end up with a different number than that unless -- well, with -- with incredibly high probability. and -- and the general fund number will change, as well. we treat aligning revenue as an offsetting cost to general funds, so those two pieces of the pie come together. and then, of course, the other piece of jump is in dignity fund. and then, if we go to this slide, which is sort of -- whatever the categories in -- what are the categories in which we spend the money in the budget, what you will see again is that the big growth is in aid -- what we call aid payments and aid payments are

made up primarily of the ihss maintenance of effort payment plus the money that we spend on contract mode services plus the money we spend on benefits for ihss workers. we also have growth in c.b.o. contracts, which is mainly dignity fund growth, and then, we have growth in salaries and fringes, which is the standard colas for city workers and the growth in health and retirement benefit costs. okay. so since the ihss m.o.e. is the biggest part of this change, i thought we'd spend a moment

talking about that. the bottom line of the biennial budget is $36 million and then further $11 million in year two. and so this breaks out into -- into various pieces. so the -- when the ihss m.o.e. was rebased back in '17-'18, the state government said okay, we will offset the cost for counties in the first year, and we will offset the cost for counties less in the second year and less still in the third year. this is the third year, so there is a reduction in the amount that the m.o.e. is

offset. this is all structured in a very complicated way, certainly. [please stand by]

>> that adds $2.4 million in the first year of the biennium. then there's an increase to the ihss by bringing our wages in san francisco up from $15 an hour to $16.15 next year and then again $17.50 in the year after that. last item in the smallest is contract increases.

so the budget is the very stable budget. the dollar amount change a lot but it's almost entirely because of the way the ihss program works. we are also moving forward making couple of proposals in the daas budget to the mayor's office for possible inclusion going forward. first of these relate to housing and we're proposing adding two positions one is a conservative -- conservator position and other is a supervisor position. the reason is to make better use in the changes of the

conservatorship programs that are currently worked through the legislature with great deal of involvement from 46. it allows to work with models of conservatorship. >> i think essentially that's the gist of it is. we want to build up our capacity to serve more people and we know that with the current legislation the way it is, we're probably not going to be serving huge number of people. we're building infrastructure and we believe that next year was some of the amendments to the current bill, there will be more people coming through our doors. if we have the staff, it will help us to serve them

appropriately. >> can you just explain where this 7% inflation number comes from and who's idea it is? it seems very high. >> in the ihss program? >> right >> i can give you my honest opinion. >> that would be welcome. >> the ihss m.o.e. has been a negotiated thing between the counties working together and the state. back in the 2012 session when the original ihss m.o.e. went into effect there was a negotiation what will be the annual inflation rate imposed. the ultimate agreement with 3.5% a year.

the concept was that that would include some group of cost increases that wasn't incredibly clearly spelled out. those could include growth in case load, growth in hours of service costs of health benefits in places like san francisco that have health benefit model where there is a health benefit package that's made available and it has not changed every year. those things would be covered by this or the county share will be covered by the 3.5% increase. at the time, we had that negotiation, the ihss program has been very stable in terms of case load for a number of years.

it happen to be right at that moment. before that the ihss program have been growing present rapidly and after that point, the ihss program has been growing pretty rapidly. when the state pass senate bill 90, they brought forward the idea of changes in the ihss program because they said and this is a true statement, that they will absorbing a larger share of the total costs of the ihss program and counties were absorbing smaller share overtime. they said, we think the program costs from case load and from health benefit increases, is closer to 7% a year. that's where that came from.

that got written in the version of sb90. >> thank you. >> the second item in the list of proposals actually comes from work that was done under the offices of the long-term care coordinating counsel. this is recommendations of the assisted living workload. the assisted living group was a group comprised members of the ltccc staff from our planning office, staff from daas and the few people we pulled in. basically, what the work group did, it focused on demands for assisted living services,

especially for low income residents, supply of assisted living services, especially for low income residents and strategies that could be used to increase supply and make this level or type of service more available to low income residents in the city who needed it. what's listed on this sheet are a set of strategies that the work group proposed. they build off the notion, sort of the central findings of the work group that there's not enough capacity for low income residents and even for capacity that exist, low income residents of the city can't afford what's there without some meaningful supplements or patches.

a contribution from someone else besides them. the strategies involved providing more supplements, they involve providing higher supplements for some folks that could gain access to more facilities that are out there now and primarily support slightly higher income market. they include notions of potentially either city building of facilities or making land available because land costs are very high. there are some recommendations that relate to better supporting the board and care sector over the market by helping with workforce, helping with

collective purchasing of various things from insurance to potentially food. then, working to enhance the states assisted living waiver program to get more assisted living waiver slots available so state medicaid money becomes available to pay a supplement for clients. those are the basic ideas of the study. daas is not the sole actor in this. department of public has a presence here. there are certain parts of this that workforce has a part.

as part of the work presented in the budget, we'll be sitting down with the mayor's office and hammering out what the next steps are and who needs to be involved and which of these recommendations we will be moving towards implementing. we don't have a specific -- first item was two positions. this was a much more open-ended recommendations. it's the beginning of a conversation that we and the mayor's office and other agencies and ultimately the private sector will be having around this issue. i think i spoke to this at the beginning. we have a schedule. we'll be submitting next week with your blessing. at this point, my presentation is finished.

i can take questions. >> thank you. very thorough. on the ihss budget, i assume you you've been working with the public authority and they're comfortable well this proposal. i'm sure they need more money, but they are comfortable well this proposal? >> yes. >> okay, good. any other comments or questions? i like record to show that >> commissioner pappas: apologie s for my tardiness. i know there's concern about recession ahead of us. how would that impact long-term? >> so, it's a good question. the challenge that we have at any given time building a budget, we start off with the financial forecast. we don't do that as individual agencies, we do that as a city.

the city's economist, the comptroller office, mayor's budget office and the budget and legislative analyst come together to do a revenue forecast and a current law expenditure forecast for the city. their goal in doing that is to establish if there is one a gap between revenues and expenditures. i'm sure it won't come as a surprise to you. this has been the case at least for the six years i've been here. we do have what is often described as a structural imbalance with our cost structure with cost growing little bit faster than our revenue structure. in building the underlying financial model for this budget,

what they have done is they've looked at the economic indicators, they have said it is reasonable to assume modest revenue growth over the next two years. they have some scenarios for what would happen in recessions of various sorts. of course, most recessions are relatively mild and they are slowing up growth or slight decline. we're all sort of very aware of the last recession we went through which was a huge and unusually large recession where we had a genuinely large drop in revenue. there are models about that. city has reserved funds. this budget is built on the notion of slow continued growth.

>> thank you. >> vice president loo: you mentioned this cut from the mayor's office and you anticipate right off from the increase in the revenue. where are you going to increase the revenue? >> revenue increases will come from a number of places. they come from the increase in statewide allocations for ihss administration and for med cal administration. they also come in our alignment growth projections. just to say, alignment growth is money that comes to this agency from the state sales tax and state i