The february 5th, 2020, Meeting Minutes . Thank you. Do i have a second. Second. Any discussion . All in favor. Any opposed . Thank you. The motion carries. Now i would like to introduce our newest commissioner, nelson lum, wholl tell us about his background. Thank you. Mr. Chair, fellow commissioners, ladies and gentlemen, good morning, my name is nelson lum, and im the newly appointed member of this commission. Ive been a resident since 1961, and i went to school here. Upon graduation from George Washington high school, in 1966, i was soon notified by uncle sam that he had a special interest in me. I was inducted in the army where i volunteers to be a member of the paratrooper unit, and after training, i was assigned to kentucky with 101st airborne division. In 1967, my division was deployed to vietnam. Luckily, i returned in november 1968, with all my fingers and my toes. I took advantage of the gi bill and completed a degree in criminology. I then joined the San FranciscoPolice Department where i served for 30 years until my retirement in 2005 with a rank of sergeant of police. Since retired, ive been devoting most of my time with American Legion where i participated with assisting veterans. Its thage laest veteran organization in our country with 2. 5 million members. The main mission of the legion is to assist veterans with benefit claims along with providing generations of veterans. There are ten posts in San Francisco. With the exception of one, they are at the Veterans Building across from city one. Theres post 384 that was formed exclusively by chineseamerican veterans back in 1931. The membership exclusiveness was not by choice. Confronted with discrimination against asian and Chinese Americans in particular, such as chinese exclusion act, the chineseamerican veterans were not welcome to join the post at that time. Thus, the formation of their own post in 1948, the members of the post voted and contributed to the purchase of the building located at 1524 powell street. I have been honored to serve as the post commander for four years. I am currently representing the district which covers all ten American Legion posts at the state level. Thats enough about me. I must confess that even though i have been doing a lot of reading about this commission since my a appointment, im nowhere near caught up with all the information necessary to render myself in the effective overseer. I will do my best to learn more about this commission and the responsibilities that encompasses. When i sat in to observe last months meeting, i heard references to how the budget of this commission has grown over the years. My thought was and is, well, it is a blessing to have a larger budget. It is far more important to measure our success by how effectively that money was being utilized to help those who are in need. So that will be my guideline as i join my fellow commissioners to implement the goals of this commission. Thank you. Thank you very much, commissioner lum. Im sure youre going to be a worth while addition to our commission and help with the services we perform. The next item on the agenda is the directors report. Good morning, commissioners. Welcome commissioner lum. Looking forward to working with you. As usual, i will start with the federal level. Last month, i said that by this time, we would probably see that the senate had reauthorized on its side the Older Americans act. However, that has not quite happened yet. What did happen is they there was a long awaited reauthorization of the National Caregiver bill which provides residence busines respite se, so that was exciting, but were working to advocate for the Older Americans act to pass. Its really focused on that. I will be assuming that it happens. I will be going to washington, d. C. In two weeks for the National Association meeting and also for the policy briefing that i go to each year and bridget is working to schedule visits with our representatives in washington. So its always a Good Opportunity to talk about the great work were doing in San Francisco and in california, rally along with other california triplea directors, you know, at the capital. So looking forward to that visit. At the state level, there are a couple of budget items that have been introduced and are being advocated for that would really help our services and help put some more money into some of our services. The first is theres a big budget ask for an enhancement to Adult Protective Services. It would increase the Adult Protective Services budget in california by 100 million. It would provide for different things. One of them would be that it would enhance the Home Safe Program which is, as you know, were doing in San Francisco, and its a way of really preventing homelessness for older adults who need extra services, who need intensive Case Management or who need to move into assisted living. Its really a partnership with homeless services. It would also enhance the training opportunities and it would also allow for Adult Protective Services to be able to keep cases a little bit longer. So theyre seeing more complex cases. They need a longer intervention. It would allow for that. Im going to sacramento tomorrow to testify on behalf of the California Welfare Directors Association and as, of course, the director in San Francisco to talk about how important this is. It will be before the Senate Budget subcommittee tomorrow. Also at the state level, there is a request from the California Association of area agencies on aging to enhance the aging and Disability Resource Center connection funding. That is a model that we use in San Francisco, and weve been lauded for our hub model that we have here. The aging and disability resource connection really integrates aging and disability by providing information, referral, and assistance for services that are for people with disabilities and older adults. We have done that here. We have an effective relationship between our area agency on aging that sits within our department and the independent living resource center. Paragraph paragraptheres a lota connection in every county or at least in every triplea across the state. This big ask im not exactly sure what the dollar amount is. Were still working on the dollar amounts on that ask. It would be a substantial infusion of money for that program so that it can really effectively work throughout the state. One of the biggest things that we know is that, you know, older people and people with disabilities dont know how to access services. This is a statewide problem, and developing the hub model in every triplea would really help with that problem. It allows us to work as a Network Across the state to, you know, use best practices for information, referral, and assistance and outreach and be sure californians know about the services that they need. Then at the local level, i think the Big Conversation this is actually should be at the knowledge level, too, but at the local level right now, were really doing a lot of work around covid19. The coronavirus is most dangerous to older people, people with diabetes and asthma, and as people get older, its people 55 and older most at risk, but of course as people get older, in their 80s and 90s, they are more at risk. There are issues around People Living in congregate living. San francisco just received testing kits on monday and has the ability to test now, and so the assumption is that we may have a positive case sometime soon. I think mayor breed is has been proactive in declaring a state of emergency so that it puts us in a position where we can activate the Emergency Response system. We have people at the Emergency Operations center every day. We have two staff there who are going to be there on a twoweek stent. They are there every day getting information, bringing information back to the department, and helping to inform practices around, you know, how do we think about ensuring that older adults are safe . How do we ensure our staff in communities are safe, out in homes, all of those things. So its a rapidly changing environment, and so the main i think the main messaging is, if youre sick, stay at home. Wash your hands, wash your hands, wash your hands. Dont shake hands. Its simple messaging because just like any flu or any virus, we need to treat it seriously. So thats been a lot of the energy over the past week or so. A couple of other things coming up. One is this year is the 30th anniversary of the americans with disabilities act. The das will not working with the Mayors Office, senior disability action, and a number of other disability groups on disability pride event. Its very exciting that were going to be part of that. April 14th is National Health care decisions day, and just like last year, das is involved along with the Palliative Care work group in supporting a number of events throughout the city through the libraries to really create conversations and discussions around advanced care planning. We, again, have had some people back out of that, of some of those events muc. Were going forward. If we need to cancel them, we will, and well think about another way. Maybe, you know, a webinar or something that we can do if we have to cancel those events. But right now, were moving forward with that april 14th National Health care decisions day group of events. Then one other thing that we are involved in is our city put out a grant opportunity for cities to apply for funding to really look at Financial Empowerment for people with disabilities, and so Mayors Office of disability and thriving in place, nonprofit thriving in place, and d aos came together and said this is something we should really look at and we decided it would be great to do a road map of Financial Empowerment opportunities in San Francisco, kind of an asset mapping exercise so we know what do we have here and what are our gaps. So its an initial grant that allows us to look at those services, kind of identify what we need to do next and then hopefully go back for a bigger grant so that we can actually make some headway in providing Financial Services for folks with disabilities. Thats a really Exciting Partnership that were embarking on. I think unless there are questions, i think thats all i have for today. Thank you. I have a couple of observations, questions. I think the potentially increased funding for the Adult Protective Services is good news. I hope its realized, but it triggered another thought. How is the city implementing the increased conservatorship options for people who are severely troubled . Many of whom are on our sheets. The housing conservatorship bill passed, and the city is working very hard to get it in place to implement it. So, you know, it seems like it would be very simple to just enact that, but there are a number of steps that have to be taken when you change law. So it comes down sometimes to the forms that youre using. So the court has been involved in working on the forms. The City Attorney has to agree to the forms. The public defender has to agree to those forms. Our staff and the department of Public Health staff have worked really hard to come together to move this forward and its frustrating a little bit because the legal ease piece takes time. Were moving forward, and looking forward to being able to have our first test case really soon. Thank you. And then on the coronavirus, its wonderful that the city is being as proactive as it can. But im sure everyone is aware of the impact on tourism in the city of the canceled flights and foreign visitors and so forth as well as domestic travel. Has any assessment been made of the potential impact on the budget and our revenues from the coronavirus and what that may do to our department and their budget . I believe the mayors Budget Office and the Controllers Office are looking at that closely, certainly have mentioned it, and i know that they probably have gathered a lot of information already. I am not privy yet to what those projections are. Thank you. Any other comments or questions from the commission . Okay. Thank you very much. The next item is employee recognition. The Das Commission and executive director will honor from the public conservator. [ applause ] how are you doing . Youre popular. You have a huge following here today. So we just talked about conservatorship. Its a great segue much the public conservators office works with people who are unable to care for their own needs due to serious mental illness. One of the things that is true about them is they have so much skill, so many people skills. Right . They work with people who are very, very hard to serve, and ive talked to a lot of them. They actually have such good connections with the people they work with and they care very much about their clients. I know its really not easy its a work i would find hard to do. Im always really impressed with the work of social workers that we have in the public conservators office as well as the people who support them in the management. So its a great group of people. Its a really Diverse Group of people, and at the same time that they are doing the hard work theyre doing theyre on the same floor as i am. And so i get to see them enjoying each Others Company and really supporting each other, and they are really strong group. I think, you know, it takes that. When youre doing the hard work that youre doing and you come back and you can be joyful and laugh and have fun and eat together, thats what makes a really good strong group of social workers. I just want to thank all of you for the work that you do. Its a changing environment and theres a lot of pressure on the conservator to be the answer. Right . And so i just think that all of you have extreme grace under pressure, and i just want to thank you for what you do. Today were talking about mike in particular. Mike, not only not just one person wrote about you, but two people did. I get to read what two people wrote. Ive known mike since i came in to the public guardian. What of the things he did immediately is he wanted to become a licensed clinical social worker, and he worked really hard at it. He didnt just say, well, ill wait and think about it. He jumped right in, got the consultation, did the work he needed to do, and then moved over to the you can public conservator. But he was great when i was in the public guardian. All of his coworkers enjoyed working with him and felt supported by him, felt his professionalism and hes carried that into this job. So im going to talk about i wont call them out, but im going to youll see because im going to hand this to you. From one of your colleagues, why he should be the employee of the month. Im nominating mike because of his body of work over the past decade, working for the city, including time at the public guardian. In his current role, he has taken on a leadership role and not a critical source of stability and support to allful our coworkers. He takes difficult situations in stride, works to develop understanding and better communication within the office, and regularly supplies our Team Meetings with sugar to keep us going. [ laughter ] personally, ive appreciated hes willing to contain situations escalated by other providers and remain a firm defender of the role and values. Then from another colleague of yours, mike is a True Team Player who works to ensure that his clients and colleagues are succeeding. During a period of transition, mike has stepped up and provided leadership and guidance to the team all the while successfully managing a heavy workload. He exemplifies the das core of value and inclusion. Its noteworthy that despite many stressors, he remains calm while keeping the needs of our clients as a top priority. Hes passionate about protecting Vulnerable People and driven by the work he carries out. Mike is an excellent role model for others at das and he is absolutely deserving of the employee of the month recognition. [ applause ] congratulations on being employee of the month for march. I just want to say that this was very unexpected, and i just really do appreciate it and im very honored to be employee of the month. I also want to say a big thank you to the lps team. They are a very resilient, dedicated team, and im really happy to be working with them. I just want to say thank you to jill who has been a great leader and support as well as kerry, cassandra and jason. The work that we do is challenging. The impact is ever lasting. I just want to say thank you. Its very heartfelt. [ applause ] the next item is the Advisory Council report. Diane lawrence. Welcome, diane. Good morning, commissioners. Welcome commissioner lum. Because this is a long agenda, im going to make this as brief as possible since i have three reports to give. Then ill detail it that youll get in the minutes as ive done in the past. So the Advisory Council met on a regular meeting in february. We had a representative from the Community Living campaign who made a quick presentation on their cracked sidewalks and well have a full presentation in march. Based on the recommendation from this commissions meeting in february, we drafted letters to our the joint Legislation Committee agreed. We presented it to the Advisory Council to prepare letters to send letters to our representatives, congresswoman pelosi and spear and then senators feinstein and harris. The reports focused on the data and evaluation report which included ethnic breakdowns on meal programs and ill include the details later. We had our Second Review which took up the area plan on aging, which took up most of our meeting and was quite a lively discussion. Youll have that report later. So i wont go into those details. Dr. Edelman for the lgbt updates discussed the master plan for aging for which she is participating adds a commission on aging at the state level member. Shes discussing the Equity Work Group and the groups purpose is to examine the development and implementation of the plan, looking at social health and social disparity issues with the focus on the equity lens and dr. Edelman is on that work group. And then we were she announced she had been she announced she had been awarded the woman of the year award for district 17. So we were quite excited about that. There were no site visits given our time was taken up with an area plan and robust discussion. Thank you very much. Any comments or questions . Okay. Joint legislative committee. The joint leg met prior to our meeting. Its a committee thats jointly its a joint committee between Commission Members and the Advisory Council members. So a number of the bills that we looked at last year and that are included are sitting with budget, in appropriations. The governor has asked the bills with possible expenditures have to be looked at in light of the budget and make sure that theres money to go with them. So well probably see a lot of bills sitting with budget asks. There are a couple new bills that were just coming out, and there probably will be additional bills next month because weve just passed the last day to introduce a bill. We spent some time reviewing the details of the Older Americans act, but ill detail the bills so that you have them in your minutes. Thank you. And last but not least. Quarterly meeting last wednesday and thursday, and i will add its a group of representatives from the 33 psas. Ill give you background for the new commissioner so you understand. We typically meet two days, a day and a half, four times a year. Oftentimes the meetings are in line with scheduled so that they back up against another event. So this time, the second day of our meeting was the c4as capital day. We focused a lot on business. We had an update on the commission on from the California Commission on aging, spent a lot of time talking about the master plan, obviously. The first deliverable of the master plan was posted last wednesday. So thats progress and thats on the longterm support and services stakeholder reports. Its a high level report with a bold vision and looks at longterm care workforce. We were reminded that the minutes and webinar meeting information was posted on the engage website so that all of the information is available for people to look at. We established an ad hoc plan committee, and that was to align our work with that of the commission to look at venues, revenue, and that work will begin in the summer, and i volunteered to be part of that. We had a presentation on elder abuse and mandated reporting, which dovetails in elder care and the variations around the state. So the point of increasing the funding is important. One of the things that came up twice in the meeting is the fact there were discrepancies between federal, state, and the department of labor definitions of older adult. So the federal law says 60. The state says 65 as does medicare. The department of labor says 50. So this does make for i didnt realize there were that many discrepancies. The Bar Association has addressed has a National AmericanBar Association has expanded their rules to allow attorneys to report without the clients consent in cases of elder abuse, to report the california Bar Association has not adopted those new rules. One thing i thought that was important in the dovetails with director mcfaddens report is that onethird of the reports of abuse are repeat. So keeping accounts, keeping the cases longer might make a difference. Thats on a statewide level. We had reports from the various ps as. Who were asked to make a quarterly report. Areas are looking at planning events. They are surveying seniors, Disaster Preparedness continually comes up as ive mentioned before. Some tax preparation activities in the communities. Thought we would begin talking about coronavirus. One of the psas is looking to get a program which dove taled into our last presentation of the first day which was on workforce and aging. We also have a quick presentation on the Ombudsman Program and how it dovetails in increased funding so more visits can be made. The other thing that struck me is the assisted living facility licensing is annual, and then the we talked about the presentation from the c4a executive director on the area agencies in the master plan. This was something that director mcfadden spoke about and also the increased funding that she mentioned earlier. Then employment communities, Senior Community employment program, Older Workers training. These are programs to get older adults either continuing in the workforce or find jobs much like we did with the workforce job fair last year. Employers that have been surveyed found they were more loyal. They also had greater Institutional Knowledge which Many Organizations are finding. So there are a number of programs throughout the state with some money and more details. Our next meeting is in may, and that will start with senior rally day on may 11th. Then on day two, we meet on the capitol, and i went to visit some of our local legislators with director mcfadden and cindy kaufman. Thank you very much, diane. Any comments or questions . Thank you very much. Youre welcome. Next item is longterm care coordinating council report. Welcome. Good morning, commissioners. I dont know some of the new commissioners. I will say im the Program Director of the longterm care Ombudsman Program in San Francisco. Its a contract through das and hsa. Thank you. We met on the 13th of february, and let me start with the action items first because thats kind of crucial for future planning. There were two action items. Dr. Julie leshae is going to okay identify the hiv aids seat, and shes presently the director of housing, aging, and retention and Care Department at the sf aids foundation. Shes focused on design, implementation, and expansion of programs. Shes a worthy nominee to occupy that eat on the longterm care coordinatetion council and we all look forward to her input and her spreading our involvement from the council to individuals that shes working with. The Second Action Item is that the council will only meet six times a year, every other month, and following recommendations from retreat i think we had in 2017, 18, around there, the work groups are going to fulfill a dominant role in reporting out to the longterm Care Coordinator and council when it does meet. Those work groups are Behavioral Health, housing, nutrition, social engagement, transportation, and workforce. Each one will be focusing on certain issues that are really important, and its sort of i would urge that commissioners go online and look at some of their reports. For instance, the report from the Behavioral Health group is rather detailed in terms of working with the deaf community, in terms of Behavioral Health, and having a position in terms of discussing future planning for unmet Behavioral Health needs and gap analysis. They have members that are both from the council and also from outside of the council. Thats a very robust work group. The main work group is going to be whats called the Steering Committee, and thats going to meet once a month. I think the next meeting is on the 13th of march, this month, and its an incarnation to earlier work groups, policy and finance and the old Steering Committee which were merged. They will look at issues such as financing, policy recommendations, and, of course, all of their recommendations will go into the Agenda Setting for the longterm care coordinating council as well as other presentations. So those are the two action items. There was a dignity report made, and theres an rfp going to be released, probably has already, for Case Management evaluation. Theres also an open bid, nine providers applied by supervisor district. That will focus on Needs Assessment and those particular districts, theres a disparity between services in some districts and not in other districts. So this will be raising all the votes with this rfp and neighborhood services. Then theres some rfps on whats called collectivity or connection which will focus on applicants to extend connection to isolated persons with disability who are aging and focus on loneliness and social isolation. Theres been some work by medical doctors at ucsf about the effects of social isolation and loneliness on the sense of personal wellness because of the lack of connection. Theres great literature on that. Finally, our funds for transgender were released to build up the services, open house and one other served some money to outreach and provide services to transgender individuals who are, perhaps, the most isolated of the Lgbt Community in terms of their political leverage. There was a presentation by dr. Laura wagner on the workforce, and it was a rather interesting powerpoint. I wish the supervisors could actually review it. I dont really want to summarize all the slides. She did an evaluation of where the shortages are in certain key positions, rn, lvn, housekeeping as it relates to longterm care. But she also, very interestingly, came up with new kinds of categories of care. For instance, a Dementia Care coordinating specialist, which would be either additional job for someone who has an msw or rn as well as other care coordination. So her recommendations are in terms of the future as the informal care giving by family members is diminishing over time, she had a graph going into 2050 about the loss of family caregivers. Thats a nationwide statistic she presented in the powerpoint. Family caregivers are not available anymore. Shes projecting a need for all these specialized caregivers for longterm care. She did talk about cnas and individuals in Skilled Nursing and how they are also theres also a labor shortage there. Part of it is because of low wages and the fact that its a pretty difficult job for such low wages. Some of us in the group raised questions that were raised by theres a famous writer about home care workers, care workers in the community who are not part of the professional class of workers and whether or not she had looked into that. Her study was limited to the professionals basically. So thats an as needed thing. Theres been a lot of work on increasing the labor force for ihss and the parameters of scarcity are they cant afford to live in the bay area. Its a long commute. What incentives will be needed . That hopefully will be a future study. So that was a really interesting and germane focus on the workforce. The other committees didnt have much to report at this juncture. But the idea is with the two with the one action item, that they will meet monthly and actually report out. So all the members of the council are going to be busy going to workshops and tackling social isolation for Behavioral Health. Some of us will be on the Steering Committee, and i think thats it. If i missed anything, okay. Thank you. Thank you for that comprehensive report. Any comments or questions . Thank you. Next item is the case report, craig moore. Good morning, commissioners and executive director mcfadden. Im not craig moore. Im the director of San Francisco senior center. I thought i retired, but im still here. So i will be as brief as possible. Ill be reading, i apologize, because this is gregs report. Hes not feeling well. So in february, case Advisory Committee met and continued planning in preparation of phase two of our advocacy campaign. It consists of a petition that will be online and in hard copy with our budget funding request that we took to das in december. Well be meeting with city supervisors. The bucket office, and hopefully the Mayors Office. Well be asking our member