Transcripts For SFGTV Aging And Adult Services Commission 21517 20170217

And note that neil sims is present. I would like to approval of the agenda with changes and Meeting Minutes and under reports no report from the nominating committee. Can i have a motion . So moved. Second. Its approved that we approve the agenda with the following changes. All in favor say aye. Aye. Opposes . Ayes have it and the motion carries. The next item is approval of the january 4 Meeting Minutes. Could i have a motion. So moved. Second. Okay. It has been moved and second that we approve the january 4 commission Meeting Minutes. All in favor say aye. Aye. Opposes. Aye it is have it and the motion carries. Item 4 approval of the february 1 Meeting Minutes. So moved. Can i have a second . Second. Okay. Its been moved and second that we approve the february 1 Meeting Minutes. All in favor say aye. Aye. Opposes . Ayes have it and so the motion is carried. [gavel] five item 5 directors report. Executive director. Good afternoon commissioners. Im going to keep my report very brief today because we have a lot of items on the agenda. One of the things that is happening this is the time of year when we start doing some of the lobbying at the state and federal levels so next week is the California Association of air agency on aging capital day next thursday and tom nolan from daas and i be attending together and hoping to meet with some of the representatives in the state. I am going to washington, d. C. In april for the National Association of aging Public Policy briefing which we have been able to attend every year. Its usually really helpful information that we get there and i have been visiting our representatives on the hill along with the rest of the california contingent so that should be interesting and i will come back and report back. I also wanted to talk a lot bit about the just to remind you that the Oversight Advisory Committee of the dignity fund is going to have its first meeting on the 24th and i know you have representation there so youre probably well aware of it already but i wanted to remind you of that, and were getting that kicked off, and then i just kind of wanted to say give a kudos to some of the staff. There was a major fire in chinatown this past week, about a week and a half ago i guess and we had great response from our staff and our cantonese speaking staff that went down and acted as translators in the shelter and i really think their work was exemplary and judy chan as part of the ad min team so it was nice to see staff kind of step up and take on volunteering you know on their off hours to be down there to help out and make sure that the seniors really had you know, were able to have their needs met because there were translators that carry cared about their neats and thats it. Thank you. I have a question. Commissioner ow. For the past for fires like that and take care of the seniors and other families. Right. And the red cross set them in a near by hotel and this time they had to be settled in a salvation army. You know thats right. Thats right. And the auditorium. I just wonder why its not forthcoming. Well unfortunately i cant speak for the red cross and thats partly why i wanted to point out the great work of our staff and youre right it wasnt an ideal situation but people felt better there were people there to speak for them and translate and all of that. Any other . Thank you. Employee recognition. Department of aging and Adult Services will honor shan yue. Did i say it right . [inaudible] [off mic] [applause] so shan come up here. We know how much you love the lime light so were going to make it as painful as possible so before you get to you shan one of the things we like to do is talk about where you came from and not where you came from really but what unit are you part of, right, and so shan is part of and has been leading actually for the past couple of years five, six years already . Okay. Shan has been leading the county Veterans Service office for five years and i know we have several people from the county Veterans Service office here and i would like them to stand if possible. [applause] so we have John Gallagher here and we have back here with the camera is dorian carr and i wanted to introduce dorian because she was just appointed by the board of supervisors as the new county Veterans Service officer for San Francisco. [applause] i am very excited about that because weve had a county Veterans Service officer in San Francisco for a long time but that officer for the past i dont know how many years, a couple of decades has not actually worked with the county Veterans Service office. Dorian works in office and works with veterans and clients that need the services. Hes accreditd and knows all of the issues to know and how to handle claims and so were really happy. This is a great change to have somebody who is accredited and knows how to work with veterans, who can actually help them get their money and their stuff to be sitting in our office so congratulations dorian. [applause] and after this week dorian will be taking over as the leader of that office so really excited to have him here, so and i dont want to take away from shan, so shan has been with it is county Veterans Service office for 28 years. You may not think that is even possible but shes has been and shes decided that its time for her to head out so we just want to really thank her for what she has done and not because of the work but her amazing spirit and her very sharp sense of humor. Shes a pleasure to work with but shan i dont know if i will read all of this because usually people give me a couple paragraphs and somebody wrote a lot about you and i will read a bit and i will give it to and your coworkers think highly of you and fortunate to have you leading the office and before that as a worker. I have gotten count countless calls and letters about how you helpy pee and i will read this and have another special presentation quick. So shan has over 28 years of service with the county Veterans Service office. I just talked about what they do, and the office regularly assists over 3,000 veteran every year and secures a Million Dollars every year in benefits for veterans and their dependents thus saving both the San Francisco county and the state of california general fund as many veterans get public assistance before they get their benefits. One of the main calls of the cvso is provide outreach and service to Homeless Veterans and 1300 Homeless Veterans are assisted annually by the office. Shan has dedicated her career to serve veterans and gone above and beyond the role that get the benefits for service to our country and highly committed to the work she does with veterans and families and her dedication to providing the highest quality of service is greatly valued and appreciated. It should be noticed that shes the last remaining member of the Phenomenal Group of pioneers whoet krad the San Francisco county vets office in 1993 and in the forefront. Innovation for the office. In her short time as supervisor of the office she has taken the reputation and accountability of the cvso to new levels and leaving hew shoes for the predecessor to follow. Thank you shan. Your dedication and passion are highly valued and greatly appreciated. Its with gratitude and pride we give you this special Recognition Award that daas so thank you. [applause] im going just to turnover the mic to a commissioner from the veterans commission. He would like to say a few words about shan. Im going to miss you. You as well bill. My name is bill barnacle and for the city and county of San Francisco. Its an honor to be working with you for the last year. During my short tenure as commissioner that we accomplished a lot and without shan these things would never happen. The first one which was the milestone we helped a 94 year old veteran world 22 veteran and needed help and bill i am trying to get my datds dad benefits and went through congress and lets see what i can do. We have a great staff in the office and she emailed me the information and i sent to shan and we had hiccups and right before christmas and those veterans and im retired Vietnam Veterans and a teardroppor bill i want to thank you so much and after eight years we got my dad benefits. Without shan this wouldnt have happened and her crew and its a milestone and incredible at 94. [applause] and then last year we did a lot of things last year and launched out the elder veterans Protection Program on november 10 before veterans day to prevent pension scams and homes and department of justice and Attorneys Office and here in San Francisco and the institution of aging. This went public last the day before veterans day and nationwide in june and were going to address all the care homes and go into the homes that people are taking advantage of the older veterans and take care of it and no more scamming and poaching. Its over now. We accomplished that. We helped a few other veterans that she helped and said bill we have been to the va and has extensions and went to the va and let me try ouroses. We have a fantastic staff and we helped four and one from iraq and afghanistan and no idea they were entitled to benefits from the va hospital and thanks to her and john and dorian these guys and women were able to get benefits. Lastly or two other things i want to thank you and staff for the privacy rooms. We had issues with veterans going into the office and its decorated and the privacy rooms thanks to you and when i took over on the Commission Part the last several years there was no mention of the veteran Service Office in the reports so for the first time and imperative that we acknowledge the county Veterans Service office and in collaboration with us we Work Together and so far we accomplished a lot and on the report we mentioned these items and thank you because you guys have never been mentioned in the annual reports so your legacy will continue on shan. Dorian will do a good job and the staff. I know dorian will do a good job and hes retired from the United States air force and the air force guys are fantastic individuals. Okay. So im going to finish here so i have an award for you. In the we have a challenge coin and the core values and the core values are basically what we go by, and in the air force we have Integrity First, [inaudible] in all that we do and serve before self and what better words to describe her and the team and Integrity First and high moral standards and looks out for the veterans before herself and service before self and bust her buns to help the veterans and thats what its about and the county Veterans Service office and i was honored when i got appointed to the office to help vet velts and we did an incredible job with and you integrity and honor in all that we do and service before self and challenge coins and google it and everything that do you and supervisor thanks for taking care of our vets on behalf of the commissioner and the president of the commission so this is for you. [applause] [inaudible] and one more and were almost done here. [inaudible] when the clock goes off, three minute warning so this from supervisor tang. She was the chairperson for the rules committee and [inaudible] so katie was she knows what the accomplishments you guys have done at the Veterans Service office and bill, i want to make sure shan is recognized for the efforts for the last 28 years and a certificate from the board of supervisors, city and county of San Francisco, the board of supervisors of city and county of San Francisco hereby issue and authorize the [inaudible] honor and appreciate the public recognition distinction and merit for Outstanding Service for the significant portion of the people of San Francisco and shan yue and the board of supervisors for the city and county of San Francisco extends to you the highest accommodation for 28 years of dedicated service to the veterans in the city. Your dedication and passion for serving veterans has been invaluable and congratulations on the well deserved retirement and signed by all the Board Members and all the new ones so congratulations. [applause] with that being said i have one more thing. I hate to say this but this was on sale at walgreens. Happy valentines day so i had to get this for you and candy. How weet. [applause] thanks. [inaudible] [off mic] [applause] thank you. [applause] next report is the Advisory Council leon schmidt. Good afternoon president james, commissioners, executive director. The Advisory Council last met on january 18. At that meeting we announced i may have said this in the last report but announced the folks who were to represent who will represent the Advisory Council for the dignity fund. We also i will make this brief we had a report from our Rick Applebee of the Education Committee and having the next Community Training will be on the 17th of february, this coming friday. Our Nomination Committee also met and nominated slate of officers and those people are in place. I can tell you who they are. Allegra [inaudible] is our secretary. Anne marie is the second vice president. Ms. Eleanor lori is the vice first president and i am the president again so thats my report. Any questions . Thank you. We also had a site visit too to the hamilton center. Any questions . Thank you. Thank you. Thank you. Our next report is joint legislative committee report. Good afternoon. Diane lawrence. Sorry. Good afternoon. I am keep this brief. In january we met on the 18th. We looked at three major areas. January is a month where things are starting especially with the new session at congress and the state level where everything is coming together so i will have a more detail the report on legislation next month actually in two weeks so at the federal level there is uncertainly with the repeal and replacements of the Affordable Care act. Theres a lot of uncertainty. There were requests for advocacy and right now back in january it was difficult to determine the impacts also on the Older Americans act with the new administration in congress. That was just authorized last year any since there has been no budget yet we dont know what is happening. The state level california is looking at a health car plan. No clarity but it was mentiond and we have to monitor that and at the time of the january meeting the legislative proposals were due friday the one and they must be introduced by this friday the 17th of february so we will have more detail. The governor has agreed that housing is an issue for california both at the affordable level and otherwise, and in his january budget release the governor proposed a 1. 1 6 billiondollar deficit and result of under stating revenues by the Budget Analyst Office and over estimating the size much the budget and we will see as they work through the process. Our local reps have been assigned of scott wiener and of Human Services committee and david chiu to housing and phil tang to the budget. We discussed the funding cuts for the coordinated Care Initiative which were allowed to expire, and there will be more details on that as we move forward and were continuing to work on the bay laws reconciliation and there will be there was further discussion at our february meeting. Any questions . Thank you. Youre welcome. Long Term Care Coordinating Council report. Good afternoon commissioners. I my name is jeremy walen dll berg and with the member with the long Term Care Coordinating Council. We m two meetings since last time. The commission was updated so i will be as brief as possible. The long Term Care Coordinating Council met brief plea with the Mayors Office to make sure we were coordinated on our budget and policy process. And also what we could do to be helpful to them in light of national changes and trends going on and one of the recommendations was to collect [inaudible] clients and Service Providers in the city. In terms of the make up of the council itself we have had have a few changes in terms of members. One proposal was to transition the seat to the department of homelessness and supportive houses and margo antoinettey from the department will join the council. Also to add the well Elder Service provider seat im sorry to switch the older Service Provider seat rather than longterm care and provider seat and add Patty Clemmons i am sure i will say the name wrong [inaudible] thank you to that spot on the council as well. Also laura liaison nominated from the institute on aging to the now vacant longterm care and Supportive Services seat as well. And there is still one remaining seat open on the council for the consumer seat and we received a legislative update from the department. A lot of the same legislative concerns that have been reflected over the last few weeks. Currently with the state budget deficit and also federal challenges. In terms sanctuary city as we know mayor lee reaffirmed the policy and the City Attorney herrera filed a lawsuit execute the executive order calling for uninstitutional and from the state level the coordinated initiative and efforts for ihss there have been updates and the california directors of welfare of california and other advocates the governors proposal and end the program and return to the counties as negotiating with the counties. At the local level as well there have been an announcement between mai lee and mayor liccardo in san jose and assemblyman david chiu that automated Speed Enforcement legislation will be proposed at the state level. Seniors and people with disabilities are disproportionality affected in terms of injuries and deaths and pedestrians and deaths in San Francisco from vehicle collisions and this legislation would look to give localities power to implement automated Speed Enforcement cameras in San Francisco and the city and county. I dont want to go on too long here. We also had a update from the Palliative Care group, working group. I am happy to run through the different updates from that group in terms of education and health care training, core support for Decision Making capacity for individuals, providing the most high quality Palliative Care, better understanding the needs of citizens around these issues, and providing a resource directory in support of san franciscans with serious illness and the Community Engagement piece as well. In terms of the aging and disability Friendly Task force weve had our second meeting. Members of long Term Care Coordinating Council are represented on that body. We heard an update from kelly deerman who say cochair on the aging and Disability Task force. Thats the world health force San Franciscos commitment to the World Health Organizations model. The next meeting is on march 8. We began last week by looking at assets and upon gas and recommendations and we will continue to do so in the next overview of all the services and asset gaps that we might have as a city currently. There is a website that will be live on february 24 and update the public ongoing problem with that task force. Dignity fund. We heard a bit of the update just now before i came up but all members have been filled for the oversight committee, the long Term Care Coordinating Council is well represented. Two year appointments. The first meeting will be an introduction of the members including [inaudible] and discussion of the aoc, Service Allocation plan, selection of cochairs and lets see. Also there will be a Service Provider working group that will be announced as well. In terms of a briefing that we received last week at our last meeting from jennifer friedenbalk the executive director of the coalition of homelessness and concerns on homelessness and Housing Needs in San Francisco. One of her estimation are the biggest issues and concerns and what we can do Going Forward and how it specifically affects seniors and people with disabilities. Also in terms of housing for seniors and people with disabilities on this panel. Josh van burger associated clinical professor of Family Community medicine at ucsf mercy spoke to a paradigm shift in the idea of making cost of homelessness as a Public Health issue and seeing where we can draw upon private sector and health care to better support Housing Needs and how Housing First policies really take care of a lot of the Subsequent Health issues that people particularly people with disabilities and aging adults on the streets face. One example they had in the state of hawaii there is a state legislator who proposed a bill to classify house ago sorry, homelessness as a disease and therefore compel the department of Public Health in that state and private Health Care Providers to help fund and leverage state and federal dollars for housing as a medical concern for homelessness. We also heard from tommy from the the director of counseling and programs and how long Housing Committee and spoke to eviction and Legal Protection for people particularly people aging and with disabilities in the city and the need for data gathering around the issue and the myriad of housing for those individuals types of non supported and some of the lowest condition and not regularred housing and the need for trying to identify those individuals and that type of housing and the data around that to make a better case for how we can improve what were doing to house Homeless People with disabilities. We heard from one of the ltccc sorry, the meeting before, last weeks meeting we had a presentation from another member of the ltccc around from sutter hospital on discharge planning and theres going to be a shift. The main take aways that hospitals must have discharge planning for all patients and that must include evaluation for self Care Capacity and medical post acute needs. Thats a shift that sutter and working with Community Based Care Organizations are going to be working on, so theres more but thats probably a lot for now if you have any questions i am glad to help. Commissioner ow. Yes, you mentioned that bring back the report to your office and she make suggestions how to alleviate the homeless of seniors. I would like you to give us some detail. Whats her suggestions . Sure. Let me pull up the notes so i remember what her suggestions are. And lets see. One is the biggest issues is that the pipeline for housing that we have right now for Affordable Housing is pretty minimal and were not on pace to meet the demands of across the spectrum of ami of very low income to affordable to middle income for housing and the current pipeline for financing, constructing and moving people in is very much behind where we should be and i think that was probably one of the main take aways for the members on the council who are here would like to add additional insight. Thats probably the main take away i heard from jennifer. Housing . Absolutely. Yes and that the Affordable Housing pipeline does not have enough projects to meet the demands that she sees. Sure. Any other questions . Thank you. Thank you. Okay. Next item tacc report. Okay. Kath senot here. Okay. Moving on case. Good afternoon part of the coalition of agencies serving the elderly board so i have two items to give a report on the activities and then wondering if i should wait until Public Comment to comment about some of our budget advocacy things so i will do the report first and come back after the nominating committee or just stay up here . No, just give your report and then i will call for that. Okay. Were very excited. Weve got some new Board Members joining our crew. Over the years some people have gone off and excited about seating new members are joining this next year or have joined us. Were having a board retreat for these new members and some of us have been around for a while on monday february 27 to kind of really map out our strategies for this next year plus, and we do have our ongoing membership meeting. This next one is march 13 and we always meet in the offices of project open hand on polk street so i will be back with more. Thank you. Okay. There is no report for the nominating committee. We said that when we adopted so now we have general Public Comment item 6. Any general Public Comment . Im back. So i know that case had sent a letter to executive director Shireen Mcspadden about our voak. Every year we pull our may be and what are some of the Critical Issues that are percolating to the top that we need to advocate for older adults and people with disabilities in the community and we know there are unknowns about the budget whether its state or local but its important to put our issues and represent forward. One of them that our membership has put forward is transportation to the tune of 510,000. This is more for group van during the whole free muni for seniors. That part of our senior population and people with disabilities was left out so the details are in the letter to director spad spad. Another ask from our membership for people with disabilities is 488,500 to continue to work sure that the Digital Divide between older people and the rest of the world is starting to shrink. This money would help agencies offer an expansion of classes, increasing Computer Centers and help individuals get internet, very affordable Internet Access set up at home so we have some specific programs underneath that amount of funds and then we have ongoing needs for Case Management. Some of you are aware the city is going to an centralized in take for Case Management which i personally having that program in our agency am excited about because i think it will really track the kinds of needs that our community has, but in the meantime we still have to get our work force up and adding to them so our ask for this next year would be 450,000 and that really represents additional case managers added to our community collaborative. This last year as you know we were successful thanks to your efforts as well as the board of supervisors that we did get some additional money to increase the hourly wage which i think has helped stabilize a little bit as the cost of living increases, so this would then help add additional case managers to the community and may also assist with increasing some of the salaries that were not done in the past so we hope that you will keep that in mind as all these budget things go forward in the next few months and that is cases requests. Thank you. Is there any other Public Comment . Hearing none Public Comment is closed at this time. Next item seven old business. There is none. New business. All items action items require a vote by the commission. Now we will have item a review and approval buzz review and approval of daas fiscal year 1718, fiscal year 1819 budget by dan kaplan. Could i have a motion to discuss . So moved. Okay. [inaudible] [off mic] i was reading an article about the fact we think more seriously about Analogue Technology so were going to do this analogue. So i do want first note we did a last minute swap out of a slide and thank you for catching a point on that. We wanted one of the things i would like to say at the beginning of this commissioners is that this budget if you look at the slides that represent the budget as revenues or expenditures or by category seems to change a great deal and i think in reality it doesnt change that much. I mean from the point of view of what were actually doing in the world. There are two items that have caused fairly profound accounting shifts in this budget, and one is the governors proposal in regard to the ihhs moe and the other is dignity fund so money moved from slide to slide and i will come to that, but i think the points they would like to make at the beginning as we start looking at this is that this is a budget that is actually a very conservative budget and a budget that is very much tied to our previous years budget. We have not added much in it at all, and thats partly because of the tightening situation that the city finds itself in and when i was last year we talked about being in a time growing revenues, but faster growing costs, and associated with that that the mayor had asked agencies to propose 3 reductions which hsa, daas, occ e and the department of Human Services collectively have done, so what we have here is a budget that does not add new positions, and really adds very little in new programming outside of what will be added through the dignity fund process, but money shifts around a lot within the budget, and i think it is more accounting than anything actual so i just want to say that up front. So just to review we have this year a small reduction which weve handled collectively so it doesnt feel like a big deal in any of the parts of the hsa budget. We have a state budget that presents some challenges to us, and these represent things that we and the Mayors Office are actually working on together and having absolutely squared around how were handling them at this point but through this process we will need to work out how were handling them so most importantly in the daas program is a change that the governor has proposed in the way we pay for ihss services and i want to emphasize that the governors proposal does not change ihss services as clienting will receive them clients will receive them. There is no change in eligibility standards. There is no change in expectations of the numbers of hours of services that clients will receive given any level of functional imparamount. The proposal is really around the financial relationship between the state and the county with regard to paying for the non federal share of the ihss program so it also doesnt obviously affect the federal share of the program, but the estimated effect of that change in San Francisco is 40 million, and basically that happens because the governor is proposing going back to the preihsshis moe method of paying and went into effect in 2012 and it has in fact before a great benefit to counties in general and the San Francisco in particular in terms of dealing with the costs of case load and hours growing at about the 7 a year rate, the impacts of the minimum wage, mild inflation in the Health Benefits arena, and so if we go back to the previous way of paying we will lose those benefits to the tune of 40 million, so thats still hanging out there. Thats something we will need we the city will need to figure out how we handle. I should say there is a whole political process as you would expect that is going on with regard to the ihss moe. The California State Association of counties had sort of the over the Umbrella Group and many subgroups that represent social services agencies, Mental Health agencies, Public Health agencies, agencies that represent public authorities are all banding together to work on midigating the impacts of this and frankly in his proposal the governor acknowledged this would have a huge impact on counties and willing to talk about ways of mitigating the impacts so thats all a process that is unfolding. Anyway what we have in this snapshot of the budget in front of you today, brought to you today for approval, assumes that we, the city, will be picking up the full costs. Obviously it is our hope in the end not to be, so i will leave it there. Excuse me. I am sorry to interrupt you but i want to make sure i understand. The governor is saying hes not cutting ihss but changing the pay formula, the reimburse formula to one that existed years ago and consequently results in a loss to ihss funds for counties . Actually it results in counties having to pay a larger share of ihss. So in effect what hes doing is hes saying were doing the same thing but you have to pay more somehow through some way, some political hocus pocus if i understand this correctly . Well, its not hocus pocus. If the proposal stands in the way he has proposed that counties will pay he estimates and i will take him at his word here 626 million more for ihss services that they would under the current fiscal years arrangement. And yet hes saying hes not cutting state funding for the program. No, i didnt say that. Hes not cutting the benefits to clients so the ihss program per se looked at from a client point of view does not change. Same people are eligible and the same way of allocating hours to clients will stand. But it would change if the counties dont come up with an additional amount of money . So this is part of the challenge. I think its i think if the policy does go through the counties actually dont have an option not to come up with the money and thats what makes it so difficult for counties because this is an entitlement program. If i as an individual meet the functional imparamount and the financial Eligibility Criteria for ihss i am entitled to ihss services. If i am living in the city and county of San Francisco, a member of manage ans team will megans team will assess me using a standard instrument and based on my imparamounts dan is eligible for so many hours of care a month and i am entitled to that and so this is really about who pays, not about whether any given client gets or doesnt get the service because they will get the service if theyre eligible. Thank you. Commissioner ow. So much money ihss comes from the federal government. How much does the state after the federal governments roughly a percentage wise . Right. So there are different pieces of the ihss program and theyre sorts of caps and complicated rules around that so if we look at the costs of provider wages and benefits which represents the largest share of the costs of the ihss program the federal government pays about 56 cents of every dollar and 44 cents of every dollar is the non federal share. Within the non federal share the state pays 65 of the whole and the counties pay 35 of the whole, but the state participation is capped, so the state only pays its 65 on the first 12. 10 per hour of the costs of the ihss program and so under 12. 10 the state pays 65 of the non federal share. Counties pay 35 . Over 12. 10 per hour counties pay all of the non federal share so i think that comes in San Francisco nets to about 20 , give or take. [inaudible] [off mic] okay. How much last year the county pay for the countys portion last year . Year . , the year before . So last year the countys portion was about 80 million over the whole ihss program, and we are estimating that next year it will go to about 123 million. Thats a lot of increase. Yeah. About 3 million of that would have happened anyway but 40 million as a result of the governors program. And not only that we will have more seniors receiving ihss with the population grew older. We agree. Okay. Yes, i mean thats part of the issue here. The program has over the last couple of years been growing in the city and county at about 7 a year in terms of the total hours of service. That is i believe a tiny bit slower than the state as a whole but not much slower, so basically in San Francisco over the last years at least the program has been growing roughly the same as the statewide program. I just have one question before you go and you mentioned that this may be the governors decision. Does the legislators have any voice in the decision that he makes regarding this or its just his decision . Yes and yes so i will explain that, so the ihss moe is a component part of something called the coordinated Care Initiative and generally referred to as cci. The cci is part of legislation that was passed in 2012. In 2013 the Legislature Passed a bill that gave the governor the authority or the responsibility of evaluating the Cost Effectiveness of the cci and the authority to back out of the cci if it wasnt Cost Effective so that is an authority that rests with the governor and he has exercised that authority. He has stated in his budget message this year that the state will be backing out of the cci, so as far as that goes the governor has that authority. The legislature of course can say well, the governor has backed us out but we are going to address this in any number of ways. They can change sharing ratios or change caps and the state participation. They can change any number of rules relating to the financing of the ihss program, so the legislature can mitigate this but its the governor who is empowered to step out of the cci. Thank you. I just wanted to know legislative committee. Okay. I actually dont really want to go in great detail through these slides and i think what you will see if i did that, and it would be very confusing. I have the ability to be confusing about this stuff, i know. What you would see is that most of the daas programs are growing by relatively small amounts and theyre growing based on personnel costs, inflation plus the annualization of the costs of some positions that were added last fiscal year, and then you would see big accounting shifts relating to things that have to do with the ihss program and you would see big accountings relating to the office of aging and the dignity fund so thats what you would see and so we can move forward to i kind of like this. What page is it . This is page 6. I skipped the pie charts. Most people are desperate to go through them so one of the things we did want to propose to the mayor that we will fund, and we are actually funding this internally which means were funding it within the reduction targets of the agency so weve gotten some additional revenues and shifted some things around that allow us to fund some very minor changes. The ihss tiered wage proposal is really a pilot proposal if you will. One of the things that we have noted both within the non relative portion of Public Authority, ihss caregivers and within homebridge, the contract mode provider is a greater and greater difficulty in attracting and retaining ihss caregivers, and a theory that makes sense on its face and may actually be right is that the minimum wage law went into effect in San Francisco we generally paid ihss caregivers about an dollar an hour, sometimes more than that above the minimum wage, and that gave us some slightly greater ability to attract and retain caregivers. When the minimum wage law came along the ihss wage became the minimum wage so its currently 13 an hour on july 4 and become 14 an hour so the minimum wage law is a good thing that it gets more money in the pockets of low wage workers. We believe its created a challenging situation within ihss which is a tough minimum wage job, so this proposal is to allow us over two years to test the notion that providing wage increments to workers who are trained and who stick around for a certain period of time will allow us to retain a slightly more robust work force than we have been able to in the past. I should say that this is based on a theory. Again we think its right. Its not absolutely proven, but we do recognize that we and longterm care in general has a huge issue with attracting and retaining direct caregivers, and so we know that this is something that we have to address you know everyone that is work ago i shouldnt say everyone. Many people working in the area look at this as a key strategic issue so this proposal is a way of testing the impact of relatively small incremental wage increases on retention and thats why its here. We have proposed 19 subcommittee substitutions and reclassification of a position from one title to another. Sometimes the reclassification costs more money, sometimes it saves money, and as you can see on this sheet we have a number that pushes the wage up a little a little and some push it down a little so what were doing is reclassifying in a way that makes more sense for the administration of the various programs. Theyre based on suggestions of individual program manageros reorganizations of their offices. Yeah . The numbers just didnt look like they equated to full time head count. Some of them are pretty small. 4,800 on Office Office of aging. Thats not a whole person . No. Its not. Its a change from one classification to another of one position. Okay. And that particular [inaudible] [off mic] so this one happens to be a reclassification from one type of analytical position to another type of analytical position that is more consistent with the other analytical positions in the same office. So effectively those are people get raises or promotions . Or if its a vacant position we go and hire. I see. Okay. And then the last item, and i should say this is one that we worked on as a potential budget concept this year and it didnt make it into our budget because the budget is tight. This is something that we intend to continue to work on over the next year. It is the concept of having some number of beds or some pot of money to supplement payments by individuals for crsf and its a way to stabilize folks in the system who are challenged in a number of ways and need to be in a supported environment. One of the other things we have been talk about and hits with this to some extent is the notion of looking. At medicare waivers and for assisted Living Programs and available in some part of the state and there is interest in seeing how they would play in San Francisco so as we continue to work on the concept that is part of it as well and a way of having the Medicaid Program pay for this or at least having a federal share associated with these costs. Yeah . Daniel two questions about that. One, what is bed patches mean, 20 bed patchs . So the concept here is for people i think now days were saying Residential Care is about 6,000 a month, maybe a little less and for i didnt hear that. Yes, in the private payment payment about on average six thousand dollars a month and people in the ihss system or. I thought we approved a budget in the last year to the Community Living campaign for some excess capacity like this. Did we not . For Community Living fund . Yes. We did do that so they do have some access to some patches but its just not enough and one of the things as dan mentioned we have a real need for this within the department so when Adult Protective Services for instance has a need to move someone into a placement like this they dont have resources and we have resources through Community Living fund but not enough and we wanted to highlight the shortage of beds and the continuing need. So this would be increasing what weve already thats correct. So just as a last item you know i know sometimes we talk about this process with more clarity than i think it deserves. Maybe my fuzzy tone is directed to that, but you know we are at the point now where we are submitting to the mayor a budget proposal, so it is reflected here in these documents and in my letter. You know there will be very minor changes around the edges in some of the numbers to get them to be perfectly lined up and then we will submit and we will do that next week, and i guess that marks officially the end of the agencys stage of the process and the beginning of the mayors stage of the process and so in one sense that is what it is and in another sense its a little artificial and we go back and forth with the mayor talking through concepts and making changes and dealing with issues as they come up and so that happens over the next several months and then of course the mayor by june 1 issues a budget and as part of that he is he or staff are consult wg us. Theyre consult wg advocates of various sorts and Board Members so this is a very fluid process so were asking for your approval at this time of this budget concept, but certainly the budget process will continue and we will be fluid all the way until the end. Thank you daniel. I have one question. I would like to go back to page three just so that i am clear on this and for give me for being obtuse but i want to make sure how this is working. The budget for fiscal year 1718 is 278. 6 million which is approximately 16 million person the previous budget. Is that correct . Thats correct. Okay and this pie chart shows the different funding streams as they currently are envisioned to get to that goal which assumes that the budget the governors formula for ihhs will prevail and that the short fall will be made up from the citys general fund and additional federal funds and other things are funded through the dignity fund but the dignity fund wont be used to supplement the similar size cut in the governors budget. Is that correct . Thats correct. Okay. Thank you. I understand. By legislation the dignity fund is not funding the ihhs program. Right. So what were assuming then the cuts coming from the governor in ihhs will be made up primarily by the general fund in this fiscal year. Entirely through the general fund. Thank you very much for clarifying that. Any other questions . Commissioner loo. Yes, i want to turn to the Program Detail in this package that we had. I want to look at the department of aging, the proposed budget by what page is that commissioner . It doesnt have the page number. Okay. Its at the first of the [inaudible] [off mic] commissioner loo can you please speak into your mic . I am talking about the Program Detail section. Oh im sorry. I didnt realize. Its page i think its page three of the Program Detail. Okay. Okay. The third page, not number 3. It doesnt have the page number. Im sorry. I just felt a little bit uncomfortable about the proposed budget by character and the Contract Services i am looking at. The pie or the years 1718. Yes. And so thats a reduction of 2. 5 million for the program, the contract. Yes. Why is that . Yeah and so does that mean that the agency, the contractors have to absorb the loss i am just asking the question. Its a good question, so i think the answer to it is no though, so as i understand there are a couple of things that account for all of this and my budget team for daas can help and one thing an alzheimers grant that we budget is about a Million Dollars grant we budgeted all of it in last in this fiscal year. It actually the money actually carries through over a three year period so its not separately budgeted in the second and the third year, so that accounts for a Million Dollars of the apparent reduction, and then another major piece was the housing subsidies that were associated with prop k so if you remember in the last election there was a sales tax increment that funded Transportation Services and homelessness services, and a small piece of the money for the Homeless Services was budgeted to come to daas for housing subsidies. Okay. So since that measure failed those dollars were never available, so we had budgeted them in anticipation of the measure passing. When it didnt pass there was no program so its not like there was anything we were actually spending that is then taken away. It was money we hoped to be able to spend that we never got, and dont have in the future. Thank you. Because i dont really want to see the agency is already struggling. I mean you know if were going to cut we shouldnt be cutting the program. Contractors should be cutting somewhere else. Okay. Thank you. Any other questions or comments . Any comments or questions from the public . Thank you very much daniel. Call the question. All in favor say aye. Aye. Im sorry. I apologize. I would like to recuse myself from the vote. Okay. Thank you. All in favor say aye. Aye. Any opposed . Thank you. Motion carries. Thank you very much daniel. That was a comprehensive presentation, rather esoteric but nonetheless you made it clear. Okay. Item b. Requesting authorization to enter into a new grant with self help for the elderly for provision of medicare improvements for patients and providers act mi ppa grant for Health Insurance counseling and Advocacy Program hicap during the period september 30, 2016 through september 29, 2017 in the amount as listed plus a 10 contingency for a title amount not to exceed amount as listed. Good afternoon commissioners. This program has a purpose to increase enrollment in the low Income Subsidy and helps with drug d costs and cover the premiums. With your approval the contract today the mimma program will be administered within the program and for the self help by the elderly and logical to be with hicap because they have the infrastructure and expertise in place with the program doing outreach and things related to medicare. This is well is a medicare related benefit. The Social Security administration estimates that extra help provided by the low Income Subsidy and medicare savings programs can be worth an average of 4,000 per year in savings for participant it is and to put that into context in the federal fiscal year 1516 self help for the elder and hi cap program completed 161 applications for one of the 12 programs. California department of aging sets the benchmark for performance level for this program. Theyre asking for 148 applications to be completed in the current federal fiscal year. Self help how do they do this . As part of the hi cap program they reach the clients through outreach campaigns, educational events and ultimately one to one counseling with the clients. Sum i am here seeking approval of the Program Contract kept with the self help for the elderly hicap program. I am happy to answer any questions. Thank you. Any questions or comments . Commissioner james. [inaudible] organization has been using hicap and at one time they had federal training so its my understanding that the federal government would not pay for them to go to out of state training. Can we its a good question. Yeah. So it used to be that they would come here to San Francisco but theyre not paying and so are we missing out on the federal training that they can receive and so i am wondering if thats something we can accommodate . [inaudible] [off mic] please come to the microphone. Thank you. The training is by the state because its a state of california so we cannot go out of the state for training so we have the training in the state right now how its managed. [inaudible] and then how [inaudible] so we dont have a federal training. They have training but set up by the state, by the rules of the state. And as far as i dont know if this answers the question but as far as you know training you know there are requirements placed on the hicap counselors that they have to go to training and its understood that some of the funding that goes to the program is being utilized to support the training of the counselors and the staff. No. But i am just saying in terms of the federal part. I mean you know like the federal agencies used to come out and provide specific training to the state to show i am saying where is that lost has been that been lost . And so do you get access to the federal training . Because you miss out going to meetings. Sometimes the staff coming out. As the manager of all of the managers in california we have to have two trainings set up by the state and different parts in the training so for the managers and we provide the training to our counselors, the volunteers. I dont know if that answers the question. All right. Thank you and i just would like to note that this is a federal grant. Yes. Its federal. No general fund money is involved . Correct. Any other comments or questions from the commission . Any comments or questions from the public before we vote. Hearing none call the question. All in favor say aye. Aye. Any opposed . [gavel] thank you the motion carries. Item c requesting authorization to enter into a Grant Agreement with home bridge for the provision of in Home Supportive Service ihss contract mode and for providing Skill Development training and supports during the period of july 1, 2016 through june 30, 2019 in the amount of listed plus a 10 contingency for a total amount not to exceed 88,221,603. Megan elliott will present the item. This maybe the biggest thing we have voted on. Oh not the biggest i am sure. Good afternoon commissioners. President james, directors. I am the ihss Program Director and i am here this afternoon to ask you to approve the grant for homebridge for the ihhs contract mode and for provider Skill Development and support. As dan kaplan was talking about earlier in his discussion of the budget its a very active time for ihss. Theres a lot of moving parts but thats been part and parcel of the program over the last several years so allow me to walk through the main pieces of this proposal, so this grant is divided into two parts. The first part is for ihss contract mode so as you may know the ihhs program in San Francisco serves people with disabilities and seniors and provide services to those vulnerable population can remain safely in their own home, not be prematurely institutionalized or homeless, so about 95 of our ihss commissioners receive service from a provider of choice that is an independent provider and the consumers are considered to be the employer of the provider and they select and they schedule and manage their own Home Care Provider on their own. However, there is a significant portion of the ihss Consumer Population has difficulty with that role of acting as the employer of an provider. These folks may have dementia or a Mental Illness or be vulnerable to abuseo neglect by family members or they may have supporting and cluttering disorder so these are the consumers that are served by the grant mode service and theyre the employee and taking care of the hiring and will asking of the home care. This grant allows for 5 of the population or 1200 consumers to benefit from the contract mode services. So that is the contract mode piece. The second piece is for provider skill training and supports, so as i am sure youre aware that the ihss program is Critical Service to our population and in many cases ihss providers are the main support to consumers that they have and they perform services that are essential to the consumers well being. As dan alluded to earlier when discussing the proposal for the tiered wage Pilot Program the cost of living and the senior population is making it more and more challenging to recruit and retain Home Care Providers, and daas has recognized this and they recognized it long ago and they have made they really prioritized ihss Workforce Development particularly in the area of training, so providing home care training to independent providers and providers through contract mode is really key to getting quality inhome support services and this grant allows for over 3,000 hours of basic and advance the training to ihss providers as well as with post training support and mentoring. So homebridge which was known as the ihss consortium was selected to provide both the contract mode and development through an rfp issued in march 2016 so again commissioners i am asking you to approve this grant to homebridge and i am happy to answer any questions that you might have. Thank you. Can i have a motion to discuss . Moved. Thank you. Commissioner loo. Yes. Tell me am just looking at the budget salary and benefits for Home Care Providers. For the contract mode . For both. I realize there is a difference in fringe benefits. Yes. So the page that says home care workers is for the actual Service Providers that are out in providing the ihss services and they have a different benefit package that is collectively bargained than the other page which is talking about the other staff and they have their benefit rate so thats why there is differences. I thought that was the case but i wanted to make sure. Thank you. Yes. Commissioner. Yeah, you mentioned about the home care workers receiving training. If the homebridge the only one training for the workers in the city. So they have a contract for ihss providers Skill Development and support. They provide training to their own employees but they also provide training to independent providers and also those providers on the Public Authority registry, so for independent providers who are not on the registry the training is optional to them but they can get a stipend to come and get it. And basic training is required for providers to be on the ihss registry. My question is homebridge the only trainers for all the city home care workers . Its the only entity that the city has a contract with, yes. From time to time i heard other entities such as self help for the elderly. They also train the home care workers before or currently. Self help for the elderly has a contract to provide some in home support which is separate from our larger ihss contract and i believe they do train their own staff. But the self help for the elderly they are working under the same program as ihss; right . No, they are not. Oh, whats the difference between self help for the elderly offering home care to the needy and the ihss . The self help contract to my understanding is a smaller contract thats funded through the office of aging, and it is used for people that may not qualify for in home Supportive Services or they only need a smaller amount of in home Supportive Services and not an ongoing need because the budget is so much smaller in that contract so theyre not able to provide an ongoing number of hours for clients. Thank you. Commissioner james. Yes. I know i was for providing education and support. I am looking at item on page two when you said item 2 grantee and example of a recipient in this category is someone formerly homeless, [inaudible] someone with anger management problems and has a history of being physically or verbally abusive towards their provider. Now what i get of the complaint that the care worker had this attitude towards the client and i am looking for where do they get training . Because its a hard job. Care giving is a hard job and sometimes they dont always recognize that they have some anger and it can be taken out on the client who cannot express themselves, so i just didnt find that part in this. Maybe i didnt see it correctly, but i would like to make sure that they receive training in terms of their own recognizing that this a hard job and they receive training or time out anyway for you know relieving their own anger and frustration so that was my concern because i heard a lot of abuse towards from ihss workers and i hear that a lot. If we become aware a provider was in the home bridge contract mode or ip mode of service is abusive to a consumer we would be investigating that both through the Adult Protective Services and then home bridge has an extensive process which they go and make sure that doesnt happen again. If somebody is working for homebridge they of really working to develop support and training and all kinds of other services to help their work force maintain employment and to really work well with the demands and the needs of the consumers that we send to them. In terms of an independent providers and training for them there are trainings that people can avail themselves to of and talk about working with difficult consumers or consumers with different issues like Mental Illness or dementia and how that might cause stress and then cause them to need some respite potentially. Commissioner simms. Timing is everything megan but since we have the projected budget for the year and a large budget item to approve i am trying to map this program to what i just heard from dan so would i be looking in the annual budget for the county dollars associated with this proposal exclusive of state and federal dollars . No. This contract has the same funding mechanism as the rest of the ihhs program. Looking in the city budget in the city budget. I see the consortium projection is 29. 7 million for 1718. Right. And this looks like a little under 17 million of county funds out of the 88 proposed so is this almost 17 million in the 29. 7 million . Im going to have to track back to the pie charts that youre looking at. Okay. Under budget by program. Its the only place i see consortium. Yes and 29. 7 million. That amount on this chart this proposed budget by program listed there. Right. Okay. And theres the slice that says ihss consortium 29. 7 million. Yes. Thats all funds. All funds. [inaudible] [off mic] that includes federal, state and local funds, yes. So apples to apples then im looking for 88 million so it must be distributed its distributed for three years. Three years. This is a three year contract. I see. All right. Im not very bright. Thank you. Im sure thats not it. Any other questions . Any comments or questions from the public . Hearing none call the question. All in favor. Aye. Any opposed . [gavel] thank you megan. Motion carries. Item d, requesting authorization to modify the existing Grant Agreement with on lock day services for provision of Health Promotion healthier Living Program service during the period of july 1, 2016 through june 30, 2017 in the amount of 40,000 plus a 10 contingency for a revised total grant amount not to exceed amount of 432,420. Linda lau. Good afternoon linda. Good afternoon commissioners. I am with the office of aging. This item is to provide funding to restore the budget for the healthier Living Program to last fiscal years budget level in order for us to be able to continue and actually we able to increase the Service Levels a little bit. With this they basically hire part time staff to help administer the program, do outreach, and were able to increase the amount of diabetes workshop called deep by a total of nine workshops and also serve another 90 consumers in the process. This program is going really well and very well accepted and we look forward to getting your approval to amend this contract. Is there any questions . Thank you. Any comments or questions from the commission . Any comments or questions from the public . Hearing none call the question. All in favor. Aye. Any opposed. [gavel] thank you linda the motion carries. Item e requesting authorization to modify the existing Grant Agreement with bay view Hunters Point Multipurpose Senior Services for provision of senior Fitness Health initiative during period of january 1, 2017 through june 30, 2017 in the additional amount of 110,000 plus a 10 contingency for a revised total amount not to exceed 1,991,077 and linda murley will present. Welcome linda. Thank you commissioners. Executive director mcfadden. The next three items on the agenda are related to the board of supervisors add back process. These monies are designated to serve the underserved communities in district 10 and district 11 in the areas of senior fitness. The funds are being divided between on lo k 30th street and the Senior Center and the southwest corporations it Senior Center. The first sum of money is going to the dr. Davis Senior Center. I asked for your approval on this. The department of Public Health reports that africanamerican seniors have higher instances of heart disease, stroke, obesity and diabetes than other older adults and the africanamerican in the bay view area live average of 14 years less than the seniors in the russian hill neighborhood. Regular exercise has proven to increase longevity and the ability to live independently. Exercise can decrease anxiety, can alleviate depression, can lower blood lower the risk of alzheimers disease and the center is focused on reaching members in the community that dont know about the programs and offerings. Dr. Davis will hire a Care Coordinator to schedule classes and the wellness passport program. The program engages individuals in Health Activities while screening them for Chronic Health conditions. Goal is instill healthy lasting behavioral change and including exercise and classes and individual goal setting by a health coach. The coalition provides programs to the black community that promote Healthy Lifestyles and support individuals with Health Issues and has been doing so in the bay view area since 1986. This funding will increase units of service this fiscal year and next fiscal year as well. Can i answer any questions . Thank you. Any comments or questions from the commission . Only one. Commissioner sims. The executive director portion of this budget is 25 of the annual salary if i am reading this correctly. Is that it seems like a lot of time devoted to the executive director for one program unless i am misreading the spreadsheet. Appendix page two. Yes. I dont think that 25 is just to this program but to the entirety of the program. Thats how i see the budget. The entirety of the bay view Senior Services program. Oh okay. So i am misreading the break out. Yes. This is the entire agency. I thought it was programmatic. Okay. Thank you. Any other comments or questions . Any comment oh questions from the public . I do have a question. Commissioner ow. [inaudible] [off mic] less than 10 . Im not sure what youre looking at commissioner. I am looking at salary and benefit detail and i see a fringe of 25 . Yes, i am looking at the salary and benefits detail. Okay. I see the fridge down below. The first column . Okay. Are we looking at the same [inaudible] [off mic] i think youre looking at a budget for a later item. This is on the southwest budget and right now okay. Lets go to my page now. Thats a letter item. Thats the next one sir. Thats the next. [inaudible] [off mic] im going to talk about that in just a second sir so we can look at that again. Any other comments or questions from the commission . Any comments or questions from the public . Hearing none call the question. All in favor . Aye any opposed . [gavel] motion carries. Thank you linda. Item f requesting authorization to modify the existing Grant Agreement with southwest Community Corporation for provision of senior Fitness Health initiative during the period of january 1, 2017 through june 30, 2017 in the additional amount of 50,000 plus a 10 contingency for a revised total amount not to exceed 788,861. Linda murley. Thank you linda. Thank you commissioner. I seek your approval to modify the community Services Grant with the it book Man Community center to enhance its senior fitness offer accident. The it book Man Community center is located in the oceanview Merced Heights ingleside area of San Francisco. 25 of the seniors attending it book man live alone. Cities indicate werely to stick with the fitness regime if we exercise with a group and they will have classes and hikes designed for elder adults and museum walking tours to grow Center Attendance and build community. The supplies that bought are yoga mats and exercise balls sand to keep the area cool. The data and Consumer Satisfaction results we gather at the end of this period of time will help us generate funding for next year. Were already looking at ways to fund the programs for next year. We will see an increase in units of service this year and next year. May i answer any questions . Thank you. Any comments or questions . Commissioner ow. Now are we talking yeah. Now i am looking at the sheet for southwest Community Corporation. The bottom of it indicate page two 9. 8 . Yes, i see that sir. [inaudible] generally i heard the fridge benefit is 25 , 30 . Yes, and i will have to research this for you sir and get back to you. I dont know the answer to that question right now. [inaudible] [off mic] oh this gentleman does. [laughter] hi. I am the contract manager for southwest Community Service contract. We have a doctor from southwest. She can detail what is in this, the rate sorry fringe benefit rates i believe includes Health Benefits. Theyre not Retirement Benefits so the package as a small agency might not be as comprehensive as other agencies [inaudible] did i hear you correctly that the contract that this particular agency does not include Health Benefits for its staff . I believe they have Health Benefits. It has so therefore the funding and the fringe benefit is substantially lower in this case, is that it . Yes. Because the fringe benefit is not as comprehensive as other okay. [inaudible] [off mic] i believe not. I can verify with this is the result of their own compensation package [inaudible] okay. Which is different from what we usually see. Okay. Thank you. Any other questions . Any comments or questions from the public . Hearing none. Call the question. All in favor. Aye. Any opposed . [gavel] thank you. The motion carries. Thank you. Item g requesting authorization to modify the existing Grant Agreement with on lo k day services for provision of senior fitness and Health Initiatives during the period of january 1, 2017 through june 30, 2017 in the additional amount of 40,000 plus a 10 contingency for a revised total amount not to exceed as listed. Welcome back linda. Gone of. As my colleague mentioned this is part three of the initiative for the Fitness Programs for bay view as well as the southwest Community Corporation. On lo k day services will provide the Evidence Base program always active Fitness Program to the two sites and able to then not only offer the classes but also train the staff who are volunteers at the two centers to lead the program, the classes after the funding ends, and so this is going to be you know the budget allows for funding for some of the equipment to equipment the sites with the necessary equipment for implementing the always active program. This is different from the other Fitness Programs that the other sites are incorporating. Are there any questions . Comments . Just a general comment. I would like to see the agency name on each budget each page so that if sometimes i tear it up and i can refer back. Just a general comment for all. Thank you. We will pass that on. Thank you. Any other comments or questions from the commission . Any comments or questions from the public . Vol ree. I just want to say that daas over ten years ago had the vision of Health Promotion and i gave on Lock Services money to launch the program and celebrating ten years this year and with the money linda proposed were adding additional sites and classes that will total 37 classes a week, and the one thing i want to point out thats a little different these days. Its not a general exercise. They really are working on Strength Training which for older adults we have to keep working on it to keep it and prevention and balance work and i am just really proud of it and at it bookman we had one demonstration and a following demonstration on february 23 from 130 to 230. I invite any of you to look what it looks like and what they do and do that with the staff and if you want i can show you maybe all the Different Centers where we are offering that along with the organizations that house this program. Its a real Great Partnership with citywide with the different agencies. Thank you. Where is the demonstration take place . It will be at the it bookman center at 446 randolph street. This is where the class will eventually be offered twice a week and thats another important part of it that in order for you see changes in the body you need to do a minimum of two days a week with Strength Training so why most of the sites have two and at george davis we added a third day and what is really exciting is were seeing more and more men. When we first started off this program it was dominated by women and now the men are getting with it as well and were seeing larger and larger especially when we get out the weights and that attracts them a lot. Commissioner james. I have a question. Do they require a permit from the doctor . Yes they do. [inaudible] [off mic] its a very simple note from the doctor that just basically says that its safe for them to do group exercise. We have found that partners with the physician has been essential. Initially they said i do have to go to the doctor . And once they get it the doctors will fax it to us and theyre involve exclude our bodies change over time so if a senior has difficulties getting that we have partners to help with that. Does the doctor get a description of the exercise . Yes, there is an enrollment packet that they get and all of that. Okay. Any questions or comments from the public . Hearing none call the question. All in favor say aye. Aye. Opposed . [gavel] thank you the motion carries. Item h requesting authorization to enter into a Grant Agreement with Community Living campaign for provisions for reserve crsf Employment Services for diseerns and adults with disabilities during the period as listed in the amountace listed plus a 10 contingency for a total amount not to exceed 745,140. Welcome back michael. Hello again commissioners. Very excited to bring this one before the commission today. This is a new program at daas and i believe also a new program in the city of San Francisco. The purpose of which program is to develop Employment Opportunities for seniors and adults with disabilities. The Program Model were basing is in already in prais. Its operation and the reserve program and started in 2005 in new york city and was successful there and ex357bded to other locations in the east coat and midwest and now bringing to San Francisco. Through the procurement process the contractor submitted a well thought out comprehensive model here they will serve as an a liliate to the program and use infrastructure such as program trls and a data base system. Theyre able to access reserve executive staff in new york for consultation during the roll out and operation. Some of the steps taken to adapt this program to San Francisco include most notably the inclusion with adults with disabilities as a target population for services in this program. Its a 55 plus model on the east koacht. They have a Advisory Group to advise on the program. They have met in january. They have secured commitments from at least a dozen nonprofits for possible work Site Development so how does the program work . There are three main things going. They will recruit seniors and adults with disabilities looking for part time work and meanwhile there is recruitment and development of work sites throughout the community which will play host to these part time work roles. Finally there will be the maxing of the reserve to the work placement. They will handle the on going of that placement. Wages are initially fully subsidized. This is used as an incentive for the work sites to develop these work opportunities. The idea though is that as the work site as the work role continues the work site themselves are asked to contribute an increasing portion to depray the cost. By doing this the program has an element of self funding in order to grow the program. The idea there is they might be 100 subsidized but as it goes on and money is brought to defray the placement and starts to start new subsidy start it is elsewhere at other sites so in sum we know that seniors and disabilities want to work and have experience and skills that great benefits to employers. We know there are barriers they face with employment. During the program were hoping to remove some or if not all of the barriers. In addition to economic benefits for the reservists and the work site placements part participants have additional benefits sense of purpose, increased connections with others and contribute to the communities. With that i am happy to answer any questions. Thank you. Any comments or questions from the commission . It sounds like a very good program. Were very excited about it. That i think will provide tremendous improvement and self worth of seniors who feel marginalized and they have nothing to contribute so its a psychological benefit that is difficult to quantify but a good idea. Any comments or questions from the public . Hearing none call the question. All in favor say aye. Aye. Any opposed . Thank you the motion carries. Item 9 any announcements . Commissioner simms. I have one. I would like to invite everyone who is interested to join us at the open House Community residents grand opening and the bob ross Senior Service grand opening on march 23 at 3 00 oclock at 55 laguna and plan long planning and housing for the Lgbt Community of senior San Francisco and come join us for the phase one completion. What date again . March 23, 3 00 oclock. I would also like [inaudible] [off mic] yes. The old uc extension campus. [inaudible] [off mic] yes. [inaudible] [off mic] the date is march 23 at 3 00 p. M. I would like to the 30th street Senior Center. I would like to invite the commissioners and audience to our annual fundraiser. This time we will be doing a luncheon at the st. Francis hotel and were featuring the work of dr. Mario martinez and a neuropsychologist and how we feel can make us sick and science based and international and joining us both for lunch as a keynote speaker and providing a continuing ed conversation afterwards for those that want to dive deeper into his information so i have things here. Can i put it over the table for you. I hope you come and join us and remember that all of the agencies that you support definitely need to do fundraising and hopefully have fun and education while we do it. Can you repeat the date and time please. Thursday march 16 at noon and then the continuing ed conversation will be from two to four and a networking event afterwards with wine and cheese. Thank you. Any other announcements . Cathy. First an apology. I should have been making a report when the Advisory Council did but i wasnt here. I was on the bus. I am the representative to tacc which is represent from all the Advisory Councils in the state. We meet quarterly and the state commission on aging sets it up, runs it, and keeps us going. I think we had a meeting last month but i think what is really important is that we had a speaker, a couple of speakers on the budget and what came out is no one was certain what was going to happen with the budget yet. It was going to be less some way about what was going to go . They were watching and we were feeling extremely like everybody here what was going on uncomfortable with what should we do or how should it be . Seems to me that you have with your state Staff Members excellent people, good. Theyre bright. They have good connections to all the different programs in the state again and again i see that and the speaker on this, so if youre at a point where you really want to ask and get some answers about what is happening with this funding now which is so confusing theyre the people. Call theyre the people. Call sandy in the state office. They will get you the people who are right on top of this and the people who can come out. You can talk to or someone will come here and talk if you need someone about some issue to talk to the group, so were very fortunate to have the people who are in your staff office up there but hey you have the resources if you really you know, to look into this and keep track of what is going on with it, and theyre super nice, and that leads into the fact that i am appointed hereby supervisor norman yee and i was in the office and came to give me an alert which i am sure he wants me to pass on to you. The city budget and finance committee is going to meet here on march 9 at ten in the morning and guess what . Its a hearing on Senior Services citywide and theyre going to have a bla, whatever that is, performance audit from july 2016 in light of the dignity fund. His suggestion to me was what he was saying to me he felt seniors should be there at that meeting. There should be seniors and people from some senior agencies. This is our budget, and finance committee, so im going to try to be there, but hey guys we need to get out and get seniors. Theyre talking about our money and