Resolution: 03-06

Resolution Recommending the Creation of a Community Living Trust Fund

WHEREAS, San Francisco has a range of home and community-based services that can help adults of all ages with disabilities to maximize self-sufficiency, safety, health, and independence so that they can remain living in the community for as long as possible and maintain the highest quality of life; and

WHEREAS, approximately one-fifth of San Francisco’s population (approximately 150,000 people) has a disability; and

WHEREAS, it is expected that the total number of adults with disabilities will increase in San Francisco, with older adults comprising an increasingly larger share of the disabled population; and

WHEREAS, the "oldest old" population, those over 85, is projected to increase by 10,000 people, from approximately 14,000 in 2005 to 24,000 in 2020; and

WHEREAS, San Franciscans face an ever increasing demand for community-based long term care and supportive services for adults of all ages with disabilities; and

WHEREAS, the 1999 Olmstead decision of the U. S. Supreme Court determined that communities must expand community-based services for persons with disabilities who would otherwise face institutionalization; and

WHEREAS, community-based services are critical in the management of risks and acute interventions for adults with disabilities of all ages; and

WHEREAS, community-based services are usually lower in cost, and can prevent or delay the need for higher cost interventions by the Department of Public Health at San Francisco General Hospital and Laguna Honda Hospital; and

WHEREAS, these cost savings can allow the City to serve more people with significant disabilities by expanding the availability of services in the community; and

WHEREAS, San Francisco needs to increase its financial support for community-based services for older adults and adults with disabilities both to comply with the Olmstead Decision and to meet increasing need; and

WHEREAS, in May 2005, Ed Harrington, the Controller outlined two options for the replacement of Laguna Honda Hospital in the report: Laguna Honda Replacement Program - Where do we go from here?, which includes the recommendation for the creation of a trust fund to support community-based long term care services; and

WHEREAS, regardless of which option is selected for the replacement of Laguna Honda Hospital, a trust fund is needed now to specifically support community-based long term care services including housing with support, homecare, and services provided in other community-based settings; and

WHEREAS, in June 2005, the Long Term Care Coordinating Council endorsed the recommendations in its Community Placement Plan, which specifically recommends the creation of a community living fund to be used for home and community-based services that provide assistance, care and support to enable people to live in the community; and

RESOLVED, Resolved, that the Health Commission recommends the creation of a Community Living Trust Fund as part of DPH’s budget this year and sustained in the future, and charges the Department to bring back details of how it could be funded and managed within the next 60 days. This will become the foundation for the development of community living options for older adults and adults with disabilities throughout San Francisco who desire to remain living in the community; and be it

FURTHER RESOLVED, that the Community Living Trust Fund be used to support the development and expansion of community-based long term care services including housing with support, homecare, and services provided in other community-based settings. This fund could be used first for LHH residents and SFGH patients, willing and able to be discharged to community living.

I hereby certify that the San Francisco Health Commission at its meeting of February 7, 2006 adopted the foregoing resolution.

Michele M. Seaton, Executive Secretary to the Health Commission