Originally posted at California Health Report.
By Matt Perry.
Some San Francisco aging advocates call it “the tin cup” — the flimsy, rattling metal container held high in hopes of snagging loose change to fund older adult services.
It’s tough work – challenging and often undignified.
“The grubbing days, people are tired of it,” says retired aging services contractor Bill Haskell.
Enter The Dignity Fund, an idea first whispered behind closed doors three years ago as the city’s aging and disability advocates pondered ways to stop the endless money cycle of feast, famine and insecurity.
In November, The Dignity Fund supporters claimed victory when San Francisco voters overwhelmingly approved a unique cash infusion for aging and disability services inspired by similar efforts a quarter century ago to benefit kids: The Children’s Fund.
For many aging advocates, it was about time.
“We need to take care of our kids – that’s important – but we need to take care of our seniors too,” says Marie Jobling, executive director of the Community Living Campaign and one of the chief architects of The Dignity Fund efforts.
With the new proceeds, the city’s budget will increase $6 million for fiscal year 2017-2018, and will jump another $3 million each year until 2027. Funding based on discretionary revenue continues for 10 years after that. All new income is protected from future budget cuts.
The landmark funding stream – considered the first of its kind nationally – would make San Francisco’s financial commitment to older adults and seniors with disabilities one of the highest in the country.
It also comes at a critical time for the city, which is facing a population boom greater than California as a whole. While older adults are expected to comprise 20 percent of the state’s population by 2030, seniors 60 and over already make up 25 percent of San Francisco’s population, with a whopping 30 percent projected over the next 20 years.
That’s 100,000 more seniors than today.
“We’re looking down the road at increasing services and not enough money,” says Haskell. “If the projections for Alzheimer’s alone for San Francisco pan out, those numbers would be as large as those for the AIDS epidemic in the 1980’s.”
Since the financial services collapse of 2008, older adults have faced a brutal trickle down effect. As city services got squeezed, seniors had to be poorer and poorer to access them.
“In the last couple of years, as we’re getting older and things are getting tougher, we decided we really did have to do something,” says Jobling. “People really have no money.”
In 1991, petitions for The Children’s Fund were brought to City Hall by children pulling red wagons. The groundbreaking property tax amendment was passed and has been renewed twice since then.
Two instrumental members of that effort – Jobling’s husband Tony Fazio and Jeff Mori – offered critical strategic advice for The Dignity Fund.
To sponsor the amendment, backers first approached city and county supervisor Malia Cohen. As a graduate student at Carnegie Mellon University, she watched as an aging Pittsburgh population became “not able to take care of their houses” during the financial services meltdown. She eventually wrote her thesis paper on “aging in place” and today insists on creating a San Francisco where seniors can age gracefully.
Last year’s essential report from the city’s Department of Aging and Adult Services outlines the extensive service improvements needed for older adults.
The Dignity Fund targets seven areas of acute financial need: home- and community-based services; food and nutrition programs; caregiver support; community centers; advocacy and legal services; health and wellness; and culturally competent services.
The new funds are designated solely for older adults, people with disabilities, veterans and long-term survivors of HIV.
Special emphasis will be placed on diversity and the LGBTQ community.
Headed by Shireen McSpadden, the Department of Aging and Adult Services oversees the fund and ultimately dispenses the money. A preliminary budget will be sent to Mayor Edwin Lee by March 15.
McSpadden says the first priority is to “strengthen our bedrock programs” – food, transportation, senior centers and caregiver support.
‘”No matter how much money we put into nutrition, there’s never enough,” she says.
Plenty of discussion has revolved around “re-branding” senior centers to make them more appealing, says McSpadden, and to offer a community space for those with disabilities.
Ideas abound, especially to expand well beyond the typical 9-3 senior center hours. Parties. Game nights. Paint and wine.
“A lot of adults have said ‘I’d come to the senior center but I work during the day,” she adds.
For caregivers, McSpadden envisions more support for adult day social programs, especially for those with dementia, and adding a mobile crisis unit for overwhelmed caregivers.
“One thing we know there’s never enough of is respite care,” she says.
With a whopping $270 million annual budget, is the additional money just a drop in the bucket?
“Way over half our budget is (dedicated to) In-Home Supportive Services,” says McSpadden — a program that helps keep older adults and the disabled in their homes and outside expensive nursing homes. “So a $6 million increase is a sizable amount.”
Members of the Dignity Fund coalition meet monthly to address these priorities. The coalition advises both McSpadden’s aging services team as well as an 11-member advisory committee created by the legislation.
Are other cities interested?
Jobling says she’s recently received inquires from Los Angeles.
For long-time San Francisco aging services advocates like Maureen Erwin, The Dignity Fund is an idea whose time has come.
It’s “a consistent source of funds for those who historically haven’t received sufficient support,” she says.