LONG TERM CARE COORDINATING COUNCIL
Guiding the development of an integrated network of home, community-based, and institutional
services for older adults and adults with disabilities
MINUTES OF MEETING
DATE: Thursday, May 9, 2013
TIME: 1:00 pm to 3:00 pm
LOCATION: 1 South Van Ness Avenue
Atrium Conference Room
Present:
Anne Hinton, Abby Kovalsky, Abby Yant, Akiko Takeshita, Alberto Abello, Amie
Haltman-Carson, Anne Romero, Anne Quaintance, Bill Hirsh, Cathy Davis, Eileen
Kunz, Jennifer Walsh, Kelly Hiramoto, Ken Hornby, Marie Jobling, Mivic Hirose,
Moli Steinert, Noelle Simmons, Sandy Mori, Steve Fields, Traci Dobronravova,
Vera Haile, Valorie Villela
Absent:
Benson Nadell, Cindy Kauffman, Donna Calame, Kate Toran, Marcia Peterzell,
Margaret Baran, Patricia Webb, Rebecca Malberg, Patricia Webb, Twima Earley,
Guests:
Jessica Lehman, Alyssa Nickell, Cathy Spensley, Diana Jensen, Shireen
McSpadden, Kate Hoppke, Val Agostino, Patrick Hoctel, Sybil Boutilier
DAAS:
Bill Haskell
I.
II.
WELCOME & INTRODUCTIONS
APPROVAL OF MINUTES
MOTION: That the LTCCC meeting minutes of April 11, 2103 be approved.
Vote: All in favor.
III.
UPDATES

IV.
LTCCC Membership Contact Information was distributed.
NEED FOR A COST OF DOING BUSINESS (CODB) POLICY
Debbi Lerman and Steve Fields talked about this issue, which is of vital concern for CBOs. The
years 2006 and 2007, until last year, have been “drought” years. Cost increases have been
experienced by CBOs with no increases in the contract amounts. Foundations do not pay for
ongoing operational costs. Foundation grants have been cut and there has been an economic
downturn.
It has not been acknowledged by contracting agencies the high quality of the work accomplished
by CBOs. These CBOs are now at risk. Last year, to the credit of the Mayor and the BOS, there
was a 2% increase in CODB for CBOs. This was 1% from the Mayor and 1% from the BOS.
However, a 2% increase in CODB is actually a service cut.
This year, CBOs were hoping to see additional CODB increases. The hope was to get a CODB
increases on an annual basis. Many costs are considered by the City as it develops its budget, but
the increasing costs incurred by CBOs is not considered. The deficit is developed before the
needs of CBOs are considered. Most CBO employees do not have health coverage after they
retire. They are not seen as part of the solution re safety net service delivery because cuts are
often made in CBO contracts first - to address the deficit.
CBOs and their services want to be considered in the same way as the city services in the City
budget. What occurred this year is that approximately $17 million was taken from CBO
contractors out of a total deficit of $30 million. DPH is looking at a huge deficit.
Short term: this is an immediate need. The LTCCC is requested to urge the Mayor to restore the
cuts for CBOs in the Health Department budget. The Health Services Network (HSN) is asking
for a letter of support to restore those cuts.
Long Term: this is a structural need. There needs to be a public policy change on this matter.
The vast majority of services are provided through the nonprofit contracting CBO sector. With
the Affordable Care Act, CBOs must have a vital, vibrant and responsive contracting system
with the City and County of San Francisco. A standardized increase for CBOs should be
included annually by the City.
Responses
Valorie Villela – this is shocking considering that all CBOs are trying to keep services alive.
CBOs do not want to cut services. CASE supports this initiative, and nutrition providers support
this initiative.
Noelle Simmons – HSN is looking for a policy for all CBO service types, and not just those
providing LTSS.
MOTION: That the LTCCC prepare a Letter of Support to be sent to Mayor Lee, urging him to
restore the DPH cuts; and (2) a new LTCCC Workgroup be created to look at a potential policy
to recommend to the City re CODB increases.
VOTE: Motion Passed.
HSN would be a part of this workgroup. Steve Fields will participate in this effort, Valorie
Villela will participate as well. Others may contact Bill Haskell and he will inform Steve Fields.
V.
DRAFT LTCCC COMMUNICATIONS PLAN
The draft LTCCC Communications Plan was presented by the LTCCC Communications
Subcommittee, including: Anne Hinton, Jennifer Walsh, Anne Quaintance, Alyssa Nickel, and
Ken Hornby
Background: This LTCCC Communications Subcommittee was appointed to come up with a
communications plan as required by the SCAN Foundation. However, even though this is
meeting a SCAN Foundation requirement, Anne Hinton said that this plan will be beneficial for
the LTCCC in all of its communication activities.
The Communications Plan, which is attached, includes the following:
 Communications Goals – page 5
 Target Audiences – page 6
 Overarching Message – page 6
 Supporting Messages – page 7
 Communications Strategies and Tactics – page 7
 Evaluation component – page 8
To do outreach, the idea is to have an Outreach or Speaker’s Program. It is necessary to make a
connection between policy development and impact on real services for consumers. We need to
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include the need for CODB increases, housing programs, and services – making the connection
to real improvements in services for consumers.
In addition to the Communications Plan and its adoption, the Subcommittee is proposing:
 An exit survey for people leaving the LTCCC, and
 A possible new name: the SF Partnership for Long Term Services and Supports.
Responses
Vera Haile: The communication strategies seem to be slim on consumer involvement. There
should be more consumer involvement included. There will need to be more languages and
written materials in other languages.
Anne Hinton: The LTCCC Communications Plan is really about promoting the policies in the
LTCCC Policy Agenda for 2013.
Ken Hornby: Many consumers have never heard of the LTCCC, or what is happening.
Eileen Kunz: a Speakers Program with common messages and communication tools would be
very helpful. This will help members speaking about the LTCCC to use the same language. She
likes the new name even though that is not being discussed at this time.
Moli Steinert – what is the Constituents Event?
Anne Hinton said this would be like the annual event put on under the RWJ Foundation. People
in CBOs need to feel that their agencies are part of something larger than themselves.
Consumers and service providers should be included. Under the RWJ Foundation grant, the
events celebrated all accomplishments under that grant. This takes both staff and committee
work to be successful. Having this kind of event would be beneficial.
MOTION: That the LTCCC approve the draft LTCCC Communications Plan.
VOTE: Motion Passed
MOTION: That the LTCCC consider the other three recommendations:
1. An Exit Survey for departing LTCCC members. Approved
2. LTCCC members to recommit every two years. Approved.
3. Name Change for LTCCC: to be considered in the future.
VOTE: Motion Passed
Other options to be considered for a name
 SF Partnership for Living with Dignity
 Long Term Care Coordinating Council (no change)
There should be a thoughtful discussion about this recommendation. The Communications
Subcommittee will consider a variety of options. Ideas should be collected and a wellconsidered proposal should be made.
Comment: A name change will be a challenge. This will be a huge educational effort in San
Francisco and the State.
Concern was raised about losing the word “Care” from the name, Long Term Care Coordinating
Council.
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VI.
NEED FOR A LEGISLATIVE AGENDA
Ideas developed by the Steering Committee for a legislative agenda were presented. See
attached.
Vera Haile added one idea:
 the homeless seniors issue discussed at the last meeting. Rents have gotten so high in
SROs and cannot afford them. Many homeless seniors are frail and need to be helped.
The other idea added:
 for those impacted bythe Affordable Care Act who are part of the Medi-Cal expansion,
but who will not include lawfully admitted permanent residents. These people would be
forced into social insurance at a higher cost. Immigrants are concerned about this. This
is an important issue.
Mivic Hirose recommended that the legislative agenda ideas developed by the LTCCC be
partnered with DPH. The DPH Policy and Planning Section has been working on the Assisted
Living Waiver issue. For Medi-Cal expansion issues, the DPH Policy and Planning Section can
leverage legislative agenda issues in collaboration with the LTCCC. For the dementia issue, this
is another DPH Policy and Planning issue again.
Sandy Mori suggested, since DPH already has a legislative agenda, she does not know if there
are legislative bills already developed and being promoted.
Noelle Simmons explained there are different ways the Mayor’s Office moves forward with a
legislative agenda. There is a high level legislative agenda report. And, at a lower level, there is
the opportunity to tag on to an existing legislative effort. Another way is for the City to start a
new legislative effort, which is a lot of work. Initiating one from the start, there is a workload
that will come back to a department.
Each department is asked to draft a legislative plan, which is adopted by the state legislative plan.
Some items are pulled in. DAAS may push some items, but the city may not include all items.
Noelle noted, in regard to the first three proposals, DPH may already have started something. If
we want something in the city’s priority document, that starts in November. If an item is
included in a larger statewide effort, it has a two year life span.
It would be helpful to know what is on the other legislative agendas of DPH, and of the DAAS
Advisory Council.
Kelly Hiramoto suggested that Jim Soos, from DPH Policy and Planning, be invited to present
what is on the DPH legislative agenda. Then the LTCCC could decide how it should be included.
In regard to issues related to dementia, Kelly Hiramoto suggested that it may not be beneficial to
have dementia remain under medical. We want to have dementia care get increased funding.
Eileen Kunz suggested not dictating how dementia is placed. It is a significant driver of medical
costs. She believes that DPH is working on restoring a 10% Medi-Cal cut. Under Medi-Cal
expansion has much less of a benefit package for long term care.
Ken Hornby: Eye care has been dropped from Medi-Cal. Even if there is a co-pay, this would be
beneficial for getting eyeglasses.
Anne Quaintance: We should know what is already on the other departmental legislative agendas,
and put that on our list.
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Anne Hinton suggested that there is a state legislative platform and a federal legislative platform.
Many of the LTCCC members are part of groups and have a legislative agenda. There needs to
be a place where this is dealt with. There is no single place where there is an outcome of these
discussions. Also, she thinks the issue of dementia needs to be considered.
Noelle Simmons suggested Jim Soos, herself and Sybil Boutilier bring potential legislative issues
to the LTCCC, so that it could take an advocacy position on each piece of proposed legislation.
Bill Haskell will contact Jessica Bullen re the recommendations made about the idea of learning
about the City’s legislative agenda and how to collaborate on that.
IV.
LTCCC POLICY MEMO SENT TO MAYOR’S OFFICE RE EMPLOYMENT
OPPORTUNITIES FOR SENIORS AND PEOPLE WITH DISABILITIES
Kate Howard, the Mayor’s Budget Director, had previously requested ideas for employment
opportunities for seniors and adults with disabilities. The attached memo was prepared and
submitted on this subject. There was not commitment of funding. We do not know what has
happened in response to this policy memo. Anne Hinton said there were only 30 days to develop
this policy memo so this was developed quickly. There was a cost attached to major ideas, but
there was no promise of funding.
Marie Jobling mentioned that there were a number of program ideas suggested, and other ideas
were included that could be further developed. Many seniors and adults with disabilities need
employment opportunities.
Is there enough interest to create another workgroup about this topic? This will be considered
and brought up at a future meeting.
V.
LTCCC MEMBERSHIP AND NOMINATIONS SUBCOMMITTEE REPORT
Val Agostino was introduced as a future new member, to be appointed by the Mayor. Marie
Jobling announced that, in the recent outreach for new members, the following nominations:
Consumers and Advocates: Adults with Disabilities.
 Jessica Leyman – Senior and Disability Action
 Victoria Tedder – Independent Living Resource Center
Labor
 Tom Ryan – Labor Council
Transitional Age Youth
 Jacy Cohen – The ARC of San Francisco
For the fifth slot for Hospitals and Health Systems, there no nominees.
MOTION: That the LTCCC approve the nominations and submit them to the Mayor’s Office for
consideration
Vote: Motion Passed
Anne Hinton mentioned she just returned from Washington DC. During the policy briefing she
received, Secretary of Health and Human Services, Kathleen Sebelius, spent a lot of time talking
about the Administration for Community Living. She talked about things that have moved to go
in this direction. Anne was struck that San Francisco is one of the few places in the country
where that the alignment, between aging and disability, has come together at the LTCCC. Anne
stated that the idea of an LTCCC Speakers Program should talk about how these two groups
have come together - as something unique about the relationships formed at the LTCCC.
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