History of Alameda County Funding for Older Adults


December 15, 2015 – On December 8, 2015 the Alameda County Board of Supervisors voted to approve Health Care Services Agency’s Measure AA recommendations, including $1.5 million in new funding for older adult services. This is a huge step forward in addressing the needs of seniors in the county. Click here to view the Board Letter detailing the recommendation that was adopted.

During the hearing Supervisor Miley asked all those who were present to support the Older Adult Priority to stand, and it was an impressive show! Thank you to everyone who attended and who helped with the preparation. Well done!

December 1, 2015 – The Alameda County Board of Supervisors will consider Health Care Services Agency’s Measure A funding recommendations on December 8th.

HCSA is proposing that the county increase the next 3-year cycle of Measure A base funding to $31.5 million a year, and make $1.5 million in new funding available for Older Adult health services. To read SSC’s November 19 article on the details of HCSA’s recommendations, see below.

The new funding is not a done deal. With many worthy causes competing for local health care dollars, seniors and providers alike must show their support for the HCSA proposal by attending the Board of Supervisors meeting. Mark your calendars and contact wendy@seniorservicescoalition.org if you plan to attend.

November 20, 2015 – SSC Director Comments at Alameda County Health Committee Hearing

November 19, 2015 – On Monday, November 9 the Alameda County Board of Supervisors’ Health Committee met to hear Health Care Services Agency’s recommendations for the next 3-year cycle of Measure A funding.

HCSA Finance Director Rebecca Gebhart and Measure A Coordinator James Nguyen presented a proposal to increase the total minimum Measure A allocation to $31.5 million a year – making available approximately $4.75 million in new funding. Click here for HCSA’s powerpoint presentation.

Under the proposal, $1.5 million of the new funding would go to Older Adult services as follows: $500,000 for home-based nursing case management (Public Health nurses assigned to key programs and areas); $250,000 for the hospice/advance life planning project; and $750,000 for injury prevention & meals/nutrition administered through the Area Agency on Aging.

At the same time, they recommended ensuring continuity of health care services currently funded by Measure A by maintaining current allocations – this means that the current $275,000 in funding for senior services that includes Injury Prevention programs will remain in place.

Supervisor Carson confirmed that the HCSA projections are conservative, making it likely that there will be an additional pot of money available in most years. HCSA proposes that this additional funding be allocated through an RFP process “to address critical health care needs based on data.”

The Health Committee passed HCSA’s proposal on to a full meeting of the Board of Supervisors – to be included in the agenda at the BOS meeting on December 1st or 8th. The proposed new $1.5 million for Older Adult services is not a done deal. With many worthy causes competing for local health care dollars, seniors and providers alike must show their support for the HCSA proposal by attending the Board of Supervisors meeting. Mark your calendars for both dates and stay tuned.

September 22, 2015 – On September 4, United Seniors of Oakland and Alameda County hosted a listening session at the Castro Valley Library. Its purpose was to give the staff working on County Measure AA recommendations and on the comprehensive Plan for Older Adults an opportunity to communicate with seniors and their allies.  Here are some “take-aways” from the session:

Supervisor Miley opened the session, and talked about the importance of Measure AA in funding essential services. He noted that there are competing needs and the process of considering and adopting funding recommendations needs the voices of seniors, their families, friends and providers.

Tracy Murray from Alameda County’s Department of Adult & Aging Services noted that the early results from the county-wide Older Adult Survey put housing and economic issues at the top of seniors’ concerns. Tracy spoke expressively about the economic disconnect between cost of living and seniors’ incomes – a simple majority of which don’t cover basic needs.

James Nguyen, Administrative Services Officer/Measure A Coordinator at County Health Care Services Agency indicated that their funding recommendations for the next 3-year cycle of Measure AA funding will be informed by the Survey results and the Older Adult Planning Committee’s preliminary findings (this is because Measure AA’s process will conclude by December, way ahead of the Older Adult Plan’s May 2016 date). HCSA’s preliminary priorities for older adult funding are injury prevention, food/nutrition, adult day health care, and case management.

Seniors and service providers spoke eloquently about the plight of the “not poor enough” seniors who can’t qualify for needed services, the housing eligibility quandary for individuals on SSI, the trauma of living on the street and the fact that emergency shelter funding is at risk, the loss of board-and-care facilities due to minimum wage increases, the gap between service capacity and the real level of services needed by seniors in the community.

Seniors and service providers also spoke about the need for investment in prevention, and the power of community-based services to turn around lives, improve health, reconnect and revitalize older adults.

August 25, 2015 – On Friday, September 4, we’ll get our first chance to hear the County’s preliminary thinking around new Measure AA funding for older adults. The “listening session” – organized by Supervisor Miley and United Seniors of Oakland and Alameda County – will also offer a forum for seniors, caregivers and community-based organizations to give feedback to Health Care Services Agency staff about services that directly impact seniors’ health.

Alameda County’s Measure AA was approved by voters last year. It extends Measure A’s half-cent sales tax through 2034 to fund critical health services, with 75% of the funds going to Alameda Health System and 25% going to community health services. HCSA proposes to add Tobacco Master Fund Settlement dollars (about $8 million annually) to the community health pot. This would enable the county to ensure continuity of the services currently funded under Measure A while prioritizing services in “underinvested areas”…including Older Adults. Detailed recommendations will be brought to the Board of Supervisiors’ Health Committee in October, and to the full board in November. Funding would start in fiscal 2016-17.

The Listening Session will be held September 4 from 10am to noon at the Castro Valley Library, 3600 Norbridge Ave in Castro Valley. Click here for USOAC’s flyer.

July 22, 2015 – SSC Director Comments at Alameda County Budget Hearing

July 22, 2015 – Ask any senior who relies on one or more community-based services – meals on wheels, dining and brown bag programs, friendly visiting, case management, information & assistance, fall prevention, legal services, adult day care, family caregiver support, senior center activities and disease prevention care – and you will hear about the power of these interventions to transform lives and health outcomes.

Alameda County has come a long way in recognizing the value of these services. The most recent example is the June 26 Board of Supervisors approval of a 15/16 budget that includes a second year of emergency stabilization funding for services contracted through the AAA. That’s $900,000 from Social Services Agency plus a 15% augmentation for Measure A programs from Health Care Services Agency. (See the June 17 post below for details and concerns around this funding.)

Also hopeful are the early sketches for new Measure AA. HCSA proposes to fold Tobacco Master Settlement Funds into Measure AA’s 25% pot for community health, and use the combined funds to “prioritize services in underinvested areas or areas experiencing declining funding”…including Older Adults. Detailed recommendations will be brought to the Board of Supervisors’ Health Committee in October, and to the full board in November. Funding would start in fiscal 2016-17.

If the final Measure AA plan thoughtfully leverages community health and social services for seniors, it could complement beautifully the AAA funding plan and cross-agency recommendations that will come out of the older adult planning committee in May 2016.

Stakeholders have our work cut out for us if these potentials are to become reality. Stay tuned and be ready to engage.

Click here for HCSA’s May 11 presentation on Measure AA (much is background, but starting on slide 25 the Measure AA timeline, process and early thinking is summarized).

Click here to go to the county’s budget report page for documents and presentations from the county’s June budget hearings.

June 17, 2015 – A decade of federal and state budget cuts and the increasing number and acuity level of seniors needing services continues to strain Alameda County’s safety net for seniors. Last year, the county was able to step in with emergency stabilization funding and backfill Federal sequester cuts to help maintain service levels and stave off cutbacks in AAA-contracted senior services. More, a technical assistance effort and planning initiative are underway. As the start of the County’s 2015/16 fiscal year approaches, it’s a great relief to confirm that most of the funding will be in place for a second year.

On June 9, County Board of Supervisors authorized contracts with 35 organizations. The contracts included approximately $900,000 in emergency stabilization funding. The lion’s share was provided by Social Services Agency, plus funding from Health Care Services Agency to augment Measure A-funded programs. Rather than allocating the stabilization funding across-the-board (as was the case last year), the AAA provided a 12% baseline and allocated the remaining portion based on need to address significant increases in seniors needing meals on wheels.

While we applaud county leaders for stepping up again to address an ongoing crisis, it must be noted that the county’s commitment is again for a single year. This is problematic for a number of reasons. Programs that need to hire staff to deliver services must plan beyond a 12 month horizon, and can’t invest in employees that will have to be laid off when the funding ends. The instability that led CBOs to beg for emergency funding last year was largely precipitated by over a decade of increases to the cost of doing business with no corresponding funding increases or COLAs – a trend that will continue into the future. The ambitious county planning process that is now underway will deliver recommendations in May of 2016, much too late to implement any changes that might mitigate the need for additional county funding in FY 2016/17. And, for the growing number of seniors who will continue to need services in the future? Those needs won’t end with the fiscal year.

What’s needed is an ongoing commitment of funding from the county to match and provide cost of living increases for senior services. We have these services in our county because these services play a critical role in helping older adults live successfully in the community. It only makes sense to support them.

June 17, 2015 – Sudden and significant growth in the number of Oakland seniors needing meals on wheels is putting these frail home-bound seniors’ lives at risk.

Oakland’s meals on wheels program is provided by SOS Meals On Wheels. SOS is a nonprofit that has been providing meals on wheels services in the county for 49 years, and in July 2014 began providing full service meals on wheels for Oakland seniors under contract with the Alameda County Area Agency on Aging. The contract funds a set number of meals, and the reimbursement does not cover the full cost of the service. Like all meals on wheels providers, SOS makes up the gap by maximizing the use of volunteers, by requesting a per-meal donation from recipients, and through fundraising. Click here to read more…

May 13, 2015 – Alameda County’s Budget Workgroup will meet on Monday, May 18th at the Hayward/Union City Room, 125 12th Street, 4th Floor in Oakland.

The Workgroup will hear reports from each agency regarding their plans for reducing their projected deficits.

Please RSVP via email at caobudgetrsvp@acgov.org by Friday, May 15th at 5pm.

May 1, 2015 – During Alameda County’s Budget Workgroup meetings held in March and April, theAdministrator’s Office outlined current projections for the county’s Fiscal Year 2015-16 budget. Although the economy is thriving, the recovery has left many people behind. Thus while County revenues are up, case loads have not fallen and the county’s expenditures have increased. According to the County’s Maintenance of Effort Budget, the county faces a projected $65.1 million shortfall for the upcoming fiscal year. Public Assistance/Social Services Agency was projected to have a $17.6 million gap (otherwise known as “Net County Cost increase”), while Public Protection projected a $32.3 million gap.

At the April 21 Budget Workgroup meeting, four options for closing the $65.1 million gap were presented. The ultimate schedule of reductions, decided by 9-16 majority vote, was a negotiated solution that created the following reduction targets: $14.6 million for Public Assistance/Social Services, $14.8 million for General Government, $19.8 million for Public Protection, and $15.7 million for Health Care Services.

The smaller budget shortfall for Social Services Agency bodes well for the 57,000 seniors who rely on community-based services funded through Alameda County’s Area Agency on Aging. Last year at this time CBOs had reached a crisis point, unable to maintain service levels after years of federal and state funding cuts. The county stepped in with a one-time 15% funding augmentation that helped to stabilize services in the short term, but the structural problem remains. SSC has communicated a willingness to support a second year of funding “in concept,” and a smaller shortfall would help make that concept a reality. But a lot could happen between now and the end of June when Supervisors adopt a new budget.

Next step? Each department’s reduction plans are due to the County Administrator by May 6th, with an update to the Budget Workgroup on May 18th.  All meeting presentations – including details on the shortfalls and reduction targets – are available on the county’s budget website at http://budget.acgov.org/#.


December 29, 2014 – In June 2014, the Alameda County Board of Supervisors directed the County’s Health Care and Social Services Agencies to work together to provide emergency funding for senior services and to develop an integrated plan for providing long term, health and supportive services to seniors in Alameda County. At the BOS’s December 16 regular meeting, Supervisors approved the fiscal stepping stones needed to proceed with the initiative.

Included in the approved budget letter was funding for: 1) a one-time 15% augmentation to all AAA contracts, a total of around $850,000 in funding that will stabilize resource-strapped programs; and 2) over $63,000 to backfill federal sequester cuts. Also included was over $400,000 in state and federal one-time-only funding for Older Americans Act programs (the California Department of Aging announced this funding earlier than usual, so the AAA decided to bundle it with the other funding to save paperwork and time for the AAA and CBOs).

Click here to view the Board Letter and funding allocations approved by the Board of Supervisors on December 16, 2014.

November 14, 2014 – On October 27, a joint hearing of the Alameda County Supervisors’ Health and Social Services Committees heard an update from Social Services Agency Director Lori Cox and Health Care Services Agency Director Alex Briscoe on the progress of the county’s new aging services initiative. This was the first chance for Supervisors outside of the Social Services Committee to be exposed to the elements of the initiative and to ask questions. I recommend watching the video.

Click here for the powerpoint presentation that accompanied Lori Cox’s report. Click here to go to the county web page where you can view the recorded hearing (scroll down to the “BOS Committee Meetings” and select one of the viewing options for the October 27 “Special Meeting and Joint Health & Social Services Committee”).

October 10, 2014 – Alameda Alliance recently announced that Complete Care (it’s Duals Special Needs Plan, or D-SNP), will not be offered in 2015. The Alliance had received federal permission to close Complete Care and “cross-walk” it’s members into the new Cal MediConnect plan in January. When the state postponed the launch of the Coordinated Care Initiative and Cal MediConnect in Alameda County to July 2015, Alliance was left with no alternative but to close Complete Care and help it’s members transition.

Many community-based organizations have already been hearing from Duals who have received letters from Alliance notifying them of the closure. Click here to see a copy of the closure letter sent to Complete Care members. Click here to see a copy of the second letter that informs Complete Care members that their Medi-Cal won’t be affected by the closure.

SSC has prepared a guide to help community-based organizations inform and assist their clients who may be Complete Care members. Click here for the guide.

October 10, 2014 – Complete Care Closure basics for Community-Based Service Providers

August 15, 2014 – At the Alameda County Board of Supervisors’ Social Services Committee meeting on July 28, 2014, Social Services Agency Director Lori Cox outlined the next steps the Agency will take to provide emergency funding for senior services and to develop an integrated plan for providing long term, health and supportive services to seniors in Alameda County. Click here to link to the committee’s agenda with Director Cox’s slides attached.

The next steps include: 1) a one-time 15% augmentation to all AAA contracts, a total of $850,000 in funding that will stabilize resource-strapped programs; 2) funding technical assistance for CBOs to develop and implement fund development strategies; 3) hiring a Planner for the Area Agency in Aging; and partner with Health Care Services Agency and stakeholders to develop a comprehensive county-wide plan for aging services.

To watch the hearing, click here (the aging services presentation and public comment are at the end). Click here for the text of SSC Director Wendy Peterson’s public comment.

Director Cox’s presentation was a response to the directive that was included in the County’s 2014/15 budget (click here to read the memo that is now part of the County Budget). If you haven’t already, please take time to thank Supervisors Miley and Chan for advancing the recommendations, and thank your own Supervisor for their support. Click here to go to SSC’s advocacy resources page for Supervisors’ contact information.

July 11, 2014 – On June 27, the Alameda County Board of Supervisors approved its 2014/15 Budget, including a directive to Social Services Agency Director Lori Cox and Health Care Services Agency Director Alex Briscoe to earmark emergency funding for senior services and to develop an integrated plan for providing long term, health and supportive services to seniors in Alameda County. Click here to read the memo that is now part of the County Budget.

The recommendation was advanced by Supervisors Nate Miley and Wilma Chan. Please take time to thank them, and to thank your own Supervisor for supporting the recommendation. Click here to go to SSC’s advocacy resources page for Supervisors’ contact information. Read more…

July 11, 2014 – SSC Letter to AC BOS Budget Committee re: Request for County Budget Augmentation for Senior Services

June 19, 2014 – Community-based programs that provide health and supportive services to seniors in Alameda County are in crisis.

Population growth and increased acuity levels are straining the service network. Funding cuts, 25.5% inflation over the last 10 years, and no mechanism for cost of living increases have whittled away at programs and organizations. In spite of exceptional fundraising and innovation, CBOs have reached the breaking point. Not only is current capacity inadequate to meet current needs; we are on the brink of losing capacity altogether.

Immediate attention is necessary. SSC is calling on the County to step up and provide funding to stabilize the programs and services that are administered through the Area Agency on Aging. This includes senior meals, case management, adult day care, information and assistance, friendly visiting, telephone reassurance, senior center activities, senior employment services, family caregiver support, legal services and HICAP, health services, elder abuse prevention funding, and senior injury prevention services.

These services are a necessary part of the equation in helping older adults meet the challenges of aging and live successfully in the community. They complement medical care, help seniors maintain economic stability, and often provide life-line interventions that increase safety and prevent institutionalization.

These programs ARE the community-based services to which APS and other county programs, hospital discharge planners and managed care plans alike refer seniors. These programs and services are essential and effective. They will serve over 57,000 people this year, a number that has been rising every year.  Our county cannot afford to lose them.

Emergency stabilization funding is urgently needed so that CBOs can shore up their infrastructure and continue to provide essential contracted services.

We’ve made our recommendation known to Social Services Agency leadership, and we hope that the Board of Supervisors will ensure that there is funding in the new County Budget to address this crisis.

Please join us at the County Budget Hearing on Monday, June 23 (details in the right hand column).  We need the community to show solidarity for this cause. If you would like to speak at the hearing, contact me at wendy@seniorservicescoalition.org.

June 3, 2014 – Map: Where Do Low-Income Seniors Live in Alameda County (150% fpl)


October 3, 2013 – Adult Protective Services is a vital safety net for thousands of Alameda County seniors and dependent adults who are at risk of financial, physical or mental abuse or neglect. Housed in Social Service Agency’s Department of Adult & Aging Services, Alameda County’s APS staff field 700 reports of abuse and self-neglect every month.

Years of state funding cuts have left APS seriously under-resourced. The county has been shouldering more and more of the cost for APS – with its share growing from about 30% in 2006 to about 40% last year while state funding has dropped from about 27% to about 15% – but this is not enough to accommodate the growing need. Currently, APS is only able to respond in person to 50% of calls. Read more…

September 18, 2013 – SSC Letter to Alameda County Board of Supervisors

July 17, 2013 – Just before adopting Alameda County’s 2013-14 Budget, the Board of Supervisors (BOS) and Social Services Agency agreed to provide $340,000 in county budget support to backfill the sequester cuts to Older American Act-funded services, including the Senior Nutrition, Supportive Services, Disease Prevention, Elder Abuse Prevention/Title II, Family Caregiver Support, Senior Employment/Title V and HICAP.

Many thanks to Senior Services Coalition members for effectively communicating the importance of these services and the devastating impact that Sequester cuts would have. Many thanks to our partners in the Social Services Agency and at the BOS for recognizing the County’s imperative to step up and commit local dollars to support these important services for seniors.

Because the agreement was reached on June 28 – after the contracts containing the Sequester cuts were already approved at the BOS regular meeting on Tuesday June 25 – the county backfill will be implemented after the BOS returns from their August recess. In the meantime, contracting organizations will have to proceed with submitting budgets and signing the approved contracts for 2013-14 as they stand.

Please let your Supervisor know how much you appreciate this decision.

June 21, 2013 – The federal Sequestration cuts that will hit Alameda County’s Older Americans Act-funded services beginning in July 2013 will limit access to an already strained system of services.  California’s Department of Aging announced a 6% overall cut to Older Americans Act for FY 2013-14, but the cuts are being allocated unevenly, so that some programs will be spared while others suffer deeper cuts.

Click here for SSC’s summary of the cuts and the impact they may have on seniors and the programs that serve them.

Community-based services and supports are a necessary part of the equation in helping older adults meet the challenges of aging and live successfully in the community. These services not only complement medical care and help seniors maintain economic stability, they often provide life-line interventions that increase safety and prevent institutionalization.  Alameda County cannot afford to lose senior service capacity.  Therefore, the Senior Services Coalition is asking the Board of Supervisors for County Budget support to mitigate the impact of the cuts.

June 21, 2013 – SSC Summary of Federal Cuts to Aging Services

June 18, 2013 – On June 10th, the Board of Supervisors Health Committee convened a Hearing on the Status of Older Adults in Alameda County. Click here for a PDF of the meeting agenda, and click here for SSC’s powerpoint presentation. A live video broadcast of the Health Committee Hearing can be viewed here.

June 18, 2013 – What Mr. B Lost in California’s Last 5 Budget Cycles

May 2, 2013 – Over a year ago a court settlement saved Adult Day Health Care (ADHC) from being eliminated as a Medi-Cal benefit, and created the Community Based Adult Services (CBAS) benefit, which provides the same service. However, the settlement agreement is a temporary measure that expires after 18 months. Read more…

April 29, 2013 – The automatic cuts known as sequestration took effect on March 1, 2013. Under the requirements of the 2011 Budget Control Act (amended in January) both defense and non-defense programs were automatically cut, reducing total funding by $85.3 billion in the first year. Half the cuts were made to non-defense programs, including a cut to discretionary appropriations of 5%, or $25.8 billion. Read more…

March 6, 2013 – Alameda County needs greater Adult Day Care and Adult Day Health Care capacity to respond to a growing elderly population and the imminent launch of the Coordinated Care Initiative, when Medi-Cal managed care plans will be responsible for members’ long term care and nursing home stays. The need is especially pronounced in central county following recent closures of two programs. To address this issue, the Adult Day Services Network announced the availability of an ADHC License with CBAS certification. Read more…

February 5, 2013 – The Alameda County Board of Supervisors adopted its 2013 Legislative Program. The Program serves both as a statement of the County’s legislative priorities and interests, and provides instruction to the county lobbyists in Sacramento and Washington DC.

The points of interest for SSC and our stakeholders include the following:

  • Support legislation and public policy that adequately funds community support systems for seniors and people with disabilities and incorporates four goals: equality of opportunity, full participation, independent living and economic self sufficiency.
  • Expand Medi-Cal enrollment through community-based providers.
  • Get adequate cost-based mechanism for mental health parity law by changing funding formula from a capped rate to a capitated rate.
  • Support policies that streamline health insurance enrollment, increase access to care, and maintain/improve the Safety Net System through increasing provider rates and improving care transitions.
  • Expand permanent supportive housing for homeless and disabled individuals.
  • Relax licensure requirements for State reimbursement for peer support services.

The link to the full Legislative Program document can be found here.


September 20, 2012 – Disability Rights California Court Motion

August 20, 2012 – California Assembly Aging and Long-Term Care Committee Letter

March for Meals / A Place At The Table

July 10, 2012 – Medi-Cal CBAS Eligibility Refusal

March 14, 2012 – Hoarding Conference

March 12, 2012 – SSC Report on Case Management and Care Coordination for Seniors In Alameda County

January 10, 2012 – Invitation to Two Important Meetings

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