Consider extending the anticipated duration of the Aging/Older Adult Ad Hoc committee's efforts to the end of Calendar Year 2026, adopt an amended Scope and Charge, direct staff to work with Ad Hoc on Aging subcommittee to draft and send a letter on behalf of the Board of Supervisors to the current AAA4 JPA to make a formal request for information. (No general fund impact) (Webb/Perez/Morales) (Est. Staff Presentation: 15 min)

1. Exploring the possibility of reconfiguring the current regional service arrangement to a localized Yolo County Agency on Aging; and
    
2. Continue to pursue funding opportunities and research best practices to provide high quality navigation services for Yolo County constituents seeking aging resources, services, and housing options.

2. Direct staff to work with Ad Hoc on Aging subcommittee to draft and send a letter on behalf of the Board of Supervisors to the AAA4 JPA to make a formal request for information.

 

On September 26, 2023, the Board of Supervisors approved the creation of the Aging/Older Adult Ad Hoc committee to coordinate with staff the development of a framework for evaluating potential County actions, including on matters that are not addressed by existing County and community (including non-profit) programs and services. The Scope and Charge (see Att. B.) calls for a presentation on the progress of this effort and related staff recommendations to the Board for further direction, at which point the continued need for (and role of) the subcommittee can also be assessed.

This staff assessment and Board report seeks to deliver:

1. An overview of the Ad Hoc committee's work which includes an assessment of the current landscape, discussion topics, and task completion for the year 2024.
2. Staff recommendations to consider extending the anticipated duration of the Ad Hoc to the end of December 2026, adopt an amended Scope and Charge (Att. C.) that details the expected tasks and general objectives, and directing staff to draft a letter on behalf of the Board of Supervisors to the AAA4 JPA to make a formal request for information.

Current Landscape:
Data from the California Department of Aging: 2030 Final Report (Att. D.) indicates an impending demand for services for the aging. California’s Master Plan for Aging (MPA) Data Dashboard shows that Yolo County’s aging population is expected to grow significantly by 2060. In 2020, the aging population was 41,541. By 2060, the aging population is projected to be 59,436, a 43% increase. 

The County has also been preparing for SB 43 implementation, which makes substantive changes to the Lanterman-Petris-Short Act and related provisions to the Health and Safety Code. One such change amends the definition of “gravely disabled”, which increases the number of persons who qualify for behavioral crisis intervention services and increases the number of persons admitted or detained in the County for treatment. CARE Court is another new process which addresses the intersection of older adult and disability issues to deliver mental health and substance-use disorder services for Californians suffering from homelessness or incarceration, and provides individuals with clinical services, social services, and housing support. This new process will increase the demands on the County for CARE Plan service delivery with no new sources of funding. The County and the State are both facing budget challenges which create funding constraints that risk core business functions in older adult issues. The broader political landscape is one in which discretionary federal funding sources are facing cuts, longstanding essential safety net services such as Medi-cal are at risk, and other entitlement programs may not be able to direct the same level of resources as in prior years.

Ad Hoc 2024 Overview:
The Ad Hoc on Aging staff were intentional in conducting research to inform potential County actions and explore the capacity of community programs and services. Ad Hoc Board members and staff attended a YoloCares Facility Tour to learn more about service coordination in the non-profit sector for older adults in February 2024. An exploration of the alignment with Yolo Healthy Aging Alliance and the County’s Commission on Aging & Adult Services was also conducted to discuss capacity building for non-profits providing services. Additionally, the Ad Hoc committee received a guest presentation from the Grove Post-Acute Nursing Home staff in November 2024 to learn more about their operating system and care coordination. This presentation reported that Yolo County currently lacks facility types and number of beds to administrate managed care plans for serious mental illness and behavioral health. Significant challenges are expected to meet the upcoming increased demand due to SB 43 and CARE court policies.

Furthermore, the Health and Human Services Agency and the County Administrator’s Office conducted an evaluation of a 2017 Grand Jury Report, an Internal Audit Report, and Corrective Action Plan of Public Guardian functions. In summary, the evaluation pointed to the importance of improving staff resources to ensure full compliance with state laws and other authorities as they apply to Public Guardian responsibilities. The auditors recommended that County management review workload and staffing resource needs to ensure good system controls and best practices are implemented. A staff recommendation from the Ad Hoc was brought to the full Board to fund a 3rd FTE Conservator Officer for the Public Guardian and was approved in June 2024. The Board approved FTEs have been hired and are undergoing extensive training for SB 43 implementation and Public Guardian administrative changes.

Moreover, currently, the California Department of Aging (CDA) is opening up applications for a Planning Service Area (PSA) change opportunity to reconsider current service delivery networks and geographic provider areas. Once every four years, county governments, county-based Joint Powers Authorities (JPAs), and tribal organizations, have the opportunity to apply to be an Area Agency on Aging (AAA) provider, even if there is an existing provider in place. In January 2027, the CDA will begin to accept applications for PSA boundary changes. A potential future objective for continuation of this Ad Hoc includes examining the County's current JPA regional aging adult services arrangement. Further staff research is needed to review the potential implications of reconfiguring the current JPA regional service arrangement to a local Yolo County Agency on Aging. A local agency model would need to address revised AAA designation criteria to become a new AAA provider, including the financial feasibility, program capacity, organizational structure and governing body. Research conducted by County staff would determine whether a Yolo County Agency can achieve a higher level of service, support a long-term sustainability model, and effectively meet the revised AAA designation criteria.

In conclusion, staff recommends extending the duration of the Ad Hoc on Aging/Older Adult issues to the Board and amending the Scope and Charge document to reflect updated objectives. By doing so, the Ad Hoc may reinforce service sustainability and best practices to provide high-quality navigation services for Yolo County constituents seeking aging resources, services, and older adult and disability-focused programs. The staff recommendation and proposed amendments to the Scope and Charge are summarized below:

1. Consider extending the anticipated duration of the Aging/Older Adult Ad Hoc committee's efforts to the end of the 2026 calendar year and adopt an amended Scope and Charge that includes the following objectives:

Health and Human Services Agency
County Administrator's Office