Title
HEARING- Health and Human Services Agency recommending the Board adopt and authorize the Chair to sign Resolution 062-2025, replacing and superseding Resolution 148-2016, to adopt Senior Day Care fees effective July 1, 2025.
FUNDING: Fee for Service and County General Fund.
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DISCUSSION / BACKGROUND:
The HHSA Community Services Division Senior Day Care program serves older adults who require supervision and care during the day, providing families with peace of mind and the opportunity to take breaks from caregiving or maintain employment. This service significantly enhances the quality of life for both clients and their caregivers. Program participants pay for the costs of the services received, through Board approved fees, including an enrollment application fee, daily rates, late fees, and extended hours fees.
On September 13, 2016, the Board approved the current Senior Day Care and Senior Center Services fee structure through Resolution 148-2016, which have been in effect since October 1, 2016 (Legistar file 16-0805).
In 2024, HHSA Community Services commissioned MGT Consulting (MGT) to conduct a fee study for County Senior Day Care sites. This study was part of a broader review that also included Public Guardian services. The primary objectives of the study were to determine the full cost of providing fee-related services, assess whether fees should be introduced or adjusted, identify opportunities to align fees with the actual cost of services while considering economic and policy factors, and develop revenue projections based on potential fee increases or decreases.
On March 4, 2025, the Board received and filed the fee study report dated June 2024, conducted by MGT, and heard a presentation from HHSA staff outlining proposed fee increases for Senior Day Care services (Legistar file 25-0144). HHSA staff recommendations aim to achieve a 97% cost recovery level over a three-year period, with annual increases scheduled at the beginning of each fiscal year (FY). These adjustments would include an annual update based on the Consumer Price Index approved by the U.S. Bureau of Labor Statistics to reflect changes in the cost of living.
The Board held additional discussions regarding the proposed rate increases and their fiscal impacts during meetings on April 8, 2025, and April 22, 2025, (Legistar files 25-0654 and 25-0732).
The planned rate increases, spread over three years, are expected to improve cost recovery from service fees and reduce reliance on the County General Fund, thereby supporting the program’s long-term financial sustainability.
A Notice of Public Hearing was published in the Mountain Democrat and Tahoe Tribune on May 2, 2025, and May 9, 2025, announcing that the Board would hold a public hearing on this agenda item.
HHSA is recommending the Board adopt and authorize the Chair to sign the attached Resolution, thereby adopting and approving Senior Day Care Fees as outlined in Exhibit A, which upon approval will replace and supersede Resolution 148-2016.
ALTERNATIVES:
Should the Board decline to adopt the Resolution, the current fees would remain the same for HHSA Senior Day Care program, resulting in continued increase in General Fund expenditures.
PRIOR BOARD ACTION:
1) 08/30/16, 16-0805 V.1, HHSA, Resolution Establishing Fees for Fiscal Year 2016-2017
2) 09/13/16, 16-0805 V.2, HHSA, Resolution Establishing Fees for Fiscal Year 2016-2017
3) 09/12/17, 16-0805 V.3, HHSA, Resolution Revising Public Guardian Fees for Fiscal Year 2017-2018
4) 03/04/25, 25-0144, HHSA Senior Day and Public Guardian Fee Study
5) 04/08/25, 25-0654, CAO - Budget Direction
6) 04/22/25, 25-0732, CAO Budget Direction
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
County Counsel
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The Senior Day Care program is funded primarily with General Fund dollars, offset by any fee revenue that is received from the client paid fees for services. Approval of the Resolution will implement a new Senior Day Care fee structure that aims to achieve a 97% cost recovery level over a three-year period, thereby decreasing the General Fund cost of the programs.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
Clerk of the Board to obtain signature of Chair on one original Resolution.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT:
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency