Commission approves $395 million contract to fund San Francisco IHSS Public Authority services

The San Francisco Department of Disability and Aging Services Commission approved a sole‑source grant awarding the San Francisco IHSS Public Authority funding to operate the independent provider mode of In‑Home Supportive Services (IHSS) beginning July 1, 2022.

Deputy Director Jill Nielsen told commissioners the amount requested is $395,190,609 for the four‑year period through June 30, 2026, with a 10% contingency that brings the total not to exceed $434,709,670. Nielsen said the bulk of the funds support wages, medical and dental benefits for roughly 23,500 independent providers and fund services for about 24,500 IHSS consumers in San Francisco.

Nielsen said the program is supported by Medi‑Cal waiver funding and other state‑federal matches, and noted the department would need to revisit the budget if collective‑bargaining or wage conditions change after the current contract expires in 2023. To address a provider shortage, the proposed budget includes two new positions for the public authority — a recruitment manager and a community engagement coordinator — responsible for outreach and registry maintenance.

Commissioners expressed support and raised questions about funding projections and workforce recruitment. Nielsen confirmed the county’s maintenance‑of‑effort and state/federal matches make the contract sustainable under current assumptions, but cautioned that post‑2023 bargaining outcomes could require future budget adjustments.

The commission approved the sole‑source waiver and contract by unanimous roll call. Staff said they will continue to coordinate with the public authority on recruitment, mentorship programs, a one‑stop resource center for independent providers, fingerprinting/background checks and emergency backup systems.

The commission directed staff to return if material changes in funding or contract terms require additional approval.