Long-Term Care Coordinating Council urges mental-health pilots and digital access for SNF residents; committee files hearing

The San Francisco Long Term Care Coordinating Council told the Budget & Finance Committee on June 8 that pandemic-era restrictions left many skilled nursing facility residents isolated and facing worsening mental-health and cognitive outcomes, and it urged a set of pilot programs and investments to begin recovery.

Co-chair Laura Leesom of the Institute on Aging summarized a Behavioral Health Work Group report that surveyed local skilled nursing facilities (about 18 facilities representing roughly 2,500 residents) and identified six core themes: extreme loneliness and isolation, higher rates of depression and suicidality, pervasive boredom from canceled activities, disrupted mealtimes and loss of culturally appropriate food access, fear of reentry to communal life, and measurable cognitive and functional decline. Susie Smith of the San Francisco Human Services Agency, who chaired the work group, described the methodology—literature reviews, stakeholder interviews and facility surveys—and emphasized opportunities for digital connection and evidence-based therapeutic practices.

Rebecca Holtzman of the San Francisco Campus for Jewish Living described a life-review pilot funded by Meta Fund and implemented with the Felton Institute to address trauma and loneliness; presenters described plans to replicate that program and requested funding to scale similar interventions. The council asked for $250,000 per year for three years for site-based therapeutic interventions (including culturally and linguistically tailored groups) and a $250,000, three-year pilot to increase teleconnectivity (tablets, upgraded Wi-Fi and staff/volunteer training).

Supervisors pressed departments on whether the asks had been transmitted to the mayor’s office and how they relate to the Dignity Fund and Department on the Aging/Department of Disability and Aging Services (DOS/HSA) budgets. Anna Gooning, deputy budget director, said the Dignity Fund’s growth is roughly $3,000,000 annually; how much of that is available for new programming after cost-of-doing-business allocations was discussed but not finalized. HSA staff said DOS includes $350,000 for technology projects in its budget, and LTCCC presenters said their SNF-specific recommendations are distinct from community-facing Dignity Fund allocations.

Public callers offered a range of views: some advocates urged adoption and emphasized digital equity and staff training; others warned that remote modalities cannot substitute for in-person therapy when residents have cognitive, sensory or mobility impairments. Dr. Teresa Palmer, a geriatrician, cautioned that screens cannot replace in-person therapeutic contact for many nursing-home residents and highlighted staffing shortfalls and limited therapist availability.

After public comment and further discussion about budget timing and add-back requests, Vice Chair Asha Safai moved to file the hearing; the committee recorded three 'aye' votes and filed the hearing, with supervisors committing to follow up with departments and to address recommendations during upcoming budget hearings.