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Unique Program Helps SF Residents Forgo Institutional Living

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For the 1,200 beneficiaries, the Community Living Fund means freedom

“I don’t know how any senior can handle all of this stuff,” sighs Mary Anne Humphrey, 68, who suffers from limited mobility due to a spinal cord injury.

Humphrey is explaining the endless paperwork, social services, doctor appointments, benefit plans and medications that she juggles as a disabled senior.

Fortunately, Humphrey is one of 1,200 San Francisco County residents that have received help over the past five years from a unique Bay Area program that keeps older adults and the disabled living independently: the Community Living Fund.

“They just must be overloaded with the paperwork and ins and outs and ‘sign this’ and ‘do that,’” she says. “CLF helps with that, with a real comfort. It takes away a lot of stress.”

Spawned in 2007 by the county, the fund is a collaboration with the city of San Francisco and the local Institute on Aging with a single focus: help San Franciscans survive independently outside the four walls of institutional living.

Besides coordinating complex medical care and social services, more specific assistance by case managers includes transportation to doctors, preparing meals, paying bills, installing ramps, buying electric wheelchairs, or any other help needed to keep clients living on their own.

With San Francisco’s impressive history of community support for the underserved, the county’s board of supervisors created the Community Living Fund in 2007, responding in part to the Olmstead Act of 1999 which requires that disabled citizens wanting to live at home can do so. (The city and county of San Francisco share the same borders.)

“You can’t keep people in institutions if they don’t want to be there and you can provide for them in the community,” says Linda Edelstein, director of Long Term Care Operations for the county’s Department of Aging and Adult Services, which administers the program.

Participants come largely from the two county facilities that serve the poor: Laguna Honda Hospital and Rehabilitation Center, which provides skilled nursing and rehabilitation services for 780 seniors and adults with disabilities, and San Francisco General Hospital.

“Those are basically the have-nots of San Francisco,” says Edelstein. “They don’t have a lot of options.”

Creating the fund served another important function. It helped reduce the patient load at the new Laguna Honda rehabilitation facility, which re-opened in the summer of 2010, with fewer beds, as a state-of-the-art “holistically planned” facility emphasizing natural lighting, community gardens, and patient-directed care.

Keeping patients in hospitals is far more expensive than integrating them into the community, says Dustin Harper, program director for the fund.

“So it’s also in the county’s best interests,” says Harper, also director of Care Management for the Institute on Aging, which contracts with the county to provide direct services. Headquartered in San Francisco, the non-profit institute promotes health, independent living and community involvement for Bay Area seniors.


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