Marin Needs A New Kind Of “Care Hub” For Seniors And Caregivers By Marc Hunter Lewis

Marin County talks a lot about “aging in place.” The County’s own studies warn that a wave of older adults is coming, with rising dementia, higher poverty among future seniors, and already fragmented services that are not prepared for what is ahead. At the same time, nearly 2,000 In‑Home Supportive Services (IHSS) caregivers in Marin earn far below what it actually costs to live here, even as they provide the daily hands‑on help that lets older and disabled residents stay in their homes instead of entering institutions. If we are serious about keeping our parents and neighbors in the community, Marin needs to invest not just in programs, but in the people who do the work and in the places where care actually happens.

One practical way to do that is with a new kind of “care hub”: a combined adult day program and workforce housing project in Marin that serves older adults during the day and provides stable, affordable apartments upstairs for IHSS and other care workers.

A county that is aging fast

Marin’s own Integrated Aging Services Study is blunt. It says the County is “not prepared to adequately serve the ` wave of older adults” and points to rising Alzheimer’s cases, growing numbers of low‑income seniors, and big racial and income disparities as warning signs. The study notes that even though Marin has many good programs, services are fragmented, and people often struggle to navigate a maze of agencies and nonprofits when they need help. Marin’s 2024‑2028 Area Plan for Older Adults also highlights adult day / adult day health care and in‑home services such as IHSS as key tools to keep people living safely at home.

These local findings sit inside a bigger statewide trend. California is in what experts are calling a care crisis: millions more adults will be over 65 and 80 in the next decade, and one in three Californians over 80 will struggle to stay at home without significant help. Policymakers already know that long‑term care needs are rising faster than the supply of workers and faster than public budgets have been built to handle. Marin is not an exception to that pattern, it is a preview of it.

The invisible workforce keeping people at home

IHSS is one of the most important programs in Marin that most people never think about. It pays caregivers to help low‑income older adults and people with disabilities with basic daily tasks like bathing, dressing, meals, and getting around, so they can avoid or delay moving into nursing homes. According to SEIU 2015, there are nearly 2,000 IHSS providers in Marin County, and they are overwhelmingly women, often immigrants and people of color. These caregivers earn around 18 per hour in a county where a living wage for a single adult with no children has been estimated at more than 32 per hour.

The math does not work. Caregivers are being asked to live and work in one of the most expensive counties in the country while making barely more than the minimum wage. Many piece together multiple jobs, long commutes, or unstable housing arrangements just to stay afloat. Yet without them, Marin’s entire “aging in place” strategy collapses, and far more people end up in institutions or hospitals at much higher public cost.

Recent local negotiations have produced modest wage increases and bonuses to try to reduce Marin’s caregiver shortage, especially in places like West Marin where it can be very hard to find workers. But wages alone will not fix the problem if caregivers still cannot afford to live anywhere near the people they serve.

What a “care hub” in Marin could look like

Imagine a new site in Marin designed from the ground up to support both older adults and the workers who care for them. On the ground floor, there is a licensed adult day program or adult day health center offering supervised activities, meals, health monitoring, memory care programming, and respite for family members during the day. Adults with Alzheimer’s, Parkinson’s, physical disabilities, or other health issues come for structured, safe daytime care that keeps them engaged and out of institutions.

Above that, instead of luxury condos, there is a stack of modest, permanently affordable apartments reserved through a legally sound workforce housing preference for IHSS caregivers, home care aides, and other front‑line human‑services workers. Rents are set at levels that someone earning IHSS wages can actually pay, and long‑term affordability is locked in through the same tools Marin already uses in other subsidized housing projects.

During the day, the building functions as a community hub for older adults and their families. In the evening, it becomes a home base for the caregiving workforce, cutting commute times, stabilizing lives, and making it easier to cover early‑morning and late‑night shifts for nearby IHSS clients. Training rooms and offices on the site could host IHSS Public Authority orientations, skills trainings, and support groups, building a stronger pipeline of qualified caregivers for all of Marin.

Marin already knows how to do pieces of this. Lifehouse pioneered a 12‑unit affordable apartment complex for adults with developmental disabilities in Marin more than 20 years ago and continues to help clients secure housing and supports. The County is pushing forward on the Oak Hill Workforce Housing Project near San Quentin, which will put 135 apartments on state land for teachers, school staff, and county employees, using creative financing and rental guarantees. A “care hub” combines those familiar ideas with the aging‑services infrastructure the County already funds through its Area Agency on Aging.

Why it matters now

Marin’s own Integrated Aging Services Study talks about a potential crisis as more residents develop dementia and cognitive impairments while also having lower incomes and fewer resources than current seniors. The report warns that these trends, combined with high housing costs and fragmented services, could overwhelm the county’s existing systems. Statewide analyses make the same point: California is not producing, training, or retaining enough long‑term care workers to meet present or future demand, and the workforce does not yet reflect the diversity of the people it serves.

If Marin does nothing, the likely future is clear. Families will continue to scramble to find IHSS caregivers. More older adults will go without the support they need, fall through cracks in the system, or enter nursing homes earlier than necessary. Public costs for institutional care and preventable hospitalizations will rise.

If Marin instead chooses to pilot a care hub that unites adult day services and stable housing for caregivers, it sends a very different message. It says the county values both elders and the people who care for them. It says that workforce housing is not only for teachers and public employees, but also for the low‑wage women and immigrants who make independent living possible for thousands of vulnerable residents. And it offers a tangible example other counties can follow as they confront the same challenges.

Where to go from here

This kind of project will not happen by accident. It will require the Board of Supervisors, Marin HHS, the IHSS Public Authority, housing nonprofits, and aging‑services organizations to sit at the same table and design something new. The good news is that the building blocks are already in place: an Area Plan that prioritizes home‑ and community‑based care, a documented IHSS workforce crisis, existing special‑needs housing models, and current county enthusiasm for workforce housing.

For residents, families, and caregivers, this is the moment to insist that “aging in place” be more than a slogan. That means urging county leaders to explore a pilot care hub in Marin, built on county or partner land, that pairs an adult day facility for older and disabled adults with permanently affordable apartments for the caregivers who keep them safe at home.