Sacramento County's Department of Child, Family and Adult Services provides an alternative to nursing homes and other boarding care facilities. The program is titled, "In-Home Supportive Services". It allows low income aged, blind, and disabled adults and children to remain at home. The services provided are: housecleaning, meal preparation, laundry, grocery shopping, personal care, accompaniment to medical appointments, and protective supervision for the mentally impaired.

Following a progress report presentation on April 22, 2025, Supervisor Serna rambled (time mark 5:35), "I'm only chuckling here because it's, it's like we saw this movie in the morning. Um. I'm not, I'm not trying to be a smart ass here. I'm just saying that, uh, we had the, the issue that, uh, Supervisor Kennedy referenced, um, earlier, uh, had to do with a totally different subject. But, the, the whole issue of substantiative work verses, I think, uh, he put it well as busy work, um, is something that I think we are sensitized to now, so we want to make sure that, yeah, we want to improve where we can improve. But, we also want to know at what cost is that, you know, is involved to do that. In, before we get to Supervisor Desmond, who's been waiting patiently to chime in here, I want to just add to, uh, Supervisor, what Supervisor Kennedy, I think, um, very appropriately suggests, in terms of, you know, taking the next step, in terms of, uh, actionable, um, changes, or, you know, improvements I suppose. Uh, I'll just go back to my earlier comment: if it's 70% we don't have, you know, 70% approval, and we haven't asked the questions, 'Well, what would get us to 100?' Then we, you know, we're not, we've only left this exercise kinda half baked. So, um, I think he's spot on in terms of, um, prompting, uh, us to do the, the next thing here to, to figure out how to, to do better, be better. Uh, certainly, not a, not a criticism of the great work that, uh, um, the authority does in its, um, practitioners and its service deliver, um, uh, service, uh, folks. But, um, that, I can't, I can't help but still go back to the one slide and 70% just doesn't blow me away. You know. Because 90%? Okay. Now there's something to talk about. So, we've got room for improvement."

Being the son of a popular Sacramento mayor isn't qualification enough to represent constituents of County District 1. An essential qualification is the ability to drill down to the root cause of a problem. Then communicate the solution to constituents "in terms so plain and firm as to command their assent." —Thomas Jefferson.

On November 10, 2023, the Sacramento Bee published an opinion titled, "The erratic behavior of Sacramento Supervisor Phil Serna is troubling and unacceptable."

The Bee said, "Serna had what can only be called a bizarre temper tantrum on Facebook last weekend, proving why it was so regrettable that no one ran against him in the 2022 election."

The Bee said Serna called a constituent, "a pathetic, disgusting coward." Serna added, "You think I'm a Sacramento political hack. DO YOU?!?! How big are your balls you coward? Run for office instead of opening your useless pie-hole!! DO IT!! Dare you!! COWARD."

The opinion summarized, "Serna's comments to [redacted] were conduct unbecoming ..., and Serna's seat on the County Board of Supervisors is simply too powerful to be wasted on a man who can't keep his anger to himself."