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Health and Human Services Agency (HHSA) recommending the Board:
1) Receive and review the County of El Dorado’s Children’s Medical Services (CMS) Program Projected Budget for Fiscal Year 2025-26 specific to the Department of Health Care Services (DHCS) California Children’s Services (CCS) Administrative (Admin) budget in the amount of $701,212, Health Care Program for Children in Foster Care (HCPCFC) budget in the amount of $542,506, and Medical Therapy Program (MTP) budget in the amount of $548,471;
2) Authorize the Chair to sign the CCS and HCPCFC Certification Statements; and
3) Delegate authority to the HHSA Director, or Chief Assistant Director, to execute any further documents or reports related to these programs.
FUNDING: Federal, State and County General Fund: CCS Admin: 11% Federal, 23% County match, 6% State; HCPCFC: 4% Federal, 11% County match, 3% State; CCS MTP: 2% Federal 14% State and 26% County match.
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DISCUSSION / BACKGROUND:
The CMS programs provide intensive case management and intervention to support high-risk and medically fragile children. These programs are designed to ensure coordinated preventive and specialty medical care, with the goal of optimizing health outcomes and reduce morbidity and mortality in the pediatric population. Key initiatives under CMS include the CCS, HCPCFC, MTP, and the Psychotropic Medication Monitoring and Oversight (PMMO) program.
The CCS program provides essential diagnostic, treatment, case management, and therapy services for children/youth under 21 with severe medical conditions such as cerebral palsy, cancer, and heart disease. This includes the MTP, which offers physical and occupational therapy as well as interdisciplinary Medical Therapy Conference (MTC) services for children with neurological or musculoskeletal disorders. Therapy services are also provided in public schools to address physical and occupational therapy needs.
The HCPCFC program, embedded within local child welfare and probation departments, involves public health nurses providing expertise in managing the medical, dental, mental, and developmental needs of children in foster care. This program addresses the unique social determinants of health affecting this vulnerable population by serving as a bridge between child welfare departments and healthcare providers.
The PMMO program focuses on monitoring and oversight of psychotropic medication use in children to ensure appropriate management.
These programs operate under California Health and Safety Code (HSC) Article 6, Section 124025, and are administered through collaboration between the County, DHCS, and the federal government. As per HSC Section 123940, the Board is obligated to annually allocate twenty-five percent (25%) of the program expenditure to a level at least equivalent to the actual Fiscal Year (FY) 1990-91 contribution, with an additional twenty-five percent (25%) from the County 1991 Realignment Social Services Subaccount. For the Fiscal Year 2025-26, budget allocations will be finalized following the state’s budget approval. Local health officials are tasked with certifying and submitting budget documents to DHCS.
In September 2025, HHSA submitted preliminary budgets to DHCS, with signed Certification Statements and Board signature to follow. Board receipt and review of CCS and HCPCFC budget packets are statutorily required, along with local health jurisdiction approval by the Public Health Director and Public Health Nursing Managers. Upon the Chair’s signature on the corresponding certifications, HHSA will submit them to DHCS.
ALTERNATIVES:
Not submitting the local Certification Statement to DHCS could disrupt or potentially suspend the provision of diagnostic and treatment services, as well as Public Health Nursing medical case management, for children under the age of 21 with CCS-eligible medical conditions. Failure to submit these Certification Statements could also disrupt or potentially suspend Public Health Nursing medical case management and psychotropic medication monitoring activities for children currently placed in foster care (approximately 200 children) and those children receiving or eligible to receive Medi-Cal specialty health services. Additionally, failure to submit the required Certifications would expose the County to potential state and federal fiscal sanctions.
PRIOR BOARD ACTION:
1) 01/11/22, 21-1878, HHSA CMS workplans/budgets FY 2021-2022
2) 02/21/23, 22-0939, HHSA CMS Budgets & Work Plans FY 2022-2023
3) 05/02/23, 23-0628, HHSA California Children’s Services FY 2022-23
4) 04/23/24, 24-0065, HHSA CMS Workplans/Budgets FY 2023-24
5) 03/25/25, 25-0234, HHSA CMS Workplans/Budgets FY 24/25
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The County contribution for CCS Admin is approximately $134,328 each of Social Services Realignment and County General Fund. The County contribution for CCS MTP is approximately $330,224 each of Social Services Realignment and County General Fund. Additionally, the County contributes approximately $293,365 for CCS Admin from Public Health Realignment. Sufficient revenue appropriations were included in HHSA’s Fiscal Year 2025-26 Budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS:
1) Clerk of the Board to obtain the Chair’s signature on the CCS and HCPCFC Certification Statements; and
2) Clerk of the Board to return one Certified Minute Order to HHSA Contracts Unit at hhsa-contracts@edcgov.us.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency