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Health and Human Services Agency (HHSA) recommending the Board:
1) Receive and review the County’s Children’s Medical Services Program Projected Budget for Fiscal Year 2026-27 specific to the Department of Health Care Services California Children’s Services (CCS) Administrative budget in the amount of $1,074,516, and Medical Therapy Program (MTP) budget in the amount of $374,749;
2) Authorize the Chair to sign the Health Care Program for Children in Foster Care Certification Statement; and
3) Delegate authority to the HHSA Director, or Chief Assistant Director, to execute any further documents or reports related to these programs.
FUNDING: CCS Admin: 48.9% Federal, 44.0% State, 7.1% County match; CCS MTP: 50.6% State and 49.4% 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 reducing morbidity and mortality in the pediatric population. Key initiatives under CMS include the CCS, HCPCFC, MTP, and the Psychotropic Medication Monitoring and Oversight (PMMO) programs.
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 are administered through collaboration between County, DHCS, and the federal government. Per HSC Section 123940, the Board is obligated to annually appropriate twenty-five percent (25%) of the actual CCS program expenditures with an additional twenty-five percent (25%) from the County 1991 Realignment Social Services Subaccount. In September 2026, HHSA’s Public Health Division submitted preliminary CMS program budgets to DHCS, with signed Certification Statements and Board signature to follow. Local health officials are tasked with certifying and submitting budget documents to DHCS, and Board receipt and review of CCS budget packets are statutorily required. Further, DHCS requires the Chair of the Board to sign the HCPCFC Certification Statement affirming that the HCPCFC program will comply with all applicable state and federal laws, and DHCS regulations.
ALTERNATIVES
Not submitting the 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/youth under the age of 21 with CCS-eligible medical conditions. Failure to submit this Certification Statement 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 certification would expose County to potential state and federal fiscal sanctions.
PRIOR BOARD ACTION
1) 05/02/2023 Legistar file 23-0628, HHSA California Children’s Services FY 2022-23
2) 04/23/2024 Legistar file 24-0065, HHSA CMS Workplans/Budgets FY 2023-24
3) 03/25/2025 Legistar file 25-0234, HHSA CMS Workplans/Budgets FY 2024-25
4) 11/18/2025 Legistar file 25-1641, HHSA Children’s Medical Services Workplans/Budgets FY25/26
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION
Approve as recommended.
FINANCIAL IMPACT
The County contribution for CCS Admin is approximately $38,072 each of Social Services Realignment and County General Fund. The County contribution for CCS MTP is approximately $92,632 each of Social Services Realignment and County General Fund. Additionally, the County contributes approximately $214,678 for CCS Admin from Public Health Realignment. Sufficient revenue appropriations were included in HHSA’s FY 2026-27 Budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain the Chair’s signature on the HCPCFC Certification Statement.
STRATEGIC PLAN COMPONENT
N/A
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency