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Health and Human Services Agency recommending the Board approve and authorize the Chair to sign a Budget Transfer Request, amending the Fiscal Year 2018-2019 Adopted Budget, increasing the General Fund contribution and appropriations for the California Children’s Services program in the amount of $100,000; and decreasing the General Fund contributions and appropriations to the County Medical Services Program and Emergency Medical Services programs by $100,000. (4/5 vote required)
FUNDING: General Fund.
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DISCUSSION / BACKGROUND:
The Health and Human Services Agency (HHSA), Public Health Division, is recommending the Board approve a Budget Transfer Request (BTR) for Fiscal Year 2018-19 to transfer identified General Fund (GF) savings within the Emergency Medical Services (EMS) and County Medical Services (CMSP) programs to the California Children’s Services (CCS) program. This request is to increase the GF revenues to the “Operating Transfers In” object for the CCS program in the amount of $100,000; and to decrease the GF contributions and appropriations to EMS by $56,508 and CMSP by $43,492 for a total of $100,000, due to higher than anticipated costs for one client.
The CCS program is a mandated state program for children under age 21 with certain diseases or health needs. The CCS program is administered as a partnership between the County Public Health Department and the California Department of Health Care Services (DHCS), with the County share of patient treatment being fifty percent (50%) of the overall cost.
The County share of cost is funded with equal amounts of Social Services realignment and general fund. Each year the County share of cost is budgeted based on historical usage; however, currently, the program is caring for a child who has a serious medical condition, and the County portion of cost for this fiscal year is significantly higher than in prior years.
This Budget Transfer Request is being recommended at this time primarily due to the timing of quarterly invoices from the State, and the determination of the length of necessary treatment. Following analysis of savings in other programs that could be used to cover these costs it has been determined that the CMSP program has savings of $43,492 due to the required annual County Participation Fee being waived for FY 2018-19 by the CMSP Governing Board. Additionally, savings were identified in the EMS Program of $56,508 due to reduced program expenditures.
ALTERNATIVES:
Should the Board decline to approve and authorize this Budget Transfer Request, the CCS budgeted revenue and appropriations would not be sufficient to fund the County share of cost. HHSA would be able to pay the County share of cost for this patient’s treatment based on appropriations contained within the sub-fund, but those costs would not be appropriately matched to the corresponding revenue.
PRIOR BOARD ACTION:
18-0940, June 18, 2018, Approval of Fiscal Year 2018-19 recommended budget.
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
It is recommended that the Board approve this item.
FINANCIAL IMPACT:
Approval and authorization of this Budget Transfer Request would result in a decrease in General Fund Contribution and appropriations for EMS and CMSP of $100,000, and an increase to the CCS program “Operating Transfers In” object of $100,000. There is no impact to the general fund as these amounts are already approved in the Public Health budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain signature of Chair on the attached Budget Transfer Request, and submission of same to the Auditor-Controller’s Office for processing.
STRATEGIC PLAN COMPONENT:
N/A
CONTACT
Donald Semon, Director