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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 Program Projected Budgets specific to the Child Health and Disability Prevention program (CHDPP), and the Health Care Program for Children in Foster Care (HCPCFC) program, including Psychotropic Medication Monitoring Oversight, for Fiscal Year 2022-23. The collective proposed budgets totaling $899,000 fund the provision of mandated preventive and specialized health care services to vulnerable children from birth to twenty-one (21) years of age, outside and internal to the HHSA support structures of Child Welfare and Behavioral Health;
2) Authorize the Chair to sign the CHDPP and the HCPCFC Certification Statements; and
3) Delegate authority to the HHSA Director, or the Deputy Director of Public Health, to execute any further documents or reports.
FUNDING: Federal and State funding: 27% Federal Children’s Medical Services Allocation, 24% State Children’s Medical Services Allocations, and 49% Public Health Realignment Fund Match.
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DISCUSSION / BACKGROUND:
Children’s Medical Services (CMS) programs are mandated intensive case management and intervention activities. These services target high risk and medically fragile children to ensure effective and coordinated preventative and specialty medical care. They are essential for preserving optimal health and wellness while minimizing morbidity and mortality in the pediatric population. CMS consists of Child Health and Disability Prevention (CHDP) program, and the Health Care Program for Children in Foster Care (HCPCFC), Psychotropic Medication Monitoring and Oversight (PMMO) program. CMS programs specific to child health are mandated at the local level as reflected in California Health and Safety Code (HSC) Article 6 Section 124025. The California State Department of Health Care Services (DHCS), the agency that administers CMS programs, removed submission of the California Children’s Services (CCS) plan and budget component as part of the County of El Dorado County (County), Board of Supervisors (Board) review at this time. The CCS plan and budget projected timeline for Board receipt is April 2023 pending final instruction from DHCS.
Funding for local CMS services is administered as a partnership between the County, DHCS, and the Federal Government. In accordance with HSC Section 123940, the Board must annually allocate twenty-five percent (25%) of the annual 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 Social Services Trust Account. The annual funding allocation for CHDP and HCPCFC programs has an effective date of July 1, 2022, through June 30, 2023. Historically, the allocation is finalized by the State after the Governor signs the State’s budget.
DHCS notified the County of El Dorado Health and Human Services Agency (HHSA) that the deadline for completion of the CHDP and HCPCFC FY 2022-23 Projected Budgets would be November 23, 2022. However, due to the continuing impact of the COVID-19 pandemic response and procedural changes by DHCS, including the removal of the certification of the CCS budget and work scope, an extension was granted. Subsequently, HHSA submitted the preliminary budgets to DHCS on December 17, 2022, with signed Certification Statements and Board Clerk attestation to follow. Board receipt and review of the CHDP and HCPDFC budget packets is required by statute along with local health jurisdiction certification by the HHSA Director and CHDP Deputy Director (County Public Health Deputy Director). Following the Chair’s signature on the corresponding certifications, HHSA will submit the certifications to DHCS.
ALTERNATIVES:
Failure to submit the local Certification Statements to the State would disrupt or potentially suspend Public Health Nursing (PHN) medical case management and psychotropic medication monitoring activities to children currently placed in foster care (currently 200 children) and those children receiving or eligible to receive Medi-Cal specialty health services. Failure to submit the required Certifications would also expose the County to potential State and Federal fiscal sanctions.
PRIOR BOARD ACTION:
1) 01-11-2022, File ID 21-1878, HHSA CMS workplans/budgets FY 2021-2022
2) 02-09-2021, File ID 21-0109, HHSA CMS workplans/budgets FY 2020-2021
3) 01-07-2020, File ID 19-1859, HHSA CMS workplans/budgets FY 2019-2020
4) 12-11-2018, File ID 18-1841, HHSA CMS workplans/budgets FY 2018-2019
5) 12-05-2017, File ID 12-1479, HHSA CMS workplans/budgets FY 2017-2018
6) 12-06-2016, File ID 12-1479, HHSA CMS workplans/budgets FY 2016-2017
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
There is no General Fund cost associated with this Agenda item. The majority of revenue received for CHDP, HCPCFC and PMMO is derived from CFR Title 19 and State Medi-Cal sources, representing approximately 80% of the revenue. The County contribution via Public Health Realignment and Social Services Realignment is approximately 20%. HHSA bills the State who reimburses HHSA with the appropriate mix of federal and state monies. Sufficient revenue appropriations were included in HHSA’s FY 2022-23 Budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain the Chair’s signature on the CHDPP and the HCPCFC Certification Statements and provide the statements and a Certified Minute Order to HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
Healthy Communities: Improved health, well-being and self-sufficiency of El Dorado County communities, residents and visitors.
CONTACT
Olivia A. Byron-Cooper, MPH, Interim Director, Health and Human Services Agency or Michael Ungeheuer, Deputy Director Public Health, Health and Human Services Agency.