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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 budget specific to the California Children’s Services (CCS) program for Fiscal Year 2022-23, with a budget totaling $690,364 in funding for the provision of diagnostic and treatment services and Public Health Nursing medical case management to children under age twenty-one (21) with CCS-eligible medical conditions;
2) Authorize the Chair to sign the CCS Certification Statement; and
3) Delegate authority to the HHSA Director, or the Deputy Director of Public Health, to execute any further documents or reports.
FUNDING: Federal, State and County General funding: 58% Federal Children’s Medical Services Allocation, 36% State Children’s Medical Services Allocations, and 3% Social Services Realignment, and 3% General Fund.
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DISCUSSION / BACKGROUND:
CCS are mandated intensive case management and intervention activities that target high risk and medically fragile children to ensure effective and coordinated preventative and specialty medical care. These services are essential for preserving optimal health and wellness while minimizing morbidity and mortality in the pediatric population. Service mandate is promulgated by Health and Safety Code, Section 123800 et seq. <https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=HSC&division=106.&title=&part=2.&chapter=3.&article=5.> with the explicit legislative intent of the CCS program to provide necessary medical services for children with CCS medically eligible conditions whose parents are unable to pay for these services, wholly or in part.
California State Department of Health Care Services (DHCS), the agency that administers Children’s Medical Services (CMS) programs, earlier this year removed submission of the CCS budget as part of the County of El Dorado County Board of Supervisors review of the overall CMS plan and budgets. The Child Health and Disability Prevention components of the plan were submitted for review by the Board in March of this year.
Funding for local CCS 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 25% from the County Social Services Trust Account. The annual funding allocation for CMS services has an effective date of July 1, 2022, through June 30, 2023.
DHCS notified Counties of the projected CCS allocation on January 24, 2023. HHSA submitted the projected local CCS budget to DHCS on March 15, 2023, with signed Certification Statements and Board Clerk attestation to follow. Board receipt and review of the CCS budget is required by statute along with local health jurisdiction certification by the Health Officer and CMS Administrator (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 Statement to the State would disrupt or potentially suspend the provision of diagnostic and treatment services and Public Health Nursing medical case management to children under age twenty-one (21) with CCS-eligible medical conditions. Failure to submit the required Certification would also expose the County to potential State and Federal fiscal sanctions.
PRIOR BOARD ACTION:
1) 02-21-2023, File ID 22-0939, HHSA CMS Budgets & Work Plans FY 2022-2023
2) 01-11-2022, File ID 21-1878, HHSA CMS workplans/budgets FY 2021-2022
3) 02-09-2021, File ID 21-0109, HHSA CMS workplans/budgets FY 2020-2021
4) 01-07-2020, File ID 19-1859, HHSA CMS workplans/budgets FY 2019-2020
5) 12-11-2018, File ID 18-1841, HHSA CMS workplans/budgets FY 2018-2019
6) 12-05-2017, File ID 12-1479, HHSA CMS workplans/budgets FY 2017-2018
7) 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:
The County contribution by 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. As a note, there is a CCS Medical Therapy Program General Fund cost that is not applicable to this agenda item.
CLERK OF THE BOARD FOLLOW UP ACTIONS
Clerk of the Board to obtain the Chair’s signature on the CCS Certification Statements and provide the statements and a Certified Minute Order to HHSA Contracts Unit at 3057 Briw Road.
STRATEGIC PLAN COMPONENT:
Healthy Communities
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.