Title
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 Child Health and Disability Prevention Program (CHDP) in the amount of $242,190, California Children’s Services (CCS) in the amount of $528,229, and Health Care Program for Children in Foster Care (HCPCFC) in the amount of $79,115 for Fiscal Year 2023-24;
2) Authorize the Chair to sign the CHDP, CCS, and HCPCFC Certification Statements; and
3) Delegate authority to the HHSA Director, or Chief Assistant Director, to execute any further documents or reports.
FUNDING: Federal, State and County General Fund: CHDP: 35% Federal Children’s Medical Services Allocation, 37% State Children’s Medical Services Allocations, and 28% Public Health Realignment Fund Match; CCS: 59% Federal, 34% State, 7% County Match; HCPCFC: 69% Federal, 31% State.
Body
DISCUSSION / BACKGROUND:
The Children’s Medical Services (CMS) programs encompass mandated intensive case management and intervention activities designed to address the needs of high-risk and medically fragile children. These services aim to ensure the provision of effective and coordinated preventative and specialty medical care, essential for maintaining optimal health and wellness while minimizing morbidity and mortality in the pediatric population.
The CMS programs include CHDP, CCS, HCPCFC, and the Psychotropic Medication Monitoring and Oversight (PMMO) programs. Local mandates for child health programs within CMS are outlined in the California Health and Safety Code (HSC) Article 6, Section 124025. The administration of CMS services involves collaboration between the County, the California State Department of Health Care Services (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. The annual funding allocation for CHDP, CCS, and HCPCFC programs is effective from July 1, 2023, through June 30, 2024, and the finalization of the allocation occurs after the State's budget is signed by the Governor.
On January 23, 2024, HHSA submitted preliminary budgets to DHCS, with signed Certification Statements and Board Clerk attestation to follow. Board receipt and review of CHDP, CCS and HCPCFC budget packets are statutorily required, along with local health jurisdiction certification by the HHSA Director and Public Health Deputy Director. Upon the Chair’s signature on the corresponding certifications, HHSA will submit them to DHCS.
ALTERNATIVES:
Not submitting the local Certification Statements to the 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) 01/07/2020, 19-1859, HHSA CMS workplans/budgets FY 2019-2020
2) 02/09/2021, 21-0109, HHSA CMS workplans/budgets FY 2020-2021
3) 01/11/2022, 21-1878, HHSA CMS workplans/budgets FY 2021-2022
4) 02/21/2023, 22-0939, HHSA CMS Budgets & Work Plans FY 2022-2023
5) 05/02/2023, 23-0628, HHSA California Children’s Services FY 2022-23
OTHER DEPARTMENT / AGENCY INVOLVEMENT:
N/A
CAO RECOMMENDATION:
Approve as recommended.
FINANCIAL IMPACT:
The majority of revenue received for CHDP is derived from Code of Federal Regulations Title 19 and State Medi-Cal sources, representing approximately 72% of the revenue. The County contribution via Public Health Realignment is approximately 27%. HHSA bills the State who reimburses HHSA with the appropriate mix of federal and state monies. HCPCFC is 69% Federal and 31% state. CCS Admin is 59% Federal, 34% and 7% Realignment. Sufficient revenue appropriations were included in HHSA’s Fiscal Year 2023-24 Budget.
CLERK OF THE BOARD FOLLOW UP ACTIONS
1) Clerk of the Board to obtain the Chair’s signature on the CHDP, CCS, and HCPCFC Certification Statements; and
2) Clerk of the Board to return one (1) Certified Minute Order to HHSA Contracts Unit at 3057 Briw Road, Suite B.
STRATEGIC PLAN COMPONENT:
Safe and Healthy Communities
CONTACT
Olivia Byron-Cooper, MPH, Director, Health and Human Services Agency