REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
September 23, 2025
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Allocation and Integrated Systems of Care Division Plan for the Health Care Program for Children in Foster Care
End
RECOMMENDATION(S)
Recommendation
1. Accept allocation from the California Department of Health Care Services for the Health Care Program for Children in Foster Care funding, for the coordination of medical, dental, mental health, and developmental services support services for enrolled foster children, in the amount of $6,540,882, for the period of July 1, 2025 through June 30, 2026.
2. Approve and authorize the submission of the 2025-26 Integrated Systems of Care Division plan to the California Department of Health Care Services for the Health Care Program for Children in Foster Care, for the coordination of medical, dental, mental health, and developmental services support services for enrolled foster children, in the amount of $5,434,553, for the period of July 1, 2025 through June 30, 2026.
3. Authorize the Chair of the Board of Supervisors, Chief Executive Officer, or Director of the Department of Public Health to execute any subsequent non-substantive amendments to the 2025-26 Integrated Systems of Care Division plan for the Health Care Program for Children in Foster Care, on behalf of the County, subject to review by County Counsel.
4. Direct the Director of the Department of Public Health to transmit any subsequent non-substantive amendments in relation to the 2025-26 Integrated Systems of the Care Division plan for the Health Care Program for Children in Foster Care to the Clerk of the Board of Supervisors within 30 days of execution.
(Presenter: Joshua Dugas, Director, 387-9146)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
Pursue County Goals and Objectives by Working with Other Agencies and Stakeholders.
FINANCIAL IMPACT
This item will not result in the use of Discretionary General Funding (Net County Cost). The allocation in the amount of $6,540,882 from the California Department of Health Care Services (DHCS) for the Health Care Program for Children in Foster Care (HCPCFC) does not require a local match. Adequate appropriation and revenue have been included in the Department of Public Health’s (DPH) 2025-26 budget.
The Department is annually required to submit an Integrated Systems of Care Division (ISCD) plan to DHCS to administer the HCPCFC program. The 2025-26 ISCD plan does not align with DHCS’ 2025-26 allocation because DPH is required to base the ISCD plan on its estimate of annual program expenditures as of October 2025, while DHCS’ allocation is based on a state-determined methodology. Actual reimbursement of costs is based on program expenditures and the availability of State funding, up to $6,540,882. The DHCS allocation is calculated in advance based on available funds for the HCPCFC program, and the DHCS ISCD provides local health jurisdictions allocation notices in July of each year. Subsequently, the ISCD plan must be developed retroactively and is submitted to the State for reimbursement based on actual expenditures incurred.
BACKGROUND INFORMATION
DHCS provides HCPCFC funding to local health jurisdictions to serve children and adolescents in foster care with unique health challenges. The goal of the program is to support the population’s access to medical, dental, developmental, and specialty health services through case management, professional consultation, and linkage to appropriate levels of care.
Specifically, public health nurses collaborate with Department of Children and Family Services social workers to coordinate medical, dental, mental health, and developmental services support services for enrolled foster children. DPH provides services to approximately 6,700 children under this program. DPH has received funding for this program since 2008.
Every July, DHCS issues an allocation notice to local health jurisdictions. The notice requires DPH to submit an annual ISCD plan detailing how the program funds will be used. Reimbursement is based on actual expenses incurred during the period of July 1, 2025 through June 30, 2026.
On July 2, 2025, DPH received the allocation notice for HCPCFC funding in the amount of $6,540,882, for the period of July 1, 2025 through June 30, 2026. DHCS requires the ISCD plan to be developed based on an estimate of actual expenditures, which is often less than the amount of State and Federal funding allocated. The recommended HCPCFC ISCD plan estimates expenditures of $5,434,553. However, in the event actual expenses exceeded the estimated budget, DPH can provide an amended plan and continue to draw down funding up to the allocated amount.
This item is being presented at this time as this is the first date available for presentation following the development of the 2025-26 ISCD plan, which is not developed until the allocation notice is received, and the required operational, fiscal, and legal reviews. Approval at this time will not impact DPH’s services or activities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniel Pasek, Deputy County Counsel, 387-5455) on August 26, 2025; and County Finance and Administration (Iliana Rodriguez, Administrative Analyst, 387-4205) on September 3, 2025.