REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
March 26, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Allocations and Integrated Systems of Care Division Plans for the Child Health and Disability Prevention Program, Health Care Program for Children in Foster Care, and Childhood Lead Poisoning Prevention Program
End
RECOMMENDATION(S)
Recommendation
1. Accept allocations from the California Department of Health Care Services for the Department of Public Health’s Integrated Systems of Care Division Plan, retroactively for the period of July 1, 2022 through June 30, 2023, in the total amount of $7,067,842 as follows:
a. Child Health and Disability Prevention program in the amount of $1,525,628.
b. Health Care Program for Children in Foster Care in the amount of $5,506,364.
c. Child Health and Disability Prevention-Childhood Lead Poisoning Prevention program in the amount of $35,850.
2. Approve and authorize submission of the 2022-23 Integrated Systems of Care Division Plan to the California Department of Health Care Services for the Child Health and Disability Prevention, Health Care Program for Children in Foster Care, and Child Health and Disability Prevention-Childhood Lead Poisoning Prevention programs, in the amount of $5,778,981, for the period of July 1, 2022 through June 30, 2023.
3. Accept allocations from the California Department of Health Care Services for the Department of Public Health’s Integrated Systems of Care Division Plan, for the period of July 1, 2023 through June 30, 2024, in the total amount of $7,107,306 as follows:
a. Child Health and Disability Prevention program in the amount of $1,525,628.
b. Health Care Program for Children in Foster Care in the amount of $5,545,828.
c. Child Health and Disability Prevention-Childhood Lead Poisoning Prevention program in the amount of $35,850.
4. Approve and authorize submission of the 2023-24 Integrated Systems of Care Division Plan to the California Department of Health Care Services for the Child Health and Disability Prevention, Health Care Program for Children in Foster Care, and Child Health and Disability Prevention-Childhood Lead Poisoning Prevention programs, in the amount of $5,802,021, for the period of July 1, 2023 through June 30, 2024.
5. Authorize the Chair of the Board of Supervisors, Chief Executive Officer, or Director of the Department of Public Health to accept and execute any subsequent non-substantive amendments to the 2022-23 or 2023-24 Integrated Systems of Care Division Plan for the Child Health and Disability Prevention, Health Care Program for Children in Foster Care, and Child Health and Disability Prevention-Childhood Lead Poisoning Prevention programs, on behalf of the County, subject to review by County Counsel.
6. Direct the Director of the Department of Public Health to transmit all non-substantive amendments in relation to the 2022-23 or 2023-24 Integrated Systems of Care Division Plan for the Child Health and Disability Prevention, Health Care Program for Children in Foster Care, and Child Health and Disability Prevention-Childhood Lead Poisoning Prevention programs, to the Clerk of the Board of Supervisors within 30 days of full 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 does not require additional Discretionary General Funding (Net County Cost). The allocations for each program, as well as any required match amounts met with 1991 Realignment funding, are detailed in the tables below:
|
Program |
2022-23 Allocation |
2023-24 Allocation |
1991 Realignment Match |
|
Child Health and Disability Prevention (CHDP) |
$1,525,628 |
$1,525,628 |
2022-23: $99,773 2023-24: $102,010 |
|
Health Care Program for Children in Foster Care (HCPCFC) |
$5,506,364 |
$5,545,828 |
Not required |
|
Child Health and Disability Prevention-Childhood Lead Poisoning Prevention (CHDP-CLPP) |
$35,850 |
$35,850 |
Not required |
For 2022-23 and 2023-24, the Department of Public Health (DPH) will meet the required CHDP match using 1991 Realignment funding. Adequate appropriation and revenue were included in DPH’s 2022-23 and 2023-24 budgets.
The State allocation is calculated in advance based on available funds for the programs, and the Department of Health Care Services (DHCS), Integrated Systems of Care Division (ISCD) issues allocation notices in July of each year. Subsequently, the ISCD Plan is submitted to the State for reimbursement based on actual expenditures incurred.
BACKGROUND INFORMATION
DHCS funds programs in local health jurisdictions to serve high-risk families, infants, children, and youth with varied health conditions through the CHDP, HCPCFC, and CHDP-CLPP programs. These programs are administered through a partnership between county health departments and the DHCS, through its ISCD. The goal of the programs is to ensure these populations have and maintain access to needed medical, dental, developmental, and specialty health services through case management, professional consultation, and linkage to appropriate levels of care. DPH has received funding for these programs since 1974.
Each year in July, DHCS issues allocation notices for the CHDP, HCPCFC, and CHDP-CLPP programs identifying annual funding, and in return, DPH must submit an ISCD Plan to DHCS detailing how each program’s funds will be used. Claimed expenditures may be submitted retroactively from July 1 through June 30.
DPH’s 2022-23 ISCD Plan was due to DHCS by September 1, 2022. Due to an administrative error, the ISCD Plan was not submitted. Upon identifying the oversight, DPH contacted the State and was instructed to submit the missing Plan along with the 2023-24 ISCD Plan. DPH leadership has reviewed this situation and established a multifaceted tracking system with additional checks and balances, as well as retrained staff responsible for ISCD Plan oversight. The 2023-24 ISCD Plan is due to DHCS by April 2, 2024. All services were able to be performed continuously and without interruption.
On July 27, 2022 and July 3, 2023, DPH received allocation notices for the CHDP, HCPCFC, and CHDP-CLPP programs for the respective periods of July 1, 2022 through June 30, 2023 and July 1, 2023 to June 30, 2024.
CHDP was allocated $1,525,628 each year to provide health assessments for early detection and prevention of disease and disabilities for low-income children and youth under the age of 21 years, as well as ongoing case management for children who require additional care and services. Approximately 248 health conditions affecting children served by DPH were addressed through the CHDP program in addition to completion of 125 provider training and skills certifications and 31 quality assurance audits.
HCPCFC received $5,506,364 in 2022-23 and $5,545,828 in 2023-24 to provide support to foster children through the use of assigned public health nurses. These nurses consult with Social Workers to facilitate coordination of medical, dental, mental health, and developmental services to foster children. DPH provides services to approximately 8,000 children under this program.
CHDP-CLPP received $35,850 each year to provide technical assistance and audit services by reviewing medical charts to ensure medical providers inform parents of the dangers of lead exposure in children, the value of early intervention, and are providing blood lead testing for children at 12 and 24 months of age. DPH provided 25 chart audits in 2022-23 under this program.
DHCS requires the ISCD Plan to be developed based on actual expenditures incurred, but the allocations are determined by the amount of State funding available, which is why the amounts detailed in the ISCD Plan and the allocation letters do not align.
This item is being presented at this time as this is the first date available for presentation following identification of the oversight, development of the 2023-24 ISCD Plan, required program planning, and mandated operational, fiscal, and legal reviews.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Deputy County Counsel, 387-5455) on March 7, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on March 11, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on March 11, 2024.