PORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
February 27, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
Allocation and 2023-24 Integrated Systems of Care Division for California Children’s Services Plan and Allocation
End
RECOMMENDATION(S)
Recommendation
1. Approve and authorize submission of the 2023-24 Integrated Systems of Care Division Plan for California Children’s Services, to the California Department of Health Care Services, in the amount of $15,366,246, including a match of $517,460, for the period of July 1, 2023 through June 30, 2024.
2. Accept an allocation from the California Department of Health Care Services for the 2023-24 Integrated Systems of Care Division Plan, in the amount of $13,346,151, for the period of July 1, 2023 through June 30, 2024.
(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 Department of Public Health (DPH) Integrated Systems of Care Division (ISCD) Plan in the amount of $15,366,246 is the estimated cost to provide California Children’s Services (CCS). The ISCD Plan total includes the required CCS County match of $517,460, comprised of $258,730 1991 Realignment and $258,730 in Discretionary General Funding appropriated in 2023-24. The ISCD Plan total exceeds the $13,346,151 allocation from the California Department of Health Care Services (DHCS), as it includes County matching dollars and estimated additional budgeted costs of $1,502,635. While the ISCD Plan covers the period of July 1, 2023 through June 30, 2024, the State allocation methodology covers the period of April 1, 2023 through March 31, 2024, resulting in a variance between the allocation amount and the amount budgeted in the ISCD Plan.
The DHCS funding allocation will be used to reimburse costs incurred retroactively from July 1, 2023, and are anticipated to be fully expended by June 30, 2024. Historically, the State has provided supplemental allocations when the original allocation did not meet actual expenses incurred. However, if supplementary State funds are not provided to meet actual CCS 2023-24 expenses, DPH may require and request further budget adjustments to support CCS.
BACKGROUND INFORMATION
DHCS issues funding to local health jurisdictions to serve high-risk families, infants, children, and youth with numerous health conditions through the CCS and Child Health and Disability Prevention programs. These programs are administered through a partnership between county health departments and DHCS, via its ISCD. The collective goal of the program is to ensure children with specific health conditions, have and maintain access to needed medical, dental, 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.
The CCS program provides diagnostic and treatment services, medical case management, and physical and occupational therapy services for children under the age of 21 with medically eligible conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, and traumatic injuries. DPH estimates the $15,366,246 in the ISCD Plan will provide approximately 14,412 children with CCS program services at an average cost of $1,066 per child.
Annually, DHCS issues retroactive allocation notices for the CCS program identifying DPH’s funding. To accept the funding, DPH must submit an ISCD Plan identifying how funds will be used. Because of the retroactive issuance of the program allocation, DHCS requires local health departments to claim expenses back to July 1st of the current fiscal year.
On March 14, 2023 (Item No. 36), the Board of Supervisors approved the DPH 2022-23 ISCD Plan and accepted the CCS program allocation.
On October 26, 2023, DPH received Information Notice 23-05 providing the 2023-24 CCS program allocation in the amount of $13,346,151. DHCS requires the ISCD Plan to be developed based on specified program caseload percentages, but the actual allocations are determined by the amount of State funding available. Additionally, the ISCD Plan must cover the period of July 1, 2023 through June 30, 2024, while the State allocation methodology covers the period of April 1, 2023 through March 31, 2024. Due to the differences in accounting periods, there are variances between the allocated amount on Information Notice 23-05 and the amount budgeted in the ISCD Plan.
This item is being presented at this time, as this is the first date available following receipt of Information Notice 23-05, ISCD Plan development, and the required operational, fiscal, and legal reviews. Approval at this time will have no impact on DPH’s CCS program services and activities.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, County Counsel, 387-5455) on January 19, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on February 9, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on February 9, 2024.