REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 22, 2024
FROM
JOSHUA DUGAS, Director, Department of Public Health
SUBJECT
Title
California Children’s Services Allocations, Monitoring and Oversight Plan and 2024-25 Integrated Systems of Care Division Plan
End
RECOMMENDATION(S)
Recommendation
1. Approve and authorize submission of the 2024-25 Integrated Systems of Care Division Plan for California Children’s Services, to the California Department of Health Care Services, in the amount of $16,307,696, including a County match of $515,107, for the period of July 1, 2024, through June 30, 2025.
2. Approve and authorize submission of the 2024-25 California Children’s Services Monitoring and Oversight plan, to the California Department of Health Care Services, in the amount of $654,474, for the period of July 1, 2024, through June 30, 2025.
3. Accept allocation (State Agreement No. 24-04) from the California Department of Health Care Services for the 2024-25 Integrated Systems of Care Division Plan and 2024-25 California Children’s Services Monitoring and Oversight, in the amount of $13,337,610, for the period of July 1, 2024, through June 30, 2025.
(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 Fund (Net County Cost). The Department of Public Health (DPH) is required to submit an annual Integrated Systems of Care Division (ISCD) Plan for the amount of $16,307,696. This amount is the estimated cost to provide CCS services based on a state-provided methodology and caseload sizes. The ISCD Plan total includes the required CCS local match of $515,107, comprised of $257,554 1991 Realignment and $257,553 in Discretionary General Funding appropriated in 2024-25. Additionally, for the newly required compliance, monitoring and oversight (Oversight) unit, DPH estimates the cost to establish the new unit will be approximately $654,474.
In addition, the California Department of Health Care Services (DHCS) allocated funds in the amount of $13,337,610, comprised of $12,646,849 for administrative expenses for the California Children’s Services (CCS) program and $690,761 for Oversight. The actual allocation amounts are determined by available state funding. Therefore, the estimated costs outlined in the Plans and the actual allocations are not typically aligned.
The DHCS funding allocations will be used to reimburse costs incurred retroactively from July 1, 2024, and are anticipated to be fully expended by June 30, 2025. Historically, DHCS has provided supplemental allocations when the original allocation did not meet actual expenses incurred. However, if supplementary DHCS funds are not provided to meet the actual CCS 2024-25 expenses, DPH may request further budget adjustments to support CCS activities and services.
BACKGROUND INFORMATION
DHCS issues funding to local health jurisdictions to serve high-risk families, children, and youth with a variety of physically disabling and/or medically fragile health conditions through the CCS program. This program is administered through a partnership between county health departments and DHCS, via the ISCD. The collective goal of the program is to ensure children with medically eligible 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 this program since 1974.
The CCS Program provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children under the age of 21 with CCS-eligible medical conditions such as cystic fibrosis, heart disease, cancer, and traumatic injuries. DPH estimates the $16,307,696 ISCD Plan will provide services to approximately 14,107 children at an average cost of $1,156 per child. Providing a plan allows DHCS to have an accurate annual estimated cost for providing services, which in turn allows DPH to request additional funding in the event the allocated amount becomes depleted.
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.
DHCS established CCS Oversight through the California Advancing and Innovating Medi-Cal Initiative to implement and evaluate consistent program standards. DHCS has issued funding for Oversight this year to determine future funding; the 2024-25 funding allocation was determined by the average caseload for 2022-23.
On August 21, 2024, DPH received Information Notice 24-04 providing the 2024-25 CCS program allocation in the amount $12,646,849 and $690,761, for the CCS Administration and Oversight respectively. DCHS 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, 204 through June 30, 2025, and is due DHCS on November 5, 2024.
This item is being presented at this time, as this is the first date available following receipt of Information Notice 24-04, 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, Deputy County Counsel) 387-5455) on September 27, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on October 4, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on October 4, 2024.