REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
December 17, 2024
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 Integrated Systems of Care Division Plan 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 total amount of $6,400,300, retroactively effective July 1, 2024 through June 30, 2025.
2. Approve and authorize submission of the 2024-25 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 $5,251,587, retroactively effective July 1, 2024 through June 30, 2025.
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 and documents to the 2024-25 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 2024-25 Integrated Systems of 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 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
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The allocation in the amount of $6,400,300 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) 2024-25 budget.
The Department is annually required to submit an Integrated Systems of Care Division (ICSD) Plan to DHCS to administer the HCPCFC program. The 2024-25 ICSD plan does not align with DHCS’ allocation because DPH is required to base the ICSD plan on its estimate of annual program expenditures as of October 2024, 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 $6,400,300.
The State allocation is calculated in advance based on available funds for the HCPCFC program, and the DHCS Integrated Systems of Care Division (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 funds programs in local health jurisdictions to serve children and adolescents with unique health challenges through the HCPCFC program. This program is administered through a partnership between local health departments and DHCS. The goal of the program is to support the population’s access to needed 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.
Each year in July, DHCS issues an allocation notice for HCPCFC programs identifying annual funding, and in return, DPH must submit an ISCD Plan to DHCS detailing how the program funds will be used. The notice serves as the program’s approval letter of the HCPCFC budget amounts. Claimed expenditures may be submitted retroactively from July 1 through June 30.
On July 1, 2024, DPH received the allocation notice for the HCPCFC program in the amount of $6,400,300, for the period of July 1, 2024 to June 30, 2025. DHCS requires the ISCD Plan to be developed based on an estimate of annual expenditures to be incurred, but the allocations are determined by the amount of State funding available, which is the reason for the difference in the in the ISCD Plan amount of $5,251,587 and the allocation amount of $6,400,300.
This item is being presented at this time as this is the first date available for presentation following development of the 2024-25 ISCD Plan, required program planning, and mandated operational, fiscal, and legal reviews. In addition, DPH asked DHCS to clarify information in September regarding the development of the ICSD Plan, of which a response was not received until November 18, 2024. 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 (Adam Ebright, Deputy County Counsel, 387-5455) on December 2, 2024; Finance (Iliana Rodriguez, Administrative Analyst, 387-4205) on December 2, 2024; and County Finance and Administration (Robert Saldana, Deputy Executive Officer, 387-5423) on December 2, 2024.