REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
January 5, 2021
FROM
CORWIN PORTER, Director, Department of Public Health
SUBJECT
Title v
California Children’s Services Program, Child Health and Disability Prevention Program, and Health Care Program for Children in Foster Care Allocations and Integrated Systems of Care Division Plan
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, for the period of July 1, 2020 through June 30, 2021, for the:
a. California Children’s Services program in the amount of $11,315,380
b. Child Health and Disability Prevention program in the amount of $1,682,617.
c. Health Care Program for Children in Foster Care in the amount of $4,355,024.
2. Approve submission of the Department of Public Health’s 2020-21 Integrated Systems of Care Division Plan to the State of California, Department of Health Care Services, in the combined amount of $17,353,021, for the California Children’s Services program, the Child Health and Disability Prevention program, and the Health Care Program for Children in Foster Care, for the period of July 1, 2020 through June 30, 2021.
(Presenter: Corwin Porter, 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.
FINANCIAL IMPACT
This item does not require additional Discretionary General Funding (Net County Cost). The California Department of Health Care Services (DHCS) requires a match for the California Children’s Services (CCS) allocation of $11,315,380 and the Child Health and Disability Prevention (CHDP) allocation of $1,682,617; DHCS does not require a match for the Health Care Program for Children in Foster Care (HCPCFC) allocation of $4,355,024. The Department of Public Health (DPH) will meet the required CCS match of $538,636 with 1991 Realignment funding of $269,318 and Net County Cost of $269,318, and the required CHDP match of $260,537 with 1991 Realignment funding. The Net County Cost amount of $269,318 will be funded out of DPH’s current Discretionary General Fund allocation, which is included in the departments 2020-21 budget. Approval of the necessary budget adjustments to the DPH and CCS 2020-21 budgets is not requested at this time, but will be included on a future quarterly countywide budget report presented to the Board of Supervisors (Board) for approval.
BACKGROUND INFORMATION
DHCS provides funding to local health jurisdictions to support health services provided to low-income families and their children through the CCS program, CHDP program, and HCPCFC. These programs are administered through a partnership between county health departments and DHCS and DPH has received funding since 1974. DPH estimates this funding will provide 13,575 children with CCS program services at a cost of an average of $1,040 per child, 627 children with CHDP program services at a cost of $3,099 per child, and 7,498 children with HCPCFC services at a cost of $581 per child.
The Board’s approval of the DPH 2020-21 Integrated Systems of Care Division (ISCD) Plan represents DPH’s agreement to comply with all Federal and State requirements pertaining to the CCS program, CHDP program, and HCPCFC and adherence to all applicable policies and procedures set forth by DHCS. In addition, approval of DPH’s 2020-21 ISCD Plan constitutes acceptance of the CCS program, CHDP program, and HCPCFC allocations.
Each year, DHCS issues local county health department allocation notices for the CCS program, CHDP program, and HCPCFC identifying annual funding and, in return, the local county health department must submit an ISCD Plan to DHCS identifying how each program’s funds will be used. DPH’s 2020-21 SCD Plan is due to DHCS by January 8, 2021. It must include verification that DPH will meet the required match.
DHCS issued the following statewide allocation notices identifying funding for the CCS program, CHDP program, and HCPCFC, for the period of July 1, 2020 through June 30, 2021:
• Notice 20-02 for the CCS program allocation, in the amount of $11,315,380. The CCS County budget and ISCD Plan is developed for July 1, 2020 - June 30, 2021, while the state allocations cover the period of April 1, 2020 through March 31, 2021. Additionally, the state requires the submitted ISCD Plan to be developed based on the caseload percentages [Medi-Cal, Straight CCS, and Optional Targeted Low Income Children’s Program (OTLICP) caseloads], but the allocations are developed based on the total amount of funding available for the state and the percentage requested in each caseload category by each county in the state. The variance in the allocated amount and total CCS program expenses has been included in the 2020-21 DPH budget. Budgets are monitored and while there is a variance between allocations and the State ISCD plan, overmatch is not necessary and there will be no need to request additional funds for the administrative portion of the CCS program. 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 CCS medically eligible conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, and traumatic injuries. The ISCD plan only covers the administrative portion of the CCS program.
• Notice 20-02 for the CHDP program allocation, in the amount of $1,525,628, which consists of $569,983 in state allocation and a cap of $955,645 in federal Title XIX matching funds. In developing the proposed budget, DPH determined it will not utilize the full amount of available Title XIX federal funding based on the level of state allocation (for the federal match) and work plan. Therefore, DPH is expecting to receive $1,407,845 of the available $1,525,628 aggregate state and federal funding amounts. DHCS did not send an allocation letter for the remainder of the CHDP program allocation in the amount of $274,772, which combined with $1,407,845 yields a total of $1,682,617. The CHDP program provides complete health assessments for the early detection and prevention of disease and disabilities for low-income children and youth.
• Notice 20-03 for the HCPCFC allocation, in the amount of $5,644,496, which consists of $1,411,124 in state allocation and a cap of $4,233,372 in federal Title XIX matching funds. In developing the proposed budget, DPH determined it will not utilize the full amount of available Title XIX federal funding based on the level of state allocation (for the federal match) and work plan. Therefore, DPH is expecting to receive $4,355,024 of the available $5,644,496 aggregate state and federal funding amounts. The CHDP program is administratively responsible for HCPCFC, which provides public health nurse expertise in meeting a variety of medical, dental, mental health, and developmental needs of children and youth in foster care.
DPH’s 2020-21 ISCD Plan allows for a CCS program administrative budget of $14,124,901, a CHDP program budget of $1,943,154, and an HCPCFC budget of $4,355,024.
This item is being presented to the Board at this time as DPH received the program allocation notices from DHCS on September 25, 2020, and this is the first date available for presentation following the required preparations of the ISCD plan by all programs involved, as well as operational, fiscal, and legal reviews. As required by DHCS, one plan document, comprised of the multiple components, must be submitted after all allocation notices are received. Approval by the Board at this time will have no impact on DPH’s CCS program, CHDP program, or HCPCFC services and activities.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Adam Ebright, County Counsel, 387-5455) on December 15, 2020; Finance (Paul Garcia, Administrative Analyst, 386-8392) on December 14, 2020; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on December 14, 2020.