Take the following actions: (1) Approve and authorize the Chairman to sign an evergreen Global Memorandum of Understanding (MOU) executed between the California Department of Social Services and the California Department of Health Care Services for the exchange of child welfare services psychotropic medication data collected and retained by California Department of Social Services and California Department of Health Care Services with no compensation effective date of signing; (2) approve and authorize the Health and Human Services Agency (HHSA) Director, or any HHSA Branch Director designated by the HHSA Director, to sign the California Department of Social Services Confidentiality and Security Requirements for California State Agencies Interagency Agreements/Memoranda of Understanding, Exhibit C of the MOU, with Information Technology approval; and (3) approve and authorize the HHSA Director, or any HHSA Branch Director designated by the HHSA Director, to sign both non-substantive and substantive amendments as set forth in Section VIII of the MOU. 

Approval of this MOU will allow HHSA to receive data pertaining to children receiving child welfare services in Shasta County. The confidential data received would include data derived from Child Welfare Services/Case Management System (CWS/CMS) and Medi-Cal paid claims data match. This individual, child level information is an important tool for counties to administer and implement applicable federal and state health and public social service programs, and will assist HHSA to monitor the use of psychotropic medication by children in foster care.

The Child and Family Services Improvement and Innovation Act of 2011 (Public Law 112-34) requires State Title IV-E agencies to improve the oversight and monitoring of psychotropic medication and to include as part of their Health Care Coordination and Oversight Plan a comprehensive description of protocols planned to ensure the safe and appropriate use of these medications.

California Welfare and Institutions Code sections 369.5 and 739.5 requires juvenile court authorization prior to the administration of psychotropic medications to children in foster care. While this process provides a certain level of oversight for psychotropic medication use by children in foster care, additional steps are needed to ensure optimal safety and a more effective delivery of mental health services to these children in care.

State level data matches between foster care data in CWS/CMS and Medi-Cal pharmacy paid claim records for all children in foster care (under 18 years-of-age) have demonstrated the urgent need to address this issue at systemic and individual case levels, and across disciplines, branches and levels of government. Counties or Tribes can individually choose whether or not to enter into this global data sharing agreement by executing the county or tribe portion of the agreement.  By entering into this global data sharing agreement with California Department of Social Services (CDSS) and California Department of Health Care Services (DHCS), Children’s Services will be able to receive individual, child level information which will be an important tool for Children’s Services/Public Health Nurses and Mental Health Clinicians for monitoring the use of psychotropic medication by children in foster care.

This MOU authorizes any party to propose written substantive changes or revisions to the information, activities and tasks of this MOU without amendment provided such changes do not alter the overall goals and basic purpose of the MOU. The changes will be effective upon the mutual agreement of the affected parties. The addition of individual Counties or Tribes to this MOU, is considered to be a non-substantive change and does not require a formal amendment.

The Board could choose not to approve this MOU.

County Counsel has approved the MOU as to form. Risk Management and Information Technology have reviewed and approved the MOU. The recommendations have been reviewed by the County Administrative Office.

This MOU provides no monetary compensation to any party in the MOU. There is no additional General Fund impact associated with this recommendation.