REPORT TO SHASTA COUNTY BOARD OF SUPERVISORS

BOARD MEETING DATE:  March  13, 2018
CATEGORY:  Consent - Health and Human Services-6.

SUBJECT:

California Department of Health Care Services Certification for Children's Medical Services

Supervisorial District No. :  All

DEPARTMENT CONTACT:  Terri Fields Hosler, MPH, RD-Public Health Branch Director, (530) 245-6861

STAFF REPORT APPROVED BY:  Terri Fields Hosler, MPH, RD-Public Health Branch Director

RECOMMENDATION

Approve and authorize the: (1) Chairman to sign retroactive renewal Certification Statements with the Children’s Medical Services branch of the California Department of Health Care Services in support of program plans and budgets for the Child Health and Disability Prevention Program in the amount of $331,405; the California Children’s Services Program in the amount of $1,642,108; the Health Care Program for the Children in Foster Care in the amount of $237,583; and for the Monitoring and Oversight of Foster Children Treated with Psychotropic Medication in the amount of $38,236 for a total of $2,249,332 for the period of July 1, 2017, through June 30, 2018; and (2) Health and Human Services Agency (HHSA) Director, or any HHSA Branch Director or Deputy Branch Director, as designated by the HHSA Director, limited authority to execute prospective and retroactive amendments to the program plans and budgets that result in a net change of no more than $224,933 and other minor, non-monetary amendments as necessary, providing all such amendments shall otherwise comply with Administrative Policy 6-101, Shasta County Contracts Manual.

SUMMARY

Approval of the plans and budgets will allow the Health and Human Services Agency (HHSA) to continue to receive funding from the California Department of Health Care Services for provision of services through Child Health and Disability Prevention Program (CHDP), California Services Program (CCS), and the Health Care Program for Children in Foster Care (HCPCFC), including Psychotropic Medication Monitoring and oversight (PMM&O) benefiting children and families in Shasta County.

DISCUSSION

The Children’s Medical Services (CMS) branch of the California Department of Health Care Services provides funding to help support health care for children through preventive screening, diagnostic treatment, rehabilitation, and follow-up services at the local level.  HHSA – Public Health provides administrative oversight and services for the four CMS programs in Shasta County, in collaboration with other HHSA programs, local medical providers, and other agencies.  These programs are aimed at meeting specific health care needs of targeted populations as noted below.

The CHDP Program provides preventive medical services such as well child examinations and immunizations to children with family incomes at or below 266 percent of the federal poverty level.  HHSA – Public Health oversees the delivery of CHDP services by over 70 private medical providers throughout the County.  HHSA – Public Health also provides outreach to increase the number of children who receive services, provides case management to children whose medical conditions are discovered during the CHDP examinations, and collaborates with other HHSA staff to ensure Medi-Cal applicants are informed of the availability of these services.

HCPCFC was initiated in Shasta County during Fiscal Year (FY) 1999-00 after a joint effort of the State Departments of Social Services and Health Care Services sought to increase medical/health oversight of children in foster care, HHSA – Public Health Nurses (PHN) and support staff assigned to HHSA – Children’s Services interacts with local medical providers to ensure a comprehensive health plan for each foster child.  This work is completed as part of the multidisciplinary team co-located at Children’s Services that provides a variety of supportive services for foster children.

PMM&O was initiated in Shasta County during FY 2016-2017 and is to be used exclusively to hire or augment existing PHN staff to permit PHN monitoring and oversight of foster children and youth treated with psychotropic medications.  PHNs under the general program will continue to address the needs of foster children youth and NMD.

CCS provides case management and treatment services to eligible Shasta County children with eligible physical disabilities and/or chronic medical conditions.  CCS services are available on an income eligible basis for chronic medical conditions such as diabetes, cystic fibrosis, cardiac anomalies, malignancies, life threatening injuries, and physical disabilities.  This plan and budget reflects eligibility determination activities, case management, and administrative oversight of CCS services provided to eligible children and their families, but does not include the medical care and therapy services cost portion of the program.

The funding and program plans are retroactive due to a delay by the State’s CMS branch in issuing the allocations.

ALTERNATIVES

Alternatives include not signing the Certification Statements or requesting changes to one or more of the documents.

OTHER AGENCY INVOLVEMENT

County Counsel has reviewed the certifications and approved them as to form.  Risk Management has reviewed and approved the certifications.  This recommendation has been reviewed by the County Administrative Office. Numerous private providers, other HHSA programs and community agencies involved in the provision of foster and medical care services have been involved in planning these programs. 

FINANCING

Revenue and appropriation authority for program administration in the four CMS programs were included in Public Health’s FY 2017-18 Adopted Budgets (BU 411 & 417).  Of the total CMS budget of $2,249,332, $66,408 is contributed by the County as local match for the administration of the CCS program.  Local match funding for administration of the CCS program is derived mainly from Social Services and Public Health Realignment funds with approximately $10,012 from the County General Fund.  Overall, the entire CCS program (Administration and the Medical Therapy Unit) receives $139,159 from the County General Fund, the majority of which is for therapy and treatment services that lie outside the scope of the CMS contract.  State funds, Medi-Cal reimbursement, and enhancement with federal financial participation make up the remainder of the funding for these programs.  The HCPCFC program budget of $237,583 and the PMM&O program budget of $38,236 relies entirely on federal and state funding.  There is no additional General Fund impact associated with this recommendation.