DATE: November 5, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive FY 2024-25 California Department of Health Care Services Allocation Plan
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to approve the retroactive submission of the FY 2024-25 California Department of Health Care Services allocation plan for child health services under the Health Care Program and Children in Foster Care and authorize the Chairman to execute the Certification Statements as required by the California Department of Health Care Services, effective July 1, 2024 to June 30, 2025 ($2,691,469).
REPORT
There is no additional Net County Cost associated with the recommended action. Approval of the recommended action will allow the County to continue to receive the non-competitive funding from California Department of Health Care Services (DHCS) for three mandated child health services programs: Health Care Program for Children in Foster Care (HCPCFC), Health Care Program for Children in Foster Care - Caseload Relief (HCPCFC-CR), and Psychotropic Medication Monitoring and Oversight (PMM&O). DHCS has granted the County a fourth allocation, Administrative, to fund administrative and fiscal support staff assisting the three mandated child health services programs. The allocation offset the administrative costs of the three programs and include full recovery of all indirect costs. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions as the County is mandated by DHCS to administer all three programs. Should your Board not approve the recommended actions, the Department would not have sufficient funds to offset these mandated program service costs.
RETROACTIVE AGREEMENT:
The Department received the FY 2024-25 allocation letter on August 20, 2024 for HCPCFC, HCPCFC-CR, PMM&O, and the Administrative component. However, the Department did not receive the DHCS workbook until September 5, 2024. All four allocations are retroactive to July 1, 2024. Due to the time required to complete the DHCS workbook, the item is being brought to your Board in accordance with the agenda item processing deadlines.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action. DHCS approved a total non-competitive allocation of $2,691,469 for FY 2024-25. The State and Federal funding is broken down to the programs as follows:
• $1,584,779 - Health Care Program for Children in Foster Care
• $532,378 - Health Care Program for Children in Foster Care - Caseload Relief
• $219,512 - Psychotropic Medication Monitoring and Oversight
• $354,800 - Administrative
The HCPCFC program allocation decreased by 3.13% compared to last fiscal year’s allocation and we do not anticipate any major program impacts. There are no changes in the allocation of HCPCFC-CR and PMM&O. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2024-25 Adopted Budget.
DISCUSSION:
The HCPCFC programs are staffed with Public Health Nurses (PHN) that consult and collaborate with the County’s Department of Social Services (DSS) - Child Welfare Service Programs to provide PHN expertise in meeting the medical, dental, mental, and developmental needs of children and youth in foster care. The HCPCFC program coordinates health care services for these children by:
• Collaborating with social workers and case managers;
• Assessing the health care status of children and promoting access to comprehensive preventive health and specialty services;
• Attending multi-disciplinary Team Decision Meetings to explain the health needs of the child; and
• Acting as a liaison between Child Welfare Services and health care providers.
DSS will be funding the remaining full-time equivalent (FTE) of the 11 PHNs and the Supervising Public Health Nurse (SPHN) to review cases and make recommendations in the areas of physical health, development, education, mental health, placement, and visitations. The PHNs will coordinate activities with DSS staff in Emergency Response (ER), Voluntary Family Maintenance (VFM), Caseload Relief (CR), PMM&O, Ongoing Child Welfare Case Management including Independent Living Program (ILP) and Non-Minor Dependent youths, and Transitional Shelter Care Facility (TrSCF).
To finalize the allocation process, DHCS requires your Board to certify approval of the recommended DHCS workbook and sign the certification stating that the County will comply with applicable laws, regulations, and policies related to the HCPCFC programs. The recommended HCPCFC allocation plans are retroactive to July 1, 2024. Historically, the DHCS allocation plan included a presentation of the California Children’s Services (CCS) program, however, currently CCS receives their allocation letter and submits their budget workbooks separate from HCPCFC. Once this item is approved by your Board, no additional Board executed documents are required to receive the HCPCFC fundings.
REFERENCE MATERIAL:
BAI #55, October 10, 2023
BAI #48, October 25, 2022
BAI #47, November 16, 2021
BAI #12, November 4, 2020
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - FY 2024-25 HCPCFC Plan and Budget
CAO ANALYST:
Ron Alexander