DATE: October 6, 2026
TO: Board of Supervisors
SUBMITTED BY: Joe Prado, Director, Department of Public Health
SUBJECT: Retroactive FY 2026-27 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 2026-27 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, 2026 to June 30, 2027 ($2,449,216).
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 - Base (HCPCFC-Base), 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, Health Care Program for Children in Foster Care - Administrative (HCPCFC-Administrative), to fund administrative and fiscal support staff assisting the three mandated child health services programs. 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 action, the Department would not have sufficient funds to offset these mandated program service costs.
RETROACTIVE AGREEMENT:
The Fresno County Department of Public Health (Department) received the fiscal year (FY) 2026-27 allocation letter on July 7, 2026 for HCPCFC-Base, HCPCFC-CR, PMM&O, and the HCPCFC-Administrative component. However, the Department did not receive the workbook until July 17, 2026. All four allocations are retroactive to July 1, 2026. 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 $2,449,216 for FY 2026-27. State and Federal funding is broken down to the programs as follows:
• $1,294,549 - Health Care Program for Children in Foster Care - Base
• $219,512 - Psychotropic Medication Monitoring and Oversight
• $532,378 - Health Care Program for Children in Foster Care - Caseload Relief
• $402,777 - Health Care Program for Children in Foster Care - Administrative
Compared to the FY 2025-26 allocation, the HCPCFC program total allocation decreased by 0.37% and we do not anticipate any major program impacts. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2026-27 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 work 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), Family Preservation Services (FPS), Pregnant and/or Parenting Youth, Ongoing Child Welfare Case Management, Independent Living Program (ILP), Non-Minor Dependent youths, and Transitional Shelter Care Facility (TrSCF).
The Department’s current allocation plan does not utilize the full allocation since the Department is able to draw down funding only up to the amount matched by the State allocation. However, the Department will continue working with DHCS to maximize revenue under this program.
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, 2026. Once this item is approved, no additional Board executed documents are required to receive the HCPCFC fundings.
REFERENCE MATERIAL:
BAI #72, December 9, 2025
BAI #59, November 24, 2024
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 2026-27 HCPCFC Plan and Budget
CAO ANALYST:
Ron Alexander