DATE: December 12, 2023
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive FY 2023-24 California Department of Health Care Services Allocation Plan
RECOMMENDED ACTION(S):
TITLE
1. Approve retroactive submission of the FY 2023-24 California Department of Health Care Services allocation plan for child health services under California Children’s Services; and
2. Approve and authorize the Chairman to execute the retroactive Certification Statement as required by the California Department of Health Care Services, effective July 1, 2023 to June 30, 2024 ($7,738,562).
REPORT
There is no additional Net County Cost associated with the recommended actions. Approval of the recommended actions will allow the County to continue to receive non-competitive funding from the California Department of Health Care Services (DHCS) to administer the California Children’s Services (CCS) program. Fresno County’s allocation is 13% more than the prior fiscal year and will cover anticipated FY 2023-24 CCS program costs. The estimated County match of $207,930 will be funded with Health Realignment. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions as the County is mandated under Health and Safety Code (H&SC) Section 123850 to administer the CCS program. Should your Board not approve the recommended action, the Department would not have sufficient funds to offset mandated program costs.
RETROACTIVE AGREEMENT:
The Department received the FY 2023-24 CCS Program allocation from DHCS on October 26, 2023 and it is retroactive to July 1, 2023. This item is brought to your Board in accordance with the agenda item processing timelines. The allocation plan, which is also known as Children’s Medical Services (CMS) Plan, is due to DHCS by December 25, 2023.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The FY 2023-24 non-competitive allocation of $7,738,562, which is primarily comprised of Federal and State funding, represents an $882,533 or a 13% increase from the prior year adjusted allocation of $6,856,029. Sufficient appropriations and estimated revenues are included in the Department’s Org 5620 FY 2023-24 Adopted Budget. The allocation allows full recovery of indirect costs and the Department’s current indirect cost rate is 18.314%.
The CMS Plan identifies the required County match for CCS at $207,930. If the County’s total allocation is expended, the County match will be covered by Health Realignment.
DISCUSSION:
The CCS programs are administered as a partnership between county health departments and DHCS, in accordance with H&SC Section 123800 et seq. The program provides medical case management, diagnostic and treatment services to infants, children and youth under the age of 21 with CCS-eligible medical conditions such as congenital heart disease, cancer, cystic fibrosis, chronic lung disease, serious birth defects, hearing loss and cerebral palsy. The recommended allocation supports the following administrative activities performed by the county CCS program:
• Medical review, evaluation and determination of children and youth under 21 applying for CCS benefits;
• Review and determination of residential and financial eligibilities of medically qualified individuals;
• Authorize appropriate diagnostic services, treatment, therapy, specialized medical care and related services eligible CCS clients;
• Medical case management to ensure eligible infants, children and youth receive the authorized medical services;
• Review, authorize and purchase supplies and other services needed for treatment of the eligible CCS medical condition;
• Assessments, interventions and coordination of care;
• Assistance, consultation and training to providers and hospitals on the CCS authorization process;
• Support for family navigation through consultation and linking to community resources and other family support organizations; and,
• Assessment, intervention and guidance to clients and families in developing transition plans as the CCS client ages out.
Each county’s annual allocation is based on the number of enrolled CCS clients. In FY 2022-23, Fresno CCS caseload was 7530.
Beyond administration of the CCS program and in accordance with H&SC Section 123940, CCS counties share with the State and Federal government financial responsibility for providing medically necessary services such as diagnostics, treatment, medication and therapy to eligible clients. The counties pay their share of cost on a quarterly basis.
Medical Therapy Program (MTP) which is a special program under CCS, provides medically necessary occupational and physical therapy services for eligible children and youth. These services are provided at the Medical Therapy Units located in three Fresno County public schools. DHCS provides a separate allocation to fund the MTP however, counties are not required to submit a plan or budget details.
To finalize the allocation process, DHCS requires your Board to certify approval of the recommended CMS Plan and that the County will comply with applicable laws, regulations, and policies related to the CCS program. The recommended CCS allocation plan is retroactive to July 1, 2023 and serves in lieu of an agreement. Upon approval of the recommended actions by your Board, no additional executed documents are required to receive funding.
REFERENCE MATERIAL:
BAI #40, January 24, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - FY 2023-24 CMS Plan and Budget for CCS
CAO ANALYST:
Ron Alexander