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  Consent-Health & Human Services   #   21.    
Board of Supervisors Child, Youth & Family  
Meeting Date: 01/12/2021  
Brief Title:    Children's Medical Services Plan Fiscal Year 2020-21
From: Karen Larsen, Director, Yolo County Health and Human Services Agency
Staff Contact: Karleen Jakowski, Child, Youth & Family Branch Director, Yolo County Health and Human Services Agency, Ext. 2978

Subject
Approve Children's Medical Services Plan for 2020-2021. (No general fund impact) (Larsen)
Recommended Action
  1. Approve and authorize the Chair to sign the Children's Medical Services Plan for FY 2020-2021; and
     
  2. Authorize the Health and Human Services Agency Director or authorized designee to respond as necessary to any additional documents or budget revisions related to this agreement.
Strategic Plan Goal(s)
Thriving Residents
Reason for Recommended Action/Background
The System of Care Division (SCD) of the California Department of Health Care Services (DHCS) is responsible for the administration and oversight of programs that focus on fragile children and adults with special health care needs including Children’s Medical Services (CMS) Programs comprised of the California Children’s Services (CCS) and Child Health Disability and Prevention (CHDP) Programs. The CHDP Program includes the Health Care Program for Children in Foster Care (HCPCFC).  Each year, Yolo County’s local CCS and CHDP Programs are required to submit to DHCS SCD an Annual Plan that includes a local CMS Program narrative as well as budget and staffing documents. Submission of the Annual Plan is contingent on the release by DHCS of the program allocations and Plan and Fiscal Guidelines. For FY 20-21, this was provided by the DHCS on October 1, 2020.

The CCS Program provides diagnostic and treatment, medical case management, and physical and occupational therapy services to children under age 21 with CCS- eligible medical conditions. Yolo County CCS is responsible for assuring that children with medically eligible conditions receive necessary and appropriate health care. Examples of CCS- eligible conditions include, but are not limited to, chronic medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae.

On January 1, 2019, Yolo County CCS started the implementation of Senate Bill 586. This bill authorized the DHCS to establish changes in the CCS program to provide health care coordination for Medi-Cal CCS clients with all medical conditions. This program is called the Whole Child Model (WCM). Yolo County CCS continues to determine medical, financial and residential eligibility to the entire CCS caseload. The responsibility of managed care coordination for the CCS Medi-Cal clients was transferred from CCS to Partnership Health Plan of California (PHC). However, we continue to provide care coordination of the non Medi-Cal clients with CCS-eligible conditions.

CCS also provides Medical Therapy services that are delivered at public schools.  The CCS Medical Therapy Program (MTP) provides physical therapy, occupational therapy, and Medical Therapy Conference (MTC) services to children who meet specific medical eligibility criteria. These services are provided in an outpatient clinic setting known as the Medical Therapy Unit (MTU) that is located at public school sites. A central MTU site is located at Greengate School, and a satellite MTU site is located at Golden Gate Middle School in West Sacramento. Currently, CCS provides a network of CCS-paneled specialty and subspecialty providers and special care center services to approximately 753 children with special health care needs.

The CHDP Program provides complete health assessments for the early detection and prevention of disease and disabilities in children and youth. The population eligible for CHDP services includes all Medi- Cal eligible children/youth under age 21 and low- income, non- Medi- Cal eligible children/youth less than 19 years old with family income at or below 200 percent of the federal poverty guidelines. The CHDP Program estimates there are 25,000 Yolo County children eligible for CHDP services. The CHDP program is responsible for resource and provider development to ensure that high- quality services are delivered to eligible children/youth. In addition, the program informs the target populations to increase their participation and community agencies and residents to increase the knowledge and acceptance of preventive services.

The Health Care Program for Children in Foster Care (HCPCFC) provides health care oversight of the physical, behavioral, dental and developmental needs of all Yolo County children placed in foster care. The caseload for HCPCFC in Fiscal Year 2019- 20 was 442 children. The Public Health Nurse works with social workers or probation officers to ensure that children in out- of- home placement receive all needed health care services. 

Board approval is needed so that CMS can continue providing effective and efficient comprehensive systems for vulnerable populations to improve their health care options and reduce health care costs. Only the Board of Supervisors can enter the County into a binding contract with the state. Therefore, the Chairman’s signature is required for the plan’s submission.
Collaborations (including Board advisory groups and external partner agencies)
The Partnership Health Plan of California (PHC), a county-organized health care system for Medi-Cal recipients, is responsible for the payments of CCS-authorized Medi-Cal patients. Yolo County CCS and Special Education Local Plan Area (SELPA) have an Interagency Agreement in order to facilitate interagency cooperation in providing medically necessary Occupational Therapy (OT) and Physical Therapy (PT) services to eligible special education children. Yolo County CCS refers eligible CCS children to the Yolo County Health and Human Services Agency (HHSA) to apply for Medi-Cal benefits.

The Yolo County CHDP program collaborates and coordinates with PHC to provide access to preventive healthcare via medical home for Medi-Cal eligible children. Yolo County CHDP works closely with Yolo County HHSA to assist families enrolled in Medi-Cal in obtaining health and dental assessment for their children. In addition, CHDP has Interagency Agreements with Yolo County Children’s Alliance and the Yolo County Head Start Program to coordinate outreach to families that may qualify for services. The HCPCFC Program works closely with Yolo County Child Welfare Services and Probation to ensure children in out-of-home placement have access to needed health care services.

Fiscal Information
No Fiscal Impact
Fiscal Impact of this Expenditure
Total cost of recommended action
Amount budgeted for expenditure
Additional expenditure authority needed $0
On-going commitment (annual cost)
Source of Funds for this Expenditure
General Fund $0
Further explanation as needed
No fiscal impact is related to approving this annual plan for fiscal year 2020-2021. The State and Federal grant funds, along with the related Social Services Realignment and general fund to be used as required match are already included in the adopted budget for FY 20-21. The amounts listed here in the plan are maximum amounts for the program during the fiscal year. The county adopted budget is based on estimated expenditures and may reflect different values than those listed in the annual plan documents.
Attachments
Att. A. CMS Annual Plan and Finance Summary

Form Review
Inbox Reviewed By Date
Karen Larsen Karen Larsen 01/04/2021 10:40 AM
Form Started By: tdickinsonb Started On: 12/11/2020 02:17 PM
Final Approval Date: 01/04/2021
Level double AA conformance,
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