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Consent-Health & Human Services # 28.
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| Board of Supervisors |
Child, Youth & Family |
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| Subject |
| Approve and authorize the Chair to sign the Children's Medical Services Annual Plan; authorize the Health and Human Services Agency Director or her/his designee to respond as necessary to any additional documents or budget revisions related to this agreement; and adopt a budget resolution increasing expense and revenue appropriations for California Children's Services. (No general fund impact) (4/5 Vote) (Larsen) |
| Recommended Action |
- Approve and authorize the Chair to sign the Children's Medical Services Annual Plan;
- 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; and
- Adopt a budget resolution increasing expense and revenue appropriations for California Children's Services.
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| Strategic Plan Goal(s) |
Operational Excellence
Thriving Residents
Safe Communities |
| Reason for Recommended Action/Background |
Background on Annual Plan
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), which is comprised of the California Children’s Services (CCS) and Child Health Disability and Prevention (CHDP) programs. CHDP 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 an Annual Plan to DHCS SCD that includes a local CMS program narrative, as well as budget and staffing documents.
Overview of California Children’s Services
The CCS program provides diagnostic and treatment services, medical case management, and physical and occupational therapy services to children under age 21 with CCS-eligible 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.
Senate Bill (SB) 586 authorizes DHCS to establish the Whole-Child Model program in designated County Organized Health Systems or Regional Health Authority counties to incorporate California Children’s Services program-covered services for the Medi-Cal-eligible CCS children and youth into a Medi-Cal managed care plan (MCP) contract. Yolo county is schedule to start WCM on January 1, 2019.
CCS also provides Medical Therapy services that are delivered at public schools. The CCS Medical Therapy Program provides physical therapy, occupational therapy, and Medical Therapy Conference 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 the public school site. The CCS program has a central MTU located at Greengate School and a satellite MTU 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 830 children with special health care needs.
Overview of Child Health and Disability Prevention Programs
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 years and low-income non-Medi-Cal eligible children/youth less than 19 years with family income at or below 200 percent of the federal poverty guidelines. The California Department of Health Services estimates there are 24,000 Yolo County children eligible for CHDP services. The total number of CHDP health assessments completed in Fiscal Year 2017-18 was 20,863. 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 informs community agencies and residents to increase the knowledge and acceptance of preventive services.
The Public Health Nurse works with the child’s social worker or probation officer to ensure that children in out-of-home placement receive all needed health care services. 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 2017-18 was 409 children.
The proposed Annual Plan for these programs in fiscal year 2018-19 is provided in Attachment A. Board of Supervisors approval is required for this Plan, so that Children’s Medical Services can continue providing effective and efficient comprehensive systems for vulnerable populations to improve their health care options and reduce health care costs.
Background on Budget Resolution
The budget that was included in the fiscal year 2018-19 Adopted Budget was based on the allocation letters received by the program at the time. The allocation available has since been increased by $154,236 which requires that the Board of Supervisors approve the attached resolution in order to be appropriated. |
| Collaborations (including Board advisory groups and external partner agencies) |
The Partnership Health Plan of California, a county organized health care system for Medi-Cal recipients, is responsible for the payments of California Children’s Services-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 and Physical Therapy services to eligible special education children. Yolo County CCS refers eligible CCS children to the Yolo County Health and Human Services Agency to apply for Medi-Cal benefits.
The Yolo County CHDP program collaborates and coordinates with Partnership to provide access to preventive healthcare via medical home for Medi-Cal eligible children. Yolo County CHDP works closely other programs in the Health and Human Services Agency 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 to coordinate outreach to families that may qualify for services and with the Yolo County Head Start Program. The HCPCFC program works closely with Yolo County Child Welfare Services and Probation to assure children in out-of-home placement have access to needed health care services.
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| Fiscal Impact |
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| Source of Funds for this Expenditure |
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Explanation (Expenditure and/or Revenue) |
| Further explanation as needed: |
There is no fiscal impact associated with approving this Annual Plan for fiscal year 2018-19. 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 fiscal year 2018-19. 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.
The budget that was included in the fiscal year 2018-19 Adopted Budget was based on the allocation letters received by the State at the time. The allocation available has since been increased by $154,236 which requires that the Board of Supervisors approve the attached resolution in order to be appropriated.
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