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  Consent-Health & Human Services   # 17.       
Board of Supervisors Child, Youth & Family  
Meeting Date: 10/25/2016  
Brief Title:    CMS Annual Plan
From: Karen Larsen, Director, Health and Human Services Agency
Staff Contact: Gaby Castaneda, Office Support Specialist, Health and Human Services Agency, x8688

Subject
Approve the Children's Medical Services Plan for 2016-17 and authorize the Health and Human Services Agency director to sign any additional related documents as necessary. (General fund impact $8,186) (Larsen)
Recommended Action
  1. Approve and authorize the Chair to sign the Children's Medical Services (CMS )Plan;
     
  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 Medical Services;(CMS) programs comprised of the California Children's Services(CCS) and Child Health Disability and Prevention (CHDP) Programs. 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 16-17, this was provided by the DHCS on August 15, 2016.

CMS is an integration of the Child Health and Disability Prevention (CHDP) Program and California Children's Services (CCS). The CHDP Program includes the Health Care Program for Children in Foster Care (HCPCFC). 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's CCS is responsible for assuring the 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. 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 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 800 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 include 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 below 200 percent of the federal income guidelines. The California Department of Health Services CHDP Program estimates there are 24,000 Yolo County children eligible for CHDP services. The total number of CHDP health assessments completed in Fiscal Year 2015-16 was 25,727. 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 Public Health Nurse works with the child's social worker and/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 2015-16 was 360 children.

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.
Collaborations (including Board advisory groups and external partner agencies)
The Partnership HealthPlan 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 eligibility staff in order 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 social services programs to assist families enrolled in Medi-Cal in obtaining health and dental assessments 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.

Fiscal Impact
Fiscal impact (see budgetary detail below)
Fiscal Impact (Expenditure)
Total cost of recommended action:    $   2,768,413
Amount budgeted for expenditure:    $   2,768,413
Additional expenditure authority needed:    $   0
On-going commitment (annual cost):    $   2,768,413
Source of Funds for this Expenditure
$1,270,250
$985,632
$158,276
$346,069
$8,186
Explanation (Expenditure and/or Revenue)
Further explanation as needed:
No additional fiscal impact is related to approving this annual plan for fiscal year 2016-17. The State and Federal grant funds, along with the related Realignment and general fund to be used as required match are already included in the adopted budget for FY1617. 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

Form Review
Inbox Reviewed By Date
Financial Services Tom Haynes 10/17/2016 05:15 PM
County Counsel Hope Welton 10/18/2016 01:13 PM
Form Started By: jbuzolich Started On: 09/20/2016 11:13 AM
Final Approval Date: 10/18/2016

    

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