SUBJECT
Title
AUTHORIZE CERTIFICATION STATEMENTS FOR CHILD HEALTH AND DISABILITY PREVENTION AND CALIFORNIA CHILDREN’S SERVICES PROGRAMS (DISTRICTS: ALL)
Body
OVERVIEW
On June 20, 2017 (18), the San Diego County Board of Supervisors (Board) authorized the certification statements for Child Health and Disability Prevention (CHDP) and California Children’s Services (CCS) programs, demonstrating a long-term commitment to helping children reach their full potential by supporting programs that encourage healthy behaviors, link eligible children to low or no-cost health care coverage, provide case management and therapy services for low-income children with serious medical conditions, and provide support for at-risk children in the dependency system. The CHDP and CCS programs receive funding from the California Department of Health Care Services Children’s Medical Services (CMS) and is administered by the County of San Diego (County) Health and Human Services Agency, Public Health Services. CMS requires an annual budget submission process for the provision of services to the children of San Diego County, with certification by Clerk of the Board. This certification process allows the County to receive reimbursements for services in the CHDP and CCS programs.
Today’s action requests the Board to approve and authorize the Clerk of the Board to execute the State’s Fiscal Year 2022-2023 CHDP and CCS Certification Statements. Additionally, this action requests the Board to approve and authorize the Clerk of the Board to execute the CCS Certification Statements for the subsequent four fiscal years through Fiscal Year 2026-2027. Today’s action also requests the Board to authorize the Agency Director, Health and Human Services Agency, to apply for funding opportunities to support child health and disability prevention.
This item supports the County’s vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe and thriving communities. This will be accomplished by supporting preventive health care, early intervention, and treatment programs for at-risk children and families.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Approve and authorize the Clerk of the Board to execute, upon receipt, the Fiscal Year 2022-2023 State Child Health and Disability Prevention Certification Statements.
2. Approve and authorize the Clerk of the Board to execute, upon receipt, the Fiscal Year 2022-2023 through Fiscal Year 2026-2027 State California Children’s Services Certification Statements.
3. Authorize the Agency Director, Health and Human Services Agency, to apply for additional funding opportunity announcements, if available, to fund support child health and disability prevention.
EQUITY IMPACT STATEMENT
Today’s actions advance equity and racial justice and supports the County of San Diego’s (County) Framework for Our Future: Declaring Racism a Public Health Crisis through a data-driven population health approach and delivers education and supportive services, such as comprehensive medical case management and hands-on rehabilitation services focusing on mobility and independent living skills for medically fragile children who live in the lowest healthy places index quartiles, through community partnerships and coalitions committed to addressing disparities and health inequities. Today’s action also supports bringing greater transparency of California Children’s Services (CCS) related data and outcomes through a comprehensive set of routine data analysis products looking at equity related outcomes or disproportionality. Through CCS’ participation in workgroups led by the California Department of Health Care Services, input is taken from community stakeholder groups on data needs useful for populations they represent, which will be used to develop revised statewide metrics and standards for the program, as well as enrollment, demographics, and utilization dashboards. The Child Health and Disability Prevention (CHDP) program supports efforts to reduce disparities and health inequities by providing access and linkage to quality preventive services and ongoing healthcare coverage to vulnerable children experiencing greater risk factors, limited access to care, and increased morbidity and mortality compared to the general population. A recent effort to improve health outcomes is the implementation of the Adverse Childhood Experiences screenings in CHDP provider practices. Screening facilitates early patient treatment, encourages trauma-informed care, and promptly connects families to interventions, resources, and other supports that can improve their health and well-being. The Public Health Services’ CCS and CHDP programs within the County Health and Human Services Agency will continue to work closely with San Diego County providers to communicate and advance equity driven initiatives and outcomes, health education, and services.
FISCAL IMPACT
There is no fiscal impact associated with the proposed actions. However, failure to execute the proposed actions will result in forfeited costs and revenue of $19,136,787 in Fiscal Year 2022-23 ($5,463,872 for Child Health and Disability Prevention Program and $13,672,915 for California Children’s Services (CCS)) and similar amounts through Fiscal Year 2026-27 for CCS. The funding sources are the State General Fund, Federal Title XIX, Federal Title XXI, and Health Realignment. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
The Health Services Advisory Board voted to approve this item at its May 3, 2022 meeting.
BACKGROUND
Child Health and Disability Prevention (CHDP) and California Children’s Services (CCS) are long-standing programs in the County of San Diego (County) Health and Human Services Agency, Public Health Services and are funded through the California Department of Health Care Services Children’s Medical Services (CMS) Branch. CMS requires an annual application process for the provision of services to the children of San Diego County with certification by the Clerk of the Board. Approval of the certification statements as part of the yearly application process allows the County to receive reimbursements for services in the CHDP and CCS programs. These certification statements certify that the CHDP and CCS programs will comply with all State and federal provisions, policies, and legal requirements pertaining to these programs.
Fiscal Year 2022-23 Certification Statement for Child Health and Disability Prevention Program
The CHDP allocation funds the County’s CHDP, Early Periodic Screening, Diagnosis and Treatment (EPSDT) and the Health Care Program for Children in Foster Care (HCPCFC). The goal of the CHDP/EPSDT program is to prevent and reduce disabilities, illnesses, and deaths among low-income children by providing community-based outreach, prevention, early intervention, and follow-up medical and dental services. The CHDP/EPSDT program also recruits, trains, certifies, and monitors CHDP providers. The HCPCFC assures continuity of health care for children in out-of-home placement by funding regional Foster Care Public Health Nurses. Funding for the CHDP/EPSDT and HCPCFC will provide for the following activities in FY 2022-23:
• Facilitating well-child exams for low-income children by community CHDP providers and assisting providers, when requested, in follow-up of high-risk health problems identified on CHDP well-child exams.
• Monitoring 164 CHDP provider sites consisting of clinics, medical groups, and individual practices representing a combined total of 695 physicians and non-physician medical practitioners; targeting one-third each year for re-certification and certification of all new providers; and increasing the frequency of closely monitoring providers with need for improvement in quality care and billing.
• Facilitating sealant and/or varnish events to ensure 250 children receive oral health screenings, sealant, or varnish application, and are provided information on access to dental and health care.
• Educating and training 300 medical/dental providers and ancillary staff on community linkage through an electronic referral system and fluoride varnish application.
• Collaborating with Child Welfare Services, County Office of Nursing Excellence, and Juvenile Probation to provide intensive care coordination activities on behalf of 1,764 children in out-of-home placement.
Fiscal Year 2022-23 Certification Statement for California Children’s Services Program
The CCS program is a statewide health care program with financial and medical eligibility requirements for children with certain physical limitations or chronic health conditions. Eligible children receive case management for medically eligible conditions, and CCS authorizes and pays for specific medical services and equipment provided by CCS approved specialists. CCS also operates a physical and occupational Medical Therapy Program in six schools and one satellite site countywide. The funding from the State CMS Branch for the CCS program will provide for the following activities in FY 2022-23:
• Managing CCS eligible medical services for 18,999 children with CCS eligible medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major complications.
• Assisting 18,999 CCS families in navigating available services for children with physical disabilities and complex medical conditions.
• Providing direct rehabilitative services in collaboration with the public schools to 1,671 children with physical disabilities and complex, special health care needs.
• Expediting CCS eligibility determinations for hospitalized children at Rady Children’s Hospital, University of California San Diego, Sharp, and Kaiser Permanente hospitals through electronic review of medical records, training, and collaboration with community hospital staff.
• Collaborating with the California Department of Health Care Services to help redesign the State’s case management informatics system to improve efficiency and timeliness in processing provider service authorization requests so children get their needed services faster.
Today’s action, if approved, will authorize certification of the CHDP and CCS programs and will allow Public Health Services to receive reimbursements to continue providing these services to San Diego County. Today’s action will also authorize the Agency Director, Health and Human Services Agency, to apply for funding opportunity announcements, if available, to support child health and disability prevention.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego’s 2022-2027 Strategic Plan by improving the health and well-being of children and families eligible for the Child Health and Disability Prevention and California Children’s Services programs.
Respectfully submitted,
HELEN N. ROBBINS-MEYER
Chief Administrative Officer
ATTACHMENT(S)
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