HomeMy WebLinkAboutAgreement A-23-553 FY 2023-24 CHDP Plan and Budget.pdf Agreement No. 23-553
R� H C S
CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES
Michelle Baass I Director
J U LY 1, 2023
CHDP PROGRAM LETTER: 23-01
TO: CHILD HEALTH & DISABILITY PREVENTION PROGRAM DIRECTORS,
DEPUTY DIRECTORS, MEDICAL CONSULTANTS, AND DEPARTMENT
OF HEALTH CARE SERVICES STAFF
SUBJECT: CHILD HEALTH & DISABILITY PREVENTION PROGRAM FISCAL YEAR
2023-2024 ALLOCATION
The purpose of this letter is to provide Child Health & Disability Prevention (CHDP)
programs with their Fiscal Year (FY) 2023-2024 allocation.
This letter serves as each local program's approved state CHDP budget and enables
each local program to use this letter to develop its budget. Budget approval letters will
not be issued. Detailed budget information may be found in the Integrated Systems of
Care Division (ISCD) Plan and Fiscal Guidelines (PFG).
Acceptance of funds constitutes an agreement that the receiving local program and its
agency will comply with all federal and state requirements pertaining to the CHDP
program and adhere to all applicable policies and procedures set forth by the
Department of Health Care Services (DHCS). Periodically, the federal program
responsible for oversight of the Medicaid program and related state administrative
expenditures will conduct programmatic audits. Finding of a federal audit exception and
subsequent liability for repayment of federal Medicaid funds related to the CHDP
program audit exception, are the exclusive and sole responsibility of each local
program.
Each local program remains responsible for overseeing and tracking its expenditures.
An audit file must be maintained. At a minimum this audit file should include:
Documentation of required time studies, performed during one or more
representative months of the fiscal quarter for each budgeted position claimed
under Federal Financial Participation (FFP).
Documentation in support of claimed expenditures.
» Documentation to demonstrate compliance with all federal and state
requirements pertaining to the CHDP program, and adherence to all applicable
policies and procedures set forth by DHCS.
California Department of Health Care Services State of California
Integrated Systems of Care Division Gavin Newsom,Governor
1501 Capitol Ave I Sacramento, CA 1 95899-7437
MS 4502 1 Phone(916)449-5005 1 www.dhcs.ca.gov California Health and Human Services Agency
July 1, 2023
CHDP PROGRAM LETTER 23-01: FISCAL YEAR 2023-2024 ALLOCATION
Page 2 of 5
The audit file must be retained in keeping with the requirements of 42 CFR § 433.32 -
Fiscal Policies and Accountability,' applicable state and federal law, and local policy.
The audit file must be produced to State and Federal entities within seven (7) calendar
days of a request.
Budget Reporting Instructions
>> Utilize the CHDP Budget Workbook.
Budget workbooks may be found in the Templates section of the ISCD Budget
Portal' and by requested to CHDPprogram@dhcs.ca.gov. Questions regarding
the ISCD Budget Portal may be directed to ISCDFiscal@dhcs.ca.gov.
Sign electronically using Adobe Acrobat Pro DC Self-signed with Digital ID
function or DocuSign.4
If access to either of these options is not available, scanned signature will be
accepted, with the original kept in the local audit file.
>> Submit electronically to the ISCD Budget Portal.
Submit only two documents to the ISCD Budget Portal:
o One Excel version of the CHDP Budget Workbook
and
o One signed PDF version of the CHDP Budget Workbook
>> Submit only the information requested in the CHDP Budget Workbook. Be
prepared to provide ISCD with additional documentation to demonstrate
compliance with program requirements, upon request.
Submit by September 15, 2023.
If all necessary signatures cannot be obtained by this date, submit completed
excel workbooks by the deadline and contact CHDPprogram@dhcs.ca.gov to
request an extension for submission of required signatures.
CHDP Transition
https://www ecfr qov/current/title-42/chapter-IV/subchapter-C/part-433/subpart-A/section-433 32#p-
433.32 a
2 https://iscdbudget.cloudapps.dhcs.ca.gov/
9 https://helpx.adobe.com/acrobat/using/digital-ids.html
4 https://support docusign com/s/articles/How-do-I-sign-a-DocuSign-document-Basic-
Signinq?language=en US&rsc 301
July 1, 2023
CHDP PROGRAM LETTER 23-01: FISCAL YEAR 2023-2024 ALLOCATION
Page 3 of 5
As announced in CHDP Program Letter and Provider Notices 22-025 and 22-06,6 the
CHDP program will be discontinued effective July 1, 2024. Information regarding the
transition, including opportunities for stakeholder engagement, can be found on the
CHDP Transition webpage.' Alternative resources and further information regarding the
transition of specific activities to existing delivery systems will be integrated into the
CHDP Program webpage8 in the coming months.
Contact Information
Questions regarding the ISCD Budget Portal and expenditure invoicing may be directed
to: ISCDFiscal@dhcs.ca.gov. All other questions and concerns may be directed to the
central program inbox: CHDPprogram@dhcs.ca.gov.
Sincerely,
ORIGINAL SIGNED BY CORTNEY MASLYN
Cortney Maslyn, Chief
Integrated Systems of Care Division
Department of Health Care Services
Attachments:
1. FY 2023-24 CHDP Allocation Table
s https://www dhcs ca gov/services/chdp/Documents/CHDP-Provider-Information-Notice-22-02.pdf
s https://wwvv dhcs ca gov/services/chdp/Documents/CHDP-Provider-Info-Notice-22-06.pdf
7 https://www.dhcs.ca.qov/services/chdp/Pages/CHDP-Transition.aspx
8 https://www.dhcs.ca.gov/services/chdp
July 1, 2023
CHDP PROGRAM LETTER 23-01: FISCAL YEAR 2023-2024 ALLOCATION
Page 4 of 5
Attachment 1 :
Child Health & Disability Prevention Program
Base Allocation
07/01/2023 throu h 06/30/2024
County/City State General Federal Funds Total Funds
Funds
Alameda 356,482 638,755 995, 237
Alpine 22,138 34,431 56,568
Amador 50,133 75,058 125,192
Berkeley 84,043 188,852 272,895
Butte 160,164 268,742 428,907
Calaveras 46,823 64,630 111,453
Colusa 50,062 70,965 121,028
Contra Costa 224,037 586,607 810,644
Del Norte 48,642 93,928 142,570
El Dorado 105,091 155,721 260,811
Fresno 416,419 71.5,690 1,132,109
Glenn 68,369 107,344 175,713
Humboldt 144,049 282,736 426,785
Imperial 160,084 264,283 424,368
Inyo 31,061 55,528 86,589
Kern 402,303 671,570 1,073,873
Kings 143,923 240,757 384,680
Lake 93,497 146,113 239,610
Lassen 34,771 59,560 94,331
Long Beach 230,963 362,929 593,893
Los Angeles 1,709,068 4,037,778 5,746,845
Madera 142,851 222,634 365,485
Marin 106,915 173,170 280,085
Mariposa 28,884 50,997 79,881
Mendocino 109,686 159,157 268,843
Merced 242,877 433,703 676,580
Modoc 48,313 90,997 139,310
Mono 28,489 42,924 71,413
Monterey 206,155 440,968 647,123
Napa 70,432 109,122 179,554
July 1, 2023
CHDP PROGRAM LETTER 23-01: FISCAL YEAR 2023-2024 ALLOCATION
Page 5 of 5
ty State General',
Nevada 69,508 104,436 173,944
Orange 727,925 1,219,355 1,947,280
Pasadena 111,163 220,282 331,446
Placer 127,543 185,612 313,155
Plumas 64,387 128,548 192,934
Riverside 445,805 651,635 1,097,440
Sacramento 422,165 790,207 1,212,372
San Benito 87,986 132,773 220,759
San Bernardino 569,983 955,645 1,525,628
San Diego 580,606 793,034 1,373,640
San Francisco 256,154 444,139 700,293
San Joaquin 278,991 590,280 869,271
San Luis Obispo 126,999 201,663 328,663
San Mateo 198,824 386,275 585,099
Santa Barbara 246,860 351,415 598,275
Santa Clara 338,654 734,790 1,073,444
Santa Cruz 141,389 237,525 378,915
Shasta 125,486 205,918 331,405
Sierra 28,146 57,296 85,441
Siskiyou 34,954 57,498 92,453
Solano 141,484 252,057 393,541
Sonoma 179,796 296,227 476,022
Stanislaus 255,699 449,962 705,660
Sutter 105,986 120,986 226,973
Tehama 89,440 117,603 207,043
Trinity 38,432 55,245 93,676
Tulare 237,940 400,022 637,961
Tuolumne 68,150 117,215 185,365
Ventura 303,401 504,683 808,085
Yolo 102,298 166,897 269,195
Yuba 42,371 71,876 114,247
• I 21,846,750 33,962,00 1
DHCS State of California—Health and Human Services Agency
Department of Health Care Services
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MICHELLE BAASS GAVIN NEWSOM
DIRECTOR GOVERNOR
Child Health and Disability Prevention Program
Plan and Budget Reporting Checklist
County/City: Fresno Fiscal Year: 2023-24 Page Number
1. CHDP Plan and Budget Reporting Checklist 1
2. CHDP Certification Statement 2
3. CHDP Organizational Chart Retain Loc
4. CHDP New or Revise Memorandum of Understanding and
Inter-agency Agreements N/A
5. If Applicable:
a. Contractor Equipment Purchased with DHCS Funds Form
(DHCS1203) N/A
b. Inventory/Disposition of DHCS Funded Equipment Form
(DHCS1204) N/A
c. Property Survey Report Form (STD 152) N/A
6. CHDP Plan and Budget Reporting Spreadsheet
a. Agency Information Sheet 3
b. CHDP Memorandum of Understanding and Inter-agency
Agreement List 4
c. CHDP Incumbent List 5
d. CHDP Budget
i. CHDP Administrative Budget
— Summary and Worksheet 6
— Budget Narrative 7
ii. Optional County/City- Federal Match Budget
— Summary and Worksheet N/A
— Budget Narrative N/A
All items listed here should be submitted to the ISCD Budget Portal as one signed PDF
document In addition, Excel worksheet components of this reporting package should
also be submitted as one document. Detailed instruction for each item listed can be
found in the Integrated Systems of Care Division Plan and Fiscal Guidelines.
Systems of Care Division 1515 K Street,Suite 400,Sacramento, CA 95814
P.O.Box 997413,MS 8100 Sacramento,CA 95899-7413
(916)327-1400
Internet Address:www.dhcs.ca.gov
DHC,S State of California—Health and Human Services Agency ,•':.Ilk.
Department of Health Care Services '*
MICHELLE BAASS GAVIN NEWSOM
DIRECTOR GOVERNOR
Child Health and Disability Prevention Program
Certification Statement
County/City: Fresno Fiscal Year: 2023-24
1 certify that the CHDP Program will comply with all applicable provisions of Health and
Safety Code, Division 106, Part 2, Chapter 3, Article 6 (commencing with Section
124025), Welfare and Institutions Code, Division 9, Part 3, Chapters 7 and 8
(commencing with Section 14000 and 14200), Welfare and Institutions Code Section
16970, and any applicable rules or regulations promulgated by DHCS pursuant to that
Article, those Chapters, and that section. I further certify that this CHDP Program
will comply with the Integrated Systems of Care Plan and Fiscal Guidelines Manual,
including but not limited to, Section 9 Federal Financial Participation. I further certify that
this CHDP Program will comply with all federal laws and regulations governing and
regulating recipients of funds granted to states for medical assistance pursuant to Title
XIX of the Social Security Act (42 U.S.C. Section 1396 at seq.). I further agree that
this CHDP Program may be subject to all sanctions or other remedies applicable if
this CHDP Program violates any of the above laws, regulations and policies with which it
has certified it will comply.
4'1, /—" 7/28/23
Signatur of gHDP Director/Dep Director Date Signed
/, Y--� 7/28/23
S' ture and Title Other—Optional Date Signed
I certify that this plan has been approved by the local governing body.
_ /D D �23
S' na ur f yl Governing Body Chairperson Date'Signed
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By_ Deputy
Systems of Care Division 1515 K Street,Suite 400, Sacramento,CA 95814
P.O.BOX997413,MS 8100 Sacramento,CA 95899-7413
(916)327-1400
Internet Address:www.dhcs.ca.gov
DHCS State of California—Health and Human Services Agency
4Qk�ao Department of Health Care Services `�..
�.;
Child Health and Disability Prevention «M
MICHELLE BAASS Agency Information GAVIN NEWSOM
DIRECTOR GOVERNOR
County/City: jFresno Fiscal Year: 2023-24
Official Agency
Street Address:1221 Fulton Street Health Officer: Dr. Rais Vohra (Interim)
City: Fresno Local CHDP
Zip Code: 93721 Central Inbox:
CMS Director(if applicable)
Name: Street Address:
Phone: City:
Email: Zip Code:
CHDP Director
Name: Trinidad Solis, MD Street Address: 1221 Fulton Street
Phone: 559-600-6412 City: Fresno
Email: tsolis@fresnocountyca.gov Zip Code: 93619
CHDP Deputy Director
Name: Ankara Lee Street Address: 380 W Ashlan Ave
Phone: 559-600-6591 City: Clovis
Email: alee@fresnocountyca.gov Zip Code: 93612
Clerk of the Board of Supervisors or City Council
Name: Bernice Seidel Street Address: 2281 Tulare St., 3rd Floor
Phone: 559-600-3529 City: Fresno
Email: bseidel@fresnocountyca.gov Zip Code: 93721
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DHCS State of California—Health and Human Services Agency4NO, f...
Department of Health Care Services •`
Child Health and Disability Prevention ?4�
MICHELLE BAASS Budget Narrative GAVIN NEWSOM
DIRECTOR GOVERNOR
State/Federal Funding Source: Base
County/City Namej Fresno I Fiscal Yearl 2023-24
I. Personnel Expenses
Identify and Explain Any Changes in Personnel/Personnel Expenses
Salary and Benefits for 5 positions,total of 4.25 FTE. Benefits rate calculated with estimated average of
total benefits for the positions. Includes retirement, health insurance, Unemployment Insurance, and
Benefits Administration,
II. Operating Expenses
Identify and Explain All Operating Expense Line Items
Private mileage reimbursement at$0.655/mile and costs for usage of County cars
Travel: associated with provider visits and travel to State-sponsored meetings and conferences.
Cost of tuition and registration fees for program staff to attend State-sponsored training
Training: and other trainings to enhance knowledge and skills.
III. Capital Expenses
Identify and Explain All Capital Expense Line Items
IV. Indirect Expenses
Identify and Explain All Indirect Expense Line Items
Fresno County Department of Public Health's indirect rate is 18.314%of personnel costs
Internal: approved for use by Fresno County's Auditor Controller/Treasurer-Tax Collector.
External:
V. Other Expenses
Identify and Explain All Other Expense Line Items
I—
Chashua Loi 0 45135
Prepared By: Sign Print Title Date Email
A ,az Ankara Lee 0 45135
Authorized CHDP Program Representative: Sign Print Title Date Email
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Agreement Between the County of Fresno and California Department of Health
Care Services
Agreement Name: Child Health & Disability Prevention Program FY 2023-24
Fund/Subclass: 0001/10000
Organization: 56201611
Revenue Account #: 4380, 3541