HomeMy WebLinkAboutAgreement A-23-671 FY 2023-24 CMS Plan and Budget for CCS.pdf Agreement No. 23-671
Plan and Budget Required Documents Checklist
MODIFIED FY 2023-24
County/City: Fresno Fiscal Year: 2023-24
Document Page Number
1. Checklist 1 - 2
2. Agency Information Sheet 3
3. Certification Statements
A. Certification Statement(CHDP)—Original and one photocopy N/A
B. Certification Statement(CCS)—Original and one photocopy 4
4. Agency Description
A. Brief Narrative 5
B. Organizational Charts for CCS, CHDP, HCPCFC, and PMM&O *Retain locally
C. CCS Staffing Standards Profile Retain locally
D. Incumbent Lists for CCS 6 - 10
E. Civil Service Classification Statements— Include if newly established, N/A
proposed, or revised
F. Duty Statements— Include if newly established, proposed, or revised N/A
5. Implementation of Performance Measures — Performance Measures for FY
2016-2017 are due November 30, 2017. N/A
6. Data Forms
Performance Measures 11 - 26
CCS Caseload Summary 27
7. Memoranda of Understanding and Interagency Agreements List
A. MOU/IAA List N/A
B. New, Renewed, or Revised MOU or IAA N/A
C. CHDP IAA with DSS biennially Retain locally
D. Interdepartmental MOU for HCPCFC biennially N/A
8. Budgets
A. CHDP Administrative Budget (No County/City Match)
1. Budget Summary N/A
1
County/City: Fresno Fiscal Year: 2023-24
Document Page Number
2. Budget Worksheet N/A
3. Budget Justification Narrative N/A
B. CHDP Administrative Budget(County/City Match)- Optional
1. Budget Worksheet N/A
2. Budget Justification Narrative N/A
3. Budget Justification Narrative N/A
C. CHDP Foster Care Administrative Budget (County/City Match)- Optional
1. Budget Summary N/A
2. Budget Worksheet N/A
3. Budget Justification Narrative N/A
D. HCPCFC—Base, PMM&O and Case Relief Administrative Budgets
1. Budget Summary N/A
2. Budget Worksheet N/A
3. Budget Justification Narrative N/A
E. CCS Administrative Budget
1. Budget Summary 31
2. Budget Worksheet 28 - 30
3. Budget Justification Narrative 32 - 33
G.. Other Forms
1. County/City Capital Expenses Justification Form N/A
2. County/City Other Expenses Justification Form N/A
9. Management of Equipment Purchased with State Funds
1. Contractor Equipment Purchased with DHCS Funds Form N/A
(DHCS1203)
2. Inventory/Disposition of DHCS Funded Equipment Form N/A
(DHCS1204)
3. Property Survey Report Form (STD 152) N/A
2
Children's Medical Services Plan and Fiscal Guidelines
Agency Information Sheet
County/City: Fresno/Fresno Fiscal Year: 2023-24
Official Agency
Name: David Luchini, Director Address: 1221 Fulton Street
Fresno, CA 93721
Health Officer Dr. Rais Vohra, MD
(Interim)
Dr. Trinidad Solis, MD
(Deputy Health Officer)
CMS Director (if applicable)
Name: Address:
Phone:
Fax: E-Mail:
CCS Administrator
Name: Pilar Vasquez Address: 1221 Fulton Street
Division Manager Fresno, CA 93721
Phone: 559-600-6595
Fax: 559-455-4789 E-Mail: pvasguez(@fresnocountygg.gov
Clerk of the Board of Supervisors or City Council
Name: Bernice Seidel Address: 2281 Tulare St, 31 Floor
Fresno, CA 93721
Phone: 559-600-3529
Fax: 559-600-1608 E-Mail: bseidel@ fresnocountygg.gov
Director of Social Services Agency
Name: Sanja Bugay Address: 200 W Pontiac Way, Bldg 3
Clovis, CA 93612
Phone: 559-600-2301
Fax: 559-600-2311 E-Mail: sbugay@ fresnocountyca.gov
Chief Probation Officer
Name: Kirk Haynes 3333 E American Ave, STE B
Fresno, CA 93725
Phone: 559-600-1298
Fax: 559-455-2412 E-Mail: khaynes@ fresnocountyca.gov
3
Children's Medical Services Plan and Fiscal Guidelines
Certification Statement-California Children's Services (CCS)
County/City: Fresno Fiscal Year: 2023-24
1 certify that the CCS Program will comply with all applicable provisions of Health and
Safety Code, Division 106, Part 2, Chapter 3, Article 5, (commencing with Section
123800) and Chapters 7 and 8 of the Welfare and Institutions Code (commencing with
Sections 14000-14200), and any applicable rules or regulations promulgated by DHCS
pursuant to this article and these Chapters. I further certify that this CCS Program will
comply with the Children's Medical Services Plan and Fiscal Guidelines Manual,
including but not limited to, Section 9 Federal Financial Participation. I further certify that
this CCS 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 et seq.) and recipients of funds
allotted to states for the Maternal and Child Health Services Block Grant pursuant to
Title V of the Social Security Act (42 U.S.C. Section 701 et seq.). I further agree that this
CCS Program may be subject to all sanctions or other remedies applicable if this CCS
Program violates any of the above laws, regulations and policies with which it has
certified it will com ly.
t C r t 3- 02,3.
Signatur 91 CCS Administrator Date Signed
—////1zJ I� (4,1613
Si re of Di ector alth Officer Date Signed
Signature and Title of Other—Optional Date Signed
I certify that this plan has been approved by the local governing body.
--5 a1 )?� 42 — !a aa 3
Sigrlatyre of Local Governing Body Chairperson Date Signed
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By Deputy
4
CMS PLAN
Fiscal Year 2023-24
Agency Description
Fresno County's California Children's Services (CCS) are located in the Fresno
County Department of Public Health under Children's Medical Services Division.
The CMS Division Manager functions as the CCS Administrator and reports directly
to the Director of the Department of Public Health. CCS medical supervision is
provided by a CCS Medical Consultant, a board-certified pediatrician. In the event
that a board-certified pediatrician is not available the CCS program defers to the
State for medical consultation needs.
5
Children's Medical Services Plan and Fiscal Guidelines
State of California - Health and Human Services Agency Department of Health Care Services- Children's Medical Services
Incumbent List — California Children's Services
For FY 2021-22, complete the table below for all personnel listed in the CCS budgets. Use the same job titles for both the budget
and the incumbent list. Total percent for an individual incumbent should not be over 100 percent.
Specify whether job duty statements or civil service classification statements have been revised or changed. Only submit job duty
statements and civil service classification statements that are new or have been revised. This includes (1) changes in job duties or
activities, (2) changes in percentage of time spent for each activity, and (3) changes in percentage of time spent for enhanced and
non-enhanced job duties or activities.
Identify Nurse Liaison positions using: MCMC for Medi-Cal Managed Care; HF for Healthy Families; IHO for In-Home Operations,
and; RC for Regional Center.
County: Fresno Fiscal Year: 2023-24
Have Job Has Civil
FTE % on Duties Service
Job Title Incumbent Name CCS Admin Changed? Classification
Budget (Yes or No) Changed?
(Yes or No)
Division Manager/Administrator Pilar Vasquez 100% No No
Staff Analyst III Susan Stasikonis 100% No No
Program Technician II Kristeena Bump 100% No No
Administrative Assistant I Rosalinda Hammerschmidt 100% No No
Rehabilitation Therapy Manager Harsharn Dhillon 20% No No
Public Health Physician Dr. Khusal Mehta 20% No No
6
Children's Medical Services Plan and Fiscal Guidelines
Have Job Has Civil
FTE % on Duties Service
Job Title Incumbent Name CCS Admin Changed? Classification
Budget (Yes or No) Changed?
(Yes or No)
Public Health Physician Dr. Rajeev Verma 40% No No
Public Health Physician Dr. Joseph Capell 20% No No
Supervising Public Health Nurse Heather Woo-Maraan 100% No No
Head Nurse Kelly Stevens 100% No No
Public Health Nurse II Noel Almaguer 100% No No
Public Health Nurse II Hilary Davis 100% No No
Public Health Nurse II Sandy Sue Arce 100% No No
Public Health Nurse II Ku Lee 100% No No
Public Health Nurse II Khamsay Vanhelsdingen 100% No No
Public Health Nurse I Lanette Ramirez 100% No No
Staff Nurse III Belinda Mayugba 100% No No
Staff Nurse III Joseph Burgess 100% No No
Staff Nurse III Vivien Tagoe 100% No No
Staff Nurse III Maribeth Jensen 100% No No
7
Children's Medical Services Plan and Fiscal Guidelines
Have Job Has Civil
FTE % on Duties Service
Job Title Incumbent Name CCS Admin Changed? Classification
Budget (Yes or No) Changed?
(Yes or No)
Staff Nurse III Marjelyn Ramiro 100% No No
Staff Nurse III Margaret Altamirano 100% No No
Staff Nurse III Veronica Reyna 100% No No
Staff Nurse III Tim Yang 100% No No
Staff Nurse III Quy Gip 100% No No
Staff Nurse III Shavonne Smith 100% No No
Staff Nurse III (Extra Help) Jing Yang 25% No No
Occupational Therapist III (Extra Renee Chien 25 % No No
Help)
Medical Social Worker II Ariana Solis-Salazar 100% No No
Medical Social Worker I Alma Garcia 100% No No
Senior Admitting Case Worker Sonya Mendoza 100% No No
Senior Admitting Case Worker Bobbi Taylor 100% No No
8
Children's Medical Services Plan and Fiscal Guidelines
Have Job Has Civil
FTE % on Duties Service
Job Title Incumbent Name CCS Admin Changed? Classification
Budget (Yes or No) Changed?
(Yes or No)
Admitting Case Worker II Luz Reyes 100% No No
Admitting Case Worker II Rudy Constantino 100% No No
Admitting Case Worker II Michael Vue 100% No No
Admitting Case Worker II Yuidico Wayne-Garza 100% No No
Admitting Case Worker II Johana Guerra 100% No No
Admitting Case Worker I Maria Rojas 100% No No
Admitting Case Worker I Adalinn Vargas 100% No No
Admitting Case Worker I Destiny Vizcarra 100% No No
Admitting Case Worker I Ana Rivera 100% No No
Office Assistant 11 Melissa Figueroa 100% No No
Office Assistant 11 Sera Gutierrez 100% No No
Office Assistant 11 Stephanie Figueroa 100% No No
Office Assistant I Fallon Smith-O'Keefe 100% No No
Office Assistant I Nathalie Montejano 100% No No
Account Clerk III Maricela Garcia 25% No No
9
Children's Medical Services Plan and Fiscal Guidelines
Have Job Has Civil
FTE % on Duties Service
Job Title Incumbent Name CCS Admin Changed? Classification
Budget (Yes or No) Changed?
(Yes or No)
Account Clerk III Jenny Araiza 25% No No
Administrative Case Worker I Vacant 25% No No
Administrative Case Worker I Vacant 30% No No
Administrative Case Worker I Vacant 30% No No
Administrative Case Worker I Vacant 50% No No
Administrative Case Worker I Vacant 50% No No
Administrative Case Worker I Vacant 50% No No
Administrative Case Worker I Vacant 50% No No
Administrative Case Worker I Vacant 0% No No
Office Assistant I Vacant 0% No No
Public Health Nurse I Vacant 0% No No
Public Health Physician Vacant 0% No No
Staff Nurse I Vacant 30% No No
Supervising Office Assistant Vacant 10% No No
10
Children's Medical Services Plan and Fiscal Guidelines for FY 2023-24
COUNTY: Fresno FISCAL YEAR 2023-24
County of Fresno
Department of Public Health
CCS
Performance Measure 1
FY 2022-23
CCS Program staff conducts routine reviews of all active cases to ensure CCS
clients have documented and up-to-date medical homes/primary care providers.
Staff contacts clients and their parents/guardians and works collaboratively with
Medi-Cal Managed Care plans, local hospitals and other local providers to
determine current primary care providers.
In addition, CCS Program staff conducts annual program eligibility reviews of all
clients to identify primary care physicians and/or medical homes. Additionally,
when families come to the CCS office, they are asked to identify their primary
care physician so their medical files can be updated.
Based on the entire active caseload as of July 2023, the following findings are:
• 99.7% of CCS clients in Fresno County have an identified primary care
provider (PCP). This represents a 1.7% increase from the previous fiscal
year.
• MSBI does not reliably reflect the number of clients with a PCP because
many clients change PCPs and neglect to inform the CCS Administrative
staff. Staff will continue with efforts to obtain PCP information for these
clients.
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
CCS Performance Measure 1 — Medical Home
Children enrolled in the CCS Program will have documented medical homes/primary
care providers. The goal is to have 100% compliance.
Definition: Children in the CCS program will have a designated primary care
physician and/or a physician who provides a medical home.
Numerator: The total number of children with a completed field with
identification of a primary care physician and/or a physician that
provides a medical home.
Denominator: The total number of children in the local CCS county program.
Data Source: Based on the entire active caseload as of July 2023
Reporting Form:
Number of children with a Number of children in the Percentage of compliance
primary care physician/ local CCS program
Medical Home
(Numerator)
(Denominator)
7,434 7,456 99.7%
Note: If county percentage of compliance is under 80%, counties need to submit with
the annual report a plan for how they will work to improve this result.
12
Children's Medical Services Plan and Fiscal Guidelines for FY 2022-23
COUNTY: Fresno FISCAL YEAR: 2023-24
County of Fresno
Department of Public Health
CCS
Performance Measure 2
FY 2022-23
Client program eligibility was determined according to the guidelines established
by the Children's Medical Services Branch, California Children's Medical
Services Administrative Procedures Manual (July 2001 Revision). Fresno
County CCS utilized a report created in MSBI to select a sample of 100
unduplicated new referrals. The findings are as follows:
• A sample of 100 unduplicated new referrals was selected at random. Out
of the 100 new referrals, 92% had their medical eligibility determined
within the prescribed guidelines. This represents a 2% increase from the
previous fiscal year.
• A sample of 100 unduplicated new referrals was selected at random. Out
of the 100 new referrals 98% had their financial and residential eligibility
determined within the prescribed guidelines. This represents a 0% change
from the previous fiscal year. 73 cases were Full Scope Medi-Cal or
TLICP clients and 25 were CCS only clients.
• Manual procedures remain in place for the tickling of applications,
Program Services Agreement (PSA), and program eligibility letters that
are sent to the families.
13
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
CCS Performance Measure 2 — Determination of CCS Program
Eligibility
Children referred to CCS have their program eligibility determined within the
prescribed guidelines per Title 22, California Code of Regulations, Section 42000,
and according to CMS Branch policy. Counties will measure the following:
Numerators:
a. Medical eligibility within five working days of receipt of all medical
documentation necessary to determine whether a CCS-eligible
condition exists.
b. Residential eligibility within 30 days of receipt of documentation
needed to make the determination.
C. Financial eligibility within 30 days of receipt of documentation
make the determination.
Denominator: Number of CCS unduplicated new referrals to the CCS program
assigned a pending status in the last fiscal year.
Data Source: 10% of the county CCS cases or 100 cases (which ever number is
less).
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
Reporting Form:
MEDICAL ELIGIBILTY Number of referrals Number of new Percentage
determined medically unduplicated referrals of
eligible within 5 days compliance
(Denominator)
(Numerator)
Medical eligibility
determined within 5 days
of receipt of all necessary 92 100 92%
documentation
PROGRAM Number of cases Number of new Percentage
ELIGIBILITY determined eligible within unduplicated referrals of
30 days of receipt of compliance
documentation needed to
make the determination
(Numerator) (Denominator)
Financial eligibility FSMC/TLICP CCS only FSMC/TLICP CC S only
determined within 30 98%
days 73 25 74 26
Residential eligibility
determined within 30
days 98 100 98%
15
Children's Medical Services Plan and Fiscal Guidelines for FY 2021-22
COUNTY Fresno FISCAL YEAR 2023-24
County of Fresno
Department of Public Health
CCS
Performance Measure 3
FY 2022-23
Part A: Annual team Report
Fresno County CCS generated an MSBI report which identified 100 random clients
(greater than 10%) out of the total list of clients with a diagnosis or condition that
requires referral to a Cardiac, Renal, Pulmonary, Neurological or Endocrine Special
Care Center, per NL 01-0108.
Review of the random sample of 100 children who received a SCC authorization yielded
the following:
• 99% compliance for Annual Team Reports of SCC authorized clients. Out of 100
children with a SCC authorization, 99 had an Annual Team Report in their
medical chart, 1 did not.
Part B: Authorization of Child to SCC
CCS generated an MSBI report which identified 100 children with a CCS
diagnosis or condition that requires referral to Cardiac, Renal, Neuro-
musculoskeletal, Endocrine, or Pulmonary Special Care Centers, per NL 01-
0108.
• Of the 100 children who had a condition that required authorization to a
SCC, 100 were in fact authorized for a SCC.
• Fresno County is 100% compliant with appropriately authorizing SCC for
children with eligible medical conditions.
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
CCS Performance Measure 3 (A & B) — Special Care Center
This Performance Measure is evaluated in two parts.
Part A: Annual Team Report
Definition: This performance measure is based on the CCS requirement for
an annual team report for each child enrolled in CCS whose
condition requires Special Care Center services and has received
an authorization to a Special Care Center. County CCS programs
will evaluate this measure by the presence of an annual team
conference report in the child's medical file.
Numerator: Number of children that received a Special Care Center
authorization and were seen at least annually at the appropriate
Special Care Center as evidenced by documentation and
completion of the interdisciplinary team report.
Denominator: Number of children enrolled in CCS whose condition as
listed in categories defined in Numbered Letter 01-0108
requires CCS Special Care Center services and has
received an authorization to a Special Care Center.
Data source: 10% of the county CCS cases authorized to SCC or 100 cases
(which ever number is less).
Part B: Referral of a Child to SCC
Definition: This measure is based on the CCS requirement that
certain CCS eligible medical conditions require a referral
to a CCS Special Care Center for ongoing coordination of
services.
Numerator: Number of children in CCS, with medical conditions in the
categories as listed in Numbered Letter 01-0108 requiring a
Special Care Center Authorization, who actually received an
authorization for services.
Denominator: Number of children enrolled in CCS, with medical conditions,
requiring Special Care Center Authorizations.
Data source: Counties shall identify and use four or five specific diagnosis
categories (cardiac, pulmonary, etc) as listed in the Special Care
Center Numbered Letter 01-0108 as it relates to the SCC(s)
identified for your client population. The county shall identify one
or more diagnostic codes and use the diagnosis codes indicated
for the SCC categories selected for this PM.
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
Reporting Form - Part A:
Category selected Number of children with Number of children Percentage of
(cardiac, pulmonary, annual team report in with SCC authorization compliance
etc.) client's medical records
(Denominator)
(Numerator)
Cardiac, Renal, Neuro-
musculoskeletal, 99 100 99%
Pulmonary, Endocrine
Reporting Form - Part B:
Category Number of Number of children Diagnostic Percentage
selected children with with eligible medical Code Chosen of
(cardiac, authorization to conditions that compliance
pulmonary SCC require an
etc.) authorization to a
(Numerator) SCC
(Denominator)
Cardiac, Renal,
Neuro- E10, E11, E70,
musculoskeletal, 100 100 E71, QO5, N18 100%
Pulmonary,
Endocrine
* Counties may select four (4) to five (5) specific medical conditions as outlined in
the SCC NIL to use as the basis for clients that should have a referral to a CCS
SCC.
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Children's Medical Services Plan and Fiscal Guidelines for FY 2023-24
COUNTY: Fresno FISCAL YEAR: 2023-24
County of Fresno
Department of Public Health
CCS
Performance Measure 4
FY 2022-23
Fresno County updated its Transition Planning protocols for the CCS Program in
January 2015 for clients who turn 14, 16, 18 and 20 years of age in the calendar
year. Because of staffing constraints, we developed a relatively automated
Transition Planning Process that generates age-focused Transition Planning
packets of information for all clients with a medical condition that warrants
Transition Planning. Fresno County understands the importance of Transition
Planning on the overall health needs of our clients. Transition Planning packets
include the following:
• A Transition Planning letter addressed to the parents for 14 and 16 year
olds and addressed to the clients who are 18 and 20 years old. The letter
addresses the importance of client-based understanding of their medical
needs, encourages discussion with the medical workers about transition
planning, and underscores the importance of finding an adult care provider
for when they become adults.
• A Health care skills worksheet to be discussed with the Primary Care
Physician.
• Community resource contact list.
• HIPAA forms (as appropriate)
o Acknowledgment of Receipt of Privacy Rights under HIPAA
o Authorization for Use and Disclosure (for 18 year olds who want to
continue including their parents/guardians in their health care
decisions).
Together, these steps have helped Fresno County shore up Transition Planning
outreach and engagement, helped reduce some of the paperwork of case
managers, and most importantly contributes to the on-going medical needs of our
CCS clients.
Fresno County's CCS Medical Therapy Program continuously provides transition
planning for children at ages 3, 14, 16, 18 and 20.
The FY 2022-23 Transition Planning Performance Measure includes the
following findings:
• Based on the results of an MSBI report, Fresno County randomly selected
a sample of 1100 clients with an age of 14, 16, 18, or 20 who's CCS
eligible medical condition appropriately required Transition Planning.
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Children's Medical Services Plan and Fiscal Guidelines for FY 2023-24
COUNTY: Fresno FISCAL YEAR: 2023-24
• The random sample (951 Cases) of all non-MTP clients who turned 14,
16, 18 and 20 years old was created to see if they received Transition
Planning after the implementation of the automated Transition Planning
process. FY 2022-23 shows 98% of the selected sample received
Transition Planning letters/information. This is 1% less than the
percentage compliance in FY 2021-22.
• The random sample (149 Cases) of all MTP clients who turned 14, 16, 18
and 20 years old shows 100% of the selected sample received Transition
Planning letters/information. This is a 1% increase from FY 2021-22.
20
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
CCS Performance Measure 4 — Transition Planning
Definition: Children, 14 years and older who are expected to have
chronic health conditions that will extend past the twenty-
first birthday will have documentation of a biannual review
for long term transition planning to adulthood.
Numerator: Number of CCS charts for clients 14, 16, 18, or 20 years
containing the presence of a Transition Planning Checklist
completed by CCS program staff within the past 12 months
for children aged 14 years and over whom requires long
term transition planning.
Denominators:
a. Number of CCS charts reviewed of clients 14, 16, 18, and
20 years in (10% of children aged 14 and over) whose
medical record indicates a condition that requires a
transition plan.
b. Number of MTP charts reviewed of clients 14, 16, 18, and
20 years in (10% of children aged 14 and over) whose
medical record indicates a condition that requires a
transition plan.
Data Source: Chart Audit, Completion of Transition Planning Checklist.
Due to caseload numbers in Los Angeles County, LA County should work with the
Regional Office to select an appropriate number of clients to be included in their
sample size.
21
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
Transition Planning Checklist
Transition Documentation YES NO Comments
1. Client has an identified need CCS transition planning is performed
for long-term transition X for all clients 14, 16, 18, and 20
planning. years old.
Transition planning for clients with
2. Transition planning noted in X appropriate DX is noted in client's
child's medical record. Annual Medical Reviews and other
Case Notes.
3. Transition planning noted in Most SCC's document transition
SCC reports. X planning with client and are found in
the Medical Social Workers' notes.
4. Vocational Rehab noted in X Noted only in 14, 16, 18, and 20 year
child's reports. olds in the MTP.
5. Adult provider discussed or In all Transition Planning Case
identified for children 17 X Notes, discussion of the need for an
years of age or older. adult provider is included.
6. Transition planning noted in Schools begin noting transition
SELPA for those children X needs at age 16.
that are in the MTP.
Note: Not all of the items in the Checklist will be applicable for each chart review.
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
Reporting Form:
Number of CCS charts Number with transition Percentage of compliance
reviewed planning
98%
951 932
Number of MTP charts Number with transition Percentage of compliance
reviewed planning
100%
149 149
23
Children's Medical Services Plan and Fiscal Guidelines for FY 2022-23
COUNTY: Fresno FISCAL YEAR: 2023-24
County of Fresno
Department of Public Health
CCS
Performance Measure 5
FY 2022-23
This performance measure indicates the level of family participation in the CCS
program. Narrative for each criterion follows:
1. CCS uses an existing CCS parent survey developed in February 2011 and
updated in 2014. This survey is distributed widely in order to gauge
parent/client satisfaction with CCS services. The survey was written at an
elementary reading level in both English and Spanish. The survey
provides CCS with information on how we can improve upon services,
asking yes or no questions and providing opportunity to comment.
Surveys are reviewed and CCS Administration employs every effort to
improve upon areas of family participation.
2. On-going challenges exist in the areas of family participation. Currently,
there are no advisory committees or task forces for family participation,
nor is there a County policy to facilitate reimbursement for child care or
transportation to such meetings, due to multiple years of budgetary
cutbacks and staffing cuts that have only recently begun to rebound, albeit
slowly.
3. Family members regularly participate in CCS Special Care Center
meetings for care planning and transition planning.
4. Fresno County CCS has no family advocates under contract or as
consultants to the program.
Fresno County CCS Administration will explore opportunities for increasing family
involvement, as dictated by Program considerations, including staffing and
budgeting constraints.
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Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
CCS Performance Measure 5 — Family Participation
The degree to which the CCS program demonstrates family participation.
Definition: This measure is evaluated based on each of the
following four (4) specific criteria that documents family
participation in the CCS program. Counties need to indicate
the score based on the level of implementation.
Checklist documenting family participation in the Yes No Comments
CCS program.
1. Family members are offered an opportunity to Fresno County uses a parent
provide feedback regarding their satisfaction with the survey and ensures
services received through the CCS program by X maximum distribution to and
participation in such areas as surveys, group collection from, client's
discussions, or individual consultation. families.
2. Family members participate on advisory
committees or task forces and are offered training, X
mentoring and reimbursement when appropriate.
3. Family members are participants of the CCS
Special Care Center services provided to their child X
through family participation in SCC team meeting
and/or transition planning.
4. Family advocates, either as private individuals or as
part of an agency advocating family centered care,
which have experience with children with special X
health care needs, are contracted or consultants to the
CCS program for their expertise.
25
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2023-24
Reporting Form:
Criteria Performing Not Performing
(25% for each criteria)
1. Family members are offered
an opportunity to provide
feedback regarding their
satisfaction with the services
received through the CCS 25%
program by participation in
such areas as surveys, group
discussions, or individual
consultation.
2. Family members participate
on advisory committees or task
forces and are offered training, 25%
mentoring and reimbursement
when appropriate.
3. Family members are
participants of the CCS Special
Care Center services provided
to their child through family 25%
participation in SCC team
meeting and/or transition
planning.
4. Family advocates, either as
private individuals or as part of
an agency advocating family
centered care, which have
experience with children with 25%
special health care needs, are
contracted or consultants to
the CCS program for their
expertise.
Total 50% 50%
26
Children's Medical Services Plan and Fiscal Guidelines
California Children's Services Caseload Summary Form
County: Fresno Fiscal Year: 2023-24
A B
23-24
CCS 21-22 %of 22-23 %of Estimated %of
Caseload 0 Actual Grand Actual Grand Caseload Grand
to 21 Years Caseload Total Caseload Total based on first Total
three months
MEDI-CAL
Average of Total Open
(Active)Medi-Cal 6649 88% 6718 88% 6516 87%
1 Children
Potential Case Medi-Cal 21 0.3% 34 0.4% 30 0.4%
2
TOTAL MEDI-CAL 6670 88% ° °
3 (Row 1 + Row 2) 6752 89/ 6546 87/
NON MEDI-CAL
OTLICP
Average of Total Open
4 (Active)OTLICP 626 8% 592 8% 679 9%
Potential Cases 3 0.04% 4 0.05% 2 0.03%
5 OTLICP
Total OTLICP (Row 4 629 8% 596 8% 681 9%
6 + Row 5)
Straight CCS
Average of Total Open
(Active)Straight CCS 200 3% 178 2% 243 3%
7 Children
Potential Cases Straight 71 0.9% 71 0.9% 63 0.8%
g CCS Children
Total Straight CCS 271 4% 249 3% °
9 (Row 7 + Row 8) 306 4/
TOTAL NON MEDI-CAL 900 12% °
10 (Row 6 + Row 9) 845 11/0 987 13/
GRAND TOTAL
11 (Row 3 + Row 10) 7570 100% 7597 100% 7533 100%
27
State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division
Revised 2/10/20
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
Total Cases of Open(Ac6ve)Straight CCS Children 195 2.59% CCS Administrative Budget Worksheet
OTLICP-
Total Cases of Open(Active)OTLICP Children 599 zss% Fiscal Year: 2023-24
MEDI-CAL- Total Cases of Open(Active)Madi-Cal 6736 89.46%
non-OTLICP)Children County: Fresno
TOTAL CCS CASELOAD 7530 j 100
Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP)
Children's Program(OTLICP)
Column 1 1 1 2 3 1 4A 4 5A 5 6A 6 7A 7 8A 8
Optional Targeted
Low Income Enhanced Non-Enhanced
Total Budget Straight CCS Non-
Category/Line kem %FTE Annual caseload Children's Medi-Cal Ennaaced% Medi-Cal Medi-Cal
Salary (1 x 2 or caseload/ Cou 015State % Program(OTLICP) Caseload% State/Federal HE StatelFederal Ern BEd State/Federal
4+5+6) (50/50) Co/State/Fed (25/75) (50I50)
(17.5/17.5/65.0)
I.Personnel Expense .1110
Program Administration
1.Filar Vasquez,Administrator,(Division Manager) 10000% 130,767 130,767 2.59% 3,386 7.95% 10,402 8946% 116,978 100.00% 116,978
2.Susan Stasikonis,Staff Analyst 111 10000% 82,929 82,929 2.59% 2,148 7.95% 6,597 89.46% 74,185 100.00% 74,185
3.Rosalinda Hammerschmidt,Administrative Assistant l 10000% 46,800 46,800 2.59% 1,212 7.95% 3,723 89.46% 41,865 100.00% 41,865
4.Harsharn Dhillon,Rehabilitative Therapy Manager 20.00% 130,767 26,153 2.59% 677 7.95% 2,080 89.46% 23,395 100.00% 23,395
5.Kristeena Bump,Program Technician II 10000% 55,827 55,827 2.59% 1,446 7.95% 4,441 89.46% 49,940 100.00% 49,940
6.Peter Jew,Business System Analyst III 0.00% 85,228 0 2.59% 0 7.95% 0 89.46% 0 100.00% 0
Subtotal 532,318 342,476 8,869 1 27,243 1306,363 306,363
Medical Case Management
1.Dr.Rai Verma,Public Health Physician(EXTRA HELP) 40.00% 298,002 119,201 2.59% 3,087 7.95% 9,482 89.46% 106,632 100.00% 106,632 0.00% 0
2.Dr.Khusal Mehta,Public Health Physician(EXTRA HELP) 20.00% 298,002 59,600 2.59% 1,543 7.95% 4,741 89.46% 53,315 0.00% 0 100.00% 53,315
3.Heather Woo-Maraan,Supervising Public Health Nurse 10000% 133,607 133,607 2.59% 3,460 7.95% 10,628 8946% 119,519 94.00% 112,348 6.00% 7,171
4.Kelly Stevens,Head Nurse 10000% 113,708 113,708 2.59% 2,945 7.95% 9,045 89.46% 101,718 60.00% 61,031 40.00% 40,687
5.Noel Almaguer,Public Health Nurse 11 10000% 1 116,776 116,776 2.59% 3,024 7.95% 9,289 1 89.46% 104,463 94.00% 98,195 6.00% 6,268
6.Sandy Sue Arce,Public Health Nurse ll 10000% 116,776 116,776 2.59% 3,024 1 7.95% 9,289 89.46% 104,463 86.00% 1 89,838 14.00% 14,625
7.Belinda Mayugba,Staff Nurse 111 10000% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 94.00% 91,293 6 00% 5,827
8.Quy Gip,Staff Nurse 111 10000% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 94.00% 91,293 600% 5,827
9.Ti.Yang,Staff Nurse 111 10000% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 94.00% 91,293 6 00% 5,827
10.Joseph Burgess,Staff Nurse 111 100.00% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 97.00% 94,206 3.00% 2,914
11.Vivian Tagoe,Staff Nurse 111 100.00% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 94.00% 91,293 6.00% 5,827
12.Marjelyn Ramiro,Staff Nurse 111 100.00% 108,568 108,568 2.59% 2,812 7.95% 8,636 89.46% 97,120 1 94.00% 91,293 6.00% 5,827
13.Maribeth Jensen,Staff Nurse 111 100.00% 108,568 108,568 2.59% 2,812 7 95% 8,636 89.46% 97,120 94.00% 91,293 6.00% 5,827
14.Hilary Davis,Public Health Nurse 11 100.00% 116,776 116,776 2.59% 3,024 7.95% 9,289 89.46% 104,463 94.00% 98,195 6.00% 6,268
15.Shavonne Smith,Staff Nurse 111 100.00% 108,036 108,036 2.59% 2,798 7.95% 8,594 89.46% 96,644 94.00% 90,845 6.00% 5,799
16.Khamsay Vanhelsdingen,Public Health Nurse ll 100.00% 104,520 104,520 259% 2,707 795% 8,314 8946% 93,499 94.00% 87,889 6.00% 5,610
17.Veronica Rayne,Staff Nurse 111 100.00% 108,555 108,555 2.59% 2,811 7.95% 8,635 89.46% 97,108 94.00% 91,282 6.00% 5,826
18.Lanette Ramirez,Public Health Nurse 1 100.00% 93,709 93,709 2.59% 2,427 7.95% 7,454 89.46% 83,828 94.00% 78,798 6.00% 5,030
19.Ku Lee,Public Health Nurse 11 100.00% 109,467 109,467 2.59% 2,835 7.95% 8,708 89.46% 97,924 94.00% 92,049 6.00% 5,875
20.Renee Chien,Occupational Therapist 111(EXTRA HELP) 25.00% 108,139 27,035 2.59% 700 7.95% 2,151 8946% 24,184 96.00% 23,217 4.00% 967
21.Margaret Altamirano,Staff Nurse 111 100.00% 106,646 106,646 2.59% 2,762 7.95% 8,484 89.46% 95,401 9400% 89,677 6.00% 5,724
22.Jing Yang,Staff Nurse(Extra Help) 25.00% 108,680 27,170 2.59% 704 7.95% 2,161 89.46% 24,305 94.00% 22,847 6.00% 1,458
23.Dr.Joseph Capell,Public Health Physician(EXTRA HELP)l 20.00% 298,002 59,600 2.59% 1,543 7.95% 4,741 89.46% 53,315 0.00% 0 100.00% 53,315
24.VACANT,Staff Nurse 1 30.00% 74,278 22,283 2.59% 577 7.95% 1,773 89.46% 1 19,933 94.00% 18,737 6 00% 1,196
25.VACANT,Public Health Nurse l 0.00% 89,763 0 2.59% 0 7.95% 0 89.46% 0 100.00% 0 0.00% 0
26.VACANT,Public Health Physician 0.00% 283,816 0 2.59% 0 7.95% 0 89.46% 0 0.00% 0 100.00% 0
Subtotal 3,547,233 2,303,441 59,656 183,231 2,060,554 1,803,544 257,010
28
Page 1 of 3
State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division
Revised 2/10/20
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
Total Cases of Open(Acuve)Straight CCS Children 195 2.59% CCS Administrative Budget Worksheet
OTLICP-
Total Cases of Open(Active)OTLICP Children 599 zss% Fiscal Year: 2023-24
MEDI-CAL- Total Cases of Open(Active)Madi-Cal 6736 89.46%
non-OTLICP)Children County: Fresno
TOTAL CCS CASELOAD 7530 j 100%
Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP)
Children's Program(OTLICP)
Column 1 1 1 2 3 1 4A 4 5A 5 6A 6 7A 7 8A 8
Optional Targeted
Low Income Enhanced Non-Enhanced
Total Budget Straight CCS Non-
Cate or/Line Item %FTE Annual caseload Children's Medi-Cal Ennaaced% Medi-Cal Medi-Cal
9 y Salary (1 z 2 or caseload% County/State 015State % Program(OTLICP) Caseload% State/Federal HE StatelFederal Ern BEd State/Federal
q+5+6) (50/50) Co/State/Fed (25175) (50150)
(17.5/17.5/65.0)
Other Health Care Professionals
1.Arian Solis-Salazar Medical Social Worker 111 10000% 83,122 83,122 2.59% 2,153 7.95% 6,612 89.46% 74,357 50.00% 37,179 50.00% 37.178
2.Alma Garcia,Medical Social Worker 1 10000% 55,557 55,557 1 2.59% 1,439 1 7.95% 4,419 89.46% 49,699 50.00% 24,850 50.00% 24.849
Subtotal 138,679 138,679 3,592 11,031 124,056 62,029 62,027
Ancillary Support
1.Sonya Mendoza,Senior Administrative Case Worker 1.00 58,933 58,933 2.59% 1,526 7.95% 4,688 89.46% 52,719 100.00% 52,719
2.Bobbi Taylor,Senior Administrative Case Worker 1.00 58,933 58,933 2.59% 1,526 7.95% 4,688 89.46% 52,719 100.00% 52,719
3.Rudy Constantino,Administrative Case Worker 11 1.00 51,362 51,362 2.59% 1,330 7.95% 4,086 89.46% 45,946 100.00% 45,946
4.Michael Vue,Administrative Case Worker II 1.00 51,367 51,367 2.59% 1,330 7.95% 4,086 89.46% 1 45,951 100.00% 45,951
5.Luz Reyes,Administrative Case Worker II 1.00 51,362 51,362 2.59% 1,330 7.95% 4,086 89.46% 45,946 100.00% 45,946
6.Johan Guerra,Administrative Case Worker 11 1.00 43,169 43,169 2.59% 1,118 7.95% 3,434 89.46% 38,617 100.00% 38,617
7.Yuidico Garza-Wayne,Administrative Case Worker 11 1.00 46,592 46,592 2.59% 1,207 7.95% 3,706 89.46% 41,679 100.00% 41,679
8.Maria Rojas,Administrative Case Worker 1 1.00 41,499 41,499 2.59% 1,075 7.95% 3,301 89.46% 37,123 100.00% 37,123
9.Adalinn Vargas,Administrative Case Worker 1 1.00 39,788 39,788 2.59% 1,030 7.95% 3,165 89.46% 35,593 100.00% 35,593
10.Destiny Vizcarra,Administrative Case Worker 1 1.00 138,022 38,022 2.59% 985 7.95% 3,025 89.46% 34,013 100.00% 34,013
11.Ana Rivera,Administrative Case Worker 1 1.00 38,022 38,022 2.59% 985 7.95% 3,025 89.46% 34,013 1 100.00% 34,013
12.Vacant,Administrative Case Worker 1 0.50 37,908 18,954 2.59% 491 7.95% 1,508 89.46% 16,955 100.00% 16,955
13.Vacant,Administrative Case Worker 1 0.50 37,908 18,954 2.59% 491 7.95% 1,508 89.46% 16,955 100.00% 16,955
14.Vacant,Administrative Case Worker 1 0.50 37,908 18,954 2.59% 491 7.95% 1,508 89.46% 16,955 100.00% 16,955
15.Vacant,Administrative Case Worker 1 0.50 37,908 18,954 2.59% 491 7.95% 1,508 89.46% 16,955 100.00% 16,955
16.Vacant,Administrative Case Worker 1 0.30 37,908 11,372 2.59% 294 7.95% 905 89.46% 10,173 100.00% 10,173
17.Vacant,Administrative Case Worker 1 0.30 37,908 11,372 2.59% 294 7.95% 905 89.46% 10,173 100.00% 10,173
18.Vacant,Administrative Case Worker 1 0.25 37,908 9,477 2.59% 245 7.95% 754 89.46% 8,478 100.00% 8,478
19.Vacant,Administrative Case Worker l 0.00% 37,908 0 2.59% 0 7.95% 0 89.46% 0 100.00% 0
Subtotal 822,313 627,086 16,238 49,885 560,963 560,963
Clerical and Claims Support
1.Vacant,Supervising Office Assistant 10.00% 48,464 4,846 2.59% 125 7.95% 385 89.46% 4,335 0.00% 0 100.00% 4,335
2.Melissa Figueroa,Office Assistant ll 10000% 46,929 46,929 2.59% 1,215 7.95% 3,733 89.46% 1 41,981 0.00% 0 100.00% 41,981
3.Sera Gutierrez,Office Assistant ll 10000% 46,929 46,929 2.59% 1,215 7.95% 3,733 89.46% 41,981 0.00% 0 100.00% 41,981
4.Stephanie Figueroa,Office Assistant ll 10000% 37,874 37,874 2.59% 981 7.95% 3,013 89.46% 33,880 0.00% 0 100.00% 33,880
5.Fallon Smith O'Keefe,Office Assistant l 10000% 39,276 39,276 2.59% 1,017 7.95% 3,124 89.46% 35,135 0.00% 0 100.00% 35,135
6. Natalie Montejano,Office Assistant l 10000% 35,069 35,069 2.59% 908 7.95% 2,790 89.46% 31,371 0.00% 0 100.00% 31,371
7.VACANT,Office Assistant l 0.00% 38,667 0 2.59% 0 7.95% 0 89.46% 0 0.00% 0 100.00% 0
8.Maricela Garcia,Account Clerk ll 1 25.00% 1 49,452 12,363 2.59% 320 7.95% 1 983 89.46% 11,059 0.00% 0 100.00% 11,059
9.Jenny Araiza,Account Clerk l 25.00% 42,723 10,681 2.59% 277 7.95% 850 89.46% 9,555 0.00% 0 100.00% 9,555
10.Fong Lee,Senior Accountant 0.00% 72,696 0 2.59% 0 7.95% 0 89.46% 0 0.00% 0 100.00% 0
11.Suzie Federline,Supervising Account Clerk 0.00% 58,786 0 2.59% 0 7.95% 0 89.46% 0 0.00% 0 100.00% 0
29
Page 2 of 3
State of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division
Revised 2/1020
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
Total Cases of Open(Active)Straight CCS Children 1ss 2.59% CCS Administrative Budget Worksheet
OTLICP-
Total Cases of Open(Active)OTLICP Children 599 7.95% Fiscal Year: 2023-24
MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6736 89.46%
non-OTLICP)Children County: Fresno
TOTAL CCS CASELOAD 7530 100%
Straight CCS Optional Targeted Low Income Mad!-Cal(Non-OTLICP)
11 Children's Program(OTLICP)
Column 1 2 0 1 4A J 4 1 5A 1 5 1 6A 1 6 1 7A 1 7 1 8A 1 8
Optional Targeted
Low Income Enhanced Non-Enhanced
Total Budget Straight CCS lon-
Cate o ILine Item %FTE Annual Caseload Children's Medi-Cal Enhanced•!. Medi-Cal Medi-Cal
g ry Salary (1 x2or Caseload•G Counlyl5ta[e % Program(OTLICP) Caseload% StatelFederal FTE StatelFederal Enhanced% State/Federal
4+5+6) (50/50) Co/State/Fed (25f75) FTE 150/50)
(17.5117.5165.0)
Subtotal 516,865 233,967 6,058 18.611 209,297 0 209,297
Total Salaries and Wages 3,645,649 2.59% 94,409 7.95% 290,006 89.46% 3,261,233 57.20% 1,865,573 42.80% 1,395,660
Staff Benefits(Specify%) 72.00% 2,624,867 2.59% 1 67,975 7.95% 1 208,004 89.46% 2,348,088 1 1,343,213 1,004,875
1.Total Personnel Expense 6,270,516 2.59% 162,3B4 7.95% 498,810 89.46% 5,609,321 3,208,786 2,400,535
II.Operating Expense
1.Travol 3.000 2.59% 78 7.95% 239 89.46% 2,684 57.20% 1,535 42.80% 1,149
2.Training 2,500 2.59% 65 7.95% 199 89.46% 2,236 57.20% 1,279 42.80% 957
3.Office Expense(including Printing) 19,795 2.59% 513 7.95% 1,575 89.46% 17,708 100.00% 17.708
4.Postage 22,000 2.59% 570 7.95% 1,750 89.46% 1 19,680 1100.00% 19,680
5.Small Tools 3692 2.59% 96 7.95% 122,509
89.46% 3,303 100,00% 3,303
6.Household Expenses 13612 2.59% 353 7.95% 89.46% 12,177 100.00% 12,177
7.Maintenance-Equipment B Security 27,045 2.59% 700 7.95% 89.46% 24,193 100.00% 24,193
B.Facility Services-including Rent Utilities 115,680 2.59% 2,996 7.95% 89.46% 103,482 100.00% 103,482
9.Data Processing-including Communication 72,640 2.69% 1,887 7.96% 89.46% 64,980 100.00% 64,980
10.Translation Services 3,000 2.69% 78 7.95% 89.46% 2,684 100.00% 2,684
It.Total Operating Expense 202,964 7,329 253,127 2,814 250,313
III.Capital Expense
1.N/A 2.59% 0 7.95% 89.46% 0 0
III.Total Capital Expense 0 0 0 0
IV.Indirect Expense
1.Indirect Cost Rate 18.31% 1,148,382 2.59% 29,739 7.95% 89.46% 1,027,291 100.00% 1,027,291
0 2.59% 0 7.95% 0 89.46% 0 100.00% 0
IV.Total Indirect Expense 1,148,382 29,739 91,352 1,027,291 1,027,291
V.Other Expense
1.Maintenance B Transportation 30,000 2.59% 777 7.95% 2,386 89.46% 26.837 100.00% 26,637
2.CRISS Council Membership 6,700 2.59% 174 7.95% 533 89.46% 5.994 100.00% 5,994
3. 2.59% 0 7.95% 0 89.46% 0 100.00% 0
V.Total Other Expense 36,700 951 2,919 32,831 32,831
Budget Grand Total 7,738,562 200.403 615,590 6,922,570 3,211,600 3,710,970
Susan Stasikonis 11/812023 559 600-6383
Prepared ByZ(Si e Prepared By(Printed Name) Date Prepared Phone Number
Pilar Vasquez 1—� Z 559 600-6595
CCS Administrator(Signature) CCS Administrator(Printed Name) Date Signed Phone Number
30
Page 3 of 3
Stale of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division
Revised 2/11120
Percent of Total CCS
CCS CASELOAD Actual Caseload Caseload
STRAIGHT CCS-
Total Cases ofOpen(Active)Straight CCS Children t95 z.s9r CCS Administrative Budget Summary
OTLICP-
Total Cases of Open(Active)OTLICP Children 599 7 95 Fiscal Year: 2023-24
MEDI-CAL- 6736 89.46%
Total Cases of Open(Active)Medi-Cal non-OTLICP)Children County: Fresno
TOTAL CCS CASELOAD 7530 100
Col 1=Col 2+3+4 Straight CCS OTLICP Medi-Cal(non-OTLICP)(Column 4=Columns 5+6)
Column 1 2 3 4 1 5 6
Optional Targeted Low
Straight CCS Income Children's Enhanced Medi-Cal Non-Enhanced Medi-
CategorylLine Item Total Budget CountylState Program(OTLICP) Medi-Cal State/Federal State/Federal(25R5) Cal State/Federal
(50150) County/Slate/Fed (50150)
(17.5117.5165.0)'
1. Total Personnel Expense 6,270,516 162,384 498,810 51609,321 3,208,786 2.400,535
It.Total Operating Expense 202,964 1 7,329 1 22,509 1 253,127 1 2.814 1 250.313
III.Total Capital Expense 0 0 0 0 0
IV.Total Indirect Expense 1,148,362 29,739 91,352 1,027,291 1.027,291
V.Total Other Expense 36,700 951 2,919 32.831 32,831
Budget Grand Total 7.738.562 200.403 615,590 6,922,570 1 3,211,600 3,710,970
Col 1=Col 2+3+4 Straight CCS OTLICP Medi-Cal(non-OTLICP)(Column 4=Columns 5+6)
Column 1 2 3 4 5 16
Optional Targeted Low
Straight CCS Income Children's Enhanced Medi-Cal Non-Enhanced Medi-
Source of Funds Total Budget County/State Program(OTLICP) Medi-Cal StatelFederal StatelFederal(25R5) Cal StatelFederal
(50150) County/Stale/Fed (60/50)
(11.75111.75R6.5)
Straight CCS
State 100,201 100,201
County 100.202 100,202
OTLICP
State 107,728 107,728
County 107,728 107,728
Federal(Title XXI) 400,134 400,134
Medi-Cal
Stale 2,658,385 i 2.658,385 802,9001 1,855.485
Federal(Title XIX) 4,264,1651 1 4,264,1851 2,408,7001 1,855.485
Susan Stasikonis sstasikonis fresnocoun Ca. ov
Prepared B jate:)/ Prepared By(Printed Name) Email Address
14_f� Filar Vasquez vas ueZ fresnocoun ca. OV
CCS Administrator(Signature) CCS Administrator(Printed Name) Email Address
31
Page 1 of 1
Children's Medical Services Plan and Fiscal Guidelines for Fiscal Year 2023-24
California Children's Services
Fresno County
Budget Narrative
FY 2023-24
I. Personnel Expenses
Total Salaries: $ 3,645,649
Staff benefits represent an estimated 72%of salaries;this is a decrease of 12%
from the previous fiscal year.This estimate was reached by using an average of the
Total Benefits: $ 2,624,867 actual County benefits budgeted for this fiscal year.Anticipated salary adjustments
and promotions are included.
Total Personnel Expenses: $ 6,270,516
Staffing Changes
Public Health Physician Represents a.80 FTE positions. This is an.5 FTE increase from previous FY.
Represents a 6 FTE positions. This is an.63 FTE increase from previous FY.
Public Health Nurse
Staff Nurse Represents a 10.55 FTE positions. This is an 1.7 FTE decrease from previous FY. Vacancy is expected
to be filled by April 2024.
Medical Social Worker Represents 2 FTE position. This is an.7 FTE increase from previous FY.
Admitting Case Worker Represents 13.85 FTE positions. This is an 3.2 FTE increase from previous FY. Vacancies are expected
to be filled up by February 2024.
II. Operating Expenses
Travel Based on expenditures:Mileage, Meals,Lodging, Freight, Parking, Garage Fees,
$ 3,000.00 etc., this is a 67%increase from previous FY.
Training $ 2,500.00 Based on anticipated update trainings, this is a 0.8%increase from previous FY.
Office Expenses $ 19,795.00 Represents a 38%increase from previous FY based on anticipated expenditures.
Postage $ 22,000.00 Represents a 25%decrease from previous FY based on anticipated expenditures.
Small Tools $ 3,692.00 Represents a 62%increase from previous FY based on anticipated expenditures.
Household Expenses $ 13,612.00 Represents a 7%increase from previous FY based on anticipated expenditures.
Maint-Equip, Bldg,&Security $ 27,045.00 Represents a 33%decrease from previous FY based on anticipated expenditures.
Facility Services(rent, utilities) $ 115,680.00 Represents a 11%increase from previous FY based on anticipated expenditures.
Combining Data Processing and Communications, this represents a 27%increase
Data Processing including Commu $ 72,640.00 from previous FY based on anticipated expenditures.
Translation Services $ 3,000.00 Based on expenditures, no change from previous FY.
Total Operating Expenses: $ 282,964.00
III. Capital Expenses
Total Capital Expenses: $ - No amount budgeted in previous FY.
32
Children's Medical Services Plan and Fiscal Guidelines for Fiscal Year 2023-24
California Children's Services
Fresno County
Budget Narrative
FY 2023-24
IV. Indirect Expenses
Represents a 35% increase from previous fiscal year due to higher Indirect Cost
Rate. Fresno's approved indirect rate for 2023-24 is 18.314%.
Internal @ 18.314% $ 1,148,382.00
External @ 0% $ - No amount budgeted in previous FY.
Total Indirect Expenses: $ 1,148,382.00
V. Other Expenses
Maintenance&Transportation $ 30,000.00 Represents a 100%increase from previous FY based on anticipated expenditures.
CRISS Council Membership $ 6,700.00 Based on expenditures, no change from previous FY.
Total Other Expenses: $ 36,700.00
Budget Grand Total: $ 7,738,562.00
33
FY 2023-24 Retroactive California Department of Health Care Services Allocation
for Fresno County California Children's Services (CCS) Program
Allocation: FY 2023-24 CMS Plan and Budget for CCS
Fund/Subclass: 0001/10000
Organization: 56201600
Revenue Account No.: 3505, 4380