HomeMy WebLinkAboutSTATE DHCS-FY2024-25 Childrens Medical Services Budget Plan_D-24-597.pdf COtj County of Fresno Hall of Records, Room 301
2281 Tulare Street
Fresno,California
601 Board of Supervisors 93721-2198
O� 1$56 0 Telephone: (559)600-3529
FRV,t' Minute Order Toll Free: 1-800-742-1011
www.fresnocountyca.gov
November 5, 2024
Present: 5- Supervisor Steve Brandau, Chairman Nathan Magsig,Vice Chairman Buddy Mendes,
Supervisor Brian Pacheco, and Supervisor Sal Quintero
Agenda No. 55. Public Health File ID: 24-1051
Re: Approve retroactive submission of the FY 2024-25 California Department of Health Care Services
allocation plan for child health services under California Children's Services, effective July 1, 2024 to
June 30, 2025($6,848,164); approve retroactive submission of the FY 2024-25 California Department of
Health Care Services allocation budget for the monitoring and oversight readiness under California
Children's Services, effective July 1, 2024 to June 30, 2025($360,825); and approve and authorize the
Chairman to execute the retroactive Certification Statement for California Children's Services as
required by the California Department of Health Care Services
APPROVED AS RECOMMENDED
Ayes: 5- Brandau, Magsig, Mendes, Pacheco, and Quintero
County of Fresno Page 58
COZj���C
Board Agenda Item 55
O 1856 O
FRE`'�
DATE: November 5, 2024
TO: Board of Supervisors
SUBMITTED BY: David Luchini, RN, PHN, Director, Department of Public Health
SUBJECT: Retroactive FY 2024-25 California Department of Health Care Services Allocation
Plan
RECOMMENDED ACTION(S):
1. Approve retroactive submission of the FY 2024-25 California Department of Health
Care Services allocation plan for child health services under California Children's
Services, effective July 1, 2024 to June 30, 2025 ($6,848,164);
2. Approve retroactive submission of the FY 2024-25 California Department of Health
Care Services allocation budget for the monitoring and oversight readiness under
California Children's Services, effective July 1, 2024 to June 30, 2025 ($360,825); and
3. Approve and authorize the Chairman to execute the retroactive Certification
Statement for California Children's Services as required by the California Department
of Health Care Services.
There is no additional Net County Cost associated with the recommended actions. Approval of the
recommended actions will allow the County to continue to receive non-competitive funding from the
California Department of Health Care Services (DHCS) to administer the California Children's
Services (CCS) program and a new allocation to support readiness for the upcoming FY 2025-26
monitoring and oversight (M&O) Memorandum of Understanding (MOU) with DHCS. Fresno County's
CCS administrative allocation is 12% less than the prior fiscal year and will cover anticipated FY
2024-25 CCS program costs. The estimated County match of$214,069 will be funded with Health
Realignment. This item is countywide.
ALTERNATIVE ACTION(S):
There are no viable alternative actions as the County is mandated under Health and Safety Code
(H&SC) Section 123850 to administer the CCS program. Should your Board not approve the
recommended actions, the Department would not have sufficient funds to offset mandated program
costs.
RETROACTIVE AGREEMENT:
The Department received the FY 2024-25 allocations from DHCS on August 21, 2024. Both are
retroactive to July 1, 2024 and are due to DHCS by November 12, 2024. This item is brought to your
Board in accordance with the agenda item processing timelines.
County of Fresno page 1 File Number.24-1051
File Number:24-1051
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The FY 2024-25
non-competitive allocation of$6,848,164, which is primarily comprised of Federal and State funding,
represents an $890,398 (12%) decrease from the prior year allocation of$7,738,562. The program
has received a second allocation of$360,825 to support readiness activities in preparation for the FY
2025-26 CCS program M&O MOU with DHCS. The combined funding of$7,208,989 will cover
approximately 96% of anticipated FY2024-25 program costs. Sufficient appropriations and
estimated revenues are included in the Department's Org 5620 FY 2024-25 Adopted Budget. The
allocation allows recovery of indirect costs and the Department's indirect cost rate is 24.43%.
The recommended CMS plan includes the required County match of$214,069. If the County's total
allocation is expended, program expenditures will be covered by Health Realignment.
DISCUSSION:
Across the State, CCS programs are administered as a partnership between county health
departments and DHCS, in accordance with H&SC Section 123800 et seq. The program provides
medical case management, diagnostic and treatment services to infants, children, and youth under the
age of 21 with CCS-eligible medical conditions such as congenital heart disease, cancer, cystic
fibrosis, chronic lung disease, serious birth defects, hearing loss and cerebral palsy.
Recommended action number one supports the following administrative activities performed by the
county CCS program:
• Medical review, evaluation and determination of children and youth under 21 applying for CCS
benefits;
• Review and determination of residential and financial eligibilities of medically qualified
individuals;
• Authorization of appropriate diagnostic services, treatment, therapy, specialized medical care
and related services eligible CCS clients;
• Medical case management to ensure eligible infants, children and youth receive authorized
medical services;
• Review, authorization and purchase of supplies and other services needed for treatment of the
eligible CCS medical condition(s);
• Assessments, interventions and coordination of care;
• Assistance, consultation and training to providers and hospitals on the CCS authorization
process;
• Support for family navigation through consultation and linking to community resources and
other family support organizations; and
• Assessment, intervention and guidance to clients and families in developing transition plans as
the CCS client ages out.
DHCS determines each county's annual allocation using the CCS program's average expenditures
during FY 2019-20 through FY 2022-23, and the average caseload for calendar year 2023.
Recommended action number two will fund readiness activities (personnel, operating, and indirect
costs) in preparation for the requirements and implementation of the upcoming FY 2025-26 M&O
County of Fresno page 2 File Number.24-1051
File Number:24-1051
MOU between DHCS and the CCS program.
Beyond administration of the CCS program and in accordance with H&SC Section 123940, CCS
counties share with the State and Federal government financial responsibility for providing medically
necessary services such as diagnostics, treatment, medication, and therapy to eligible clients. The
counties pay their share of cost on a quarterly basis.
A special program within the CCS program is the Medical Therapy Program (MTP). The MTP
provides medically necessary occupational and physical therapy services for eligible children and
youth. These services are provided at the Medical Therapy Units located in three Fresno County
public schools. DHCS provides a separate allocation to fund the MTP however, counties are not
required to submit a plan or budget details.
To finalize the allocation process, DHCS requires your Board to certify approval of the recommended
CMS Plan and that the County will comply with applicable laws, regulations, and policies related to the
CCS program. The recommended CMS allocation plan and CCS monitoring and oversight (M&O)
allocation budget are retroactive to July 1, 2024, and serve in lieu of an agreement. Upon approval of
the recommended actions by your Board, no additional executed documents are required to receive
funding.
REFERENCE MATERIAL:
BAI #46, December 12, 2023
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk- FY 2024-25 CMS Plan and Budget
On file with Clerk- CCS FY 2024-25 Allocation Memo
CAO ANALYST:
Ron Alexander
County of Fresno Page 3 File Number.24-1051
D-24-597
Plan and Budget Required Documents Checklist
MODIFIED FY 2023-24
County/City: Fresno Fiscal Year: 2024-25
Document Page Number
1. Checklist
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: 2024-25
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: 2024-25
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: pvasauez(a)fresnocountyca.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@ fresnocountyca.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: 2024-25
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 comply.
Signature of CCS Administrator Date Signed
0 —7 12,a Z C
Si atu e of Director or.H th Officer Date Signed
Signature and Title of Other—Optional Date Signed
I certify that this plan has been approved by the local governing body.
Signature of Local Governing Body Chairperson Date Signed
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By)4/��
� Deputy
4
CMS PLAN
Fiscal Year 2024-25
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: 2024-25
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 55% No No
Staff Analyst III Susan Stasikonis 60% No No
Program Technician I Ana Gastelum-Rivera 80% No No
Rehabilitation Therapy Manager Harsharn Dhillon 10% No No
Staff Analyst III Marissa Vogeler 15% No No
Public Health Physician Dr. Khusal Mehta 1.5% 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 80% No No
Head Nurse Kelly Stevens 80% No No
Public Health Nurse II Noel Almaguer 89% No No
Public Health Nurse II Sandy Sue Arce 89% No No
Public Health Nurse II Hilary Davis 89% No No
Public Health Nurse II Ku Lee 89% No No
Public Health Nurse II Khamsay Vanhelsdingen 89% No No
Public Health Nurse II Lanette Ramirez 89% No No
Staff Nurse III Belinda Mayugba 90% No No
Staff Nurse III Joseph Burgess 90% No No
Staff Nurse III Vivien Tagoe 90% 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 Veronica Reyna 90% No No
Staff Nurse III Maribeth Jensen 90% No No
Staff Nurse III Tim Yang 90% No No
Staff Nurse III Quy Gip 90% No No
Staff Nurse III Shavonne Smith 90% No No
Staff Nurse I Ashley Fisk 90% No No
Staff Nurse I Harjanet Bedi 70% No No
Staff Nurse III (Extra Help) Jing Yang 8% No No
Occupational Therapist III (Extra Renee Chien 15 % No No
Help)
Medical Social Worker II Ariana Solis-Salazar 89% No No
Medical Social Worker I Alma Garcia 89% No No
Senior Admitting Case Worker Sonya Mendoza 89% No No
Senior Admitting Case Worker Michael Vue 89% No No
Admitting Case Worker II Luz Reyes 89% 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 Rudy Constantino 89% No No
Admitting Case Worker II Johana Guerra 89% No No
Admitting Case Worker I Adalinn Vargas 89% No No
Admitting Case Worker I Rachel (See) Xiong 89% No No
Admitting Case Worker I Jess Boone 89% No No
Admitting Case Worker I Jalen Swank 89% No No
Admitting Case Worker I Tiffany Acosta 40% No No
Admitting Case Worker I Danny Danglai 40% No No
Admitting Case Worker I Jessica Ramirez 40% No No
Admitting Case Worker I Tamryn Norris 40% No No
Supervising Program Technician Kristeena Bump 40% No No
Office Assistant 11 Sera Gutierrez 40% No No
Office Assistant 11 Fallon Smith-O'Keefe 89% No No
Office Assistant I Jose Guerrero 89% No No
Account Clerk III Maricela Garcia 20% 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)
Program Technician I Jenny Araiza-Chavez 20% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Administrative Case Worker I Vacant 0% No No
Office Assistant I Vacant 30% No No
Office Assistant 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
In lieu of the Supervising Office Assistant, the Supervising Program Technician will provide supervisory oversight of the clerical and
technical functions. These functions will support the new requirements stipulated in the upcoming new MOU with DHCS.
10
CO U�
County of Fresno
`� . . ` SUPERVISING PROGRAM TECHNICIAN
CLASS CODE 3625 SALARY $25.68 - $32.78 Hourly
$2,054.00 - $2,622.00 Biweekly
$4,450.33 - $5,681.00 Monthly
$53,404.00 - $68,172.00 Annually
BARGAINING UNIT Unrepresented REVISION DATE August 27, 2018
Description
Under general supervision, supervises, monitors and coordinates the work of technical and clerical staff; performs
the most complex technical and specialized support work; and performs related work as required.
The Program Technician classification series is utilized within County departments to perform
paraprofessional/technical work in support of County programs and services. Positions in this classification series
focus on the technical aspects of work involved in developing, implementing, and evaluating various programs
within the County. Incumbents in the Program Technician classification series typically report to professional,
supervisory, or managerial positions.
Supervising Program Technician provides day-to-day supervision to staff in support of department programs and
services. Supervisory responsibilities include interviewing, selecting, training, assigning, evaluating, disciplining and
promoting subordinate staff. Incumbents in this classification may be working supervisors in that they perform the
most complex paraprofessional/technical work.
Samples of Duties
11
The information listed below is meant to serve as samples of job duties and responsibilities for positions in this
classification. This list is neither inclusive nor exclusive, but indicative of several types of duties performed.
Consequently, this information does not reflect Essential Functions for any given position in this classification.
• Supervises, monitors and coordinates the day-to-day operations and work of staff responsible for providing
paraprofessional/technical and clerical work in support of County department programs and services
involving the knowledge, interpretation, and application of policies, rules, regulations, and procedures.
Supervisory duties include interviewing, selecting, training, assigning, evaluating, disciplining, and promoting
staff.
• Performs the most complex technical and specialized support work.
• Evaluates and recommends policies and procedures; consults with managerial, professional, and technical
staff in the development of clerical processes.
• Communicates and interprets department/program policies, rules, regulations and procedures.
• Maintains a close working relationship with all levels of departmental management.
• Monitors and reviews documents for completeness, accuracy, and compliance with County policies, rules,
regulations and procedures.
• Prepares or oversees the preparation of reports, correspondence and special studies, and conducts research.
• May represent the department in meetings with other County department staff, other agencies and the public.
Knowledge, Skills and Abilities
Knowledge of:
• Practices, policies and procedures necessary to supervise employees, including interviewing, selecting,
training, assigning, evaluating, disciplining and promoting subordinate staff;
• Department policies, rules, regulations, and procedures;
• Operations, services and activities of the department or program to which assigned;
• Comprehensive specialized knowledge related to the specific program of assignment;
• Program terminology;
• Principles and practices of data collection, statistical analysis and report preparation;
• Principles of record keeping, case files, and records management;
• Standard office applications, including computer software such as Microsoft Office;
12
• Proper English usage, grammar, spelling and punctuation;
• Mathematics and statistics;
• Principles and practices of effective customer service.
Skills/Abilities to:
• Supervise, interview, select, train, evaluate, discipline and promote subordinate staff;
• Understand, interpret and apply department/program policies, rules, regulations and procedures;
• Assess and interpret program information, and develop findings and recommendations;
• Clearly transmit, verbally and in writing, analysis, findings, and recommendations to subordinate and
management staff,
• Effectively manage multiple work assignments, set priorities and meet established deadlines;
• Work independently and in a team-oriented environment;
• Solve complex and difficult administrative, technical problems;
• Operate modern office equipment including multi-line telephone systems, computer hardware and software,
and internet and web-based applications;
• Understand and carry out oral and written instructions;
• Provide technical guidance to professional staff on the most complex projects or issues;
• Community effectively, both orally and in writing;
• Establish and maintain effective working relationships at all organizational levels, as well as with other
agencies and the public;
• Demonstrate and maintain a high degree of initiative, maturity, integrity, accountability and good judgment.
Minimum Qualifications
Applicants must qualify under one (1) of the options listed below:
OPTION 1:
Education: Completion of sixty (60) semester units of coursework that is acceptable within the United States'
accredited college or university system.
Experience: Three (3) years of full-time, paid work experience equivalent to that gained as a Program Technician
with the County of Fresno.
OPTION 2:
13
Education: Completion of thirty (30) semester units of coursework that is acceptable within the United States'
accredited college or university system.
Experience: Two (2) years of full-time, paid work experience in an office setting which involved data entry,
maintaining records and files, and contact with the public.
AND
Three (3) years of full-time paid work experience equivalent to that gained as a Program Technician with the County
of Fresno.
OPTION 3:
Experience: Four (4) years of full-time, paid work experience in an office setting which involved data entry,
maintaining records and files, and contact with the public.
AND
Three (3) years of full-time, paid work experience equivalent to that gained as a Program Technician with the
County of Fresno.
In addition to the options listed above, the following may be required:
License: Possession of a valid Class "C" driver's license, or equivalent, may be required.
Notes: Recruitment and/or certification may be limited to candidates possessing a specific education and/or
experience background related to the specific position vacancy as authorized by the Director of Human Resources.
Incumbents may be required to obtain and maintain Federal Bureau of Investigation (FBI) and Department of
Justice (DOJ) clearance as a condition of employment.
14
FRESNO COUNTY DEPARTMENT OF PUBLIC HEALTH
Children's Medical Services
California Children's Services (CCS)
Duty Statement
Supervising Program Technician
DEFINITION:
Under direct supervision of the Children's Medical Services (CMS) Division Manager, plans, directs
and supervises a staff engaged in technical and clerical activities; performs the most complex
technical and clerical work; and performs related work as required.
DISTINGUISHING CHARACTERISTICS:
The Supervising Program Technician is responsible for an administrative support unit consisting of five
to ten employees and is responsible for selecting, evaluating, disciplining, and promoting
subordinates. The CCS Supervising Program Technician plans, directs, and supervises program
technicians and office assistants. As a full supervisorial class, incumbents are primarily oriented to
planning; organizing and directing work accomplishment and do not generally devote most of the time
personally performing the same or similar duties as subordinate staff. Incumbents are knowledgeable
of a wide variety of complex paraprofessional/technical work and clerical procedures; possess
organizational and supervisorial skills; and relate well to management and employees at all levels, as
well as the public.
DUTIES AND RESPONSIBILITIES:
# FC Non-Enhanced Activities %
1. 5 Supervise CCS administrative support unit including, selecting, training, 30.0%
assigning work, evaluating, disciplining, and promoting staff.
2. 5 Perform majority of the most complex clerical and technical tasks. 15.0%
3. 5 Provide coverage for staff assignments as needed. 3.0%
4. 5 Maintain filing system of confidential correspondence,job evaluations, clerical 15.0%
procedures, program policies, letters and memos. Follow up and maintain case
management reports.
5. 5 Coordinate and arrange meeting time and place with participants. 1.0%
6. 5 Process, copy and send cases to the Medical Therapy Program and counties 5.0%
where client is transferring.
7. 7 Participate in CCS meetings, trainings, and seminars to assure compliance with 10.0%
state CCS regulations and policies.
8. 5 Develop and implement new technical and clerical procedures and processes. 10.0%
9. 10 Provide ergonomic evaluations and safety training for CCS staff. 6.0%
10. 10 Participate in non-program related Department of Public Health meetings, 5.0%
trainings, in-services, and other staff development activities including reviewing
time sheets and leave requests.
100.0%
*FC = Time Study Function Code
These positions are funded 100% through CCS Administration.
Revised 9-24
15
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY: Fresno FISCAL YEAR 2024-25
County of Fresno
Department of Public Health
CCS
Performance Measure 1
FY 2023-24
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 2024, the following findings are:
• 99.7% of CCS clients in Fresno County have an identified primary care
provider (PCP). This represents no change 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.
16
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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 2024
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)
79347 71393 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.
17
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY: Fresno FISCAL YEAR: 2024-25
County of Fresno
Department of Public Health
CCS
Performance Measure 2
FY 2023-24
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, 89% had their medical eligibility determined
within the prescribed guidelines. This represents a 3% decrease 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 no change
from the previous fiscal year. 67 cases were Full Scope Medi-Cal or
TLICP clients and 31 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.
18
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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).
19
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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 89 100 89%
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 67 31 69 31
Residential eligibility
determined within 30
days 98 100 98%
20
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY Fresno FISCAL YEAR 2024-25
County of Fresno
Department of Public Health
CCS
Performance Measure 3
FY 2023-24
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, 96 were in fact authorized for a SCC.
• Fresno County is 96% compliant with appropriately authorizing SCC for
children with eligible medical conditions.
21
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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.
22
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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, o
musculoskeletal, 96 100 E71, Q05, N18 96 /o
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.
23
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY: Fresno FISCAL YEAR: 2024-25
County of Fresno
Department of Public Health
CCS
Performance Measure 4
FY 2023-24
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 2023-24 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.
24
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY: Fresno FISCAL YEAR: 2024-25
• The random sample (968 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 2023-24 shows 99% of the selected sample received
Transition Planning letters/information. This is 1% more than the
percentage compliance in FY 2022-23.
• The random sample (132 Cases) of all MTP clients who turned 14, 16, 18
and 20 years old shows 99% of the selected sample received Transition
Planning letters/information. This is a 1% decrease from FY 2022-23.
25
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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.
26
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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.
27
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
Reporting Form:
Number of CCS charts Number with transition Percentage of compliance
reviewed planning
99%
968 961
Number of MTP charts Number with transition Percentage of compliance
reviewed planning
99%
132 131
28
Children's Medical Services Plan and Fiscal Guidelines for FY 2024-25
COUNTY: Fresno FISCAL YEAR: 2024-25
County of Fresno
Department of Public Health
CCS
Performance Measure 5
FY 2023-24
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.
29
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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.
30
Children's Medical Services Plan and Fiscal Guidelines
COUNTY: Fresno FISCAL YEAR: 2024-25
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%
31
Children's Medical Services Plan and Fiscal Guidelines
California Children's Services Caseload Summary Form
County: Fresno Fiscal Year: 2024-25
A B
24-25
CCS 22-23 %of 23-24 %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 6,718 88% 6,342 84% 6,303 84%
1 Children
Potential Case Medi-Cal 34 0.4% 24 0.3% 22 0.3%
2
TOTAL MEDI-CAL 6,752 89% °
3 (Row 1 + Row 2) 6,366 85/ 6,325 84/NON MEDI-CAL
OTLICP
Average of Total Open
4 (Active)OTLICP 592 8% 729 10% 752 10%
Potential Cases 4 0.05% 66 0.9% 4 0.1%
5 OTLICP
Total OTLICP (Row 4 596 8% 795 11% 756 10%
6 + Row 5)
Straight CCS
Average of Total Open
(Active)Straight CCS 178 2% 282 4% 331 4%
7 Children
Potential Cases Straight 71 0.9% 71 0.9% 75 1%
g CCS Children
Total Straight CCS 249 3% 353 5/ 406 5°
9 (Row 7 + Row 8)
TOTAL NON MEDI-CAL
10 (Row 6 + Row 9) 845 11% 1,148 15% 1,162 16%
GRAND TOTAL
11 (Row 3 + Row 10) 7,597 100% 7,514 100% 7,487 100%
32
State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division
Revised 5/16/23
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
TotalCasesofOpen(Active)Straight CCS Children 231 3.12% CCS Administrative Budget Worksheet
OTLICP- PzO;�
Total Cases of Open(Active)OTLICP Children 662 8.94� Fiscal Year: 2024-25
MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6508 87.93%
(non-OTLICP)Children County: Fresno CALIFORNIA D E PA
TOTAL CCS CASELOAD 7401 j 100% HEALTH CARE
11
Straight CCS Optonal Targeted Low Income Medi-Cal(Non-OTLICP)
Children's Program(OTLICP)
Column 1 2 1 3 4A 4 5A 5 6A 6 7A 7 8A 8
Optional Targeted
Low Income Enhanced Non-Enhanced
Total Budget Straight CCS Noo-
Category/Line Item %FTE Annual Caseload Children's Medi-Cal Enhanced k Medi-Cal Medi-Cal
Salary (1 x 2 or Caseload% Cou 015State % program(OTLICP) Caseload% State/Federal FTE State/Federal Enn FTE / State/Federal
4+5+6) (50/50) Co/State/Fed (25175) FTE (50/50)
(17.5/17.5/65)
I.Personnel Expense
Program Administration
1.Filar Vasquez,Administrator(Division Manager 55.00% 139922 76,957 3.12% 2,402 894% 6,884 87.93% 67,671 100.00% 67,671
2.Susan Stasikonis,Staff Analyst 111 60.00% 86,996 52,198 3.12% 1,629 8.94% 4,669 87.93% 45,900 10000% 45,900
3.Vacant,Administrative Assistant l 25.00% 45,125 11,281 3.12% 352 8.94% 1,009 87.93% 9,920 100.00% 9,920
4.Harsharn Dhillon-Wood,Rehabilitative Therapy Manager 10.00% 139,922 13,992 3.12% 437 8.94% 1,252 87.93% 12,304 10000% 12,304
5.Ana Gastelum Rivera,Program Technician I 80.00% 43,809 35,047 3.12% 1,094 8.94% 3,135 87.93% 30,818 10000% 30,818
6.Peter Jew,Business Systems Analyst 111 0.00% 0 0 3.12% 0 894% 0 87.93% 0 100.00% 0
7.Marissa Vogeler,Staff Analyst 111 15.00% 76,581 11,487 3.12% 359 8.94% 1,027 87.93% 10,101 1 10000% 10,101
Subtotal 532,355 200,962 6,273 ir 17,976 176,714 176,714
Medical Case Management
1.Dr.Rajeev Verma,Public Health Physician((Ezra Help) 40.00% 292,331 116,932 3.12% 3,650 8.94% 10,459 87.93% 102,823 100.00% 102,823 0.00% 0
2.Dr.Khusal Mehta,Public Health Physician(Extra Help) 1.50% 292,331 4,385 3.12% 137 8.94% 392 87.93% 3,856 0.00% 0 10000% 1 3,856
3.Heather Woo-Maman,Supervising Public Health Nurse 80.00% 141,199 112,959 3.12% 3,526 8.94% 10,104 87.93% 99,329 10.00% 9,933 90.00% 89,396
4.Kelly Stevens,Head Nurse 80.00% 126,886 101,509 3.12% 3,168 8.94% 9,080 87.93% 89,261 52.00% 1 46,416 48.00% 42,845
5.Noel Almaguer,Public Health Nurse 11 89.00% 123,418 109,842 3.12% 3,428 8.94% 1 9,825 87.93% 96,589 91.00% 87,896 9.00% 8,693
6.Sandy Sue Arce,Public Health Nurse ll 89.00% 127,680 113,635 3.12% 3,547 8.94% 10,164 87.93% 99,924 83.00% 82,937 17.00% 16,987
7.Belinda Mayugba,Staff Nurse 111 90.00% 118,905 107,015 3.12% 3,340 8.94% 9,572 87.93% 94,103 90.00% 84,693 10.00% 9,410
8.Quy Gip,Staff Nurse 111 90.00% 120,219 108,197 3.12% 3,377 8.94% 9,678 87.93% 95,142 92.00% 87,531 8.00% 7,611
9.Tim Yang,Staff Nurse 111 90.00% 116,496 104,846 3.12% 3,272 8.94% 9,378 87.93% 92,195 93.00% 85,741 7.00% 6,454
10.Joseph Burgess,Staff Nurse 111 90.00% 112,545 101,291 3.12% 3,161 8.94% 9,060 87.93% 89,069 82.00% 73,037 18.00% 16,032
11.Vivian Tagoe,Staff Nurse 111 90.00% 112,545 101,291 3.12% 3,161 8.94% 9,060 87.93% 89,069 86.00% 1 76,599 14.00% 12,470
12.Ashley Fisk,Staff Nurse l 90.00% 76,299 68,669 3.12% 2,143 8.94% 6,142 87.93% 160,383 9000% 54,345 10.00% 6,038
13.Maribeth Jensen,Staff Nurse 111 90.00% 119,781 107,803 3.12% 3,365 8.94% 9,643 87.93% 94,796 82.00% 77,733 18.00% 17,063
14.Hilary Davis,Public Health Nurse ll 89.00% 123,661 110,058 3.12% 3,435 8.94% 9,844 87.93% 96,778 92.00% 89,036 8.00% 7,742
15.Shavonne Smith,Staff Nurse 111 90.00% 119,562 107,606 3.12% 3,359 8.94% 9,625 87.93% 94,622 92.00% 87,052 8.00% 7,570
16.Khamsay Vanhelsdingen,Public Health Nurse ll 89.00% 1 121,150 107,824 3.12% 3,365 8.94% 9,645 87.93% 94,814 83.00% 78,696 17.00% 16,118
17.Veronica Rayne,Staff Nurse 111 90.00% 114,730 103,257 3.12% 3,223 18.94% 9,236 87.93% 90,798 88.00% 79,902 12.00% 10,896
18.Lanette Ramirez,Public Health Nurse 1 89.00% 100,846 89,753 3.12% 2,801 8.94% 8,028 87.93% 78,923 91 00% 1 71,820 9.00% 7,103
19.Ku Lee,Public Health Nurse ll 89.00% 121,879 108,472 3.12% 3,386 8.94% 9,703 87.93% 1 95,384 90.00% 85,846 10.00% 9,538
20.Renee Chien,Occupational Therapist III(Extra Help) 15.00% 116,954 17,543 3.12% 548 8.94% 1,569 87.93% 15,426 92 00% 14,192 8.00% 1,234
21.Margaret Altamirano,Staff Nurse 111 90.00% 118,029 106,226 3.12% 3,316 8.94% 9,502 87.93% 93,409 75.00% 70,057 25.00% 23,352
22.Jing Yang,Staff Nurse(Extra Help) 8.00% 111,940 8,955 3.12% 280 8.94% 801 87.93% 7,874 92.00% 7,244 8.00% 630
23.or Joseph Capell,Public Health Physician(Extra Help) 20.00% 292,331 58,466 3.12% 1,825 8.94% 5,230 87.93% 51,412 0.00% 0 100.00% 51,412
24.Harjanet Bed!,Staff Nurse l 70.00% 75,679 52,975 3.12% 1,653 8.94% 4,738 87.93% 46,583 9000% 41,925 10.00% 4,658
25.VACANT,Public Health Nurse 1 0.00% 90,291 0 3.12% 0 8.94% 0 87.93% 0 1 0.00% 1 0 100.00% 0
3,387,686 2,129,509 66,466 190,478 1,872,562 1,495,454 377,108
Other Health Care Professionals
1.Arlene Robles-Solis Medical Social Worker 111 89.00% 89,258 79,440 3.12% 2,479 8.94% 7,106 87.93% 69,855 1 5600% 1 39,119 44.00% 30,736
33
Page 1 of 3
State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division
Revised 5/16/23
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
Total Cases of Open(Active)Straight CCS Children 231 3.12% CCS Administrative Budget Worksheet
OTLICP- P4t*O;,e
Total Cases of Open(Active)OTLICP Children 662 8.94� Fiscal Year: 2024-25
MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6508 87.93%
(non-OTLICP)Children County: Fresno CALIFORNIA D E PA
TOTAL CCS CASELOAD 7401 j 100% HEALTH CARE
11
Straight CCS Optonal Targeted Low Income Medi-Cal(Non-OTLICP)
Children's Program(OTLICP)
Column 1 2 1 3 4A 4 5A 5 6A 6 7A 7 8A 8
Optional Targeted
Low Income Enhanced Non-Enhanced
Total Budget Straight CCS Noe-
Annual Caseload Children's Medi-Cal Enhanced k Medi-Cal Medi-Cal
Category/Line Item %FTE Salary (1 x 2 or Caseload% County/State % Program(OTLICP) Caseload/ State/Federal FTE State/Federal Enhanced FrE State/Federal
4+5-6) (50150) Co/State/Fed (25/75) (50/50)
(17.5117.5165)
2.Alma Garcia,Medical Social Worker I 89.00% 64,076 57,028 3.12% 1,780 8.94% 5,101 87.93% 50,147 56 00% 28,082 44.00% 22,065
Subtotal 153,334 136,468 4,259 12,207 120,002 67,201 52,801
Ancillary Support
1.Sonya Mendoza,Senior Administrative Case Worker 89.00% 65,274 58,094 3.12% 1,813 8.94% 5,196 87.93% 51,084 10000% 51,084
2.Michael Vue,Senior Administrative Case Worker 89.00% 62,889 55,971 3.12% 1,747 8.94% 5,006 87.93% 49,218 10000% 49,218
3.Rudy Constantino,Administrative Case Worker 11 89.00% 56,879 50,622 3.12% 1,580 8.94% 4,528 87.93% 44,514 10000% 44,514
4.Luz Reyes,Administrative Case Worker II 89.00% 56,879 50,622 3.12% 1,580 8.94% 4,528 87.93% 44,514 10000% 44,514
5.Johana Guerra,Administrative Case Worker II 89.00% 50,353 44,814 3.12% 1,399 8.94% 4,008 87.93% 39,407 10000% 39,407
6.Adalinn Vargas,Administrative Case Worker I 89.00% 44,971 40,024 3.12% 1,249 8 94% 3,580 87.93% 35,195 100.00% 35,195
7.Rachel Xiong,Administrative Care Worker I 89.00% 41,335 36,788 1 3.12% 1,148 1 8.94% 3,291 87.93% 32,349 10000% 32,349
8.Jess Boone,Administrative Case Worker 1 89.00% 41,335 36,788 3.12% 1,148 8.94% 3,291 87.93% 1 32,349 110000% 32,349
9.Jalen Swank,Administrative Case Worker 1 89.00% 41,335 36,788 3.12% 1,148 8.94% 3,291 87.93% 32,349 10000% 32,349
10.Tiffany Acosta,Administrative Case Worker l 40.00% 50,353 20,141 3.12% 629 8.94% 1,802 87.93% 17,711 10000% 17,711
11.Danny Danglai,Administrative Case Worker l 40.00% 40,469 16,188 3.12% 505 8.94% 1,448 87.93% 14,235 10000% 14,235
12.Jessica Ramirez,Administrative Case Worker l 40.00% 40,469 16,188 3.12% 505 8.94% 1,448 87.93% 14,235 10000% 1 14,235
13.Tamaryn Norris,Administrative Case Worker 1 40.00% 40,469 16,188 3.12% 505 8.94% 1,448 87.93% 14,235 10000% 14,235
14.Vacant,Administrative Case Worker l 0.00% 41,335 0 1 3.12% 0 1 8.94% 0 87.93% 0 100.00% 0
15.Vacant,Administrative Case Worker l 0.00% 41,335 0 3.12% 0 8.94% 0 87.93% 0 1 100.00% 0
16.Vacant,Administrative Case Worker l 0.00% 41,335 0 3.12% 0 8.94% 0 87.93% 0 100.00% 0
17.Vacant,Administrative Case Worker l 0.00% 41,335 0 3.12% 0 8.94% 0 87.93% 0 100.00% 0
18.Vacant,Administrative Case Worker l 0.00% 41,335 0 3.12% 0 8.94% 0 87.93% 0 100.00% 0
19.Vacant,Administrative Case Worker l 0.00% 41,335 0 3.12% 0 8.94% 0 87.93% 0 100.00% 0
20. Vacant,Administrative Case Worker 1 0.00% 0 0 3.12% 0 8 94% 0 87.93% 0 100.00% 0
Subtotal 967 881,021 479,216 14,956 1 42,865 421,395 421,395
Clerical and Claims Support
1.Krisleena Bump,Supervising Program Technician 40.00% 61,693 24,677 3.12% 770 8.94% 2,207 87.93% 21,699 0.00% 0 100.00% 21,699
2.Sera Gutierrez,Office Assistant 11 40.00% 51,260 20,504 3.12% 640 8.94% 1,834 87.93% 18,030 0.00% 0 100.00% 18,030
3.Fallon Smith O'Keefe,Office Assistant ll 89.00% 44,569 39,666 3.12% 1,238 8.94% 3,548 87.93% 34,880 0.00% 0 100.00% 1 34,880
4.Jose Guerrero,Office Assistant l 89.00% 41,601 37,025 3.12% 1,156 8.94% 3,312 87.93% 32,558 0.00% 0 100.00% 32,558
5.Viviana Hernandez Office Assistant ll 16.70% 51,260 8,560 3.12% 267 8.94% 766 87.93% 7,527 0.00% 0 10000% 7,527
6.Melissa Figueroa,Office Assistant ll 16.70% 49,995 8,349 3.12% 261 8.94% 747 87.93% 7,342 0.00% 0 10000% 7,342
7.Vacant Office Assistant l 30.00% 38,223 11,467 3.12% 358 8.94% 1,026 87.93% 10,083 0.00% 0 100.00% 10,083
8.Vacant Office Assistant l 0.00% 38,223 0 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
9.Maricela Garcia,Account Clerk ll 20.00% 55,015 11,003 3.12% 343 8.94% 984 87.93% 9,675 0.00% 0 10000% 9,675
10.Jenny Araiza,Program Technician l 20.00% 49,920 1 9,984 3.12% 312 8.94% 893 87.93% 8,779 0.00% 0 10000% 8,779
11.Suzie Federline,Supervising Account Clerk 0.00% 63,115 0 1 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
12.Fong Lee,Senior Accountant 0.00% 85,788 0 1 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
13.Luu,An Truong,Account Clerk l 0.00% 44,646 0 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
14.Vacant,Account Clerk 1 0.00% 1 43,620 0 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
34
Page 2 of 3
State of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division
Revised 5/1623
Percent of
Actual Total CCS
CCS CASELOAD Caseload Caseload
STRAIGHT CCS-
TotalCasesofOpen(Active)Straight CCS Children 231 3.12% CCS Administrative Budget Worksheet H4
OTLICP-
Total Cases of 0 en Active OTLICP Children 662 8.94%
P (Active) Fiscal Year: 2024-25
MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6508 87.93%
non-OTLICP)Children County: Fresno CALIFORNIA DERA
TOTAL CCS CASELOAD 7401 100% HEALTH CARE
Straight CCS Optional Targeted Law Income Medi-Cal(Non-OTLICP)
Children's Program(OTLICP)
Column 1 2 3 4A 4 SA 5 6A 6 7A 7 BA 8
Optional Targeted
Total Budget Straight CCS Low Income Enhanced Non Non-Enhanced
Cate (Line Item %FTE Annual caseload Children's Medi-Cal Enhanced% Medi-Cal Medi-Cal
gory Salary 11 x 2 or Caseload% Countyl5tate % program(OTLICP) caseload Stale/Federal FTE State/Federal Enhances% State/Federal
4+5+6) (50150) FTE
Co/State/Fed (25/75) (50150)
(17.5117.5/65)
15.Employee Name,Position 0.00% 0 0 3.12% 0 8.94% 0 87.93% 0 0.00% 0 100.00% 0
Subtotal 718,928 171,235 5,345 15,317 150,573 0 150,573
Total Salaries and Wages 3,117,390 3.12% 97,300 8.94% 278,842 87.93% 2,741,246 57.01% 1,562,655 42.99% 1,178,591
Staff Benefits(Specify%) 70.00% 2,182.173 3.12% 68.110 8.94% 195,190 87.93% 1,918,873 1,093,859 825,014
I.Total Personnel Expense 5.299,563 3.12% 165,410 8.94% 474,032 87.93% 4,660,119 2,656,514 2,003,605
II.Operating Expense
1.Travel 1,000 3.12% 31 8.94% 89 87.93% 879 57.01% 501 42.99% 378
2.Training 500 3.12% 16 8.94% 45 87.93% 440 57.01% 251 42.99% 189
3.Office Expense(including Printing) 16,500 3.12% 515 8.94% 1,476 87.93% 14,509 1 100.00% 14,509
4.Postage 16,500 1 3.12% 515 1 8.94% 1,476 87.93% 14.509 100.00% 14,509
5.Small Tools 1,500 3.12% 47 8.94% 134 87.93% 1,319 100.00% 1,319
6.Household Expenses 12,600 3.12% 393 8.94% 1,127 87.93% 11,080 100.00% 11,080
7.Maintenance-Equipment B Security 20,887 3,12% 652 8.94% 1,868 87.93% 18,367 100.00% 18,367
8.Facility Services-including Rent,Utilities 96,731 3.12% 3,019 8.94% 8,652 87.93% 85,059 100.00% 85,059
9.Data Processing-including Communication 68,000 3.12% 2,122 8.94% 6,082 87.93% 59,795 100.00% 59.795
10,Translation Services 3,000 3.12% 94 8.94% 268 87.93% 2,638 100.00% 2,636
11.Total Operating Expense 237,218 1 7,404 1 21,217 208,595 752 207,843
III.Capital Expense
1.N/A 3.12% 0 B.94% 0 87.93% 0 0
III.Total Capital Expense 0 0 0 0 0
IV.Indirect Expense
1.Indirect Cost Rate 24.43% 1,294,683 3.12% 40.410 8.94% 115,806 87.93% 1,138,467 100.00% 1,138,467
0 3.12% 0 8.94% 10 67.93% 0 100.00% 0
IV.Total Indirect Expense 1,294,683 1 40,410 115,806 1,138,467 1,138,467
V.Other Expense
1.Maintenance B Transportation 10,000 3.12% 312 B.94% 894 87.93% 8,793 100.00% 8,793
2.CRISS Council Membership 6,700 3.12% 209 8.94% 599 87.93% 5,892 100.00% 5,892
3. 3.12% 0 8.94% 0 87.93% 10 100.00% 0
V.Total Other Expense 16,700 521 1,493 1 1 14,685 14,685
Budget Grand Total 6,848,164 213,745 1 612,548 6,021,866 2,657,266 3,364,600
Susan Stasikonis 9/25/2024 559 600-6383
tPreparedBy Sin re) Prepared By(Printed Name) Date Prepared Phone Number
Pilar Vas uez 3 559 600-6595
inistrator(Signature) CCS Administrator(Printed Name) Date Signed Phone Number
35
Page 3 of 3
State of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division
Revised 5116123
Percent of Total
CCS CASELOAD Actual Caseload CCS Caseload
STRAIGHT CCS-
TolalCasesofOpen(Active)Straight CCS Children 231 3.12% CCS Administrative Baseline Budget Summary
OTLICP-
Total Cases of Open(Active)OTLICP Children 662 8.94% Fiscal Year: 2024-25
MEDI-CAL- 6508 87.93%
Total Cases of Open(Active)Medi-Cal non-OTLICP)Children County: Fresno
TOTAL CCS CASELOAD 7401 100%
Col 1=Col 2+3+4 Straight CCS OTLICP Medi-Cal(non-OTLICP)(Column 4=Columns 5+6)
Column 1 1 2 3 4 1 5 1 6
Optional Targeted Low
Straight CCS Income Children's Non-Enhanced Medi-
CategorylLlne Item Total Budget County/State Program(OTLICP) Medi-Cal State/Federal di-Cal
Stale/Federal Enhanced Me di-Cal(251` ) Cal State/Federal
(50/50) County/State/Fed (50/50)
(17.5117.5165)
I. Total Personnel Expense 5,299,563 165.410 474,032 4,660,119 2,656,514 2,003,605
It.Total Operating Expense 237,218 7,404 21,217 208,595 752 207,843
III.Total Capital Expense 0 0 0 1 0 0
IV.Total Indirect Expense 1,294,683 40,410 115,806 1,138.467 1,138,467
V.Total Other Expense 16,700 521 1,493 1 14,685 14,685
Budget Grand Total 6,840,164 213,745 612,548 1 6,021,866 2.657.266 3.364,600
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 1 6
Optional Targeted Low
Straight CCS Income Chitd Enhanced Me
ren's di-Cal Non-Enhanced Medi-
Source of Funds Total Budget County/State Program(OTLICP) Medi-Cal State/Federal State/Federal di-Cal) Cal State/Federal
(50150) - County/State/Fed (50150)
(17.5/17.5/65)
Straight CCS
State 106,072 106,872
County 106,873 1061873
OTLICP
Stale 107,196 107,196
County 107,196 107,196
Federal(Title XXI) 390,156 398,156
Medi-Cal
ZState 2,346,617 2.346,617 664,311 1,682,300
ederai(Title XIX) ,�� 3,675,249 3,675,249 1,992,949 1,682,300
zC ufi match 214,069
Susan Stasikonis sstasikonis fresnocoun ca. ov
�Preparredalu ) Prepared By(Printed Name) Email Address
Pilar Vasquez vas uez fresnocount ca. ov
A istrator(Signature) CCS Administrator(Printed Name) Email Address
36
Page 1 of 1
Sample Budget Justification Narrative
Integrated Systems of Care Division
County
Budget Narrative
Fiscal Year 2024-2025
I.PERSONNEL EXPENSES Identify and explain any changes in Personnel including FTE percentage
changes.
Salaries represent an estimated 14%decrease from previous FY.Salaries include
Total Salaries: $3,117,390 actual annual salaries with cost of living adjustments however,FTEs were lowered in
all classifications to meet the allocation.
Staff benefits represents an estimated 70%of salaries;this is a decrease of 2.8%
Total Benefits: $2,182,173 from previous FY.This estimate was reached by using an average of the actual
County benefits budgeted for this fiscal year.
Total Personnel Expenses: $5,299,563
Program Administration To meet FTEs were reduced by 42%from previous FY. A total of 1.6 FTE of Program Administration were moved to the M&O budget to perform M&O
activities.
Medical Case Management To meet allocation,FTEs of Physicians and Nurses were reduced by 11%from previous FY.
Other Health Care Professionals To meet allocation,FTEs were reduced by 11%from previous FY.
Ancillary Support To meet alloction,FTEs were reduced by 31%from previous FY.In lieu of the Supervising Office Assistant,a Supervising Program Technician is
responsible staff to provide oversight for the Clerical and Technical support.
Clerical and Claims Support To meet allocation,FTEs were reduced by 36%from previous FY.
It.OPERATING EXPENSES List all Operating Expense line items.Identify and explain any increase,
decrease.or newly listed line item.
Travel $1,000 To meet allocation,travel expenses are reduced by 67%from previous FY.
Training $500 There is no change on the Training expense from previous FY.
Office Expenses $16,500 To meet allocation,office expenses are reduced by 17%from previous FY.
Postage To meet allocation,postage expenses are reduced by 25%from previous FY.
$16,500
Small Tools $1,500 To meet allocation,small tools expenses are reduced by 59%from previous FY.
Household Expenses $12,600 To meet allocation,household expenses are reduced by 7%from previous FY.
Maint-Equip,Bldg,&Security $20,887 Represents a 8%increase from previous FY based on anticipated expenditures.
Facility Services(rent,utilities) $96,731 To meet allocation,facilities services including utilities are reduced by 16%from
previous FY.
Data Processing including Communications $68,000 To meet allocation,facilities services including utilities are reduced by 6%from
previous FY.
Translation Services $3,000 There is no change on the budget for translation services expense from previous
FY.
Total Operating Expenses: $237,218
III.CAPITAL EXPENSES List all Capital Expense line items.Identify and explain any newly listed
Capital Expense.Include County/City Capital Expenses Justification Form.
Total Capital Expenses: 0 None
IV.INDIRECT EXPENSES
A.Internal @ 24.43% $1,294,683 Represents a 12%increase from previous FY due to higher Indirect Cost Rate.
Fresno's approved indirect cost rate for 2024-25 is 24.43%.
B.External
Total Indirect Expenses: $1,294,683
List all Other Expense line items.Identify and explain increased,decreased,or
V.OTHER EXPENSES newly listed line items.Include County/City Other Expenses Justification
Form.
37
Maintenance and Transportation $10,000 To meet allocation,budget for Maintenance and Transportation is reduced by 67%.
Student Internship $6,700 There is no change on the budget for CRISS Membership from previous FY.
Total Other Expenses: $16,700
Budget Grand Total $6,848,164
38
FY 2024-25 Retroactive California Department of Health Care Services Allocation
for Fresno County California Children's Services (CCS) Program
Allocation: FY 2024-25 CMS Plan and Budget for CCS
FY 2024-25 CCS Monitoring and Oversight Budget
Fund/Subclass: 0001/10000
Organization: 56201600
Revenue Account No.: 3505, 4380
39
PzAoHCS
CALIFORNIA DEPARTMENT OF
HEALTH CARE SERVICES
Michelle Baass I Director
DATE: August 21, 2024
CCS Information Notice: 24-04 REVISED
TO: CALIFORNIA CHILDREN'S SERVICES PROGRAM
ADMINISTRATORS, CALIFORNIA CHILDREN'S SERVICES
MEDICAL CONSULTANTS, AND DEPARTMENT OF HEALTH
CARE SERVICES STAFF
SUBJECT: FISCAL YEAR 2024-2025 COUNTY ALLOCATIONS FOR
CALIFORNIA CHILDREN'S SERVICES COUNTY
ADMINISTRATION, COMPLIANCE MONITORING AND
OVERSIGHT, AND MEDICAL THERAPY PROGRAM
The purpose of this California Children's Services (CCS) Information Notice is to
provide County CCS Programs with their CCS Program County Administrative,
Compliance Monitoring and Oversight (M&O), and Medical Therapy Program (MTP)
approved budget allocations for fiscal year (FY) 2024-25. DHCS will not issue individual
county budget notices. The Department of Health Care Services (DHCS) calculated the
FY 2024-25 allocations as follows:
• CCS Administrative Allocation: This allocation is based on each county's
average expenditures during FY 2019-20 through FY 2022-23 and the counties'
average caseload for calendar year (CY) 2023.
• CCS M&O Allocation: This allocation is based on each county's average
caseload for CY 2023.
• MTP Allocation: This allocation is based on each county's average caseload for
CY 2023 and their baseline budget submissions for the MTP.
Each county remains responsible for overseeing and tracking its administrative budget
and MTP expenditures and will only be reimbursed up to the county's authorized
allocation. In addition, counties cannot shift funding between CCS Program participation
categories (i.e., "straight" CCS, CCS/Medi-Cal, and CCS/Optional Targeted Low-
Income Children Program).
County CCS Programs must adhere to DHCS guidelines for the determination of
enhanced and non-enhanced designation of local county CCS Program staff. The
documentation for skilled professional medical personnel who qualify for enhanced
California Department of Health Care Services State of California
Integrated Systems of Care Division Gavin Newsom, Governor �J)
1501 Capitol Ave I Sacramento, CA 1 95899-7437
MS 45021 Phone (916)449-5005 1 www.dhcs.ca.gov California Health and Human Services Agency
CCS Information Notice: 24-04
August 21, 2024
Page 2 of 10
Federal Financial Participation (FFP) or who work on more than one program must
conform to the FFP time study requirements and guidelines.
County CCS Programs must maintain an audit file. At a minimum, this audit file should
include:
1. Documentation on required time studies performed during one or more
representative months of the fiscal quarter for each budgeted position claimed
under FFP.
2. Documentation in support of training and travel costs and other claimed
operational expenditures.
3. Documentation in support of claimed internal and external overhead costs.
County CCS Programs should maintain and be able to produce the audit file to State
and Federal regulators within seven (7) calendar days of a request.
County CCS Programs are expected to comply with all Federal and State requirements
pertaining to the CCS Program and must adhere to all applicable Department policies
and procedures. County CCS Programs must submit invoices based only on actual
CCS Program Administration, MTP expenditures, and in accordance with Section 7,
Expenditure Claims and Property Management of the Plan and Fiscal Guidelines (PFG)
manual.
County CCS Programs must submit CCS Program plans and budgets for FY 2024-25
no later than sixty (60) days from the date of this Information Notice. Please submit your
plans and budgets electronically to the ISCD Budget Portal. County CCS Programs
requiring the most recent version of the PFG manual Section 7 may contact
ISCDFiscal(a_dhcs.ca.gov.
Senate Bill (SB) 108 amended SEC. 166. Item 4260-101-0001 of Section 2.00 of the
Budget Act of 2024 to include provision 21 which allows the counties to deviate from the
department's established allocation staffing methodology governing the use of the
county Health Care Program for Children in Foster Care (HCPCFC) administrative
budget and CCS M&O budget for purposes of extending flexibility to the counties
regarding appropriate staffing necessary to implement and operationalize the HCPCFC
program manual requirements and readiness activities for the CCS M&O.
To be eligible for this flexibility, the County CCS Program must submit the One-Time
Flexibilities - SB 108 Administrative Support Budget workbook to the Department of
Health Care Services (DHCS) no later than October 1, 2024. The budget must be
approved through the County's Board of Supervisors and proof of their approval must
be included with your budget submission to DHCS. The budget must describe the
county's proposed use of funds to support HCPCFC program and CCS M&O activities,
including direct and indirect administrative costs.
CCS Information Notice: 24-04
August 21, 2024
Page 3 of 10
DHCS will send the One-Time Flexibilities - SB 108 Administrative Support Budget
workbook and instructions to the County CCS Program via email. For questions
regarding this IN, fiscal questions and/or requests, please contact
ISCDFiscal(a)-dhcs.ca.gov.
Sincerely,
ORIGINAL SIGNED BY
Cortney Maslyn, Chief
Integrated Systems of Care Division
Department of Health Care Services
Attachments:
Attachment A: CCS Administrative Allocation
Attachment B: CCS Medical Therapy Program Allocation
Attachment C: CCS Monitoring and Oversight Allocation
CCS Information Notice: 24-04
August 21, 2024
Page 4 of 10
Attachment A
FY 2024-25 CCS ADMINISTRATIVE ALLOCATION
•
CCS . � •
OT ';7 MEDI-CAL MEDI-CAL LE 19)
LC 0 6U.N T Y L6 (TITLE 21) (TIT
• •N* ALLOCATIO AL • • • LY
GF ONLY ONLY ONLY
1 Alameda $1,218,552 $1,401,309 $355,207 $1,046,103 $7,749,872 $2,924,906 $4,824,966
2 Alpine $0 $4 $1 $4 $71,888 $34,539 $37,349
3 Amador $10,919 $33,731 $8,555 $25,176 $185,238 $81,841 $103,396
4 Butte $49,832 $110,103 $27,918 $82,186 $867,819 $351,490 $516,329
5 Calaveras $14,951 $11,549 $2,928 $8,621 $71,410 $34,304 $37,107
6 Colusa $14,634 $62,652 $15,892 $46,761 $200,251 $85,545 $114,705
7 Contra Costa $668,869 $727,488 $184,394 $543,094 $4,741,071 $1,657,223 $3,083,848
8 Del Norte $23,772 $9,891 $2,507 $7,385 $85,819 $41,219 $44,599
9 El Dorado $65,3011 $47,438 $12,012 $35,426 $468,355 $192,567 $275,787
10 Fresno $296,2861 $650,266 $164,862 $485,404 $5,901,612 $2,163,390 $3,738,222
11 Glenn $7,956 $40,638 $10,337 $30,302 $221,076 $93,448 $127,627
12 Humboldt $35,085 $55,697 $14,121 $41,576 $432,401 $169,775 $262,626
13 Imperial $51,404 $58,583 $14,850 $43,733 $481,016 $185,060 $295,955
14 Inyo $15,712 $14,561 $3,691 $10,870 $97,139 $46,665 $50,473
15 Kern $158,604 $382,331 $96,935 $285,396 $3,484,793 $1,295,184 $2,189,609
16 Kings $33,976 $64,859 $16,445 $48,414 $484,342 $185,794 $298,549
17 Lake $9,313 $22,001 $5,579 $16,423 $145,739 $58,501 $87,238
18 Lassen $1,920 $8,170 $2,077 $6,093 $57,518 $27,711 $29,807
19 Los Angeles $4,947,421 $4,721,267 $1,198,127 $3,523,140 $40,512,060 $14,112,559 $26,399,501
20 Madera $89,026 $141,442 $35,865 $105,577 $1,039,118 $499,244 $539,874
21 Marin $82,563 $94,084 $23,850 $70,234 $575,463 $237,410 $338,053
22 Mariposa $10,337 $7,976 $2,021 $5,955 $93,096 $44,724 $48,372
23 Mendocino $13,253 $56,527 $14,299 $42,228 $311,292 $131,303 $179,989
CCS Information Notice: 24-04
August 21, 2024
Page 5 of 10
•
COUNTY • •
• •N* ALLOCATIONGFO • • •
24 Merced $27,423 $208,915 $53,070 $155,845 $1,155,340 $555,532 $599,808
25 Modoc $4,099 $11,969 $3,057 $8,912 $88,554 $38,557 $49,997
26 Mono $25,436 $49,102 $12,452 $36,650 $171,696 $82,495 $89,201
27 Monterey $64,135 $148,137 $37,560 $110,577 $945,025 $361,937 $583,088
28 Napa $45,098 $127,290 $32,277 $95,012 $468,505 $168,967 $299,538
29 Nevada $28,177 $76,736 $19,462 $57,275 $353,348 $152,690 $200,658
30 Orange $420,660 $783,434 $198,667 $584,767 $3,636,183 $1,747,054 $1,889,129
31 Placer $124,510 $259,910 $65,903 $194,007 $1,422,781 $575,480 $847,301
32 Plumas $4,389 $15,946 $4,053 $11,893 $68,914 $30,870 $38,044
33 Riverside 1 $669,539 $1,650,742 $418,631 $1,232,111 $10,634,949 $5,109,855 $5,525,093
34 Sacramento $430,077 $1,150,002 $291,586 $858,416 $7,388,953 $2,714,909 $4,674,044
35 San Benito $22,107 $25,887 $6,564 $19,324 $147,197 $68,099 $79,098
36 Be nardino an $437,339 $1,457,226 $369,523 $1,087,703 $10,752,284 $4,449,168 $6,303,116
37 San Diego $1,067,045 $1,890,947 $479,503 $1,411,444 $11,255,933 $5,408,002 $5,847,931
38 San Francisco $295,596 $551,241 $139,761 $411,481 $3,103,697 $1,183,147 $1,920,550
39 San Joaquin $239,339 $720,580 $183,459 $537,120 $3,914,951 $1,563,801 $2,351,150
40 San Luis $88,652 $121,716 $30,858 $90,858 $618,514 $257,718 $360,796
Obispo
41 San Mateo $244,251 $180,644 $45,780 $134,864 $1,104,157 $442,153 $662,004
42 Santa Barbara $84,776 $127,857 $32,415 $95,441 $725,796 $292,728 $433,068
43 Santa Clara $964,044 $1,406,929 $356,740 $1,050,189 $7,226,523 $3,471,914 $3,754,610
44 Santa Cruz $42,664 $90,394 $22,920 $67,474 $690,766 $266,940 $423,826
45 Shasta $58,307 $142,968 $36,517 $106,451 $791,742 $381,627 $410,115
46 Sierra $0 $0 $0 $0 $58,195 $27,961 $30,234
47 Siskiyou $20,758 $16,033 $4,064 $11,969 $149,811 $62,979 $86,831
CCS Information Notice: 24-04
August 21, 2024
Page 6of10
OTLICP
CCS . � •
COUNTY • •N* ALLOCATIONOTLICP (TITLE 21 • • •
ONLY ONLY ONLY
48 Solano $61,404 $135,100 $34,260 $100,839 $834,244 $395,156 $439,088
49 Sonoma $121,308 $361,595 $91,707 $269,888 $1,377,773 $601,615 $776,158
50 Stanislaus $138,619 $376,430 $95,634 $280,796 $2,300,164 $932,498 $1,367,665
51 Sutter 1 $34,417 $82,058 $21,023 $61,036 $523,403 $240,529 $282,874
52 Tehama $31,592 $22,021 $5,582 $16,439 $158,279 $69,369 $88,910
53 Trinity $7,762 $9,986 $2,532 $7,455 $79,186 $36,160 $43,026
54 Tulare $154,605 $296,838 $75,613 $221,225 $3,048,520 $1,467,644 $1,580,876
55 Tuolumne $30,031 $32,683 $8,285 $24,398 $171,808 $68,795 $103,012
56 Ventura $235,225 $792,350 $201,265 $591,085 $3,748,308 $1,461,840 $2,286,468
57 Yolo $70,935 $123,843 $31,403 $92,439 $632,290 $303,789 $328,501
58 Yuba $28,996 $63,113 $16,005 $47,108 $433,635 $181,518 $252,117
*CCS State Only Administrative Allocation: This allocation is based on each county's average expenditures during FY 2019-20 through FY 2022-23 and the
counties'average CCS Only caseload for calendar year(CY) 2023.
**CCS OTLICP Combined(GF/FF)Administrative Allocation: This allocation represents the total General Fund(GF) and Federal Fund(FF) funding for CCS
OTLICP. The allocation is based on each county's average expenditures during FY 2019-20 through FY 2022-23 and the counties'average caseload for CY
2023.
***CCS MEDI-CAL Combined(GF/FF)Administrative Allocation: This allocation represents the total GF and FF funding for CCS Medi-Cal. The allocation is
based on each county's average expenditures during FY 2019-20 through FY 2022-23 and the counties'average caseload for CY 2023.
CCS Information Notice: 24-04
August 21, 2024
Page 7of10
Attachment B
CCS MEDICAL THERAPY PROGRAM ALLOCATION FY 2024-25
CCS MEDICAL
COUNTY THERAPY PROGRAM
L:(��� ALLOCATION
1 Alameda $3,990,521
2 Alpine — No MTU** $0
3 Amador— No MTU** $0
4 Butte $313,691
5 Calaveras $94,401
6 Colusa — No MTU** $0
7 Contra Costa $2,215,727
8 Del Norte — No MTU** $0
9 El Dorado $285,927
10 Fresno $1,408,553
11 Glenn $24,494
12 Humboldt $461,401
13 Imperial $206,930
14 Inyo —AB 3632* $10,026
15 Kern $2,472,534
16 Kings $100,134
17 Lake $171,316
18 Lassen — No MTU** $0
19 Los Angeles $15,474,165
20 Madera $363,833
21 Marin $387,090
22 Mariposa — No MTU** $0
23 Mendocino $0
24 Merced $744,094
25 Modoc — No MTU** $0
26 Mono —AB 3632* $8,162
27 Monterey $965,854
28 Napa $551,669
29 Nevada $192,400
30 Orange $7,045,786
31 Placer $482,927
32 Plumas — No MTU** $0
33 Riverside $5,767,946
34 Sacramento $1,395,769
CCS Information Notice: 24-04
August 21, 2024
Page 8of10
CCS MEDICAL
• PROGRAM
• •
35 San Benito $170,470
36 San Bernardino $3,584,102
37 San Diego $5,297,795
38 San Francisco $1,516,744
39 San Joaquin $934,908
40 San Luis Obispo $855,070
41 San Mateo $1,378,780
42 Santa Barbara $1,541,503
43 Santa Clara $4,210,290
44 Santa Cruz $476,015
45 Shasta $503,437
46 Sierra — No MTU** $0
47 Siskiyou — No MTU** $0
48 Solano $442,140
49 Sonoma $1,596,466
50 Stanislaus $1,170,432
51 Sutter $90,654
52 Tehama $16,179
53 Trinity — No MTU** $0
54 Tulare $552,832
55 Tuolumne $33,988
56 Ventura $2,389,770
57 Yolo $410,654
58 Yuba $12,4181
Total Allocation � � �
Statewide
*AB3632 = State only
**No MTU = No Medical Therapy Unit
CCS Information Notice: 24-04
August 21, 2024
Page 9 of 10
Attachment C
CCS MONITORING AND OVERSIGHT ALLOCATION FY 2024-25
1 Alameda $332,585
2 Alpine $32,466
3 Amador $38,540
4 Butte $75,881
5 Calaveras $41,658
6 Colusa $41,750
7 Contra Costa $238,010
8 Del Norte $34,323
9 El Dorado $60,707
10 Fresno $360,825
11 Glenn $42,484
12 Humboldt $57,750
13 Imperial $105,227
14 1 nyo $34,415
15 Kern $335,822
16 Kings $81,016
17 Lake $45,372
18 Lassen $34,644
19 Los Angeles $2,053,266
20 Madera $97,223
21 Marin $58,140
22 Mariposa $33,956
23 Mendocino $48,833
24 Merced $114,877
25 Modoc $33,475
26 Mono $36,477
27 Monterey $109,331
28 Napa $50,896
29 Nevada $47,801
30 Orange $436,603
31 Placer $84,362
CCS Information Notice: 24-04
August 21, 2024
Page 10 of 10
0 CS Monitoring &
Lc �iA Oversight
q32 Plumas $34,529
33 Riverside $669,598
34 Sacramento $359,687
35 San Benito $43,722
36 San Bernardino $690,761
37 San Diego $803,500
38 San Francisco $111,248
39 San Joaquin $211,535
40 San Luis Obispo $69,511
41 San Mateo $82,485
42 Santa Barbara $112,174
43 Santa Clara $326,324
44 Santa Cruz $64,605
45 Shasta $65,453
46 Sierra $32,558
47 Siskiyou $40,512
48 Solano $85,213
49 Sonoma $84,916
50 Stanislaus $219,210
51 Sutter $69,554
52 Tehama $57,819
53 Trinity $33,498
54 Tulare $305,097
55 Tuolumne $40,764
56 Ventura $265,854
57 Yolo $60,592
58 Yuba $65,543