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HomeMy WebLinkAboutSTATE Department of Health Care Services-Allocation Plan for Child Health Services_A-25-422.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 August 19, 2025 Present: 5- Vice Chairman Garry Bredefeld, Supervisor Luis Chavez, Supervisor Nathan Magsig, Chairman Buddy Mendes, and Supervisor Brian Pacheco Agenda No. 54. Public Health File ID: 25-0785 Re: Approve retroactive submission of the FY 2025-26 California Department of Health Care Services allocation plan for child health services under California Children's Services, effective July 1, 2025,to June 30, 2026($6,821,682); approve retroactive submission of the FY 2025-26 California Department of Health Care Services allocation budget for the monitoring and oversight reporting under California Children's Services, effective July 1, 2025, to June 30, 2026 ($362,796); 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- Bredefeld, Chavez, Magsig, Mendes, and Pacheco Agreement No. 25-422 County of Fresno Page 55 co Board Agenda Item 54 O 1856 O FRE`'� DATE: August 19, 2025 TO: Board of Supervisors SUBMITTED BY: Joe Prado, Interim Director, Department of Public Health SUBJECT: Retroactive FY 2025-26 California Department of Health Care Services Allocations RECOMMENDED ACTION(S): 1. Approve retroactive submission of the FY 2025-26 California Department of Health Care Services allocation plan for child health services under California Children's Services, effective July 1, 2025, to June 30, 2026 ($6,821,682); 2. Approve retroactive submission of the FY 2025-26 California Department of Health Care Services allocation budget for the monitoring and oversight reporting under California Children's Services, effective July 1, 2025, to June 30, 2026 ($362,796); 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 to support monitoring and oversight (M&O) reporting activities to DHCS. The combined allocations are 6%, or$459,988, decrease from prior fiscal year and will cover anticipated FY 2025-26 CCS program costs. The estimated County match of$271,465 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 2025-26 allocations from DHCS on July 1, 2025. Both are retroactive to July 1, 2025, and are due to DHCS by August 29, 2025. This item is brought to your Board in accordance with the agenda item processing timelines. FISCAL IMPACT: There is no increase in Net County Cost associated with the recommended actions. The FY 2025-26 non-competitive combined allocations of$7,184,478, which is primarily comprised of Federal and State funding, represents a $459,988 (6%)decrease from the prior year allocation of$7,644,466. The combined funding of$7,184,478 will cover approximately 96% of anticipated FY2025-26 program costs. Sufficient County of Fresno Page I File Number.25-0785 File Number:25-0785 appropriations and estimated revenues are included in the Department's Org 5620 FY 2025-26 Recommended Budget. The allocation allows recovery of indirect costs, and the Department's indirect cost rate is 24.47%. The recommended CCS allocation plan includes the required County match of$271,465. 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 guidance 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 determined each county's annual allocation using the CCS program's average expenditures during FY 2020-21 through FY 2023-24, and the average caseload for calendar year 2024. Recommended action number two will fund personnel, operating, and indirect costs related to new quarterly and annual reporting by the County to DHCS. 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 CCS Plan and that the County will comply with applicable laws, regulations, and policies related to the CCS County of Fresno Page 2 File Number.25-0785 File Number:25-0785 program. The recommended CCS allocation plan and CCS M&O allocation budget are retroactive to July 1, 2025, 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 #55, November 5, 2024 ATTACHMENTS INCLUDED AND/OR ON FILE: On file with Clerk- FY 2025-26 CCS Administrative and CCS M&O Budget On file with Clerk- CCS FY 2025-26 Allocation Memo CAO ANALYST: Ronald W. Alexander Jr. County of Fresno Page 3 File Number.25-0785 Agreement No. 25-422 Plan and Budget Required Documents Checklist MODIFIED FY 2025-26 County/City: Fresno Fiscal Year: 2025-26 Document Page Number 1. Checklist 1 - 2 2. Agency Information Sheet 3 3. Certification Statements 4 4. Agency Description A. Brief Narrative 5 B. Organizational Charts 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. Data Forms A. CCS Caseload Summary 11 6. Memoranda of Understanding and Interagency Agreements List A. MOU/IAA List N/A B. New, Renewed, or Revised MOU or IAA N/A 7. Budgets A. CCS Administrative Budget 1. Budget Worksheet 12 - 14 2. Budget Summary 15 3. Budget Justification Narrative 16 B. CCS Monitoring and Oversite Budget 1. Agency Information 17 2. Budget Worksheet 18 3. Budget Narrative 19 1 County/City: Fresno Fiscal Year: 2025-26 Document Page Number 4. Budget Summary 20 G.. Other Forms 1. County/City Capital Expenses Justification Form N/A 2. County/City Other Expenses Justification Form N/A 8. 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: 2025-26 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(@_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: 2025-26 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 wi o ply. Signat re of CCS Admini or D7(J-112 Signed / -7 uZf ature o Dire or r Health 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 Govirning 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 2025-26 Agency Description Fresno County's California Children's Services (CCS) program is housed in the County of Fresno, Department of Public Health, under the Children's Medical Services (CMS) 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: 2025-26 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 45% No No Rehabilitation Therapy Manager Harsharn Dhillon Wood 10% No No Staff Analyst I Kristeena Bump 50% No No Staff Analyst III Marissa Vogeler 15% No No Administrative Assistant Victoria Verdugo 85% No No Program Technician II Ana Gastelum Rivera 35% 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) Program Technician I Vacant 0% No No Public Health Physician Dr. Rajeev Verma 40% No No Public Health Physician Dr. Joseph Capell 40% No No Supervising Public Health Nurse Heather Maraan 72% No No Head Nurse Kelly Stevens 75% No No Public Health Nurse 11 Noel Almaguer 85% No No Public Health Nurse 11 Sandy Sue Arce 85% No No Public Health Nurse II Hilary Davis 85% No No Public Health Nurse II Ku Lee 85% No No Public Health Nurse II Khamsay Vanhelsdingen 85% No No Public Health Nurse II Lanette Ramirez 85% No No Staff Nurse III Margaret Altamirano 85% No No Staff Nurse III Joseph Burgess 85% No No Staff Nurse III Quy Gip 85% 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 Maribeth Jensen 85% No No Staff Nurse III Belinda Mayugba 85% No No Staff Nurse III Veronica Reyna 85% No No Staff Nurse III Shavonne Smith 85% No No Staff Nurse III Vivien Tagoe 85% No No Staff Nurse III Tim Yang 85% No No Staff Nurse I Ashley Fisk 85% No No Staff Nurse I Vacant polo No No Staff Nurse III (Extra Help) Jing Yang 0% No No Occupational Therapist III (Extra Renee Chien 0% No No Help) Medical Social Worker III Ariana Salazar 85% No No Medical Social Worker II Alma Garcia 85% No No Senior Administrative Case Worker Sonya Mendoza 75% No No Senior Administrative Case Worker Michael Vue 75% 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) Administrative Case Worker II Luz Reyes 80% No No Administrative Case Worker II Rudy Constantino 80% No No Administrative Case Worker II Tiffany Acosta 80% No No Administrative Case Worker II Yuidico Garza-Wayne 80% No No Administrative Case Worker II Johana Flores Guzman 80% No No Administrative Case Worker I Jessica Ramirez 80% No No Administrative Case Worker 11 Rachel Xiong 80% No No Administrative Case Worker 11 Jalen Swank 80% No No Administrative Case Worker I Adalinn Vargas 80% No No Administrative Case Worker I Tamaryn Norris 80% No No Administrative Case Worker I Vacant 0% No No Administrative Case Worker I Felisha Delgado 80% No No Administrative Case Worker I Samantha Amescua 80% No No Administrative Case Worker I Jose Cisneros 80% No No Administrative Case Worker I Vacant 0% 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) Supervising Program Technician Angel Rodriguez g0% No No Office Assistant II Briana Casey 85% No No Office Assistant I Sean Garcia 85% No No Office Assistant I Vacant 0% No No Office Assistant I Vacant 0% No No Account Clerk II Maricela Garcia 5% No No Office Assistant II Ismene Hernandez 5% No No 10 Children's Medical Services Plan and Fiscal Guidelines California Children's Services Caseload Summary Form County: Fresno Fiscal Year: 2025-26 A B 25-26 CCs 23-24 %of 24-25 %of Estimated %of Caseload 0 Actual Grand Actual Grand Caseload Grand to 21 Years Caseload Total Caseload Total based on first Total month MEDI-CAL Average of Total Open (Active)Medi-Cal 6,342 84% 6,215 84% 6,102 84% 1 Children Potential Case Medi-Cal 24 0.3% 26 0.4% 22 0.3% 2 TOTAL MEDI-CAL 6,366 85% 6,241 84% 6,124 84% 3 (Row 1 + Row 2) NON MEDI-CAL OTLICP Average of Total Open 4 (Active)OTLICP 729 10% 767 10% 809 11% Potential Cases 66 0. ° 5 OTLICP 9% 3 0.04/ 3 0.04/Total OTLICP (Row 4 795 11% ° ° 6 + Row 5) 770 10% 812 11/ Straight CCS Average of Total Open (Active)Straight CCS 282 4% 331 4% 273 4% 7 Children Potential Cases Straight 71 0 9% ° ° g CCS Children 68 0.9/ 58 0.8/ Total Straight CCS 353 5% 399 5% 331 5% 9 (Row 7 + Row 8) TOTAL NON MEDI-CAL 1,148 15% 1,169 16% 1,143 16% 10 (Row 6 + Row 9) GRAND TOTAL (Row 3 + Row 10) 7,514 100% 7,410 100% 7,267 100% 11 11 State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division Revised 3/6/24 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 322 4.36% Pj; Total Cases of Open(Active)Straight CCS Children CCS Administrative Budget Worksheet OTLICP- Total Cases of Open(Active)OTLICP Children 750 10.21% Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (non-OTLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 100% HEALTH CARE SERVICES Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP) Children's Program(OTLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Low Income Enhanced Non-Enhanced Total Budget Straight CCS Non- Annual Caseload Children's Medi-Cal Enhanced/ Medi-Cal Medi-Cal Category/Line Item %FTE Salary (1 x 2 or Caseload/ CountylState % Program(OTLICP) Caseload% State/Federal FTE State/Federal Enh FTEd/ State/Federal 41 5+6) (50/50) Co/State/Fed (25175) (50150) (17.5117.5/65) I.Personnel Expense Program Administration 1.Pilar Vasquez,Administrator(Division Manager) 45.00% 148,686 66,909 4.38% 2,934 10.21% 6,833 85.40% 57,142 100.00% 57,142 2.Harsharn Dhillon-wood,Rehabilitative Therapy Manager 10.00% 148,686 14,869 4.38% 652 10.21% 1,518 85.40% 12,699 100.00% 12,699 3.Kristeena Bump,Staff Analyst l 50.00% 67,214 33,607 4.38% 1,474 10.21% 3,432 85.40% 28,701 100.00% 28,701 4.Marissa Vogeler,Staff Analyst 111 15.00% 87,114 13,067 4.38% 573 10.21% 1,334 85.40% 11,160 100.00% 11,160 5.Victoria Verdugo,Administrative Assistant l 85.00% 46,858 39,829 4.38% 1,746 10.21% 4,068 85.40% 34,015 100.00% 34,015 6.Ana Gastelum Rivera,Program Technician II 35.00% 53,267 18,643 4.38% 817 10.21% 1,904 85.40% 15,922 100.00% 115,922 7.Vacant,Program Technician 1 0.00% 42,302 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 Subtotal 594,126 186,924 8,196 19,089 159,639 1 159,639 Medical Case Management IM 1.Rajeev Verma,MD,Public Health Physician(Extra Help) 40.00% 198,671 79,468 4.38% 3,484 10.21% 8,116 85.40% 67,868 100.00% 67,868 0.00% 0 2.Joseph Capell,MD,Public Health Physician(Extra Help) 40.00% 198,671 79,468 4.38% 3,484 10.21% 8,116 85.40% 67,868 100.00% 67,868 0.00% 0 3.Heather Maman,Supervising Public Health Nurse 72.00% 158,750 114,300 4.38% 5,012 10.21% 11,673 85.40% 97,616 94.00% 91,759 6.00% 5,857 4.Kelly Stevens,Head Nurse 75.00% 136,241 102,181 4.38% 4,480 10.21% 10,435 85.40% 87,266 94.00% 82,030 6.00% 5,236 5.Noel Almaguer,Public Health Nurse II 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 1 90,713 6.00% 5,790 6.Sandy Sue Arce,Public Health Nurse 11 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 90,713 6.00% 5,790 7.Hilary Davis,Public Health Nurse 11 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 90,713 6.00% 5,790 8.Ku Lee,Public Health Nurse II 85.00% 130,878 111,246 4.38% 4,878 10.21% 11,361 85.40% 95,007 94.00% 89,307 6.00% 5,700 9.Khamsay Vanhelsdingen,Public Health Nurse 11 85.00% 130,878 111,246 4.38% 4,878 10.21% 11,361 85.40% 95,007 94.00% 89,307 6.00% 5,700 10.Lanette Ramirez,Public Health Nurse II 85.00% 115,610 98,269 4.38% 1 4,309 10.21% 1 10,036 85.40% 83,925 94.00% 78,890 6.00% 5,035 11.Margaret Altamirano,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 12.Joseph Burgess,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 13.Quy Gip,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 14.Maribeth Jensen,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 15.Benilda Mayugba,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 16.Veronica Rayne,Staff Nurse 111 85.00% 123,578 105,041 4.38% 1 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 17.Shavonne Smith,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 18.Vivien Tagoe,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 19.Tim Yang,Staff Nurse III 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 20.Ashley Fisk,Staff Nurse 1 85.00% 80,546 68,464 4.38% 3,002 10.21% 6,992 85.40% 58,470 94.00% 54,962 6.00% 3,508 21.Vacant,Staff Nurse 1 0.00% 76,780 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 22.Jing Yang,Staff Nurse III(Extra Help) 1 0.00% 1 79,880 0 1 4.38% 1 0 10.21% 0 1 85.40% 1 0 100.00% 0 1 0.00% 0 23.Renee Chien,Occupational Therapist(Extra Help) 0.00% 81,848 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 0.00% 0 Subtotal 21899,769 2,049,002 89,843 209,253 1,749,908 1,653,064 96,844 Other Health Care Professionals 1.Ariana Salazar,Medical Social Worker 111 85.00% 94,330 80,606 4.38% 3,534 10.21% 8,232 85.40% 68,840 1 0.00% 1 0 100.00% 68,840 12 Page 1 of 3 State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division Revised 3/6/24 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 322 4.3e% Pj; Total Cases of Open(Active)Straight CCS Children CCS Administrative Budget Worksheet OTLICP- Total Cases of Open(Active)OTLICP Children 750 10.21% Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (non-OTLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 1 BB r HEALTH CARE SERVICES Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP) Children's Program(OTLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Low Income Enhanced Non-Enhanced Total Budget Straight CCS Non- Annual Caseload Children's Medi-Cal Enhanced% Medi-Cal Medi-Cal Category/Line Item %FTE Salary 11 x 2 or Caseload% Co(ntylState % Program(OTLICP) Caseload% State/Federal FTE State/Federal Enh FTEd/ State/Federal 4+5+6) (50150) Co/State/Fed (25175) (50150) (17.5117.5165) 2.Alma Garcia,Medical Social Worker II 85.00% 74,714 63,507 4.38% 2,784 10.21% 1 6,486 85.40% 54,237 1 0.00% 0 100.00% 54,237 Subtotal 169,544 144,113 6,318 14,718 123,077 0 123,077 Ancillary Support 1.Sonya Mendoza,Senior Administrative Case Worker 75.00% 69,340 52,005 4.38% 2,280 10.21% 5,311 85.40% 44,414 100.00% 44,414 2.Michael Vue,Senior Administrative Case Worker 75.00% 67,523 50,642 4.38% 2,220 10.21% 5,172 85.40% 43,250 100.00% 43,250 3.Luz Reyes,Administrative Case Worker II 80.00% 60,434 48,347 4.38% 2,120 10.21% 4,937 85.40% 41,290 100.00% 41,290 4.Rudy Constantino,Administrative Case Worker ll 80.00% 60,434 48,347 4.38% 2,120 10.21% 1 4,937 85.40% 1 41,290 100.00% 41,290 5.Tiffany Acosta,Administrative Case Worker II 80.00% 59,615 47,692 4.38% 2,091 10.21% 4,871 85.40% 40,730 100.00% 40,730 6.Yuklico Garza-Wayne,Administrative Case Worker 11 80.00% 55,725 44,580 4.38% 1,955 10.21% 4,553 85.40% 38,073 100.00% 38,073 7.Johan Flores Guzman,Administrative Case Worker II 80.00% 54,070 43,256 4.38% 1,897 10.21% 4,417 85.40% 36,942 100.00% 1 36,942 8.Jessica Ramirez,Administrative Case Worker 1 80.00% 51,374 41,099 4.38% 1,802 10.21% 4,197 85.40% 35,100 100.00% 35,100 9.Rachel)(long,Administrative Case Worker II 80.00% 47,682 38,146 4.38% 1,673 10.21% 3,896 85.40% 32,578 100.00% 32,578 10.Jalen Swank,Administrative Case Worker II 80.00% 1 47,585 38,068 4.38% 1,669 1 10.21% 3,888 85.40% 32,511 100.00% 32,511 11.Adalinn Vargas,Administrative Case Worker 1 80.00% 46,951 37,561 4.38% 1,647 10.21% 3,836 85.40% 32,078 100.00% 32,078 12.Tamaryn Norris,Administrative Case Worker 1 80.00% 42,656 34,125 4.38% 1,496 10.21% 3,485 85.40% 29,144 100.00% 29,144 13.Vacant,Administrative Case Worker l 0.00% 41,186 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 14.Felisha Delgado,Adminstrative Case Worker 1 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 15.Samantha Amescua,Administrative Case Worker l 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 16.Jose Cisneros,Administrative Case Worker l 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 17.Vacant,Administrative Case Worker l 0.00% 41,186 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 Subtotal 869,319 622,715 27,305 63,595 1 531,817 531,817 Clerical and Claims Support 1.Angel Rodriguez,Supervising Program Technician 60.00% 63,700 38,220 4.38% 1,676 10.21% 3,903 85.40% 32,641 0.00% 0 100.00% 32,641 2.Brian Casey,Office Assistant II 85.00% 47,435 40,320 4.38% 1,768 10.21% 4,118 85.40% 34,435 0.00% 0 100.00% 34,435 3.Sean Garcia,Office Assistant II 85.00% 42,400 36,040 4.38% 1,580 10.21% 3,681 85.40% 30,779 0.00% 0 100.00% 30,779 4.Vacant,Office Assistant 1 0.00% 38,078 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 5.Vacant,Office Assistant 1 0.00% 38,078 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 6.Maricela Garcia,Account Clerk ll 5.00% 56,160 2,808 4.38% 123 10.21% 287 85.40% 2,398 0.00% 0 100.00% 2,398 6.Ismene Hernandez,Office Assistant ll 5.00% 46,020 2,301 4.38% 101 10.21% 235 85.40% 1,965 0.00% 0 100.00% 1,965 Subtotal 331,871 119,689 5,248 12,224 102,218 0 102,218 Total Salaries and Wages 3,122,443 4.38% 136,904 10.21% 318,877 85.40% 2,666,659 61.99% 1,653,064 38.01% 1,013,595 Staff Benefits(Specify%) 70.00% 2,185,710 4.38% 95,833 10.21% 223,214 85.40% 1,866,663 1,157,146 709,517 I.Total Personnel Expense 5,308,153 4.38% 232,737 10.21% 1 542,091 1 85.40% 4,533,322 2,810,210 1,723,112 It.Operating Expense 1.Travel 600 4.38% 26 10.21% 61 85.40% 512 61.99% 317 38.01% 195 2.Training 500 4.38% 22 10.21% 51 85.40% 427 61.99% 265 38.01% 162 3.Office E)penses and Printing 12,909 4.38% 566 10.21% 1,318 85.40% 11,025 1 100.00% 1 11,025 13 Page 2 of 3 Slate of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division Revised 3/624 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 6, Total Cases of Open(Active)Straight CCS Children 322 4.38% CCS Administrative Budget Worksheet f ) TLICP-T 750 10.2t% Total Cases of Open(Active)0TLICP Children Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (n on-0TLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 100 i HEALTH CARE SERVICES _i ht CCS Optional Targeted Low Income g Children's Program(0TLICP) Medi-Cal(Non-0TLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Total Budget Straight CCS Low Income Enhanced Non-Enhanced Annual caseload Children's Medi-Cal Enhanced% Medi-Cal NOn. Medi-Cal Category/Line Item %FTE Salary 11 x 2 or caseload Y. county/State % program(0TLICP) Caseload% State/Federal FTE State/Federal Enhanced N. SIM diederal 4+5+6 )(50150 Co/State/Fed (25175) FTE 150/50) (17.5117.5/65) 4.Postage 13.000 4.38% 570 10.21% 1.328 85.40% 11,102 100.00% 11,102 5.Small Tools B Instruments 315 4.38% 14 10,21% 32 85.40% 1 269 100.00% 1 269 6.Household Expenses 12,600 4.38% 552 10.21% 1,287 85.40% 10,761 100.00% 10,761 7.Maintenance-Equipment 8Security Services 15,000 4.38% 658 10.21% 1,532 85.40% 12,810 100.00% 12,810 8.Facility Services and Utilities 85,000 4.38% 3,727 10.21% 8,681 85,40% 72,593 100.00% 72,593 9.Data Processing Services 60,000 4.38% 2,631 10.21% 6,127 85.40% 51,242 100.00% 51,242 10.Translation Services 3,000 4.36% 132 10.21% 1 306 85.40% 2,562 100.00% 2,562 It.Total Operating Expense 202,924 8,898 20,723 173,303 582 172,721 III.Capital Expense 1. 4.38% 0 10.21% 0 85.40% 1 0 0 2. 4.38% 0 10.21% 0 85,40% 0 0 3. 4.38% 0 10.21% 0 85.40% 0 0 Ill.Total Capital Expense 0 0 0 0 0 IV.Indirect Expense 1.Indirect Cost Rate 24.47% 1,298,905 4.38% 56,951 10.21% 132.650 85.40% 1,109,304 100.00% 1,109,304 0 14.38% 0 10.21% 0 85.40% 0 1100.00% 0 IV.Total Indirect Expense 1,298,905 56,951 132,650 11,109,304 1,109,304 V.Other Expense 1.Maintenance 8 Transportation 5,000 4.38% 1 219 10.21% 511 85.40% 4,270 100.00% 4,270 2.CRISS Council Membership 6,700 4.38% 294 10.21% 6B4 85.40% 5,722 100.00% 5,722 V.Total Other Expense 11,700 513 1,195 9,992 9,992 Budget Grand Total 6,821,682 299,099 696,659 5,825,921 2,810,792 3,015,129 1.l Vw•�A/ Kristeena Bump Staff Analyst 711/2025 (559)600-6521 Prepared By IS' to Prepared By(Printed Name) Date Prepared Phone Number I I�lzoz� C Pilar Vasquez Division Manager (559)600-6595 CCS Administrator(Signature) CCS Administrator(Printed Name) Date Signed Phone Number 14 Page 3 of 3 Slate of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division Revised 316124 Percent of Total CCS ,�H CS CCS CASELOAD Actual Caseload Caseload CALIFORNIA DEPARTMENT OF STRAIGHT CCS- HEALTH CARE SERVICES Total Cases of Open(Active)Straight CCS Children 322 4.38% CCS Administrative Budget Summary OTLICP- 750 10.z1 i Total Cases of Open(Active)OTLICP Children Fiscal Year: 2025-26 MEDI-CAL- 6272 85.40% Total Cases of Open(Active)Medi-Cal non-OTLICP)Children County: Fresno County TOTAL CCS CASELOAD 7344 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 Enhadi-Cal Non-Enhanced Medi- Category/Line Item Total Budget County/State Program(OTLICP) Medi-Cal State/Federal State/Federalnced Me dl-Cal) Cal StatelFederal (50/60) County/State/Fed (50150) (17.5117.5165) I. Total Personnel Expense 5,308.153 232,737 542,091 4,533.322 2,810,210 1,723,112 If.Total Operating Expense 2D2,924 8.898 20,723 173,303 582 172,721 Ill.Total Capital Expense 0 0 0 0 0 IV.Total Indirect Expense 1,298,905 66.951 132.650 1,109,304 1,109.304 V.Total Other Expense 11,700 513 1,195 9.992 9,992 Budget Grand Total 6,821,682 299.099 696,659 5,825,921 2,810,792 3,015,129 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 Chi I' Non-Enhanced Medi- Source of Funds Total Budget County/State Program(OTLICP) Medi-Cal State/Federal Enhanced Medi-Cal Cal StatelFederal (50150) County/State/Fed State/Federal(25/75) (SOISD) (17.5/17.5165) Straight CCS State 149,549 149,549 County 149,550 149,550 OTLICP State 121,915 121,915 County 121,915 121,915 Federal(Title XXI) 452,829 452,829 Medi-Cal State 2,210,263 2.210,263 702,698 1,507,565 Federal(Title XIX) 3,615,658 3,615,658 2,108,094kAX 1,507,564 . p1JJAA) Kristeena Bump Staff Analyst kbumD aa)fresnocountyca aov Prepared B Signa re) Prepared By(Printed Name) Email Address Pilar Vasquez Division Manager PvasquezCcDfresnocountyca.qov CCS Administrator(Signature) CCS Administrator(Printed Name) Email Address 15 Page 1 of 1 Budget Justification Narrative Integrated Systems of Care Division County Budget Narrative Fiscal Year 2025-2026 I.PERSONNEL EXPENSES Identify and explain any changes in Personnel including FTE percentage changes. Salaries remain relatively the same as previous FY,with a 0.002%increase. Total Salaries: $3,122,443 Salaries include actual annual salaries with cost of living adjustments however,FTEs were lowered in all classifications to meet the allocation. Total Benefits: $2,185,710 Staff benefits remain the same as previous FY.This estimate was reached by using an average of the actual County benefts budgeted for this fiscal year. Total Personnel Expenses: $5,308,153 To meet allocation,FTEs were reduced by 2%from previous FY.A total of 1.8 FTE of Program Administration were moved to the M&O budget to Program Administration perform M&O activities. Medical Case Management To meet allocation,FTEs of Physicians and Nurses were reduced by 9%from previous FY. Other Health Care Professionals To meet allocation,FTEs were reduced by 4%from previous FY. Ancillary Support With vacant positions filled,FTEs were increased by 24%from previous FY. Clerical and Claims Support To meet allocation,FTEs were reduced by 34%from previous FY. II.OPERATING EXPENSES List all Operating Expense line items.Identify and explain any increase, decrease,or newly listed line item. Travel $600 Travel expenses are reduced by 40%from previous FY. Training $500 There is no change to training expense from previous FY. Office Expense and Printing $12,909 To meet allocation,office expenses and printing expenses are reduced by 22%from previous FY. Postage $13,000 To meet allocation,postage expenses are reduced by 21%from previous FY. Small Tools&Instruments $315 Small tools expenses are reduced by 79%from previous FY. Household Expenses $12,600 There is no change to household expenses from previous FY. Maintenance-Equipment&Security Services $15,000 To meet allocation,maintenance-equipment and security services expenses are reduced by 28%from previous FY. Facility Services and Utilities $85,000 To meet allocation,facility services and utilities expensesare reduced by 12%from previous FY. Data Processing Services $60,000 To meet allocation,data processing services expenses are reduced by 12%from previous FY. Translation Services $3,000 There is no change to translation services expenses from previous FY. Total Operating Expenses: $202,924 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% $1,298,905 Fresno County approved indirect cost rate for 2024-25 is 24.47%.This is a 0.03% from previous FY. B.External Total Indirect Expenses: $1,298,905 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. Maintenance and Transportation $5,000 There is no change to maintenance and transportation expenses from previous FY. Student Internship $6,700 There is no change on the budget for CRISS Membership from previous FY. Total Other Expenses: $11,700 Bud et Grand Total $6,821,682 16 CALIFORNIA DEPARTMENT OF huHCS HEALTH CARE SERVICES California Children's Services(CCS)Monitoring&Oversight(M&O) Agency Information County: Fiscal Year: Fresno 2025-26 Street Address: 1221 Fulton Street City: Fresno Central Email Address: ccs@fresnocountyca.gov Zip Code: 93721 Director Deputy Director Name,Title: David Luchini, Director Name: Joe Prado,Assistant Director Phone: 559 600-6401 Phone: 559 600-6402 Email: d1uchini@fresnocountyca.gov Email: jprado@fresnocountyca.gov List All Program Staff(CCS M&O) Name: Position/Classification: Email: Pilar Vasquez Division Manager pvasquez@fresnocountyca.gov Harsharn Dhillon-Wood Rehabilitative Therapy Manager hdhillon@fresnocountyca.gov Marissa Vo eler Staff Analyst III mvogeler@fresnocountvca.gov Kristeena Bump Staff Analyst I kbump@fresnocountyca gov Angel Rodriguez Supervising Program Technician rodriguezang@fresnocountvca.gov Ana Gastelum Rivera Program Technician II Ana Rivera1@fresnocountyca.gov Additional rows may be added above this line. Authorized Direct :David Luchini,RN,Pubfc Health Signature and Date: Director 1/ J Zbv 17 CALIFORNIA DEPARTMENT OF RoHCS HEALTH CARE SERVICES California Children's Services (CCS) Monitoring &Oversight(M&O) Budget Worksheet County/City Name: Fiscal Year: Fresno 2025-26 I. Personnel Expenses Total FTE % Annual Salary Total Budget # Name Position Classification 1 Pilar Vasquez Division Manager 25% $148,686 $37,172 2 Harsharn Dhillon-Wood Rehabilitative Therapy Manager 10% $148,685 $14,869 3 Marissa Vo eler Staff Analyst III 75% $87,114 $65,336 4 Kristeena Bump Staff Analyst 1 20% $67,214 $13,443 5 An el Rodri uez Supervising Program Technician 20% $63,700 $12,740 6 Ana Gastelum Rivera Program Technician II 50% $53,267 $26,634 7 0 0 0% $0 $0 8 0 0 0% $0 $0 9 0 0 0% $0 $0 100 10 1 0% $0 $0 (insert additional rows above this line as needed) Total Support Staff FTE % 2.00 Total Net Salaries and Wages $170,192 Staff Benefits(Specify%) 70% $119,134 I.Total Personnel Expenses $289,326 11. Total Operating Expenses (Provide Details in Narrative) $2,672 III.Total Capital Expenses (Provide Details in Narrative) $0 IV. Indirect Expenses (Provide Details in Narrative) 1. Internal (Specify%) 24% $70,798 2. External (Specify%) 0% $0 IV.Total Indirect Expenses (Provide Details in Narrative) $70,798 V.Total Other Expenses (Provide Details in Narrative) $0 Budget Grand Total $362,796 1 certify under penalty of perjury under the laws of the State of California that the forgoing information is,to the best of my knowledge, information and/or belief,that the information submitted is true, accurate,and complete, and that the corresponding documents and records are available and accessible to the California Department of Health Care Services(DHCS)upon request. In addition, that the county California Children's Services(CCS)program will comply with all applicable federal and state laws and regulations, including those governing recipients of federal funds granted to states for medical assistance.Additionally, county CCS program will adhere to all rules set forth by DHCS under these authorities, including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual. I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§ 12650)if it fai o co ply with the a ve requirements. A11A A -7 A? Authorized Director: David Luchini, RN, Public a rid a Health Director 18 CALIFORNIA DEPARTMENT OF 141wHCS HEALTH CARE SERVICES State of California—Health and Human Services Agency Department of Health Care Services California Children Servies(CCS)Monitoring&Oversight(M&O) Budget Narrative County/City Name: Fiscal Year: Fresno �2025-26 I.Personnel Expenses:Identify Personnel Expenses, specifying roles and M&O activities, time allocations, and costs supporting M&O activities. 1. Pilar Vasquez-Division Manager:As CCS Administrator and designated Deputy Director for the M&O activities, she will be the lead in identiying the needs for the program to implement the Monitoring and Oversight(M&O)reporting; monitors status of all activities related to M&O activities and M&O implementation;and reviews and approves all developed and revised program workflows, PPGs and all related fiscal deliverables. 2. Harsharn Dhillon-Wood-Rehabilitative Therapy Manager:Assist CCS Administrator is establishng new and revised workflows to conform with the M&O requirements. 3. Marissa Vogeler-Staff Analyst III:Assist CCS Administrator in monitoring and tracking the progress of M&O activities and expenditures;assist in establishing new processes; prepares needed PPGs and reviews and makes recommendations on all fiscal related deliverables 4. Kristeena Bump-Staff Analyst I:Assist CCS Administrator in monitoring and tracking the progress of M&O activities and expenditures;assist in establishing new processes;prepares needed PPGs and reviews and makes recommendations on all fiscal related deliverables. Prepare and organize required M&O documents for submission to DHCS. 5.Angel Rodriguez-Supervising Program Technician:Takes lead on data gathering, preparation of new logs and templates in relation to new PPGs and assist in establishing new workflows and guidances. 6.Ana Gastelum Rivera-Program Technician II: Exporting reports, gathering data,entering necessary M&O data in new logs and templates in preparation for submission to DHCS. II.Operating Expenses: Identify and explain all expenses included in the"Operating Expenses"line item of the Budget Worksheet. There will be a$2,672 expense for incurred Data Processing expenditures during the M&O activities. III.Capital Expenses: Identify and explain all expenses included in the in the "Capital Expenses"line item of the Budget Worksheet. No Capital Expenses will be incurred under the M&O allocation. IV.Indirect Expenses: Identify and explain all expenses included in the"Indirect Expenses"line items(Internal and External)of the Budget Worksheet. An Indirect Cost Rate(ICR)OF 24.47%wil be applied to the Total Personnel Expenses under the M&O Internal: allocation. The FY 2025-26 CDPH's approved County ICR is 24.47%. External: V.Other Expenses: Identify and explain all expenses included in the"Other Expenses"line item of the Budget Worksheet. No other expenses will be incurred under the M&O allocation. I certify under penalty of perjury under the laws of the State of California that the forgoing information is,to the best of my knowledge,information and/or belief,that the information submitted is true,accurate,and complete,and that the corresponding documents and records are available and accessible to the California Department of Health Care Services(DHCS)upon request.In addition,that the county California Children's Services (CCS)program will comply with all applicable federal and state laws and regulations,including those governing recipients of federal funds granted to states for medical assistance.Additionally,county CCS program will adhere to all rules set forth by DHCS under these authorities,including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual.I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§12650)if it fails to comply with the above requirements. Authorized Director: David Luchini, RN, Public Health Signature: Director Vf 19 CALIFORNIA DEPARTMENT OF H C SHEALTH CARE SERVICES State of California—Health and Human Services Agency Department of Health Care Services California Children Servies (CCS) Monitoring & Oversight(M&O) Budget Summary County Name Fiscal Year Fresno 2025-26 Category/Line Item Total Budget I. Total Personnel Expenses $289,326 II. Total Operating Expenses $2,672 III. Total Capital Expenses $0 IV. Total Indirect Expenses $70,798 V. Total Other Expenses $0 Budget Grand Total $362,796 I certify under penalty of perjury under the laws of the State of California that the forgoing information is, to the best of my knowledge, information and/or belief, that the information submitted is true, accurate, and complete, and that the corresponding documents and records are available and accessible to the California Department of Health Care Services (DHCS) upon request. In addition, that the county California Children's Services (CCS) program will comply with all applicable federal and state laws and regulations, including those governing recipients of federal funds granted to states for medical assistance. Additionally, county CCS program will adhere to all rules set forth by DHCS under these authorities, including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual. I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§ 12650) if it fails to comply with the above requirements. Authorized Director: David Luchini, RN, Public Health Signatu e d Dat Director 20 FY 2025-26 Retroactive California Department of Health Care Services Allocation for Fresno County California Children's Services (CCS) Program Allocation: FY 2025-26 CMS Plan and Budget for CCS FY 2025-26 CCS Monitoring and Oversight Budget Fund/Subclass: 0001/10000 Organization: 56201600 Revenue Account No.: 3505, 4380 21 RD H C S CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES Michelle Baass I Director DATE: July 1, 2025 CCS Information Notice: 25-02 TO: CALIFORNIA CHILDREN'S SERVICES PROGRAM ADMINISTRATORS FISCAL YEAR 2025-2026 COUNTY ALLOCATIONS FOR CALIFORNIA CHILDREN'S SERVICES COUNTY SUBJECT: ADMINISTRATION, COMPLIANCE MONITORING AND OVERSIGHT The purpose of this California Children's Services (CCS) Information Notice is to provide County CCS Programs with their CCS Program County Administrative and Compliance Monitoring and Oversight (M&O) approved budget allocations for fiscal year (FY) 2025-26. The Department of Health Care Services (DHCS) will not issue individual county budget notices. The allocation for the Medical Therapy Program (MTP) will be issued separately on or around August 1, 2025, following receipt and review of county-submitted baseline budgets. DHCS calculated the FY 2025-26 CCS Administrative and M&O allocations as follows: • CCS Administrative Allocation: This allocation is based on each county's average expenditures during FY 2020-21 through FY 2023-24 and the counties' average caseload for calendar year (CY) 2024. • CCS M&O Allocation: This allocation is based on each county's average caseload for CY 2024. Each county remains responsible for overseeing and tracking their administrative budget 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). California Department of Health Care Services State of California Integrated Systems of Care Division Gavin Newsom, Governor 1501 Capitol Ave I Sacramento,CA 1 95899-7437 MS 45021 Phone(916)449-5005 1 www.dhcs.ca.gov California Health and Human Services Agency CCS Information Notice: 25-02 July 1, 2025 Page 2 of 8 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 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 that opt to participate in the new CCS M&O activities by submitting their County Quarterly and Annual Reports will be eligible to invoice for additional CCS M&O allocations. To be eligible for the M&O allocations, counties must (1) inform DHCS of their intent to submit the reports and (2) submit a budget outlining how the funds will be used to support the new monitoring and oversight activities. 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, 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 Expenditures, 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 budgets for FY 2025-26 within sixty (60) days from the date of this Information Notice. Submissions must be made electronically through the ISCD Budget Portal at: https://iscdbudget.cloudapps.dhcs.ca.gov/. The most recent versions of PFG Sections 6 and 7—Budget Submission and Expenditure Claims—are also available for download through the portal. CCS Information Notice: 25-02 July 1, 2025 Page 3 of 8 Sincerely, ORIGINAL SIGNED BY Joseph Billingsley, Assistant Deputy Director Health Care Delivery Services Department of Health Care Services Attachments: Attachment A: CCS Administrative Allocation Attachment B: CCS Monitoring and Oversight Allocation CCS Information Notice: 25-02 July 1, 2025 Page 4 of 8 Attachment A CCS ADMINISTRATIVE ALLOCATION FY 2025-26 • CCS ADMIN TOTAL • • • • • • • • • ONLY N GF ONLY (TITLE 21) GF/FF)*** FF ONLY] ON 1 Alameda $666,865 $1,337,267I $293,799I $1,043,468 $8,608,191 I $3,710,052I $4,898,139 2 Alpine $103,828 1 $0 $0 $0 $132,618 $22,971 $109,648 3 Amador $105,597 1 $68,857 $34,558 $34,299 $240,686 $81,551 $159,135 4 Butte $120,699 $137,914 $48,479 $89,435 $947,581 $398,583 $548,997 5 Calaveras $105,320 1 $49,331 $30,654 $18,676 $143,995 $29,839 $114,156 6 Colusa $125,959 $97,641 $40,490 $57,151 $256,628 $89,782 $166,846 7 Contra Costa $386,221 $727,081 $167,460 $559,621 $4,965,265 $1,908,897 $3,056,368 8 Del Norte $114,281 $50,827 $30,991 $19,836 $172,372 $46,423 $125,949 9 El Dorado $120,483 $115,898 $44,046 $71,852 $528,433 $183,891 $344,542 10 Fresno $203,414 1 $569,000 $135,701 $433,299 $6,049,268 $2,447,493 $3,601,775 11 Glenn $104,823 $71,706 $35,194 $36,512 $271,509 $88,636 $182,873 12 Humboldt $121,166 $92,525 $39,502 $53,023 $532,591 $205,181 $327,411 13 Imperial $123,517 $95,362 $40,048 $55,314 $592,453 $230,556 $361,897 14 Inyo $106,978 1 $51,502 $31,154 $20,348 $170,812 $36,146 $134,666 15 Kern $339,738 $405,212 $102,682 $302,530 $3,762,890 $1,560,664 $2,202,226 16 Kings $114,283 1 $99,521 $40,681 $58,840 $545,251 $194,933 $350,318 17 Lake $103,620 $55,057 $31,765 $23,292 $202,603 $57,574 $145,029 18 Lassen $103,552 1 $44,294 $29,659 $14,635 $123,367 $20,753 $102,614 19 Los Angeles $1,832,287 $4,282,136 $885,009 $3,397,128 $40,473,412 $15,175,075 $25,298,337 20 Madera $127,240 $161,769 $53,511 $108,258 $1,178,326 $515,084 $663,242 21 Marin $127,856 1 $127,374 $46,382 $80,992 $637,945 $278,119 $359,825 22 Mariposa $106,695 $46,813 $30,181 $16,632 $156,364 $38,038 $118,326 23 Mendocino $124,1391 $84,441 $38,044 $46,3981 $375,418 $148,968 $226,450 CCS Information Notice: 25-02 July 1, 2025 Page 5 of 8 IF MC/OTLUP MC/ MC/ • OUNTY • • •N* ALLOCATION ALLOCATIONONLY GF ONLY ONLY ONLY r (GF/FF) (GF/FF) 24 Merced $116,5291 $202,480 $61,623 $140,857 $1,207,695 $528,857 $678,839 25 Modoc $122,198 1 $48,921 $30,630 $18,291 $151,801 $33,349 $118,453 26 Mono $122,094 $91,702 $39,327 $52,375 $265,868 $81,811 $184,057 27 Monterey $119,613 1 $145,874 $50,181 $95,693 $1,077,751 $410,002 $667,749 28 Napa $148,649 $160,825 $54,049 $106,776 $581,085 $200,565 $380,520 29 Nevada $121,600 1 $106,945 $41,641 $65,305 $427,480 $161,578 $265,902 30 Orange $339,111 $1,001,099 $224,538 $776,561 $5,556,724 $2,439,666 $3,117,058 31 Placer $148,588 1 $294,709 $76,801 $217,908 $1,451,795 $601,225 $850,569 32 Plumas $106,045 $50,833 $30,960 $19,873 $129,062 $20,064 $108,998 33 Riverside $356,052 1 $1,485,687 $322,050 $1,163,636 $11,023,909 $4,457,182 $6,566,727 34 Sacramento $236,696 $983,229 $214,854 $768,375 $7,443,061 $2,992,085 $4,450,977 35 San Benito $109,931 $58,882 $32,511 $26,371 $196,921 $59,205 $137,716 36 San Bernardino $286,557 $1,380,276 $298,873 $1,081,403 $11,043,087 $4,705,053 $6,338,033 37 San Diego $542,748 1 $1,837,332 $393,912 $1,443,419 $12,710,607 $5,500,006 $7,210,601 38 San Francisco $195,9861 $488,144 $117,546 $370,597 $3,171,040 $1,367,383 $1,803,657 39 San Joaquin $176,541 $664,288 $155,167 $509,121 $3,918,336 $1,675,500 $2,242,836 40 San Luis Obispo $138,776 $147,598 $50,397 $97,201 $731,563 $294,408 $437,155 41 San Mateo $197,465 1 $200,791 $61,093 $139,698 $1,218,662 $496,829 $721,833 42 Santa Barbara $130,571 $155,021 $51,975 $103,046 $837,597 $335,775 $501,822 43 Santa Clara $510,608 $1,367,354 $297,046 $1,070,308 $8,065,409 $3,163,254 $4,902,155 44 Santa Cruz $118,630 1 $119,973 $44,782 $75,191 $761,441 $298,203 $463,238 45 Shasta $486,280 $151,300 $51,509 $99,791 $908,161 $411,129 $497,032 46 Sierra $0 $0 $0 $0 $120,684 $19,226 $101,457 47 Siskiyou $108,048 1 $54,943 $31,833 $23,110 $225,578 $67,114 $158,463 CCS Information Notice: 25-02 July 1, 2025 Page 6 of 8 OTLICPMC/OTLICP MCI MCI COUNTYOTLICPCCS ADMIN TOTAL • • • • • • ONLY ONLY ONLY ONLY 48 Solano $124,165 $160,814 $53,244 $107,570 $953,670 $333,747 $619,923 49 Sonoma $149,290 $367,662 $95,668 $271,994 $1,494,538 $649,964 $844,574 50 Stanislaus $155,249 $381,925 $98,016 $283,909 $2,510,895 $1,080,116 $1,430,779 51 Sutter $110,722 $117,123 $44,483 $72,640 $647,655 $229,271 $418,384 52 Tehama $110,210 $60,855 $32,197 $28,658 $241,503 $81,233 $160,270 53 Trinity $103,915 $46,089 $30,043 $16,046 $138,470 $28,642 $109,828 54 Tulare $140,239 $298,289 $81,032 $217,257 $3,071,479 $1,311,038 $1,760,441 55 Tuolumne $107,136 $66,234 $34,232 $32,002 $259,519 $75,727 $183,792 56 Ventura $203,167 $716,060 $166,183 $549,877 $4,120,240 $1,770,146 $2,350,094 57 Yolo $127,357 $152,850 $51,757 $101,093 $731,758 $296,351 r $435,407 58 Yuba $107,673 $86,659 $38,142 $48,517 $505,683 $178,439 $327,24Fstatewide j $5,688,285 $16,73 $63,823,33 $95,1 *CCS State Only Administrative Allocation: This allocation is based on each county's average expenditures during FY 2020-21 through FY 2023-24 and the counties'average CCS Only caseload for calendar year(CY) 2024. **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 2020-21 through FY 2023-24 and the counties'average caseload for CY 2024. ***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 2020-21 through FY 2023-24 and the counties'average caseload for CY 2023. CCS Information Notice: 25-02 July 1, 2025 Page 7 of 8 Attachment B CCS MONITORING AND OVERSIGHT ALLOCATION FY 2025-26 MonitoringCCS : Oversightounty 1 Alameda $337,192 2 Alpine $35,652 3 Amador $41,635 4 Butte $77,806 5 Calaveras $43,537 6 Colusa $44,592 7 Contra Costa $238,491 8 Del Norte $37,555 9 El Dorado $61,463 10 Fresno $362,796 11 Glenn $44,959 12 Humboldt $59,354 13 Imperial $108,299 14 Inyo $37,073 15 Kern $336,096 16 Kings $79,502 17 Lake $48,902 18 Lassen $37,715 19 Los Angeles $2,022,545 20 Madera $100,821 21 Marin $60,661 22 Mariposa $37,188 23 Mendocino $50,919 24 Merced $112,103 26 Modoc $36,409 26 Mono $39,640 27 Monterey $110,935 28 Napa $53,509 29 Nevada $51,377 M30 Orange $426,401 31 Placer $86,035 CCS Information Notice: 25-02 July 1, 2025 Page 8 of 8 7R • 32 Plumas $37,440 33 Riverside $651,418 34 Sacramento $360,832 35 San Benito $46,931 36 San Bernardino $675,217 37 San Diego $696,620 38 San Francisco $113,929 39 San Joaquin $211,902 40 San Luis Obispo $69,396 41 San Mateo $84,456 42 Santa Barbara $118,959 43 Santa Clara $329,166 44 Santa Cruz $66,530 45 Shasta $65,980 46 Sierra $35,744 47 Siskiyou $43,446 481 Solano $89,087 491 Sonoma $87,094 50 Stanislaus $217,307 51 Sutter $71,961 52 Tehama $58,552 53 Trinity $36,661 54 Tulare $301,932 55 Tuolumne $43,698 56 Ventura $271,218 57 Yolo $63,067 58 Yuba $68,294 FY 2025-26 Retroactive California Department of Health Care Services Allocation for Fresno County California Children's Services (CCS) Program Allocation: FY 2025-26 CMS Plan and Budget for CCS FY 2025-26 CCS Monitoring and Oversight Budget Fund/Subclass: 0001/10000 Organization: 56201600 Revenue Account No.: 3505, 4380 Plan and Budget Required Documents Checklist MODIFIED FY 2025-26 County/City: Fresno Fiscal Year: 2025-26 Document Page Number 1. Checklist 1 - 2 2. Agency Information Sheet 3 3. Certification Statements 4 4. Agency Description A. Brief Narrative 5 B. Organizational Charts 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. Data Forms A. CCS Caseload Summary 11 6. Memoranda of Understanding and Interagency Agreements List A. MOU/IAA List N/A B. New, Renewed, or Revised MOU or IAA N/A 7. Budgets A. CCS Administrative Budget 1. Budget Worksheet 12 - 14 2. Budget Summary 15 3. Budget Justification Narrative 16 B. CCS Monitoring and Oversite Budget 1. Agency Information 17 2. Budget Worksheet 18 3. Budget Narrative 19 1 County/City: Fresno Fiscal Year: 2025-26 Document Page Number 4. Budget Summary 20 G.. Other Forms 1. County/City Capital Expenses Justification Form N/A 2. County/City Other Expenses Justification Form N/A 8. 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: 2025-26 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(@_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: 2025-26 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 wi ply. Sign at re of CCS Admini or Date Signed ature o Dire or r Health 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 4 CMS PLAN Fiscal Year 2025-26 Agency Description Fresno County's California Children's Services (CCS) program is housed in the County of Fresno, Department of Public Health, under the Children's Medical Services (CMS) 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: 2025-26 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 45% No No Rehabilitation Therapy Manager Harsharn Dhillon Wood 10% No No Staff Analyst I Kristeena Bump 50% No No Staff Analyst III Marissa Vogeler 15% No No Administrative Assistant Victoria Verdugo 85% No No Program Technician II Ana Gastelum Rivera 35% 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) Program Technician I Vacant 0% No No Public Health Physician Dr. Rajeev Verma 40% No No Public Health Physician Dr. Joseph Capell 40% No No Supervising Public Health Nurse Heather Maraan 72% No No Head Nurse Kelly Stevens 75% No No Public Health Nurse 11 Noel Almaguer 85% No No Public Health Nurse 11 Sandy Sue Arce 85% No No Public Health Nurse II Hilary Davis 85% No No Public Health Nurse II Ku Lee 85% No No Public Health Nurse II Khamsay Vanhelsdingen 85% No No Public Health Nurse II Lanette Ramirez 85% No No Staff Nurse III Margaret Altamirano 85% No No Staff Nurse III Joseph Burgess 85% No No Staff Nurse III Quy Gip 85% 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 Maribeth Jensen 85% No No Staff Nurse III Belinda Mayugba 85% No No Staff Nurse III Veronica Reyna 85% No No Staff Nurse III Shavonne Smith 85% No No Staff Nurse III Vivien Tagoe 85% No No Staff Nurse III Tim Yang 85% No No Staff Nurse I Ashley Fisk 85% No No Staff Nurse I Vacant polo No No Staff Nurse III (Extra Help) Jing Yang 0% No No Occupational Therapist III (Extra Renee Chien 0% No No Help) Medical Social Worker III Ariana Salazar 85% No No Medical Social Worker II Alma Garcia 85% No No Senior Administrative Case Worker Sonya Mendoza 75% No No Senior Administrative Case Worker Michael Vue 75% 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) Administrative Case Worker II Luz Reyes 80% No No Administrative Case Worker II Rudy Constantino 80% No No Administrative Case Worker II Tiffany Acosta 80% No No Administrative Case Worker II Yuidico Garza-Wayne 80% No No Administrative Case Worker II Johana Flores Guzman 80% No No Administrative Case Worker I Jessica Ramirez 80% No No Administrative Case Worker 11 Rachel Xiong 80% No No Administrative Case Worker 11 Jalen Swank 80% No No Administrative Case Worker I Adalinn Vargas 80% No No Administrative Case Worker I Tamaryn Norris 80% No No Administrative Case Worker I Vacant 0% No No Administrative Case Worker I Felisha Delgado 80% No No Administrative Case Worker I Samantha Amescua 80% No No Administrative Case Worker I Jose Cisneros 80% No No Administrative Case Worker I Vacant 0% 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) Supervising Program Technician Angel Rodriguez g0% No No Office Assistant II Briana Casey 85% No No Office Assistant I Sean Garcia 85% No No Office Assistant I Vacant 0% No No Office Assistant I Vacant 0% No No Account Clerk II Maricela Garcia 5% No No Office Assistant II Ismene Hernandez 5% No No 10 Children's Medical Services Plan and Fiscal Guidelines California Children's Services Caseload Summary Form County: Fresno Fiscal Year: 2025-26 A B 25-26 CCs 23-24 %of 24-25 %of Estimated %of Caseload 0 Actual Grand Actual Grand Caseload Grand to 21 Years Caseload Total Caseload Total based on first Total month MEDI-CAL Average of Total Open (Active)Medi-Cal 6,342 84% 6,215 84% 6,102 84% 1 Children Potential Case Medi-Cal 24 0.3% 26 0.4% 22 0.3% 2 TOTAL MEDI-CAL 6,366 85% 6,241 84% 6,124 84% 3 (Row 1 + Row 2) NON MEDI-CAL OTLICP Average of Total Open 4 (Active)OTLICP 729 10% 767 10% 809 11% Potential Cases 66 0. ° 5 OTLICP 9% 3 0.04/ 3 0.04/Total OTLICP (Row 4 795 11% ° ° 6 + Row 5) 770 10% 812 11/ Straight CCS Average of Total Open (Active)Straight CCS 282 4% 331 4% 273 4% 7 Children Potential Cases Straight 71 0 9% ° ° g CCS Children 68 0.9/ 58 0.8/ Total Straight CCS 353 5% 399 5% 331 5% 9 (Row 7 + Row 8) TOTAL NON MEDI-CAL 1,148 15% 1,169 16% 1,143 16% 10 (Row 6 + Row 9) GRAND TOTAL (Row 3 + Row 10) 7,514 100% 7,410 100% 7,267 100% 11 11 State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division Revised 3/6/24 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 322 4.36% Pj; Total Cases of Open(Active)Straight CCS Children CCS Administrative Budget Worksheet OTLICP- Total Cases of Open(Active)OTLICP Children 750 10.21% Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (non-OTLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 100% HEALTH CARE SERVICES Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP) Children's Program(OTLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Low Income Enhanced Non-Enhanced Total Budget Straight CCS Non- Annual Caseload Children's Medi-Cal Enhanced/ Medi-Cal Medi-Cal Category/Line Item %FTE Salary (1 x 2 or Caseload/ CountylState % Program(OTLICP) Caseload% State/Federal FTE State/Federal Enh FTEd/ State/Federal 41 5+6) (50/50) Co/State/Fed (25175) (50150) (17.5117.5/65) I.Personnel Expense Program Administration 1.Pilar Vasquez,Administrator(Division Manager) 45.00% 148,686 66,909 4.38% 2,934 10.21% 6,833 85.40% 57,142 100.00% 57,142 2.Harsharn Dhillon-wood,Rehabilitative Therapy Manager 10.00% 148,686 14,869 4.38% 652 10.21% 1,518 85.40% 12,699 100.00% 12,699 3.Kristeena Bump,Staff Analyst l 50.00% 67,214 33,607 4.38% 1,474 10.21% 3,432 85.40% 28,701 100.00% 28,701 4.Marissa Vogeler,Staff Analyst 111 15.00% 87,114 13,067 4.38% 573 10.21% 1,334 85.40% 11,160 100.00% 11,160 5.Victoria Verdugo,Administrative Assistant l 85.00% 46,858 39,829 4.38% 1,746 10.21% 4,068 85.40% 34,015 100.00% 34,015 6.Ana Gastelum Rivera,Program Technician II 35.00% 53,267 18,643 4.38% 817 10.21% 1,904 85.40% 15,922 100.00% 115,922 7.Vacant,Program Technician 1 0.00% 42,302 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 Subtotal 594,126 186,924 8,196 19,089 159,639 1 159,639 Medical Case Management IM 1.Rajeev Verma,MD,Public Health Physician(Extra Help) 40.00% 198,671 79,468 4.38% 3,484 10.21% 8,116 85.40% 67,868 100.00% 67,868 0.00% 0 2.Joseph Capell,MD,Public Health Physician(Extra Help) 40.00% 198,671 79,468 4.38% 3,484 10.21% 8,116 85.40% 67,868 100.00% 67,868 0.00% 0 3.Heather Maman,Supervising Public Health Nurse 72.00% 158,750 114,300 4.38% 5,012 10.21% 11,673 85.40% 97,616 94.00% 91,759 6.00% 5,857 4.Kelly Stevens,Head Nurse 75.00% 136,241 102,181 4.38% 4,480 10.21% 10,435 85.40% 87,266 94.00% 82,030 6.00% 5,236 5.Noel Almaguer,Public Health Nurse II 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 1 90,713 6.00% 5,790 6.Sandy Sue Arce,Public Health Nurse 11 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 90,713 6.00% 5,790 7.Hilary Davis,Public Health Nurse 11 85.00% 132,938 112,997 4.38% 4,954 10.21% 11,540 85.40% 96,503 94.00% 90,713 6.00% 5,790 8.Ku Lee,Public Health Nurse II 85.00% 130,878 111,246 4.38% 4,878 10.21% 11,361 85.40% 95,007 94.00% 89,307 6.00% 5,700 9.Khamsay Vanhelsdingen,Public Health Nurse 11 85.00% 130,878 111,246 4.38% 4,878 10.21% 11,361 85.40% 95,007 94.00% 89,307 6.00% 5,700 10.Lanette Ramirez,Public Health Nurse II 85.00% 115,610 98,269 4.38% 1 4,309 10.21% 1 10,036 85.40% 83,925 94.00% 78,890 6.00% 5,035 11.Margaret Altamirano,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 12.Joseph Burgess,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 13.Quy Gip,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 14.Maribeth Jensen,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 15.Benilda Mayugba,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 16.Veronica Rayne,Staff Nurse 111 85.00% 123,578 105,041 4.38% 1 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 17.Shavonne Smith,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 18.Vivien Tagoe,Staff Nurse 111 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 19.Tim Yang,Staff Nurse III 85.00% 123,578 105,041 4.38% 4,606 10.21% 10,727 85.40% 89,708 94.00% 84,326 6.00% 5,382 20.Ashley Fisk,Staff Nurse 1 85.00% 80,546 68,464 4.38% 3,002 10.21% 6,992 85.40% 58,470 94.00% 54,962 6.00% 3,508 21.Vacant,Staff Nurse 1 0.00% 76,780 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 22.Jing Yang,Staff Nurse III(Extra Help) 1 0.00% 1 79,880 0 1 4.38% 1 0 10.21% 0 1 85.40% 1 0 100.00% 0 1 0.00% 0 23.Renee Chien,Occupational Therapist(Extra Help) 0.00% 81,848 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 0.00% 0 Subtotal 21899,769 2,049,002 89,843 209,253 1,749,908 1,653,064 96,844 Other Health Care Professionals 1.Ariana Salazar,Medical Social Worker 111 85.00% 94,330 80,606 4.38% 3,534 10.21% 8,232 85.40% 68,840 1 0.00% 1 0 100.00% 68,840 12 Page 1 of 3 State of California-Health and Human Services Agency Department of Health Care Services-Integrated Systems of Care Division Revised 3/6/24 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 322 4.3e% Pj; Total Cases of Open(Active)Straight CCS Children CCS Administrative Budget Worksheet OTLICP- Total Cases of Open(Active)OTLICP Children 750 10.21% Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (non-OTLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 1 BB r HEALTH CARE SERVICES Straight CCS Optional Targeted Low Income Medi-Cal(Non-OTLICP) Children's Program(OTLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Low Income Enhanced Non-Enhanced Total Budget Straight CCS Non- Annual Caseload Children's Medi-Cal Enhanced% Medi-Cal Medi-Cal Category/Line Item %FTE Salary 11 x 2 or Caseload% Co(ntylState % Program(OTLICP) Caseload% State/Federal FTE State/Federal Enh FTEd/ State/Federal 4+5+6) (50150) Co/State/Fed (25175) (50150) (17.5117.5165) 2.Alma Garcia,Medical Social Worker II 85.00% 74,714 63,507 4.38% 2,784 10.21% 1 6,486 85.40% 54,237 1 0.00% 0 100.00% 54,237 Subtotal 169,544 144,113 6,318 14,718 123,077 0 123,077 Ancillary Support 1.Sonya Mendoza,Senior Administrative Case Worker 75.00% 69,340 52,005 4.38% 2,280 10.21% 5,311 85.40% 44,414 100.00% 44,414 2.Michael Vue,Senior Administrative Case Worker 75.00% 67,523 50,642 4.38% 2,220 10.21% 5,172 85.40% 43,250 100.00% 43,250 3.Luz Reyes,Administrative Case Worker II 80.00% 60,434 48,347 4.38% 2,120 10.21% 4,937 85.40% 41,290 100.00% 41,290 4.Rudy Constantino,Administrative Case Worker ll 80.00% 60,434 48,347 4.38% 2,120 10.21% 1 4,937 85.40% 1 41,290 100.00% 41,290 5.Tiffany Acosta,Administrative Case Worker II 80.00% 59,615 47,692 4.38% 2,091 10.21% 4,871 85.40% 40,730 100.00% 40,730 6.Yuklico Garza-Wayne,Administrative Case Worker 11 80.00% 55,725 44,580 4.38% 1,955 10.21% 4,553 85.40% 38,073 100.00% 38,073 7.Johan Flores Guzman,Administrative Case Worker II 80.00% 54,070 43,256 4.38% 1,897 10.21% 4,417 85.40% 36,942 100.00% 1 36,942 8.Jessica Ramirez,Administrative Case Worker 1 80.00% 51,374 41,099 4.38% 1,802 10.21% 4,197 85.40% 35,100 100.00% 35,100 9.Rachel)(long,Administrative Case Worker II 80.00% 47,682 38,146 4.38% 1,673 10.21% 3,896 85.40% 32,578 100.00% 32,578 10.Jalen Swank,Administrative Case Worker II 80.00% 1 47,585 38,068 4.38% 1,669 1 10.21% 3,888 85.40% 32,511 100.00% 32,511 11.Adalinn Vargas,Administrative Case Worker 1 80.00% 46,951 37,561 4.38% 1,647 10.21% 3,836 85.40% 32,078 100.00% 32,078 12.Tamaryn Norris,Administrative Case Worker 1 80.00% 42,656 34,125 4.38% 1,496 10.21% 3,485 85.40% 29,144 100.00% 29,144 13.Vacant,Administrative Case Worker l 0.00% 41,186 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 14.Felisha Delgado,Adminstrative Case Worker 1 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 15.Samantha Amescua,Administrative Case Worker l 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 16.Jose Cisneros,Administrative Case Worker l 80.00% 41,186 32,949 4.38% 1,445 10.21% 3,365 85.40% 28,139 100.00% 28,139 17.Vacant,Administrative Case Worker l 0.00% 41,186 0 4.38% 0 10.21% 0 85.40% 0 100.00% 0 Subtotal 869,319 622,715 27,305 63,595 1 531,817 531,817 Clerical and Claims Support 1.Angel Rodriguez,Supervising Program Technician 60.00% 63,700 38,220 4.38% 1,676 10.21% 3,903 85.40% 32,641 0.00% 0 100.00% 32,641 2.Brian Casey,Office Assistant II 85.00% 47,435 40,320 4.38% 1,768 10.21% 4,118 85.40% 34,435 0.00% 0 100.00% 34,435 3.Sean Garcia,Office Assistant II 85.00% 42,400 36,040 4.38% 1,580 10.21% 3,681 85.40% 30,779 0.00% 0 100.00% 30,779 4.Vacant,Office Assistant 1 0.00% 38,078 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 5.Vacant,Office Assistant 1 0.00% 38,078 0 4.38% 0 10.21% 0 85.40% 0 0.00% 0 100.00% 0 6.Maricela Garcia,Account Clerk ll 5.00% 56,160 2,808 4.38% 123 10.21% 287 85.40% 2,398 0.00% 0 100.00% 2,398 6.Ismene Hernandez,Office Assistant ll 5.00% 46,020 2,301 4.38% 101 10.21% 235 85.40% 1,965 0.00% 0 100.00% 1,965 Subtotal 331,871 119,689 5,248 12,224 102,218 0 102,218 Total Salaries and Wages 3,122,443 4.38% 136,904 10.21% 318,877 85.40% 2,666,659 61.99% 1,653,064 38.01% 1,013,595 Staff Benefits(Specify%) 70.00% 2,185,710 4.38% 95,833 10.21% 223,214 85.40% 1,866,663 1,157,146 709,517 I.Total Personnel Expense 5,308,153 4.38% 232,737 10.21% 1 542,091 1 85.40% 4,533,322 2,810,210 1,723,112 It.Operating Expense 1.Travel 600 4.38% 26 10.21% 61 85.40% 512 61.99% 317 38.01% 195 2.Training 500 4.38% 22 10.21% 51 85.40% 427 61.99% 265 38.01% 162 3.Office E)penses and Printing 12,909 4.38% 566 10.21% 1,318 85.40% 11,025 1 100.00% 1 11,025 13 Page 2 of 3 Slate of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division Revised 3/624 Percent of Actual Total CCS CCS CASELOAD Caseload Caseload STRAIGHT CCS- 6, Total Cases of Open(Active)Straight CCS Children 322 4.38% CCS Administrative Budget Worksheet f ) TLICP-T 750 10.2t% Total Cases of Open(Active)0TLICP Children Fiscal Year: 2025-26 HC MEDI-CAL- Total Cases of Open(Active)Medi-Cal 6272 85.40% (n on-0TLICP)Children County: Fresno County CALIFORNIA DEPARTMENT OF TOTAL CCS CASELOAD 7344 100 i HEALTH CARE SERVICES _i ht CCS Optional Targeted Low Income g Children's Program(0TLICP) Medi-Cal(Non-0TLICP) Column 1 2 3 4A 4 5A 5 6A 6 7A 7 8A 8 Optional Targeted Total Budget Straight CCS Low Income Enhanced Non-Enhanced Annual caseload Children's Medi-Cal Enhanced% Medi-Cal NOn. Medi-Cal Category/Line Item %FTE Salary 11 x 2 or caseload Y. county/State % program(0TLICP) Caseload% State/Federal FTE State/Federal Enhanced N. SIM diederal 4+5+6 )(50150 Co/State/Fed (25175) FTE 150/50) (17.5117.5/65) 4.Postage 13.000 4.38% 570 10.21% 1.328 85.40% 11,102 100.00% 11,102 5.Small Tools B Instruments 315 4.38% 14 10,21% 32 85.40% 1 269 100.00% 1 269 6.Household Expenses 12,600 4.38% 552 10.21% 1,287 85.40% 10,761 100.00% 10,761 7.Maintenance-Equipment 8Security Services 15,000 4.38% 658 10.21% 1,532 85.40% 12,810 100.00% 12,810 8.Facility Services and Utilities 85,000 4.38% 3,727 10.21% 8,681 85,40% 72,593 100.00% 72,593 9.Data Processing Services 60,000 4.38% 2,631 10.21% 6,127 85.40% 51,242 100.00% 51,242 10.Translation Services 3,000 4.36% 132 10.21% 1 306 85.40% 2,562 100.00% 2,562 It.Total Operating Expense 202,924 8,898 20,723 173,303 582 172,721 III.Capital Expense 1. 4.38% 0 10.21% 0 85.40% 1 0 0 2. 4.38% 0 10.21% 0 85,40% 0 0 3. 4.38% 0 10.21% 0 85.40% 0 0 Ill.Total Capital Expense 0 0 0 0 0 IV.Indirect Expense 1.Indirect Cost Rate 24.47% 1,298,905 4.38% 56,951 10.21% 132.650 85.40% 1,109,304 100.00% 1,109,304 0 14.38% 0 10.21% 0 85.40% 0 1100.00% 0 IV.Total Indirect Expense 1,298,905 56,951 132,650 11,109,304 1,109,304 V.Other Expense 1.Maintenance 8 Transportation 5,000 4.38% 1 219 10.21% 511 85.40% 4,270 100.00% 4,270 2.CRISS Council Membership 6,700 4.38% 294 10.21% 6B4 85.40% 5,722 100.00% 5,722 V.Total Other Expense 11,700 513 1,195 9,992 9,992 Budget Grand Total 6,821,682 299,099 696,659 5,825,921 2,810,792 3,015,129 1.l Vw•�A/ Kristeena Bump Staff Analyst 711/2025 (559)600-6521 Prepared By IS' to Prepared By(Printed Name) Date Prepared Phone Number �C Pilar Vasquez Division Manager I I( l L o�7 (559)600-6595 CCS Administrator(Signature) CCS Administrator(Printed Name) Date Signed Phone Number 14 Page 3 of 3 Slate of California—Health and Human Services Agency Department of Health Care Services—Integrated Systems of Care Division Revised 316124 Percent of Total CCS ,�H CS CCS CASELOAD Actual Caseload Caseload CALIFORNIA DEPARTMENT OF STRAIGHT CCS- HEALTH CARE SERVICES Total Cases of Open(Active)Straight CCS Children 322 4.38% CCS Administrative Budget Summary OTLICP- 750 10.z1 i Total Cases of Open(Active)OTLICP Children Fiscal Year: 2025-26 MEDI-CAL- 6272 85.40% Total Cases of Open(Active)Medi-Cal non-OTLICP)Children County: Fresno County TOTAL CCS CASELOAD 7344 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 Enhadi-Cal Non-Enhanced Medi- Category/Line Item Total Budget County/State Program(OTLICP) Medi-Cal State/Federal State/Federalnced Me dl-Cal) Cal StatelFederal (50/60) County/State/Fed (50150) (17.5117.5165) I. Total Personnel Expense 5,308.153 232,737 542,091 4,533.322 2,810,210 1,723,112 If.Total Operating Expense 2D2,924 8.898 20,723 173,303 582 172,721 Ill.Total Capital Expense 0 0 0 0 0 IV.Total Indirect Expense 1,298,905 66.951 132.650 1,109,304 1,109.304 V.Total Other Expense 11,700 513 1,195 9.992 9,992 Budget Grand Total 6,821,682 299.099 696,659 5,825,921 2,810,792 3,015,129 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 Chi I' Non-Enhanced Medi- Source of Funds Total Budget County/State Program(OTLICP) Medi-Cal State/Federal Enhanced Medi-Cal Cal StatelFederal (50150) County/State/Fed State/Federal(25/75) (SOISD) (17.5/17.5165) Straight CCS State 149,549 149,549 County 149,550 149,550 OTLICP State 121,915 121,915 County 121,915 121,915 Federal(Title XXI) 452,829 452,829 Medi-Cal State 2,210,263 2.210,263 702,698 1,507,565 Federal(Title XIX) 3,615,658 3,615,658 2,108,094kAX 1,507,564 . p1JJAA) Kristeena Bump Staff Analyst kbumD aa)fresnocountyca aov Prepared B Signa re) Prepared By(Printed Name) Email Address Pilar Vasquez Division Manager PvasquezCcDfresnocountyca.qov CCS Administrator(Signature) CCS Administrator(Printed Name) Email Address 15 Page 1 of 1 Budget Justification Narrative Integrated Systems of Care Division County Budget Narrative Fiscal Year 2025-2026 I.PERSONNEL EXPENSES Identify and explain any changes in Personnel including FTE percentage changes. Salaries remain relatively the same as previous FY,with a 0.002%increase. Total Salaries: $3,122,443 Salaries include actual annual salaries with cost of living adjustments however,FTEs were lowered in all classifications to meet the allocation. Total Benefits: $2,185,710 Staff benefits remain the same as previous FY.This estimate was reached by using an average of the actual County benefts budgeted for this fiscal year. Total Personnel Expenses: $5,308,153 To meet allocation,FTEs were reduced by 2%from previous FY.A total of 1.8 FTE of Program Administration were moved to the M&O budget to Program Administration perform M&O activities. Medical Case Management To meet allocation,FTEs of Physicians and Nurses were reduced by 9%from previous FY. Other Health Care Professionals To meet allocation,FTEs were reduced by 4%from previous FY. Ancillary Support With vacant positions filled,FTEs were increased by 24%from previous FY. Clerical and Claims Support To meet allocation,FTEs were reduced by 34%from previous FY. II.OPERATING EXPENSES List all Operating Expense line items.Identify and explain any increase, decrease,or newly listed line item. Travel $600 Travel expenses are reduced by 40%from previous FY. Training $500 There is no change to training expense from previous FY. Office Expense and Printing $12,909 To meet allocation,office expenses and printing expenses are reduced by 22%from previous FY. Postage $13,000 To meet allocation,postage expenses are reduced by 21%from previous FY. Small Tools&Instruments $315 Small tools expenses are reduced by 79%from previous FY. Household Expenses $12,600 There is no change to household expenses from previous FY. Maintenance-Equipment&Security Services $15,000 To meet allocation,maintenance-equipment and security services expenses are reduced by 28%from previous FY. Facility Services and Utilities $85,000 To meet allocation,facility services and utilities expensesare reduced by 12%from previous FY. Data Processing Services $60,000 To meet allocation,data processing services expenses are reduced by 12%from previous FY. Translation Services $3,000 There is no change to translation services expenses from previous FY. Total Operating Expenses: $202,924 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% $1,298,905 Fresno County approved indirect cost rate for 2024-25 is 24.47%.This is a 0.03% from previous FY. B.External Total Indirect Expenses: $1,298,905 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. Maintenance and Transportation $5,000 There is no change to maintenance and transportation expenses from previous FY. Student Internship $6,700 There is no change on the budget for CRISS Membership from previous FY. Total Other Expenses: $11,700 Bud et Grand Total $6,821,682 16 CALIFORNIA DEPARTMENT OF huHCS HEALTH CARE SERVICES California Children's Services(CCS)Monitoring&Oversight(M&O) Agency Information County: Fiscal Year: Fresno 2025-26 Street Address: 1221 Fulton Street City: Fresno Central Email Address: ccs@fresnocountyca.gov Zip Code: 93721 Director Deputy Director Name,Title: David Luchini, Director Name: Joe Prado,Assistant Director Phone: 559 600-6401 Phone: 559 600-6402 Email: d1uchini@fresnocountyca.gov Email: jprado@fresnocountyca.gov List All Program Staff(CCS M&O) Name: Position/Classification: Email: Pilar Vasquez Division Manager pvasquez@fresnocountyca.gov Harsharn Dhillon-Wood Rehabilitative Therapy Manager hdhillon@fresnocountyca.gov Marissa Vo eler Staff Analyst III mvogeler@fresnocountvca.gov Kristeena Bump Staff Analyst I kbump@fresnocountyca gov Angel Rodriguez Supervising Program Technician rodriguezang@fresnocountvca.gov Ana Gastelum Rivera Program Technician II Ana Rivera1@fresnocountyca.gov Additional rows may be added above this line. Authorized Direct :David Luchini,RN,Pubfc Health Signature and Date: Director 1/ J Zbv 17 CALIFORNIA DEPARTMENT OF RoHCS HEALTH CARE SERVICES California Children's Services (CCS) Monitoring &Oversight(M&O) Budget Worksheet County/City Name: Fiscal Year: Fresno 2025-26 I. Personnel Expenses Total FTE % Annual Salary Total Budget # Name Position Classification 1 Pilar Vasquez Division Manager 25% $148,686 $37,172 2 Harsharn Dhillon-Wood Rehabilitative Therapy Manager 10% $148,685 $14,869 3 Marissa Vo eler Staff Analyst III 75% $87,114 $65,336 4 Kristeena Bump Staff Analyst 1 20% $67,214 $13,443 5 An el Rodri uez Supervising Program Technician 20% $63,700 $12,740 6 Ana Gastelum Rivera Program Technician II 50% $53,267 $26,634 7 0 0 0% $0 $0 8 0 0 0% $0 $0 9 0 0 0% $0 $0 100 10 1 0% $0 $0 (insert additional rows above this line as needed) Total Support Staff FTE % 2.00 Total Net Salaries and Wages $170,192 Staff Benefits(Specify%) 70% $119,134 I.Total Personnel Expenses $289,326 11. Total Operating Expenses (Provide Details in Narrative) $2,672 III.Total Capital Expenses (Provide Details in Narrative) $0 IV. Indirect Expenses (Provide Details in Narrative) 1. Internal (Specify%) 24% $70,798 2. External (Specify%) 0% $0 IV.Total Indirect Expenses (Provide Details in Narrative) $70,798 V.Total Other Expenses (Provide Details in Narrative) $0 Budget Grand Total $362,796 1 certify under penalty of perjury under the laws of the State of California that the forgoing information is,to the best of my knowledge, information and/or belief,that the information submitted is true, accurate,and complete, and that the corresponding documents and records are available and accessible to the California Department of Health Care Services(DHCS)upon request. In addition, that the county California Children's Services(CCS)program will comply with all applicable federal and state laws and regulations, including those governing recipients of federal funds granted to states for medical assistance.Additionally, county CCS program will adhere to all rules set forth by DHCS under these authorities, including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual. I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§ 12650)if it fai o co ply with the a ve requirements. A11A A -7 A? Authorized Director: David Luchini, RN, Public a rid a Health Director 18 CALIFORNIA DEPARTMENT OF 141wHCS HEALTH CARE SERVICES State of California—Health and Human Services Agency Department of Health Care Services California Children Servies(CCS)Monitoring&Oversight(M&O) Budget Narrative County/City Name: Fiscal Year: Fresno �2025-26 I.Personnel Expenses:Identify Personnel Expenses, specifying roles and M&O activities, time allocations, and costs supporting M&O activities. 1. Pilar Vasquez-Division Manager:As CCS Administrator and designated Deputy Director for the M&O activities, she will be the lead in identiying the needs for the program to implement the Monitoring and Oversight(M&O)reporting; monitors status of all activities related to M&O activities and M&O implementation;and reviews and approves all developed and revised program workflows, PPGs and all related fiscal deliverables. 2. Harsharn Dhillon-Wood-Rehabilitative Therapy Manager:Assist CCS Administrator is establishng new and revised workflows to conform with the M&O requirements. 3. Marissa Vogeler-Staff Analyst III:Assist CCS Administrator in monitoring and tracking the progress of M&O activities and expenditures;assist in establishing new processes; prepares needed PPGs and reviews and makes recommendations on all fiscal related deliverables 4. Kristeena Bump-Staff Analyst I:Assist CCS Administrator in monitoring and tracking the progress of M&O activities and expenditures;assist in establishing new processes;prepares needed PPGs and reviews and makes recommendations on all fiscal related deliverables. Prepare and organize required M&O documents for submission to DHCS. 5.Angel Rodriguez-Supervising Program Technician:Takes lead on data gathering, preparation of new logs and templates in relation to new PPGs and assist in establishing new workflows and guidances. 6.Ana Gastelum Rivera-Program Technician II: Exporting reports, gathering data,entering necessary M&O data in new logs and templates in preparation for submission to DHCS. II.Operating Expenses: Identify and explain all expenses included in the"Operating Expenses"line item of the Budget Worksheet. There will be a$2,672 expense for incurred Data Processing expenditures during the M&O activities. III.Capital Expenses: Identify and explain all expenses included in the in the "Capital Expenses"line item of the Budget Worksheet. No Capital Expenses will be incurred under the M&O allocation. IV.Indirect Expenses: Identify and explain all expenses included in the"Indirect Expenses"line items(Internal and External)of the Budget Worksheet. An Indirect Cost Rate(ICR)OF 24.47%wil be applied to the Total Personnel Expenses under the M&O Internal: allocation. The FY 2025-26 CDPH's approved County ICR is 24.47%. External: V.Other Expenses: Identify and explain all expenses included in the"Other Expenses"line item of the Budget Worksheet. No other expenses will be incurred under the M&O allocation. I certify under penalty of perjury under the laws of the State of California that the forgoing information is,to the best of my knowledge,information and/or belief,that the information submitted is true,accurate,and complete,and that the corresponding documents and records are available and accessible to the California Department of Health Care Services(DHCS)upon request.In addition,that the county California Children's Services (CCS)program will comply with all applicable federal and state laws and regulations,including those governing recipients of federal funds granted to states for medical assistance.Additionally,county CCS program will adhere to all rules set forth by DHCS under these authorities,including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual.I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§12650)if it fails to comply with the above requirements. Authorized Director: David Luchini, RN, Public Health Signature: Director Vf 19 CALIFORNIA DEPARTMENT OF H C SHEALTH CARE SERVICES State of California—Health and Human Services Agency Department of Health Care Services California Children Servies (CCS) Monitoring & Oversight(M&O) Budget Summary County Name Fiscal Year Fresno 2025-26 Category/Line Item Total Budget I. Total Personnel Expenses $289,326 II. Total Operating Expenses $2,672 III. Total Capital Expenses $0 IV. Total Indirect Expenses $70,798 V. Total Other Expenses $0 Budget Grand Total $362,796 I certify under penalty of perjury under the laws of the State of California that the forgoing information is, to the best of my knowledge, information and/or belief, that the information submitted is true, accurate, and complete, and that the corresponding documents and records are available and accessible to the California Department of Health Care Services (DHCS) upon request. In addition, that the county California Children's Services (CCS) program will comply with all applicable federal and state laws and regulations, including those governing recipients of federal funds granted to states for medical assistance. Additionally, county CCS program will adhere to all rules set forth by DHCS under these authorities, including the Integrated Systems of Care Division's Plan and Fiscal Guidelines Manual. I understand and acknowledge that submitting false information may subject the county to civil and/or criminal penalties under the California False Claims Act(Government Code§ 12650) if it fails to comply with the above requirements. Authorized Director: David Luchini, RN, Public Health Signatu e d Dat Director 20 FY 2025-26 Retroactive California Department of Health Care Services Allocation for Fresno County California Children's Services (CCS) Program Allocation: FY 2025-26 CMS Plan and Budget for CCS FY 2025-26 CCS Monitoring and Oversight Budget Fund/Subclass: 0001/10000 Organization: 56201600 Revenue Account No.: 3505, 4380 21