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Approve an Appropriation Transfer Request of $72,407 recognizing unanticipated revenue for FY2017/18 for the Health Care Program for Children in Foster Care funded by the California Department of Health Care Services, to provide public health nurse expertise in meeting the medical, dental, mental and developmental needs of children and youth in foster care (4/5 vote required)
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Published Notice Required? Yes _____ No __X__
Public Hearing Required? Yes _____ No __X__
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board approve an Appropriation Transfer Request (ATR) of $72,407 recognizing unanticipated revenue for FY2017/18 for the Health Care Program for Children in Foster Care (HCPFC) funded by the California Department of Health Care Services (DHCS), to provide public health nurse expertise in meeting the medical, dental, mental and developmental needs of children and youth in foster care (4/5 vote required).
SUMMARY:
Social workers and probation officers with case management responsibilities are required, with assistance from Public Health Nurses (PHN), to monitor the developmental, dental and mental health needs of children and youth in foster care. Assembly Bill 1111 (Chapter 147, Statutes of 1999) enacted Welfare and Institutions Code Section 16501.3 to establish the Health Care Program for Children in Foster Care (HCPCFC) and increase the use of PHNs in meeting the health care needs of children in foster care. PHNs were given authority to receive medical records directly from physicians to coordinate health care services and serve as a liaison with health care professionals and other providers of health-related services, including coordination of appropriate medical treatment and follow-up. With this additional funding, Solano County PHNs will provide additional assistance to Child Welfare and Probation Department staff as well as increase the number of children receiving services.
FINANCIAL IMPACT:
For FY2017/18, H&SS is requesting approval of an ATR in the amount of $72,407 to accept unanticipated revenue from the DHCS, per Child Health and Disability Prevention program letter 18-01, to support County child welfare efforts in providing health care oversight and monitoring of children and youth in foster care. The allocation will fund PHN case management services that comply with specific administrative functions eligible for enhanced federal matching funds through the Medicaid Title XIX Program. There are no County General funds associated with this request.
DISCUSSION:
In FY2016/17, the Board approved the acceptance of a new funding source for the HCPCFC and on May 23, 2017, the Board approved acceptance of unanticipated revenue for FY2016/17 in the amount of $49,718. This request is to approve additional unanticipated revenue in the amount of $72,407 in HCPCFC funds, which provide for a PHN to work collaboratively with Solano County Child Welfare Services (CWS) social workers and consult with the Probation Department to ensure that children, youth, and non-minor dependents in foster care receive all needed health care services. The PHN provides health care oversight of the physical, behavioral, dental, and developmental needs to an average of 350 children in foster care, including those in out-of-county and out-of-state placement.
The PHNs perform administrative activities to oversee and monitor health care needs and do not provide direct medical services to children. These administrative activities can only be performed by an individual with the required level of medical expertise, Skilled Professional Medical Personnel (SPMP). As required by Welfare and Institutions Code (WIC) section 16501.3(d), the activities of PHNs are limited to specific administrative functions eligible for enhanced Federal Financial Participation matched at up to a maximum of 75% through the Medicaid Title XIX program. The allowable SPMP activities under the new funding include, but are not limited to:
Foster Care Public Health Nurses may:
• Review and interpret medical reports for case workers and the courts.
• Expedite timely referrals for medical, dental and mental health services.
• Follow children placed out of county to assure health care access to needed services.
• Serve as a resource to facilitate referrals to early intervention providers, specialty providers, dentists, mental health providers and other community programs.
• Review and document in the child's health and education passport the completion of laboratory tests, other screenings and measurements, evaluations, and assessments required to meet reasonable standards of medical practice.
• Provide guidance and consultation to social workers and probation officers in the scheduling of periodic follow up visits with physicians, laboratory services, and other necessary health services.
• Review, interpret, and document as necessary, the results of laboratory tests, screenings, and evaluations for case planning and coordination.
• Review clinical documentation to assess the child or youth’s progress in meeting treatment plan goals.
Allowing PHNs to assist social workers and probation officers in the coordination of health care needs is intended to support the ability of child welfare agencies to provide an additional level of attention to improve the developmental, dental and mental health care needs of children and youth in foster care.
ALTERNATIVES:
The Board may choose not to approve the ATR of unanticipated revenue from DHCS for the HCPCFC Program. This is not recommended because with the increased funds, Solano County has an opportunity to increase the oversight and follow-up of children in need of additional health care services.
OTHER AGENCY INVOLVEMENT:
H&SS worked with County Counsel, Solano County Probation Department on the agreement to accept the additional funds from DHCS and the Health Care Program for Children in Foster Care.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION