File #: RES 22-008    Name: Add 21 Medi-Cal positions for Social Services
Type: BoS Resolution Status: Department of Social Services - Consent
File created: 12/23/2021 In control: Board of Supervisors
On agenda: 1/11/2022 Final action:
Title: a. Adopt a resolution to amend the Department of Social Services Budget Unit 001-5010-8262-SOC005 to add 21 Medi-Cal positions: fourteen (14) Eligibility Specialist II, four (4) Eligibility Specialist III, two (2) Eligibility Supervisors, and one (1) Management Analyst III; and b. Authorize and direct the County Administrative Office and the Auditor-Controller's Office to incorporate the changes in the FY 2021-22 Adopted Budget Unit 001-5010-SOC005-8262 to reflect the change in position counts; and c. Approve an increase in appropriations and estimated revenues of $1,038,118 for the Social Services Budget Unit 001-5010-SOC005-8262 FY 2021-22 Adopted Budget (4/5ths vote required); and d. Authorize and direct the Auditor-Controller to amend the FY 2021-22 Adopted Budget by increasing appropriations and estimated revenues by $1,038,118 in the Social Services Budget Unit 001-5010-SOC005-8262 (4/5ths vote required).
Attachments: 1. Board Report, 2. Resolution, 3. Attachment A_Position Numbers, 4. Completed Board Order Item No. 49, 5. Completed Resolution Item No. 49

Title

a. Adopt a resolution to amend the Department of Social Services Budget Unit 001-5010-8262-SOC005 to add 21 Medi-Cal positions:  fourteen (14) Eligibility Specialist II, four (4) Eligibility Specialist III, two (2) Eligibility Supervisors, and one (1) Management Analyst III; and

b. Authorize and direct the County Administrative Office and the Auditor-Controller’s Office to incorporate the changes in the FY 2021-22 Adopted Budget Unit 001-5010-SOC005-8262 to reflect the change in position counts; and

c. Approve an increase in appropriations and estimated revenues of $1,038,118 for the Social Services Budget Unit 001-5010-SOC005-8262 FY 2021-22 Adopted Budget (4/5ths vote required); and

d. Authorize and direct the Auditor-Controller to amend the FY 2021-22 Adopted Budget by increasing appropriations and estimated revenues by $1,038,118 in the Social Services Budget Unit 001-5010-SOC005-8262 (4/5ths vote required).

Report

RECOMMENDATION:

It is recommended that the Board of Supervisors adopt a resolution to:

a.  Amend the Department of Social Services Budget Unit 001-5010-8262-SOC005 to add 21 Medi-Cal positions:  fourteen (14) Eligibility Specialist II, four (4) Eligibility Specialist III, two (2) Eligibility Supervisors, and one (1) Management Analyst III; and

b.  Authorize and direct the County Administrative Office and the Auditor-Controller’s Office to incorporate the changes in the FY 2021-22 Adopted Budget Unit 001-5010-SOC005-8262 to reflect the change in position counts; and

c.  Approve an increase in appropriations and estimated revenues of $1,038,118 for the Social Services Budget Unit 001-5010-SOC005-8262 FY 2021-22 Adopted Budget (4/5ths vote required); and

d.  Authorize and direct the Auditor-Controller to amend the FY 2021-22 Adopted Budget by increasing appropriations and estimated revenues by $1,038,118 in the Social Services Budget Unit 001-5010-SOC005-8262 (4/5ths vote required).

 

SUMMARY/DISCUSSION:

As a result of new Affordable Care Act initiatives, the Pandemic, and the economic challenges in the community, the Department of Social Services Community Benefits Branch, the department continues its agency goal to meet the needs of our community with the complexity and volume of work for applicants and ongoing recipients, which is currently 183,000.   The increase in workload has strained the Department’s capacity and Staff are unable to keep up with the increased demand which is expected to continue growing. In addition to the new applications, staff will also be processing approximately 5,000 to 8,500 benefit re-determinations monthly.   The request for 21 positions represents two units who will specialize in Medi-Cal only, processing applications and conducting re-assessments on current caseload. The Medi-Cal allocation for Monterey County has increased by $3,518,646 this fiscal year and can absorb the additional position costs.

 

Over the past two years, the Medi-Cal program has expanded to include full scope Medi-Cal eligibility to young adults through age 25 and increased the income disregard of all countable income up to 138% of the federal poverty level for aged, blind and disabled individuals.  The Medi-Cal program now has 80 Medi-Cal aid categories that an eligibility specialist must ensure they are reviewing and determining eligibility for, which includes different income levels and eligibility criteria.  In addition, Assembly Bill 133 will expand eligibility for full scope Medi-Cal to individuals who are 50 years of age or older who do not have satisfactory immigration status by May 01, 2022, and the American Rescue Plan Act will extend pregnancy postpartum care to 12 months effective April 01, 2022.  With the expansion of the program, systems and/or resources have been added for individuals to submit an application or agency referral on behalf of an individual which includes; Covered CA, BenefitsCal, County Jail Prerelease Inmate Applications, State Prison Prerelease, Application/Referrals from Breast and Cervical Cancer Treatment Program, Application/Referral from San Andreas Regional Center for Home and Community Based Waivers, Social Security Low-Income Subsidy Assistance Referrals, SSI Craig vs. Bonta referrals, phone, mail, fax and in-person.  All of these different methods/portals of applications require constant monitoring, follow-up with customers and updates to procedures for staff as changes occur. The additional front-line staff of Eligibility Specialists and Supervisors will allow the Department to address the growth in community need while sustaining efforts to provide community outreach while also meeting the federal/state mandates for program accuracy and timely eligibility determination. 

 

The Department recommends amending the Department of Social Services Budget Unit 001-5010-SOC005-8262 to add the following positions as per Attachment A:

 

 

Classification                     Code                     FTEs                     Change                     FTEs                     

Eligibility Specialist II                     25E21                     168                     14                     182

Eligibility Specialist III                     25E22                     107                      4                     111

Eligibility Supervisor                     25E80                     38                      2                     40

Management Analyst III                     14C31                     13                      1                     14                     

                                                               TOTAL                                                                                                         21

 

 

OTHER AGENCY INVOLVEMENT:

The Human Resources Department has reviewed and approved the request to classifies for these positions and the County’s Budget Committee reviewed and provided their support on December 16, 2021. County Counsel has approved to form.

 

FINANCING:

The Department’s recommendation of adding 21 positions: fourteen (14) Eligibility Specialist II, four (4) Eligibility Specialist III, two (2) Eligibility Supervisors, and one (1) Management Analyst III nets an increase of $2,491,484 annually, and $1,038,118 pro-rated (5 months) for the FY 2021-22 Adopted Budget.  These positions are funded by Medi-Cal funding with a very small amount that is County share for the Management Analyst which will be covered by realignment Funds as shown below:

 

Description

Expenditures

Medi-Cal Funding

‘1991 Tax Realignment

21 Positions, Annually

$2,491,484

$2,465,555

$25,928

21 Positions, 5 Months

$1,038,118

$1,027,315

$10,804

The Department is requesting an increase in appropriations and revenues in the amount of $1,038,118 for the Social Services 001-5010-SOC005-8262 FY 2021-22 Adopted Budget. The Medi-Cal funding allocation for Monterey County in FY 2022 is $33.7 million, an increase of $3.5 million from the prior fiscal year, less $1.2 million in one-time funding for benefit re-determinations. The ongoing increase in allocation of $2.4 million supports this additional increase.  Recommended actions will not require additional County General Fund contributions (GFC) in DSS in the current or next fiscal year as additional cost will be managed within the Department’s allocated GFC.

 

BOARD OF SUPERVISORS STRATEGIC INITIATIVES:

This action correlates to the Administration Strategic Initiative adopted by the Board of Supervisors by providing the adequate staffing to meet the program needs for the Community, the Department and the State.

 

Mark a check to the related Board of Supervisors Strategic Initiatives

 

___ Economic Development

_X_Administration

___ Health & Human Services

___ Infrastructure

___ Public Safety

 

 

Prepared by:                     Becky Cromer, Finance Manager III, x4404

 

 

 

Approved by:                     Lori A. Medina, Social Services Director, x4430