California Health and Human Services Agency

Tribal Consultation Policy Development

Consultation with Tribal Leaders And Tribal Health Program Leaders

Wednesday, May 21, 20149:00 a.m. - Noon

www.chhs.ca.gov

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Meeting Overview

• Blessing: Shingle Springs Band of Miwok Indians

• Welcome by Judge Cynthia Gomez, Tribal Advisor to Governor Brown

• Remarks by Secretary Diana Dooley

• Introductions: Tribal Leaders, Tribal Council Members, Tribal Health Program Board Members/Directors, Tribal Staff, CHHS Agency/Department Directors and Staff

• Overview of California Health and Human Services Agency and Departments

• Discussion on Tribal Consultation Policy Development

• Next Steps

• Closing Remarks by Secretary Diana Dooley

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Overview: California Health and Human Services Agency • The California Health and Human Services Agency (CHHS)

oversees twelve departments and one board that provide a range of health care services, social services, mental health services, alcohol and drug treatment services, income assistance and public health services to Californians from all walks of life.

• Approximately 32,000 people work for departments in CHHS at state headquarters in Sacramento, regional offices throughout the state and state facilities serving individuals with mental illness and people with developmental disabilities. Website: www.chhs.ca.gov

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Departments and OfficesDepartments• Department of Aging• Department of Child Support

Services • Department of Community

Services and Development• Department of Developmental

Services• Emergency Medical Services

Authority• Department of Health Care

Services • Department of Managed Health

Care• Department of Public Health• Department of Rehabilitation

• Department of Social Services • Department of State Hospitals• Managed Risk Medical Insurance

Board• Office of Statewide Health

Planning and Development

Offices• Office of Health Information

Integrity• Office of the Patient Advocate• Office of Systems Integration

Will use the term “department” for both in this presentation

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Department of Aging (CDA)www.aging.ca.gov

• Community-Based Adult Services Program Certification• Congregate and Home Delivered Meals• Disease Prevention and Health Promotion Programs• Family Caregiver Support Program• HICAP - Health Insurance Counseling and Advocacy

Program• Legal Assistance• Long-Term Care Ombudsman Program• Multipurpose Senior Services Program

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Department of Child Support Services (DCSS) www.childsup.ca.gov• The mission of the California Child Support Services is to

enhance the well-being of children and the self-sufficiency of families by providing professional services to locate parents, establish paternity and establish and enforce orders for financial and medical support.

• Program Highlights:• Provides no-cost paternity and order-establishment services and

a range of enforcement services.• Ensures that children receive a reliable source of financial and

medical support• Supplements and stabilizes family income, increases self-

sufficiency 7

Department of Community Services and Development (CSD) www.csd.ca.gov • CSD partners with a network of private, non-profit and local

government community service providers dedicated to helping low-income families achieve and maintain self-sufficiency, meet their home energy needs and reside in housing free from the dangers of lead hazards.

• Core Programs and services• U.S. Department of Health & Human Services (HHS), Community

Services Block Grant (CSBG)• U.S. Department of Health & Human Services (HHS), Low-Income

Home Energy Assistance Program (LIHEAP) • U.S. Department of Energy (DOE), Weatherization Assistance

Program (WAP) • U.S. Department of Housing and Urban Development (HUD),

Lead-Based Paint Hazard Control Program

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Department of Developmental Services (DDS) www.dds.ca.gov

• Provides services and supports to individuals with developmental disabilities

• What Disabilities are eligible for services?• Intellectual Disability• Cerebral Palsy• Autism• Epilepsy• Other Developmental Disabilities

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Emergency Medical Services Authority (EMSA)www.emsa.ca.gov

• The mission of the California Emergency Medical Services Authority is to ensure quality patient care by administering an effective, statewide system of coordinated emergency medical care, injury preventions, and disaster medical response.

• EMSA’s functions include:• System Planning & Medical Oversight• Communication Systems for EMS• First Responders and Ambulance Transportation• Emergency Medical Technicians (EMTs), Paramedics & other EMS personnel• Hospitals, including Trauma Centers, Heart Attack, Stroke & Pediatrics• Data Collection, Evaluation, Quality Improvement• Public Information and Education• Disaster Medical Response

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Department of Health Care Services (DHCS) www.dhcs.ca.gov

• Health Care Delivery Systems: • Medi-Cal Managed Care• Long Term Care

• Health Care Benefits & Eligibility:• Primary, Rural & Indian Health • Pharmacy Benefits

• Mental Health and Substance Use Disorder Services• Mental Health Services• Substance Use Disorder Services

• Health Care Financing• Safety Net Financing• Capitated Rates Development

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Department of Managed Health Care (DMHC)www.dmhc.ca.gov • The people of the Department of Managed Health Care work

toward an affordable, accountable and robust managed care delivery system that promotes healthier Californians.

• Services:• Regulate Health Plans• Benefit & Rights• Help Center: Assists with Problems and Complaints• Health Resources

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Department of Public Health (CDPH) www.cdph.ca.gov

• Core Public Health Centers and Programs:• Center for Chronic Disease and Health Promotion

• Chronic Disease and Injury Control• Office of Problem Gambling

• Center for Environmental Health• Drinking Water and Environmental Management

• Center for Family Health• Woman, Infants, Children (WIC) Program• Genetic Disease Screening Program

• Center for Health Care Quality• Healthcare Associated Infections (HAI) Program• Licensing & Certification

• Center for Infectious Diseases13

Department of Rehabilitation (DOR) www.dor.ca.gov

• Core Programs and Services: • Vocational Rehabilitation Services

• Assessment – medical and vocational• Counseling, guidance and referral

• Independent Living Services• Information and referral• Independent living skills education

• Business Enterprise Program • Disability Access Services • Older Individuals who are Blind Services• Orientation Center for the Blind• Mobility Evaluation Program

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Department of Social Services (DSS) www.dss.cahwnet.gov

• Core Services and Programs:

• California Work Opportunity and Responsibility to Kids (CalWORKs)• CalFresh (formerly known as Food Stamps)• Emergency Food Assistance Program• Child Welfare Services• Foster Care• Adoptions• In-Home Supportive Services• Disability Determination Services• Community Care Licensing• Child Care Licensing 15

Department of State Hospitals (DSH) www.dsh.ca.gov

• DSH manages the state hospital system, which provides mental health services to patients admitted into DHS facilities. They strive to provide effective treatment in a safe environment and in a fiscally responsible manner.

• Department of State Hospitals facilities:• DSH-Atascadero• DSH-Coalinga• DSH-Metropolitan LA• DSH-Napa• DSH-Patton• DSH-Sacramento• DSH-Salinas Valley• DSH-Stockton• DSH-Vacaville

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Managed Risk Medical Insurance Board (MRMIB) www.mrmib.ca.gov

• Core Programs and Services:• Access for Infants & Mothers Program (AIM)• Major Risk Medical Insurance Program (MRMIP)• CA Pre-Existing Condition Insurance Plan (PCIP) Close Out &

Other Coverage Options • County Children’s Health Initiative Program (C-CHIP)• MRMIB is proposed to be eliminated, effective July 1, 2014, with

programs to be transitioned to the Department of Health Care Services (DHCS)

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Office of Statewide Health Planning and Development (OSHPD) www.oshpd.ca.gov • Core Programs and Services:• Healthcare Construction and Financing

• Building official for hospital and skilled nursing facilities• Hospital Seismic Safety Program• Cal-Mortgage health facility loan insurance program

• Healthcare Data Collection and Reporting• Collects data and distributes information on health & healthcare in California

• Health Workforce Development• Scholarships and Loan Repayments for health professionals and students who

will practice in medically underserved areas.• Song-Brown Program grants for health professions training institutions• California Student /Resident Experiences and Rotations in Community Health

(Cal-SEARCH)• Mini-grants for organizations that provide health career exploration activities to

encourage underrepresented and/or economically disadvantaged students to pursue health careers.

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Office of Health Information Integrity (OHI) www.ohii.ca.gov

The California Office of Health Information Integrity's (CalOHII) focus is to advance the secure movement of electronic health information, while ensuring that the data is protected and exchanged under strict medical privacy and confidentiality standards. • CalOHII collaborates with external organizations, such as:• National Association for Trusted Exchange (NATE)• California Association of Health Information Exchanges (CAHIE)• Policy Steering Team (PoST)

• CalOHII is the State of California’s Health Insurance Portability and Accountability Act (HIPAA) subject matter expert, providing technical assistance at the Executive level.

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Office of the Patient Advocate (OPA) www.opa.ca.gov

• OPA is charged with the responsibility to inform Californians about how to:• Obtain health care services for which they are entitled or for

which they are eligible under law, • Receive timely assistance in resolving problems in accessing care

or other problems with their health plan or providers, and • OPA publishes annual Health Care Quality Report Cards to

provide consumers with performance ratings for the state’s largest health plans and over 200 medical groups.

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Office of Systems Integration (OSI) www.osi.ca.gov

• Office of Systems Integration’s (OSI) mission is to procure, manage and deliver technology systems that support the delivery of health and human services to Californians

• OSI Projects• Case Management Information and Payrolling Systems (CMIPS II)• Child Welfare Services-New System Project (CWS-NS)• Child Welfare Services/Case Management System (CWS/CMS)• Electronic Benefit Transfer Project (EBT)• Welfare Date Tracking Implementation Project (SAW-WDTIP)• Unemployment Insurance Project (UIMOD)• Statewide Automated Welfare Systems (SAWS)• Statewide Fingerprint Imaging System (SFIS)• State Systems Interoperability and Integration Project (SSIIP)

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Policy Development: Work to Date• Surveyed our departments about whether they had a written tribal

consultation policy and/or designated tribal liaison (July/August 2013)• Reviewed state department written policies (e.g., Department of

Health Care Services, Managed Risk Medical Insurance Board, Covered California) and Cabinet-level agencies written policies (July/August 2013)

• Met with the Governor’s Tribal Advisor, Judge Cynthia Gomez, to better understand government-to-government tribal consultation and best practices in developing a tribal consultation policy (August 2013)

• Consulted with a similarly organized Cabinet-level agency (California Natural Resources Agency) about how they developed their policy

• Consulted with the Department of Health Care Services about its written tribal consultation policy and practices (October 2013)

• Developed a work plan, with the goal of completing the development of a policy by August 2014 (November 2013)

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Policy Development: Work to Date• Regularly briefed department Chief Deputy Directors on development

of the tribal consultation policy (December 2013, January 2014, February 2014, March 2014, and May 2014)

• Presented at the Department of Health Care Services’ Annual Tribal Consultation about the development of a Health and Human Services Agency tribal consultation policy (February 2014)

• Based on the feedback, revised work plan to seek input at a tribal consultation prior to releasing any draft of a policy (March 2014)

• Mailed 45-day advance notice for this tribal consultation to tribal leaders using contact lists from the Governor’s Tribal Advisor (for elected tribal leaders and administrators) and Department of Health Care Services (for tribal health programs) - (April 2014)

• Consulted with representatives of tribal health program leaders and the Indian Health Service in the planning of this tribal consultation (April 2014)

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Policy Development: Discussion• Seeking your input today on the potential components of a

tribal consultation policy for our agency:1. Purpose of the Policy2. Outreach to Tribal Leaders3. Designated Tribal Liaisons 4. Tribal Contact Information5. Other Components

• For each potential component, will pose questions, then ask for feedback and input by:• Tribal leaders• Tribal Council Members• Tribal health program leaders

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1. Purpose of the Policy• Purpose: What should the purpose of the policy be?

• Existing Laws and Regulations: Each department and office has its own applicable laws and regulations. Should this be recognized in the policy?

• Values: What values should we build into this policy?

• Scope: Will guidance to the employees of our departments and offices support engagement with tribes and tribal health programs?

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1. Purpose of the Policy

Feedback and Input:

• Tribal leaders• In room• On phone

• Tribal Council Members• In room• On phone

• Tribal health program leaders• In room• On phone

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2. Outreach to Tribal Leaders

A. Who and what:

• Tribes and tribal health programs: Should departments outreach to leaders of California Native American tribes and/or tribal health program leaders?

• Issue identification: On what issues should departments outreach?

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2. Outreach to Tribal Leaders

B. When:

• Timing: When should departments conduct their outreach in their planning processes?

• Frequency: How often should departments conduct their outreach?

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2. Outreach to Tribal Leaders

C. How:

• Dissemination of information: How should departments disseminate public documents, notices and information?

• Notification of meetings: What advance notice should departments give?

• Time and location: How should departments make meetings accessible?

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2. Outreach to Tribal Leaders

Feedback and Input:

• Tribal leaders• In room• On phone

• Tribal Council Members• In room• On phone

• Tribal health program leaders• In room• On phone

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3. Designated Tribal Liaisons• Designation by departments: Should each department

designate a tribal liaison? Who should this be within the department?

• Role: What should be the role and responsibilities of the tribal liaison? Should they be responsible for compliance with the developed policy?

• Activities: How can they support communication, consultation, and partnership with tribal leaders and/or tribal health program leaders?

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3. Designated Tribal Liaisons

Feedback and Input:

• Tribal leaders• In room• On phone

• Tribal Council Members• In room• On phone

• Tribal health program leaders• In room• On phone

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4. Tribal Contact Information• For Elected Tribal Leaders: The Office of the Governor’s Tribal

Advisor maintains a contact list on its website (http://tribalgovtaffairs.ca.gov/). If there are any changes or inconsistencies, please contact Heather Hostler, Chief Deputy, (heather.hostler@gov.ca.gov).

• For Tribal Health Program Leaders: The Department of Health Care Services maintains a contact list of tribal health programs. If there are any changes or inconsistencies, please contact Andrea Zubiate, Coordinator, Indian Health Program, (andrea.zubiate@dhcs.ca.gov).

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4. Tribal Contact Information

Feedback and Input:

• Tribal leaders• In room• On phone

• Tribal Council Members• In room• On phone

• Tribal health program leaders• In room• On phone

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5. Other Components• Other components: What else should this policy cover or

address? Is there anything missing?

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5. Other Components

Feedback and Input:

• Tribal leaders• In room• On phone

• Tribal Council Members• In room• On phone

• Tribal health program leaders• In room• On phone

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Next Steps• Any written feedback on today’s presentation: Please send

to TribalConsultation@chhs.ca.gov by Friday, June 6, 2014

• Draft policy: We will review input from today and any written feedback and release draft policy by Friday, June 13, 2014

• Any written feedback on the draft policy: Please send to TribalConsultation@chhs.ca.gov by Tuesday, July 15, 2014

• Final policy: Our goal is to release a final policy by the end of August 2014

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Next Steps• Mailing address: If email is not available, you can mail it to:

California Health and Human Services AgencyAttn: Jim Suennen, Associate Secretary1600 9th Street, Room 460Sacramento, CA 95814

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Thank You• Thank you: We greatly appreciate your participation and input

into the development of our Tribal Consultation Policy.

• Contacts: Key points of contact at the California Health and Human Services Agency:

Kiyomi Burchill, Assistant Secretarykiyomi.burchill@chhs.ca.gov(916) 654-3454

Jim Suennen, Associate Secretaryjim.suennen@chhs.ca.gov

(916) 651-8056

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