California Children’s Services (CCS) is a statewide program for children with certain medical conditions. CCS provides medical care, case management, physical/occupational therapy and financial assistance for these children. At this time, CCS services are carved-out of most Medi-Cal Managed Care Plans, including CalOptima.
Orange County Health Care Agency (OCHCA) is responsible for administering the CCS program locally. OCHCA provides case management, eligibility determination, service authorization and direct therapy under the Medical Therapy Program.
However, the California Department of Health Care Services (DHCS) intends to make CCS services a Medi-Cal Managed Care Plan benefit, no sooner than July 1, 2017. The goal is to improve care coordination for the whole child, rather than handle CCS conditions separately. This approach is known as the Whole-Child Model.
Under this model, OCHCA will remain responsible for determining eligibility and for the Medical Therapy Program. CalOptima will become responsible for most other CCS functions no sooner than January 1, 2018. CalOptima and OCHCA are meeting regularly to plan for this change.
CalOptima is aware that families, providers, community-based organizations, advocacy groups and others have considerable interest in and concern about the implementation of the Whole-Child Model. CalOptima will keep stakeholders informed and provide opportunities for feedback about our implementation plans.
We are committed to providing stakeholders with current information and look forward to updating this page as the implementation approaches.
Click on the links below to learn more about the Whole-Child Model and how it will affect CalOptima members and providers.
June 10, 2016 Memo From Michael Schrader, CalOptima CEO
March 25, 2016 Stakeholder Meeting Materials
June 29, 2016 DHCS Stakeholder Advisory Meeting Materials
Click on the links below to learn more about CCS and the Whole-Child Model. These programs are coordinated by DHCS, OCHCA and CalOptima.
DHCS - CCS Advisory Group
DHCS - Whole-Child Model Documents
DHCS - CCS Program Overview
OCHCA - CCS Information and Resources
OCHCA - Provider FAQ
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