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Whole-Child Model

About the Whole-Child Model

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, 2018. 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, 2019. CalOptima has been meeting with OCHCA to learn more about CCS in Orange County, and discussions about implementation of the changes are ongoing, with decisions pending further guidance from the state. As a priority, CalOptima and OCHCA are focused on ensuring a seamless transition for the children involved.

Given the considerable interest in the Whole-Child Model among families, providers, community-based organizations, advocacy groups and others, CalOptima intends to keep stakeholders informed and provide opportunities for feedback about our implementation plans. We look forward to sharing current information and updating this page as the implementation approaches.

General Information

Click on the links below to learn more about the Whole-Child Model and how it will affect CalOptima members and providers.

February 24, 2017 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

September 14, 2016 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

June 10, 2016 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

March 25, 2016 Stakeholder Meeting MaterialsPDF File Indicator Image

Resources

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 - Whole-Child Model

DHCS - CCS Advisory Group

DHCS - CCS Program Overview

OCHCA - CCS Information and Resources

OCHCA - Provider FAQ

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