CCS

From the Orange County CCS website.

What is CCS?
California Children Services is a statewide program of specialized medical care providing the following for children with certain healthcare needs

medical case management
physical/occupational therapy services
financial assistance

What are the goals of CCS?

To locate California children who may need the specialized medical care and program benefits offered by CCS
To prevent disabling conditions in children through early diagnosis and treatment
To help California families obtain quality medical care and financial assistance to enable the maximum development of their children
To maximize function for children with severe physically disabling conditions

Who is eligible for CCS?

The program is open to anyone who meets the following conditions:

Under 21 years of age
Has a physical disability or condition that is eligible for medical care under CCS
Is an Orange County, California resident
Family adjusted gross income of less than $40,000 per year...OR...
Over $40,000 per year with eligible out-of-pocket medical expenses are expected to exceed 20 percent of family income

Which medical conditions are eligible?

Eligible conditions include severe physical disabilities resulting from congenital defects or those acquired through disease, accident or abnormal development. Examples include cerebral palsy, cystic fibrosis, cancer, heart conditions and orthopedic disorders.

What services are provided?

Physical/Occupational Therapy
CCS provides physical and occupational therapy to children with certain health care needs free, regardless of family income. These services are provided in Medical Therapy Units (MTU) located on public school throughout the county and may help a child to be more independent with functional skills, such as feeding, dressing, walking or wheelchair mobility.

Case Management Services
Services include assistance with referrals to specialists and special centers and follow-up with schools, social workers, and other agencies involved in the child's medical care.

Management Partners
CCS is a partner with CalOptima, Medi-Cal, and Healthy Families, to case manage medical care for children with a CCS eligible medical condition. CCS may cover services that are not covered by Medi-Cal.

How are CCS services obtained?

Anyone may refer a child to CCS, including his or her family, hospitals, doctors and public health or school nurses. The child must be referred to CCS in the county of residence. Once a referral is made, a CCS application completed by the parent or legal guardian and medical reports must be received to begin the eligibility determination process.

What if I have private health insurance coverage for my child?
Your child can be eligible for the CCS program even though you have private health insurance coverage. If your child is a CCS applicant/client and has individual or group private health insurance coverage, you must report it to the county CCS office and to the child's health care provider. Private health insurance coverage is used to help reduce CCS program costs.

What if my child is Medi-Cal eligible?
Children who are Medi-Cal eligible and have approved CCS medical conditions are usually eligible for CCS case management and other services not covered by Medi-Cal. This is also true for children who are enrolled in Medi-Cal managed care plans. This arrangement assures that all California children with complex, disabling medical conditions will receive appropriate specialized care.

Will there be a cost to the family of a CCS eligible child?
Some families may be required to pay an annual assessment fee and/or annual enrollment fee. These fees are used to help cover the cost of treatment, processing applications, telephoning hospitals, physicians and other caregivers, mailing authorizations to these caregivers and coordinating care with other agencies. All of these services are provided by the CCS program to ensure that clients receive the best care possible from physicians and specialists who provide medical care to children. The annual assessment fee is $20 and the annual enrollment fee is calculated based on family size and income.

Which applicants/clients or families are required to pay the annual assessment fee?
Applicants/clients or families applying for the CCS program whose income exceeds 100 percent of the federal poverty level are required to pay the annual assessment fee unless they are determined by the county CCS office to be exempt from paying the fee.

Which applicants/clients or families are not required to pay the annual assessment fee?

Applicants/clients or families with full Medi-Cal benefits without a monthly share of cost.
Applicants/clients receiving Medical Therapy Unit Program therapy services as part of an individualized education plan.
Families with incomes less than 100 percent of the federal poverty level.
Applicants/clients who are Healthy Family subscribers.