California Children's Services (CCS)
California Children's Services (CCS) is a statewide program that arranges, directs, and pays for medical care, equipment, and rehabilitation, when these services are authorized by the program. Services can be authorized for children and young adults less than 21 years of age who have eligible medical conditions and whose families are unable to pay for all or part of their care. +more
CCS defines eligibility and selects the most qualified professionals to treat the child's CCS-eligible condition. However, it is important for you to know that CCS is not a health insurance program. It will not meet all of the child's health needs, only those related to the CCS-eligible condition. The Medical Therapy Program (MTP) is a coordinated program of medically necessary physical and occupational therapy services provided to medically eligible children. These services are provided in the Medical Therapy Units (MTUs) located at certain public schools. Therapy may help your child to be independent in such areas as getting around, getting in and out of a wheelchair, walking, feeding, dressing, staying clean and neat, and home skills.
Is Your Child Eligible
Your child may be eligible if he/she meets all four of the following requirements:
- Age: Your child must be under 21 years of age
- Residence: Your child must be a permanent resident of the California county where you apply. Your child's residence is usually where you live.
- Income: If your child is not already enrolled in Medi-Cal or the Healthy Families Program, your income must be less than $40,000 per year, according to the adjusted gross income on you California income taxes. A child may be eligible when the family income is more than $40,000 if medical care for the child's CCS condition is expected to cost the family more than 20 percent of the family's yearly income. If your child is adopted and has a CCS eligible conditions at the time of adoption, your income will not matter. There is no financial eligibility requirement for CCS diagnostic services or the CCS Medical Therapy program.
- Medical Conditions: Only certain conditions are eligible for CCS. In general, CCS covers medical conditions that are physically disabling or require medical, surgical, or rehabilitative services.
What Medical Conditions Are Covered
Conditions covered by CCS include:
- Conditions involving the heart (congenital heart disease, Rheumatic heart disease)
- Neoplasms (cancers, tumors)
- Diseases of the blood (hemophilia, sickle cell anemia)
- Diseases of the respiratory system (cystic fibrosis, chronic lung disease)
- Endocrine, nutritional, and metabolic diseases (thyroid problems, PKU, diabetes that is hard to control)
- Diseases of the genito-urinary system (serious kidney problems)
- Diseases of the gastrointestinal system (liver problems, such as biliary atresia)
- Serious birth defects (cleft lip/palate, spina bifida)
- Diseases of the sense organs (eye problems leading to loss of vision such as glaucoma and cataracts, hearing loss)
- Diseases of the nervous system (cerebral palsy, uncontrolled epilepsy/seizures)
- Diseases of the musculoskeletal system and connective tissue (rheumatoid arthritis, muscular dystrophy)
- Severe disorders of the immune system (HIV infection)
- Disabling injuries and poisonings requiring intensive care or rehabilitation (severe head, brain or spinal cord injuries and severe burns)
- Complications of premature birth requiring an intensive level of care
- Diseases of the skin and subcutaneous tissue (severe hemangioma)
- Medically handicapping malocclusion (severely crooked teeth)
If you have any questions about whether your child has any of these conditions, please consult your child's doctor.
The list above is made up of common qualifying conditions. If you have a question about additional eligible medical conditions, please contact Placer County CCS at (530) 886-3630.
What Services are Provided
If a potential CCS client is suspected of having a CCS eligible medical condition, but additional tests or studies are needed to confirm the medically eligible condition, the case may be opened for just those studies or tests needed to confirm the presence or absence of the suspected CCS medical condition.
- Doctor services
- Hospital and surgical care
- Physical therapy (PT)
- Occupational therapy (OT)
- Laboratory tests
- Orthopedic appliances
- Medical equipment
Medical Case Management
Medical case management can help access specialty care when medically necessary, and make referrals to other agencies, including public health nursing and regional centers.
Medical Therapy Program (MTP)
The MTP is a special program within CCS that provides physical, occupational , and medical therapy conference services for children who have handicapping conditions generally due to neurological or musculoskeletal disorders.
Frequently Asked Questions
How can I find out if my child has a CCS medically eligible condition?
Anyone may refer a child to CCS to determine if the child has an approved CCS medically eligible condition. Most children are referred by the family physician, specialist or hospital. The physician or hospital can supply important medical information necessary in making the CCS medical eligibility determination and may also participate in the child’s CCS treatment program.
Where do I apply for the CCS program?
You should apply for the CCS program at your local CCS office in the county where you reside. This office should be contacted for assistance as requests for CCS coverage must be made on or before the day services are rendered, except for emergencies. This office can tell you if your child may be eligible for the CCS program. CCS eligibility must be determined before services can be covered by CCS.
How will I know if my child is eligible for CCS program benefits?
The county CCS office or the appropriate State Regional Office will consider your child’s medical condition as well as the family’s residential and financial status to determine CCS eligibility. This is accomplished by completing the necessary application forms and providing the required documentation. Based on this information and completed paperwork the CCS program will approve or deny your application. If your application is denied, you have the right to appeal the decisions
What if my child has health insurance coverage with the Healthy Families (HF) Program?
Your child’s HF coverage does not provide payments for services to fully diagnose or treat a CCS eligible medical condition. If your child is suspected of having a CCS eligible medical condition, you will be referred to a special CCS paneled provider who is experienced in diagnosing and treating the suspected eligible medical condition. Upon approval by CCS, the diagnosis and treatment services will be covered by the CCS program. CCS is a partner with the HF program to provide your child with the specialized medical care needed to treat your child’s CCS eligible medical condition. You must accept the CCS referral to a CCS paneled or approved provider in order to receive all the benefits of the CCS program. The HF plan remains responsible for providing your child’s primary care, prevention and other treatment services not authorized by the CCS program. You must inform CCS at the time your child’s HF coverage changes or is terminated.
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 children with complex, disabling medical conditions will receive appropriate specialized care.
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 office and the child’s health care provider. Private health insurance entitlement is used to help reduce CCS program costs.
Will there be any cost to the family of a CCS client?
Some families may be required to pay an annual assessment and/or annual enrollment fee. These fees are used to help cover the cost of treatment, process 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 income and household size.