Disclosures I have nothing to disclose. Overview & Learning - - PDF document

California Children’s Services: Nuts & Bolts

Ben Meisel, MD – Medical Director CCS San Francisco

19th Annual Developmental Disabilities: An Update for Health Professionals March 5‐6, 2020

Disclosures

I have nothing to disclose.

Overview & Learning Objectives

• History and Basics – What is California Children’s Services
• Eligibility
• Services
• What CCS is NOT!
• The Medical Therapy Program
• Whole Child Model vs Independent Counties vs Dependent Counties
• Who Can Refer to CCS and HOW?
• Life After 21 years old?

CCS – THE BASICS

The The His History

• ry
• 1927 California Crippled Children’s Program
• Care for children affected by Polio
• Dept of Health Care Services (DHCS) funding to improve medical

care of children and mothers

• NOT the Department of Developmental Services
• Separately created in 1979 – Lanterman Act
• Regional Center Funding

CCS – THE BASICS

The The Mi Missi ssion

• Making Pediatric Subspecialty Medical Care available to children with eligible

medical conditions.

• Providing expert Physical Therapy and Occupational Therapy to children with

qualifying neuromuscular & musculoskeletal conditions.

• To arrange, direct, and pay for specialized medical care, equipment, and

rehabilitation for children who qualify.

• Improving care and decreasing costs in the long run.

CCS – THE BASICS

Elig Eligib ibility ility

Under 21 years of age. Permanent resident of the California County where you apply. Medi‐Cal eligible or Family income < $40,000/yr or Cost >20% AGI Medically eligible condition “Think Chronic, Lifelong Conditions”

• Some examples:
• Cancers
• Sickle cell, Hemophilia, Thalassemia
• Intractable seizure disorder
• Transplants
• Congenital Heart disease

CCS – THE BASICS

Ser Servic ices es Pr Provi

• vided
• Specialized Treatment*:
• Board Certified Physician Services
• Hospital & Surgical Care
• Rehabilitation OT/PT
• Skilled Nursing
• Lab Tests, Radiology
• Medical Equipment, Supplies, & Medicines
• Medical Case Management
• Medical Therapy Program (MTP)

PT & OT separate from public school PT/OT program

• High Risk Infant Follow‐up (HRIF)

*All medical services must be done by CCS approved providers and at CCS approved institutions, including Special Care Centers.

CCS – THE BASICS

What What CC CCS is is NO NOT! T!

NOT Developmental, Behavioral, or Hypotonic conditions NOT Primary Care Services NOT Short term hospitalizations or transient health challenges

Medical Therapy Program (MTP)

Medically Necessary PT & OT services

Specific musculoskeletal or neuromuscular conditions Not hypotonic CP

Medical Therapy Units (MTU’S) at public school sites NO COST to the family

Eligibility for Services

CCS

Reside in San Francisco Eligible medical condition Under 21 yo Financial

MTP

Reside in San Francisco Eligible medical condition Under 21 yo Based on Physical Exam by Specialist MD (Ortho/Neuro/Rehab)

CCS Case Management

3 Different Possibilities:

Independent Counties

The County Public Health Department

Whole Child Model Counties

A Contracted Medi‐Cal Managed Care Plan

Dependent Counties

State Employees

CCS – How to Access

Anyone can Refer – Normally subspecialty MD providers

Medical Providers submit a SAR Request Form

https://www.dhcs.ca.gov/formsandpubs/forms/Forms/ChildMedSvcForms/dhcs4488.pdf

Families submit an application

https://www.dhcs.ca.gov/formsandpubs/forms/Forms/ChildMedSvcForms/dhcs4480.pdf

For MTP Referral

Neurologist, Rehab, or Ortho MD note with physical exam

Life After 21yo

When CCS Stops?

There is nothing for adults that replaces CCS Few Adult Medicine offices have Case Management Medi‐Cal is supposed to continue care for eligible clients Regional Center clients get some case management support

Questions

CONTACT US

@

30 Van Ness Ave, Suite 210 San Francisco, CA 94102 (415)575‐5700

Ben “Dr. Ben” Meisel – Medical Director

• (415)575‐5738
• Ben.Meisel@sfdph.org

Katie Kim – NURSE MANAGER

• (415)575‐5674
• Katie.Kim@sfdph.org