California Children Services

California Children Services (CCS) is a statewide program that arranges and pays for medical care, equipment, and rehabilitation for eligible children and youth. Services can be authorized for children and young adults under 21 years of age who have eligible medical conditions (such as congenital heart disease, sickle cell anemia, cystic fibrosis, cleft palate, and HIV infection) and whose families are unable to pay for all or part of their care. CCS determines eligibility and selects the most qualified professionals to treat each child's CCS-eligible condition.

Who is Eligible for CCS?

A child may be eligible for CCS if she or he meets all of the four following criteria.

1. Age - The child must be under 21 years of age.
2. Residence - The child must be a permanent California resident.
3. Family Income - The child's family income must meet one of the following criteria.
   • Be less than $40,000 per year (adjusted gross income as reported on California State income taxes) - OR
   • If greater than $40,000, a child may be eligible if medical care for the CCS-eligible condition is expected to cost more than 20% of the family's income.
   • EXCEPTION: Income is not a factor in determining eligibility for the medical therapy program. Eligibility for the medical therapy program is based on medical condition and clinical findings.
4. 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.
5. Even if a child has private insurance, she/he may still qualify for CCS.

What Services Does CCS Provide?

Diagnostic Services

CCS will pay for diagnostic services if sufficient evidence exists that a child may have a CCS eligible condition.

Treatment Services

CCS will pay for treatment services that are medically necessary to treat a child's CCS-eligible condition. Services may include medical, dental, and surgical care, pharmaceuticals, laboratory tests, x-rays, appliances, and equipment.

Medical Therapy Program

The CCS Medical Therapy Program provides medically necessary physical, occupational, and medical therapy conference services to children who are medically eligible for the program.

Case Management

Every family involved in the CCS program receives case management. Services include referrals to medical specialists and centers, help to coordinate care with schools, public health/school nurses, social workers, and other agencies, transferring medical records, locating new facilities and services when needed, and assisting families to cope with a child's condition.

Collaboration

Contra Costa County CCS works collaboratively with local school districts, family resource centers, public health programs, health plans and insurance companies to provide high quality, appropriate services to children and families. Collaboration involves ongoing communication and coordination between agencies to ensure children's needs are met in a timely, well-integrated manner, and in accordance with state and federal law.

How Can a Child Receive CCS Services?

• Step 1 - Child's Condition Identified By a Physician (CCS uses the physician's report to clarify and define whether the child has a CCS eligible condition)
• Step 2 - Referral Made. Anyone can refer a child to CCS, including parents. Simply call Contra Costa County CCS at 925 313-6100.
• Step 3 - Application Completed Parent/Guardian must complete and submit an application form.
• Step 4 - Eligibility Determined
  • Age
  • Residency
  • Financial
  • Medical
• Step 5 - Services Provided (CCS eligibility must be determined before CCS can cover services.)

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Eligible Medical Conditions

• 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, or diabetes that is difficult 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, and 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)

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