California Children’s Services (CCS) Whole Child Model Program

The Alliance helps with case management and care coordination to support and improve overall care for children who are part of the WCM program. Alliance staff can help families enrolled in CCS by:

• Showing them how to use and pay for medical treatment and services through the Whole Child Model.
• Explaining their child’s medical condition(s) and recommending specialists who can treat it.
• Helping families apply for social services like Supplemental Security Income (SSI), food stamps, housing services and other medical programs.
• Helping families resolve concerns or complaints about their child’s medical care.
• Helping families use services and file appeals if their child is not approved for care.

Children who are under the age of 21 with special health care needs that need to be treated with medicines, surgery or rehabilitation. The county’s CCS program decides who is eligible for CCS.

If you think your child might be eligible, contact the Alliance’s Care Management team at 800-700-3874, ext. 5512. Our team is made up of nurses, social workers and care coordinators to help your child with case management and care coordination. We can work with you to create a plan that fits your needs by meeting with you over the phone or in person at your home or your doctor’s office.

You can also ask your doctor to refer you to the CCS program in your county, or you can check your county’s website to learn how to make your own referral:

• Merced County
• Monterey County
• Santa Cruz County

If your child is eligible for the CCS Whole Child Model, your child’s doctor will treat him or her for their special health care needs. You will also be assigned a dedicated care coordination team to make sure your child receives the care he/she needs.

For more information on the Whole Child Model, view the California Department of Health Services (DHCS) Whole Child Model Flyer.

The CCS Whole Child Model program can help pay for services and treatments if they are medically necessary. Some examples include:

• Doctor and specialist visits.
• Hospital stays.
• In-Home Nursing Services (IHSS).
• Incontinence supplies.
• Lab tests and x-rays.
• Medical equipment, like wheelchairs and hearing aids.
• Medicine.
• Medical supplies.
• Mental health services.
• Orthopedic appliances.
• Physical, occupational and speech therapy.
• Surgeries.

The CCS Whole Child Model is part of the Alliance’s Medi-Cal program. There is no extra cost. If your child is covered under Medi-Cal, the Alliance will pay for the services that your child needs, even if your child is not eligible for the CCS Whole Child Model.

When children in the CCS Whole Child Model program turn 21, they are no longer covered by CCS. Instead, they get their health coverage through the Alliance’s Medi-Cal plan. This change is called transition planning. Transition planning helps youths ages 18-21 to:

• Learn the life and social skills needed to live independently.
• Create a plan with family and other trusted people.
• Focus on their interests and plan for the future.
• Transition from pediatric health care to adult health care.

Transition planning can help youths with setting and reaching goals around:

• Health care.
• Post-high school education.
• Career or vocational training.
• Finding a job.
• Taking part in community activities.
• Living as an adult.
• Other support services based on needs.

For help with transition planning, contact our Care Management team at 800-700-3874, ext. 5512.

The Whole Child Model Family Advisory Committee (WCMFAC) represents the needs and concerns of families of CCS-eligible children. This committee works to build family-centered care and makes suggestions on how to meet the Whole Child Model goals.

The group is made up of families with children who have special health care needs, Alliance staff, county CCS staff, Alliance Board members and representatives from community-based organizations.

The WCMFAC provides feedback to the Alliance’s Santa Cruz-Monterey-Merced Managed Medical Care Commission, also known as the Alliance Board, on services provided by the health plan and health care coordination. WCMFAC’s goal is to hear from families of children with special health care needs and provide support.

WCMFAC members will:

• Advise the Alliance Board on issues and concerns of members and their families as they relate to the Whole Child Model program.
• Serve as voices of Alliance members who might not be heard otherwise.
• Educate families about the services provided for children with special health care needs.
• Help improve services for current and future CCS Alliance members.

WCMFAC meetings meet through video conference. Meetings last 90 minutes.

If you are interested in being on the committee, complete the online application or email [email protected] for more information.