California Children’s Services (CCS) Whole Child Model Program
What is California Children’s Services (CCS)?
The CCS program provides services to children under 21 years old with eligible medical conditions. CCS services include:
- Diagnostic and treatment services.
- Medical case management.
- Physical and occupational therapy services.
- Medical therapy services at public schools.
What is the CCS Whole Child Model program?
Under the Whole Child Model program, CCS children get care from their Medi-Cal managed care health plan (health plan) instead of their county CCS program. This helps children get all of their care through one system. This model helps prevent confusion about where children get care. It can lead to better care management and health results.
As part of CCS WCM, you will get services in the language you speak. You will also get services in places that meet your child’s needs.
When CCS WCM children turn 21, they do not have to change where they get their services.
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.
Examples of CCS-eligible conditions include chronic medical conditions like:
- Cystic fibrosis.
- Hemophilia.
- Cerebral palsy.
- Heart disease.
- Cancer.
- Traumatic injuries.
- Infectious diseases producing major sequelae. Sequelae is the effect of a disease, condition or injury after it happens.
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.
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:
If your child is eligible for the CCS Whole Child Model program, your child’s doctor will treat them for their special health care needs. You will also be assigned a dedicated care coordination team to make sure your child receives the care they need.
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 Supportive 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.
| SERVICE | HOW TO ACCESS |
|---|---|
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The Alliance works directly with you to coordinate behavioral health care. This means your mental health care is managed along with your physical health care, making it easier for you to get the support you need. The goal is to give you complete and connected care for your overall health. |
800-700-3874 Call Member Services at 800-700-3874, Monday through Friday, from 8 a.m. to 5:30 p.m. We'll help you find the right doctor or therapist. |
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When you have health questions, the Alliance Nurse Advice Line is a good place to start. A registered nurse will answer your health questions and help you decide what to do next. |
844-971-8907 (24 hours a day,7 days a week) It is fast, easy and at no cost to you. You won’t spend hours waiting in the emergency room. |
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The Alliance can provide transportation if your child has a medical appointment or you need to pick up a prescription or supplies. |
800-700-3874, 5577 Prior approval is required. Call at least 5 business days before the appointment or service date. |
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If you speak a language other than English, language assistance services are available to you at no cost. |
800-700-3874 We can get an interpreter who speaks your language. For the Hearing or Speech Assistance Line, call 800-735-2929 (TTY: Dial 7-1-1). |
This is a resource guide for families with children who have special needs. This guide shares contact information for places that can help you and your child get the support you need.
Mariposa County
Merced County
Monterey County
San Benito County
Santa Cruz County
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 WCMFAC is an advisory committee to the Alliance that provides input and recommendations on policies and issues that affect children and their families served through the Alliance’s Whole Child Model (WCM) program. The group is made up of representatives of WCM members and parent centers.
WCMFAC meetings meet through video conference once every quarter (four times per year). Meetings are held on Monday afternoons and last 90 minutes.
If you are interested in being on the committee, complete the online application or email the WCMFAC coordinator at [email protected] or call the Alliance at 800-700-3874 for more information. This email is only monitored for WCMFAC topics.
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