California Children’s Services (CCS) [1] is a state program that provides and funds diagnostic and treatment services to children under age 21 with CCS-eligible medical conditions. CCS can be an avenue of assistance for children with significant medical needs regardless of whether they are Regional Center clients.
Services funded via CCS include:
CCS can also help provide coordination between different members of a child's care team. Dr. Shafali Jeste explains in this clip:
CCS-eligible medical conditions, include, among others:
You can find a complete list of eligible conditions at the Department of Health Care Services CCS eligibility website. [2]
In addition to having a CCS-eligible medical disability, your child also needs to meet the following criteria in order to access services:
Your child must be a California resident under age 21.
Your family adjusted gross income (AGI) must be less than $40,000 OR your out-of-pocket medical expenses for your child must be expected to exceed 20 percent of your family’s income.
Family income is NOT a factor for children who:
Need diagnostic services to confirm they have a CCS-eligible medical condition.
Were adopted with a known CCS-eligible medical condition.
Are applying only for services through the Medical Therapy Program [3]. Children with certain neuromusculoskeletal conditions may be eligible for physical and occupational therapy services in conjunction with local education agencies regardless of household income or Medi-Cal status.
Have full-scope Medi-Cal with no share of cost — meaning that you never pay for some of the costs of services provided to your child each month. (For families of children who are Regional Center eligible, it may be worthwhile to investigate Medi-Cal enrollment under the institutional deeming waiver so that income will not be a factor for CCS.)
As with most public programs, private insurance is treated as the primary avenue of funding. If your child has private insurance, CCS will require a written denial from your private insurance before it agrees to fund services or equipment.
If a child has full-scope Medi-Cal, they automatically meet CCS financial eligibility criteria. CCS then acts as a case manager, reviewing and authorizing service requests to be funded by Medi-Cal. If a service is not covered by Medi-Cal, the request is returned to CCS for further review and potential funding.
For step-by-step guides to applying for CCS and enrolling in Medi-Cal, become an Undivided member.
References
[1] California Department of Health Care Services, "California Children’s Services"
[2] California Department of Health Care Services, "Overview of CCS Medical Eligibility"
[3] California Department of Health Care Services, "Medical Therapy Program"
[4] California Department of Health Care Services, "County Offices for California Children's Services"
[5] California Department of Health Care Services, "How to Apply"
