Kev piav qhia​​ 

CCS qhov kev pab cuam muab kev kuaj mob thiab kev kho mob, kev tswj xyuas cov ntaub ntawv kho mob, thiab kev kho lub cev thiab kev ua haujlwm rau cov menyuam yaus hnub nyoog qis dua 21 xyoos nrog CCS-tsim nyog kho mob. Piv txwv ntawm CCS-kev tsim nyog muaj xws li, tab sis tsis txwv rau, cov mob ntev xws li cystic fibrosis, hemophilia, cerebral palsy, kab mob plawv, mob qog noj ntshav, kev raug mob, thiab cov kab mob sib kis uas tsim cov kab mob loj. CCS tseem muab cov kev kho mob kho mob uas xa hauv cov tsev kawm ntawv pej xeem.​​ 

To qualify for the CCS program, a child must have a CCS-eligible condition, reside in California and meet financial eligibility. CCS financial eligibility is not limited to families earning $40,000 or less. Families with an adjusted gross income (AGI) of $40,000 or less may qualify, but those with higher incomes may still be eligible if their child’s medical expenses are very high. Children enrolled in Medi-Cal may qualify for CCS. The Medical Therapy Program does not have an income limit and is available to all children who qualify. 
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Txoj haujlwm CCS yog tswj hwm los ntawm kev sib koom tes ntawm lub nroog cov chaw saib xyuas kev noj qab haus huv thiab California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS). Tam sim no, kwv yees li 70 feem pua ntawm cov me nyuam uas tsim nyog CCS kuj yog Medi-Cal tsim nyog. Qhov kev pab cuam Medi-Cal them nyiaj rov qab rau lawv txoj kev saib xyuas. Tus nqi saib xyuas rau lwm tus 30 feem pua ntawm cov menyuam raug faib sib npaug ntawm CCS nkaus xwb thiab CCS Cov Tsev Neeg Noj Qab Haus Huv.  Tus nqi saib xyuas rau CCS nkaus xwb yog pab nyiaj sib npaug ntawm Lub Xeev thiab cov nroog.  Tus nqi ntawm kev saib xyuas rau CCS Healthy Families yog pab nyiaj 65 feem pua tsoom fwv lub luag haujlwm Title XXI, 17.5 feem pua Lub Xeev, thiab 17.5 feem pua cov nyiaj hauv nroog.​​ 

In addition, Insurance Code Sections 12693.62, 12693.64 and 12693.66, relating to the California’s Healthy Families Program, provides that the services authorized by the CCS program to treat a Healthy Families plan’s subscriber’s CCS-eligible medical condition are excluded from the plan’s responsibilities. The participating health plan’s responsibility for providing all covered medically necessary health care and case management services changes at the time that CCS eligibility is determined by the CCS program for the plan subscriber. The health plan is still responsible for providing primary care and prevention services not related to the CCS-eligible medical condition to the plan subscriber so long as they are within the Healthy Families program scope of benefits. The health plan also remains responsible for children referred to but not determined to be eligible for the CCS program.​​   

Legislative Authority​​ 

Ua kom muaj kev cai lij choj ntawm CCS txoj haujlwm​​ 

Kev Noj Qab Haus Huv thiab Kev Nyab Xeeb Code, Tshooj 123800 thiab lwm yam. yog txoj cai tswjfwm rau CCS txoj haujlwm.  Lub hom phiaj tsim cai lij choj ntawm CCS qhov kev pab cuam yog los muab cov kev pab kho mob tsim nyog rau cov me nyuam uas muaj CCS cov kev kho mob uas lawv niam txiv tsis tuaj yeem them rau cov kev pab no, tag nrho lossis ib feem.  Txoj cai lij choj tseem xav kom DHCS thiab lub nroog CCS qhov kev pab cuam nrhiav cov menyuam tsim nyog los ntawm kev koom tes nrog cov pej xeem hauv zos lossis cov koom haum ntiag tug thiab cov kws kho mob kom coj cov menyuam muaj peev xwm tsim nyog rau qhov chaw kuaj mob thiab kho mob.​​ 

Qhov kev pab cuam CCS raug txib los ntawm Welfare and Institutions Code thiab California Code of Regulations (Title 22, Section 51013) los ua "tus neeg sawv cev ntawm Medi-Cal" rau cov neeg tau txais txiaj ntsig Medi-Cal nrog rau CCS kev tsim nyog kho mob.  Medi-Cal yuav tsum xa tag nrho cov neeg tau txais kev pabcuam CCS mus rau CCS rau kev pabcuam kev tswjfwm thiab kev tso cai rau kev khomob.  Txoj cai tseem xav kom txhua tus neeg thov CCS uas tuaj yeem tsim nyog tau txais Medi-Cal qhov kev pab cuam thov Medi-Cal.​​ 

Program Administration​​ 

In counties with populations greater than 200,000 (independent counties), county staff perform all case management activities for eligible children residing within their county. This includes determining all phases of program eligibility, evaluating needs for specific services, determining the appropriate provider(s), and authorizing for medically necessary care. For counties with populations under 200,000 (dependent counties), the Children’s Medical Services (CMS) Branch provides medical case management and eligibility and benefits determination through its regional offices located in Sacramento and Los Angeles. Dependent counties interact directly with families and make decisions on financial and residential eligibility. Some dependent counties have opted to participate in the Case Management Improvement Project (CMIP) to partner with regional offices in determining medical eligibility and service authorization. The regional offices also provide consultation, technical assistance, and oversight to independent counties, individual CCS paneled providers, hospitals, and the Special Care Centers within their region.​​ 

Kev piav qhia txog nyiaj txiag​​ 

Cov nyiaj pab rau lub nroog CCS qhov kev pab cuam yog kev sib txuas ntawm cov nyiaj uas tsim nyog los ntawm lub nroog, Cov Nyiaj Txiag Hauv Xeev, thiab tseem fwv. AB 948, txoj cai hloov kho dua tshiab tau dhau los hauv xyoo 1992, tau txib kom Lub Xeev thiab lub nroog CCS cov kev pab cuam koom nrog rau cov nqi ntawm kev muab kev kho mob tshwj xeeb thiab kho kom rov zoo rau cov menyuam uas tsis taus lub cev los ntawm kev faib nyiaj ntawm Xeev General Fund thiab cov nyiaj hauv nroog. Cov nyiaj hauv Xeev muaj rau qhov kev pab cuam CCS raug txiav txim txhua xyoo los ntawm Txoj Cai Lij Choj Nyiaj Txiag.​​