California Children’s Services Demonstration Project
The 1115 "Bridge to Reform" Waiver (Waiver) renewal of November 2010 was intended to identify and test alternative health care delivery models for the California Children’s Services (CCS) program. A CCS Demonstration Project (DP) was pursued to test the efficacy of transitioning the CCS program from a fee-for-service based health care delivery model to an organized health care delivery model with a capitated payment. The CCS DP tests new approaches to improve the quality of care provided to children (up to 21 years of age) with special health care needs and focuses on identifying and solving roadblocks to access to care and ensuring families receive appropriate health care services for their child or youth.
Goals of the CCS DP include:
Improve coordination of care and remove delivery of fragmented health care;
Improve health outcomes;
Improve patient and provider satisfaction;
Establish clear provider and State accountability;
Maintain a family-centered delivery system; and
Preserve the existing CCS Regional Provider Network.
CCS DP Request for Proposal
On April 1, 2013 the Health Plan of San Mateo (HPSM), in partnership with the San Mateo County Health System, became the first operational CCS DP pilot under the Waiver. DHCS selected the HPSM to participate in the CCS DP pilot under a full risk Medi-Cal Managed Care Plan model to improve the county’s CCS program through enhanced care coordination. The HPSM provides comprehensive health care to approximately 1,400 CCS eligible clients, and manages and coordinates a full range of health care services for the "whole" child including periodic health assessments, immunizations, primary health care services not related to the CCS eligible medical condition and specialty health care services.