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.

Mục tiêu của CCS DP bao gồm:

• Cải thiện sự phối hợp chăm sóc và loại bỏ tình trạng cung cấp dịch vụ chăm sóc sức khỏe rời rạc;
• Cải thiện kết quả sức khỏe;
• Nâng cao sự hài lòng của bệnh nhân và người cung cấp dịch vụ;
• Thiết lập trách nhiệm giải trình rõ ràng giữa nhà cung cấp và Nhà nước;
• Duy trì hệ thống cung cấp dịch vụ lấy gia đình làm trung tâm; và
• Bảo tồn mạng lưới nhà cung cấp khu vực CCS hiện có.

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.