專案描述​​ 

CCS 計劃為患有 CCS 符合條件的醫療狀況的 21 歲以下兒童提供診斷和治療服務、醫療病例管理以及物理和職業治療服務。 CCS 符合條件的疾病例包括但不限於慢性醫療狀況，例如囊性纖維化，血友病，腦麻痺，心臟病，癌症，創傷傷和引起主要後果的傳染病。 CCS 還提供在公立學校提供的醫療治療服務。​​ 

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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CCS 計劃是由縣衛生部門和加州衛生護理服務部（DHCS）之間的合作夥伴關係管理。 目前，大約 70％ 的 CCS 合格兒童也符合 Medi-Cal 資格。 Medi-Cal 計劃可以補償他們的護理。 其他 30% 的兒童的照顧費用均分為「僅限 CCS」和「CCS 健康家庭」之間。 僅 CCS 的護理成本在州和縣之間均等資助。 CCS 健康家庭的護理成本獲得 65％ 的聯邦第 XXI 項目，17.5% 的州基金和 17.5% 的縣資金。​​ 

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.​​   

立法機關​​ 

CCS專案的立法​​ 

健康和安全守則，第 123800 條及以下條。是 CCS 計劃的啟用法規。 CCS 計劃的明確立法目的是為患有 CCS 醫療符合條件的兒童提供必要的醫療服務，而父母無法全部或部分支付這些服務費用的兒童。 該法規還要求 DHCS 和縣 CCS 計劃通過與當地公共或私人機構和醫療服務提供商合作來尋找合資格的兒童，以將潛在符合條件的兒童帶到專家診斷和治療來源。​​ 

CCS專案根據《福利和機構法》和《加州法規》（第 22 章第 51013 條）授權，作為CCS加州醫療補助健康保健計劃受益人的「加州醫療補助健康保健計劃的代理人」符合醫療條件。 加州醫療補助健康保健計劃需要將所有符合CCS資格的客戶轉介給CCS以獲得個案管理服務和治療授權。 該法規還要求所有可能符合加州醫療補助健康保健計劃專案資格的CCS申請人申請加州醫療補助健康保健計劃。​​ 

專案管理​​ 

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.​​ 

資金說明​​ 

縣CCS專案的資金來源是縣、州普通基金和聯邦政府撥款的組合。 1992 年通過的調整立法 AB 948 規定，州和縣CCS專案透過分配州普通基金和縣資金來分擔為身體殘疾兒童提供專門醫療護理和康復的費用。 可用於CCS專案的國家資金金額每年透過《預算法》確定。​​