Frequently Asked Questions
What is California Children’s Services?
CCS is a statewide program that treats children with certain physical limitations and chronic health conditions or diseases. CCS can authorize and pay for specific medical services and equipment provided by CCS-approved specialists. The California Department of Health Care Services manages the CCS program. Larger counties operate their own CCS programs, while smaller counties share the operation of their program with state CCS regional offices in Sacramento, San Francisco, and Los Angeles. The program is funded with state, county, and federal tax monies, along with some fees paid by parents.
What does CCS offer children?
If you or your child’s doctor think that your child might have a CCS-eligible medical condition, CCS may pay for or provide a medical evaluation to find out if your child’s condition is covered.
If your child is eligible, CCS may pay for or provide:
- Treatment, such as doctor services, hospital and surgical care, physical therapy and occupational therapy, laboratory tests, X-rays, orthopedic appliances and medical equipment.
- Medical case management to help get special doctors and care for your child when medically necessary, and referral to other agencies, including public health nursing and regional centers, or a
- Medical Therapy Program (MTP), which can provide physical therapy and/or occupational therapy in public schools for children who are medically eligible.
Who qualifies for CCS?
The program is open to anyone who:
- Is under 21 years old,
- Has or may have a medical condition that is covered by CCS;
- Is a resident of California, and
- Has a family income of less than $40,000 as reported on the adjusted gross income on the state tax form or whose out-of-pocket medical expenses for a child who qualifies are expected to be more than 20 percent of family income; or the child has Healthy Families coverage.
Family income is not a factor for children who:
- Need diagnostic services to confirm a CCS eligible medical condition; or
- Were adopted with a known CCS eligible medical condition; or
- Are applying only for services through the Medical Therapy Program; or
- Have Medi-Cal full scope, no share of cost; or
- Have Healthy Families coverage.
What medical conditions does CCS cover?
Only certain conditions are covered by CCS. In general, CCS covers medical conditions that are physically disabling or require medical, surgical, or rehabilitative services. There also may be certain criteria that determine if your child’s medical condition is eligible. The State medical eligibilty website has a list of medical conditions that may be covered and some examples of each.
What must the applicant or family do to qualify?
Families (or the applicant if age 18 or older, or an emancipated minor) must:
- Complete the application form on page 3 and return it to their county CCS office,
- Give CCS all of the information requested so CCS can determine if the family qualifies,
- Apply to Medi-Cal if CCS believes that a family’s income qualifies them for the Medi-Cal program. (If a family qualifies for Medi-Cal, the child is also covered by CCS. CCS approves the services; payment is made through Medi-Cal.)
How is my privacy protected?
California law requires that families applying for services be given information on how CCS protects their privacy.
To protect your privacy:
- CCS must keep this information confidential.
- CCS may share information on the form with authorized staff from other health and welfare programs only when you have signed a consent form.
You have the right to see your application and CCS records concerning you or your child. If you wish to see these records, contact our office. By law, the information you give CCS is kept by the program.
Do I have a right to appeal a decision?
You have the right to disagree with decisions made by CCS. This is called an appeal. The appeal process gives the parent/legal guardian or applicant a way to work with the CCS program to find solutions to disagreements. For information on the appeal process, contact our office.
Where can I get more information about CCS?
For more information, or help in filling out this application, please contact our office.
How do I know if my child is eligible?
California children and young adults under the age of 21 may be eligible if they have a serious medical condition requiring special care such as diabetes, cerebral palsy, cancer, sickle cell anemia, traumatic injuries, hearing loss, and many others.
How does CCS help my child?
CCS can help you find and pay for medical services that may include the following: hospital and physician care; x-ray and laboratory services; medical supplies and equipment; medications; home health care; physical and occupational therapy; orthodontic care; confidential HIV testing and monitoring. (All services except emergencies need CCS approval before the services are given.)
How are children referred to CCS?
Typically, a referral to CCS is made by your child's health care provider or medical insurance plan. However, any concerned person, such as a parent, teacher, or social worker may refer a child to CCS.
What are the income guidelines?
Children with full-scope Medi-Cal insurance are eligible. Children in families with adjusted gross income under $40,000 are eligible. Children in families with adjusted gross income over $40,000 may be eligible. If you are being referred for the Medical Therapy Program that provides occupational and physical therapy, there are no income requirements. Eligibility is based on diagnosis.
If my child already has Medi-Cal, why does she need CCS?
Medi-Cal has an agreement with CCS for CCS to manage medical care for children with special health needs. CCS may cover some services that Medi-Cal does not cover.
Are there any fees for CCS services?
There are no fees for children who have full-scope Medi-Cal insurance. Other families may need to pay a small annual fee based on family size and income.
Can my child have CCS and Regional Center services?
Yes. Many children are eligible for both CCS and Regional Center services. CCS ends at the age of 21, Regional Center services often continue.
What if my child has an HMO?
Children with HMOs may be eligible for CCS if the requested services are not a benefit of their HMO. Children with HMOs are eligible for Medical Therapy Unit (MTU) services.
Is treatment for autism covered by CCS?
No. Autism is not a CCS-covered diagnosis. Current, detailed information on medical eligibility and conditions covered can be found on the State medical eligibility web page.