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California Children Services FAQs



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. Listed below are categories of medical conditions that may be covered and some examples of each:

• Conditions involving the heart (congenital heart disease)

• Neoplasms (cancers, tumors)

• Disorders of the blood (hemophilia, sickle cell anemia)

• Endocrine, nutritional, and metabolic diseases (thyroid problems, PKU, diabetes)

• Disorders of the genito-urinary system (serious chronic kidney problems)

• Disorders of the gastrointestinal system (chronic inflammatory disease, diseases of the liver)

• Serious birth defects (cleft lip/palate, spina bifida)

• Disorders of the sense organs (hearing loss, glaucoma, cataracts)

• Disorders of the nervous system (cerebral palsy, uncontrolled seizures)

• Disorders of the musculoskeletal system and connective tissues (rheumatoid arthritis, muscular dystrophy)

• Severe disorders of the immune system (HIV infection)

• Disabling conditions or poisonings requiring intensive care or rehabilitation (severe head, brain, or spinal cord injuries, severe burns)

• Complications of premature birth requiring an intensive level of care

Notes 1 Civil Code, Section 1798.17 2 In accordance with Section 41670, Title 22, California Code of Regulations and the California Public Records Act (Government Code, Sections 6250–6255) 3 Section 123800 et. seq. of the California Health and Safety Code 4 California Code of Regulations, Title 2, Chapter 13, Sections 42702–42703 DHCS 4480 (01/08) Page 2 of 5

• Disorders of the skin and subcutaneous tissue (severe hemangioma)

• Medically handicapping malocclusion (severely crooked teeth)

Ask your county CCS office if you have questions.

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.1

To protect your privacy:

• CCS must keep this information confidential.2

• 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 your county CCS office. By law, the information you give CCS is kept by the program.3

Do I have a right to appeal a decision?

You have the right to disagree with decisions made by CCS.4 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 your county CCS office.

Where can I get more information about CCS?

For more information, or help in filling out this application, please contact your county CCS office. Their phone number is usually listed in the government section of your local telephone directory. Look under California Children’s Services or county Health Department.

State of California—Health and Human Services Agency Department of Health Care Services California Children’s Services (CCS) DHCS 4480 (01/08)