Since 1996 CRISS has been working to create a regional seamless system of care for the CCS children in a 25-county region in Northern California.  This region encompasses the following counties:

• Alameda
• Butte
• Colusa
• Contra Costa
• El Dorado
• Glenn
• Humboldt
• Marin
• Mendocino
• Napa
• Placer
• Sacramento
• San Francisco
• San Joaquin
• San Mateo
• Santa Clara
• Santa Cruz
• Shasta
• Solano
• Sonoma
• Stanislaus
• Sutter
• Tehama
• Yolo
• Yuba

CRISS includes:

• American Academy of Pediatrics, CA Dist.
• California Children's Hospital Association
• CARE Parent Network
• CCS Programs of Alameda, Contra Costa, Marin, Napa, Sacramento, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Stanislaus, and Yolo County
• Children's Hospital & Research Center Oakland
• Children's Specialty Care Coalition
• Community Gatepath
• Colusa County Family Resource Center
• Family Resource Network of Alameda County
• Family Resource Network of San Joaquin County
• Family Voices of California
• Lucile Packard Children's Hospital
• Matrix Parent Network and Resource Center
• Parents Helping Parents
• Peaks and Valleys
• Rowell Family Empowerment of Northern Ca
• Safe Passage Family Resource Center
• Santa Clara Valley Health and Hospital System
• Support for Families of Children with Disabilities
• Sutter County Parent Network
• Sutter Medical Center
• The Special Needs Connection
• UC Davis Medical Center
• UCSF Children's Hospital
• WarmLine Family Resource Center
• Yuba County Family Resource Network
  
  

What We Do

We bring together the three major CCS stakeholder groups in a cohesive regional coalition for collaboration and planning. 

Our goals are to:

• Maintain a consistent regional vehicle for coordination and collaboration in the CRISS region.

• Promote family-centered care and medical homes for children with special health care needs.

• Reduce cross-county barriers posed by different eligibility and authorization interpretation and processes.

• Improve regional information sharing with members and other groups regarding the CCS program, best practices, and quality standards.

To meet these goals, we carry out activities such as:

• We convene quarterly meetings of CRISS with representatives of our three core constituencies--families, pediatric providers, and CCS programs--to share information and practices, identify barriers to timely and appropriate care, and design strategies to promote a strong, effective and efficient CCS program.

• We promote family-centered care for children with special health care needs through annual conferences, information-sharing on strategies for promoting family-centered care, and provision of technical assistance to support local CCS program efforts toward family centeredness. We are particularly interested in promoting transition planning for youth graduating out of the CCS program and creation of parent health liaison positions to work with local CCS programs.

• We review CCS medical eligibility regulations and their local interpretation on a regular basis, recommend clarifications and updates to the state, and agree on consistent interpretation and implementation in our region. These activities help to reduce inter-county differences in interpretations that can disrupt children’s care and create obstacles for large pediatric institutions serving children from multiple counties.

• We develop guidelines for consistent interpretation and implementation of state CCS policy and regulations within the CRISS region. Consistency at the county level makes life easier for children and their families, CCS providers, and local CCS programs.

• We work with State CMS, Medi-Cal and EDS to identify and correct barriers to timely processing of CCS claims.  CRISS efforts helped result in the elimination of EDS edits that limited CCS billing and reimbursements (e.g. frequency and location of service edits).  We continue to follow implementation of electronic authorizations and billing, apprising the state of questions and concerns and sharing information on the authorizations and claims processes among provider groups and institutions.

Breaking News

CCS REDESIGN AND FEDERAL WAIVER RENEWAL PLANNING

In August of 2009 the State Department of Health Care Services (DHCS) contracted with a consulting group, Health Management Associates (HMA), to convene a stakeholder process to look at CCS and consider options for redesign of the program.  CRISS submitted comments to HMA and DHCS on the CCS Stakeholder Discussion Guide circulated for consideration by stakeholders.  CRISS comments are available here.  HMA subsequently completed its written report on CCS, “Considerations for Redesign of the California Children’s Services (CCS) Program”, submitted to the state in September, 2009.  A copy of that report is available here.

In addition, the State Department of Health Care Services has embarked on a stakeholder process to contribute to planning for the state’s federal 1115 Medi-Cal waiver effort.  California must submit a new waiver application to the federal government by August, 2010 to replace the expiring current waiver.  DHCS is looking to the waiver process as a means to reorganize health care delivery for several high-cost populations of Medi-Cal recipients, including:

• children in CCS;
• seniors;
• persons with disabilities (including children);
• adults with severe mental illness; and
• people who are dually eligible for both Medicare and Medi-Cal. 

The state issued a draft concept paper for the new waiver in October, 2009.  CRISS submitted comments on the draft concept paper; those comments are available here.  The state issued its final version of the concept paper in December, 2009; a copy of that paper is available here.

The state’s Waiver Stakeholder Advisory Committee is holding meetings in 2010.  CRISS anticipates that the state will establish a subcommittee focused specifically on CCS and will monitor developments concerning CCS redesign.  Information on the waiver and the Advisory Committee is available on the state Waiver Renewal website.  Future CRISS comments and news will be posted here.