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News and Updates

CCS Advisory Group

The State CCS Advisory Group has been convened to investigate potential improvements or changes to the CCS program. RSAB is composed of individuals from various organizations and backgrounds with expertise in both the CCS program and care for CYSHCN. For updates, and further information on the CCS Advisory Group process, click here.

CCS Advisory Group is also organizing six Technical Work Groups as part of the CCS redesign process, focused on:

For more information and updates on the technical work groups, click here.

CCS PILOT PROJECT: State Approves Five CCS Pilot Projects

On October 12, 2011 the State issued the list of approved CCS pilot projects.  The five awardees are:
  • Alameda County Health Care Services Agency: Enhanced Primary Care Case Management Model
  • Rady Children's Hospital, San Diego: Accountable Care Organization
  • Children's Hospital of Orange County: Accountable Care Organization
  • Los Angeles Care Health Plan (aka LA Care): Specialty Health Plan
  • Health Plan of San Mateo: Medi-Cal Managed Care Plan

As of April, 2015, only one of the pilots—Health Plan of San Mateo—has implemented its project.  HPSM, a County-Organized Health System in a county that already had a CCS carve-in, contracted with county CCS staff to co-locate and work with the plan to implement a series of program changes beginning April1, 2013 for approximately 1500 CCS/Medi-Cal enrollees.  Program changes include:

  • better coordination of primary, specialty and support services through authorization of all services by CCS nurse case managers;
  • comprehensive assessments and development of care plans;
  • more intensive care coordination as needed;
  • attention to family-centered care, including family liaisons (already a feature of San Mateo County CCS) and creation of a family subcommittee.

Click here for more information.

Rady Children’s Hospital in San Diego is preparing to launch an ACO-type CCS pilot of integrated care for CCS-enrolled children/youth with five specific conditions:

  • cystic fibrosis
  • sickle cell
  • hemophilia
  • acute lymphoid leukemia
  • diabetes.

The model would include integrated whole-child care, acuity assessment and care planning, care coordination/care navigation, and a robust evaluation looking at process, cost and quality.

Find more information here.

Both Alameda County and Los Angeles County CCS Programs, while unable to implement formal pilot projects, have embarked upon significant program redesign, built on similar program changes:

  • acuity assessment and stratification by complexity and need for care coordination;
  • enhanced care coordination/family navigation based on child assessment and family need;
  • authorization of services for the whole child;
  • other improvements, including cross-system case management, transition planning, and enhanced support for medical homes.

In addition, Alameda County CCS convened and led the Bay Area Stakeholders Collaborative, which produced a report describing three potential approaches to CCS Redesign. 

For more information:

Information current as of April 7, 2015

NATIONAL HEALTH CARE REFORM

In January 2014, the federal Patient Protection and Affordable Care Act (known as ACA) was fully implemented nationwide. California created its health benefits exchange, Covered California, to allow consumers to easily find and purchase health insurance. Plans on Covered California are available to individuals and families with income between 138-400% of the Federal Poverty Level. Individuals with incomes up to 138% FPL are eligible for Medi-Cal. Open enrollment in Covered California runs from November through February, annually, while Medi-Cal enrollment is year round. Small businesses can also shop for coverage for their employees through Covered California’s Small Business Health Options Program (SHOP).  

Several provisions of the ACA are particularly important for children and youth with special health care needs, requiring plans to:

  • provide recommended preventive services (such as well-child visits and immunizations) without co-pays for enrollees in all new group and individual plans;
  • eliminate annual and lifetime coverage limits in plans; and
  • allow young adults to remain on their parents' health plans until age 26 if they are otherwise uninsured (former foster youth also are eligible for Medi-Cal until age 26 if they were in foster care on their 18th birthday).

For more information on health coverage and how to obtain it, please visit Covered California. If you would like more information on health care reform, please visit Center for Children and Families, Georgetown University Health Policy Institute and Kaiser Family Foundation.

FAMILY HEALTH OUTCOMES PROJECT: TITLE V REPORT

The Family Health Outcomes Project (FHOP) is in the process of submitting the final Title V CSHCN Assessment report to the state. They have completed CCS provider and family surveys, which you can find out more about here and here. You can find out more about the work they are doing by going to their website. Their last report, completed in 2010, is available here.

Governor’s Draft State Budget for FY 2013-2014 Summary – January 2013

Governor Jerry Brown released his proposed Fiscal Year 2013-14 budget on January 10, 2013, proposing total expenditures of $138.6 billion, with $97.65 billion in General Fund and $40.9 billion in special fund expenditures.  For the first time in years, the Governor’s budget proposes a 5% increase in state funding, while creating a $1 billion reserve and paying down over $4 billion in budget-related debt.  Instead of the billions of dollars in budget cuts over the past decade, the draft budget proposes to increase spending on K-12 education and higher education and also proposes to expand Medi-Cal, primarily to low-income single adults, as part of the state’s implementation of the federal Affordable Care Act.

The budget includes new revenue from voter approval of two propositions, Prop 30 and Prop 39, in the November 2012 election.  Without passage of the two propositions, particularly 30, we would be looking at implementation of $6 billion in drastic budget “trigger cuts” (mostly to K-12 education) in the current fiscal year (i.e. right now) and a reduction of $6 billion in Fiscal Year 2013-14 as well. Download the full summary of the draft State budget here.

 

  • State CCS Technical Workgroup

The state created a CCS Technical Workgroup under its Federal 1115 Waiver planning process.  CRISS project director Laurie Soman was named to the group as the official representative of CRISS, and several other CRISS members also served on the group representing other organizations and county CCS programs.  The CCS Workgroup met four times from February to April. All materials for the Workgroup are posted on a special tab on the state federal waiver site at the DHCS website. Links to the minutes of the CCS Technical Workgroups meetings are below:

 

Future CRISS comments and news will be posted here.