The Future of the California Children’s Services (CCS)

The Future of the California Children’s Services (CCS) Program: Overview of CCS Laurie A. Soman Children’s Regional Integrated Service System (CRISS) Lucile Packard Children’s Hospital March 14, 2016

What Is CCS? Oldest Public Health Program in California Created in 1927-- 8 Years Before Federal Maternal and Child Health Program Originally Created to Address Polio Epidemic and Serve as Safety Net to Keep Families from Bankruptcy

What Is CCS? CCS Now CA’s Official Maternal and Child Health Program for CSHCN Covers 180,000 Children/Youth Aged Birth to Age 21 with Complex, Chronic, and/or Potentially Disabling Conditions, e.g. o Sickle Cell Disease o Cancer o Cerebral Palsy o Cystic Fibrosis o Congenital Heart o Hemophilia Conditions

What Is CCS? Built on Managed Care Principles but Specifically for CSHCN Statewide Pediatric Quality Standards that Drive State System of Health Care for All Children Statewide Network of Approved Pediatric Providers, Hospitals and Special Care Centers Prior Authorization of Health Services According to Treatment Plan Medical Case Management with Goal of “Right Care at Right Place at Right Time”

What Has Worked Well in CCS? Population-Based Health Care Delivery Program for CSHCN Regionalized System of Pediatric Specialty Care with Providers/Hospitals/Centers Certified under Statewide Standards Access to Medically Necessary Services Determined by Pediatric Experts and Driven By Child’s Medical Conditions and Needs Access to Statewide CCS Provider Network and Beyond

What Has Worked Well in CCS? Excellent Medical Outcomes Reported in Pediatric Literature High Family and Provider Satisfaction, e.g. o State Title V Need Assessment Reported 89% of Families Very Satisfied/Satisfied with Case Management Fiscally Efficient Program o 92% of CCS Costs Spent on Health-Related Care o 8% on Administration, including Case Management

What Needs Improvement? Does Not Serve “Whole Child”– Responsibility for Care Split Based on Condition Lack of Inclusion of Families and Youth at All Levels of Planning and Decision-Making Inconsistent Coordination of CCS Care with PCPs/ Medical Homes and Across Other Systems-Mental Health, Developmental Services, Special Education Lack of Intensive Care Coordination for High-Need Children and Families Inadequate Preparation for Transition from CCS

CCS At a Crossroad Current CCS Carve-Out Sunsets 12/31/16 CCS Is Last of State’s Fee-for-Service Medi-Cal Programs for Special Populations State CCS Redesign Process Underway DHCS Proposed “Whole Child Model” to Transfer Many CCS Functions to Medi-Cal Managed Care Plans Today’s Panel Will: oExplain State Proposal oProvide Family Perspectives oDiscuss Principles for Redesign