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California Children’s Services
If your child has a life threatening or disabling medical condition that meets program eligibility criteria, this program may be able to provide financial assistance for medical services and coordinate health care services. Services include physical and occupational therapy, financial assistance, case management and access to specialized medical care. Your child must be under 21 years of age, family income must meet certain eligibility guidelines and only certain eligible conditions are covered.
Eligibility
- Age: Your child must be under 21 years of age.
- Residency: Your child must be a permanent resident of the California County where you apply. County of employment does not qualify for application.
- Income: Your family income must be less than $40,000 per year, according to the adjusted gross income on your California income taxes. A child whose family has a higher income may receive services if the estimated cost of medical care in one year is expected to exceed 20 percent of the family income. If your child has full scope Medi-Cal with no Share of Cost, the family income can exceed $40,000. State regulations require families to apply for Medi-Cal when they are requesting medical coverage to pay for hospitalizations, medical provider appointments, medications and/or durable medical equipment or supplies from the California Children's Services (CCS) program.
- Only certain medical conditions are eligible for CCS. In general, CCS covers medical conditions that are physically disabling or require medical, surgical or rehabilitative services. If there is adequate medical documentation to suggest an eligible medical condition, your child may qualify for free diagnostic services, including examinations, laboratory tests and X-rays.
- Find a list of medical conditions that are generally eligible for the CCS program.
Applying for the Program
Please contact the CCS Program to apply, by calling County of Lake Health Services at (707) 263-5806 or visiting County of Lake Health Services Department at 922 Bevins Court, Lakeport, California.
CCS Program Application English (PDF)
Solicitud del Programa de CCS Spanish (PDF)
Referral
Anyone may refer a child to CCS, including but not limited to:
- Child’s family,
- Physician,
- Nurse,
- Hospital,
- Medical specialist.
Referral to CCS can be made by calling Lake County Health Services 707-263-5806 (CCS Office) or 800-794-9291 (Public Health Reception). CCS staff can answer your general questions about medical eligibility. Actual medical eligibility determinations are determined by the Department of Health Care Services Integrated Systems of Care Division in Sacramento, CA.
Children with Medi-Cal and an eligible CCS medical condition are usually eligible for CCS case management and other services not covered by Medi-Cal only. Children covered by private health insurance may also be eligible for CCS services. Some families may be required to pay a small fee, based on their income. County CCS Programs collaborate with Medi Cal Managed Care Plans in Whole Child Model Counties.
CCS eligibility must be determined and services authorized before care can be covered by CCS, except in some emergencies.
- What is California Children's Services (CCS)?
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This federal and state tax-supported program provides specialized medical care and rehabilitation services for children whose families cannot provide all or part of the care. Children with commercial (private) health insurance may or may not be eligible for some services depending upon their insurance plan. California's medical program for treating children with physically disabling conditions was started by The California Legislature in 1927. Many life threatening or disabling conditions are eligible for benefits under the CCS program. For more information, contact us at 707-263-5806
- What are the CCS program goals?
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The California Children's Services program goals are:
- To identify and refer eligible California children who may require CCS specialized medical care
- To encourage eligible California families with physically disabled children to obtain the medical services necessary to bring about optimal development of their children
- To enable eligible California families to obtain medical treatment of their child's condition at the time care will be most effective
For more information, contact us at 707-263-5806
- Who is eligible for the CCS program?
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The program is available to California residents:
- Who are under 21 years of age
- Have a CCS eligible life threatening or disabling medical condition
- Family income is less than $40,000 a year (State adjusted gross income). An individual whose family has a higher income may be eligible to enroll in CCS to receive services if the estimated cost of medical care for the qualifying medical condition in one year is expected to exceed 20 percent of their annual gross income
For more information, contact us at 707-263-5806
- What services does the CCS program provide?
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- Children with medical documentation of a suspected CCS eligible medical condition(s) may be eligible for free diagnostic evaluations.
- Treatment services for the life threatening or disabling condition, including: medical and surgical care, pharmaceuticals, physical and occupational therapy, laboratory tests, X-ray, appliances, equipment, and other needed services.
- Physical and occupational therapy is provided in medical therapy units located in public schools to children with qualifying physical disabilities who have a medical need for these treatment services. (These CCS services do not require financial eligibility).
- Medical case management is provided by the CCS program. It includes: referrals to approved medical specialists and specialty centers; follow-up with others involved with the care of the child such as schools, public health/school nurses, social workers and other agencies; transferring medical records; locating new facilities and services when families move. Most of these specialists and centers for the North Bay region are in San Francisco, Oakland, Sacramento and Palo Alto.
For more information, contact us at 707-263-5806
The Medical Therapy Program is located currently at Konocti Education Center. Financial eligibility is not a factor in qualifying for therapeutic services at the Medical Therapy Unit. For more information, contact 707-995-1596.
- Where do I apply for the CCS program?
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You should apply for the CCS program at the local CCS office in the county where you reside. This does not include the county where you are employed. This office can be contacted by phone for assistance. Your county CCS office can tell you if your child may be eligible for the CCS program. CCS eligibility must be determined before services can be covered by CCS. For more information, contact us at 707-263-5806
- How will I know if my child is eligible for CCS program benefits?
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The Lake County CCS office will consider your child's medical condition as well as the family's residential and financial status to determine CCS eligibility. This is accomplished by completing the necessary application forms and providing the required documentation. Based on this information and completed paperwork the CCS program will approve or deny your application. For more information, contact us at 707-263-1090
- What if I have private health insurance coverage for my child?
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Your child might be eligible for the CCS program even though you have private health insurance coverage, depending on the extent of coverage. If your child is a CCS applicant/client and has individual or group private health insurance coverage, you must report it to the county CCS office and to the child's health care provider. For more information, contact us at 707-263-5806
- What if my child is Medi-Cal eligible?
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Per state regulations:
- Children with a CCS eligible medical condition who also are eligible for Medi-Cal, must apply for Medi-Cal.
- Medi-Cal beneficiaries with a CCS eligible medical condition(s) are required to be referred to CCS for case management and authorization of medically necessary services. This may include authorizing some services not otherwise covered by Medi-Cal. This assures that all California children with complex, disabling conditions will receive appropriate specialized care.
- Children enrolled in the Healthy Families program are financially eligible for the CCS in the county they reside if they meet the age and medical condition criteria.
- Children enrolled in the Healthy Kids program (Child Health Initiative) might be financially eligible for the CCS program.
For more information, contact us at 707-263-5806
- Will there be any cost to the family of a CCS client?
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Some families may be required to pay an annual assessment fee and/or annual enrollment fee. These fees are used to help cover the cost of treatment, processing applications, telephoning hospitals, physicians and other caregivers, mailing authorizations to these caregivers, and coordinating care with the CCS agencies. All these services are provided by the CCS program to ensure that clients receive the best care possible from approved physicians and specialists who provide medical care to children. The annual assessment fee is $20 and the annual enrollment fee is calculated based on income and family size. For more information, contact us at 707-263-5806
- Which applicants/clients or families are required to pay the annual assessment fee?
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Applicants/clients or families applying for the CCS program whose incomes exceed 100 percent of the federal poverty level are required to pay the annual assessment fee unless they are determined by the county CCS office to be exempt from paying the fee. For more information, contact us at 707-263-5806
- Which applicants/clients or families are not required to pay the annual assessment fee?
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Applicants/clients or families with full Medi-cal benefits without a monthly share of cost
- Families with incomes less than 200 percent of the federal poverty level
- Applicants/clients or families applying for services to diagnose a child's medical condition which may be eligible for CCS
- Applicants/clients or families applying only for physical therapy or occupational therapy in the medical therapy units in public schools
- Families who, at the time of adoption, knew their child had a eligible CCS condition
For more information, contact us at 707-263-5806
- What if the family cannot pay the enrollment fee?
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If a family is unable to pay the full fee because of undue hardship, the family may ask for reconsideration in writing. Undue hardship means, for example, the family now has either less income due to unemployment or change in job; or, unavoidable expenses that reduce the ability to pay. The county may then reduce or waive the fee. The family may formally appeal a county's decision and should ask the county how to file an appeal under CCS regulations. For more information, contact us at 707-263-5806
- How do I find out if my child has an approved CCS medically eligible condition?
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Anyone may refer a child to CCS; Public health/school nurses, other agencies, or the family itself may refer to CCS to determine if the child has an approved CCS medically eligible condition. Complete referral information includes the name of the family physician and contact information.
Most children are referred by the family physician, specialist, hospital, or Medi-Cal Managed Care Plan. The physician, hospital or Managed Care Plan can supply important medical information necessary in making the CCS medical eligibility determination and may also participate in the child's CCS treatment program.
For more information, contact us at 707-263-5806.