One third of all children in California are enrolled in Medi-Cal (3,607,189 children)
One third of all children in California are enrolled in Medi-Cal (3,607,189 children)
175,000 children in California are enrolled in California Children’s ServicesKey features impacting children and youth with special health care needs:
• Mandatory enrollment of “Seniors and Persons with Disabilities” (SPDs) into managed care
• California Children’s Services (CCS) demonstration pilots
What is a Waiver?
If a state, like California, wants to change the way they deliver Medi-Cal services, they usually have to ask permission from the federal government. Waivers have benefitted many children and youth with special health care needs—by providing families with home and community-based waivers for nursing or other services that help them keep their children at home and out of institutions.
California recently applied and got approved an 1115 Waiver called “A Bridge to Reform” in November 2010. This new waiver has a number of key features that will impact children, youth and adults with special health care needs now and in the future: mandatory enrollment of seniors and persons with disabilities into managed care plans, and California Children’s Services demonstration pilots.
Mandatory Enrollment of “Seniors and Persons with Disabilities” (SPDs) into Managed Care
California Children’s Services (CCS) Demonstration Pilots
The Department of Health Care Services will be running a number of pilots to change the way services are delivered to children enrolled in the CCS program. Currently, children who need specialized medical care are enrolled in California Children’s Services, the state’s Title V agency, to ensure children and youth with special health care needs get health care coverage and access to qualified specialists and subspecialists.
These pilots will test new models for delivering health care for children in CCS and, depending on their success, may result in changes to the CCS program. It is currently unclear how these demonstration projects will affect children and youth with special health care needs, and what counties will be taking on pilot projects. Family advocacy groups, like Family Voices of California, continue to be part of the Stakeholder and Workgroups overseeing the implementation of the pilots.
The Department released its draft “Request for Proposals” in January 2011 for public input. Final “Request for Proposal” will be released in March 2011, with responses due by May. Pilots are expected to be selected in July 2011, and beginning in 2012. Children living in pilot counties will most likely be mandated to participate in the pilots—there is currently no ability to “opt out.” Stay tuned to see if a pilot will be running in your county and check the following websites:
To Keep Updated