California Children's Services (CCS)

CCS is a program for kids and youth with certain diseases. CCS chooses the best services and pays for the care.

A child or youth can get California Children’s Services (CCS) if they meet the four requirements below. They must:

  1. Be 0 to 21 years old
  2. Live in Santa Clara County
  3. Have a chronic, disabling, or life-threatening medical condition that is a CCS eligible medical condition 
  4. Have one of the following:
  • Family income (AGI-Adjusted Gross Income) of $40,000 or less
  • Family income (AGI-Adjusted Gross Income) over $40,000 and out-of-pocket medical expenses are likely to be more than 20 percent of the family income (AGI-Adjusted Gross Income)
  • A need for an evaluation to find out if there is a health problem that is covered by CCS
  • Was adopted with a known health problem that is covered by CCS
  • A need for the Medical Therapy Program (children and youth can get Medical Therapy Program services no matter what their family income is)
  • Medi-Cal, with full benefits (Full-Scope or Share-Of-Cost)
     

How to apply: Steps to get CCS services

  1. Referral
    Anyone can refer a child or youth to CCS (doctor, parent, teacher, etc.)
  2. Diagnosis
    A doctor identifies that the child or youth may have a CCS eligible medical condition. The doctor sends a report to CCS for a nurse case manager to review.
  3. Application
    Family or youth fills out and signs an application for CCS, faxes it to (408) 793-6250 or mails it to 720 Empey Way, San Jose CA, 95128.

    CCS Application (English)
    CCS Application (Spanish)
  4. Case management and care coordination
    The CCS nurse case manager helps the child or youth get the right care at the right place in a timely manner.
  5. Treatment
    CCS approves health care services to treat the child or youth's CCS eligible medical condition. A copy of the approval is mailed to the child or youth’s home. The family/ client can then make an appointment to get the approved care. You can call CCS anytime at 408-793-6200 to find out the status of your request.
  6. For any other questions, see our FAQ section.

 

CCS provides the following:

Nurse Case Management

Nurse case managers work with your child’s medical providers to coordinate and make all aspects of your child’s care easier. This includes inpatient and outpatient services.

The nurse case managers also make sure that your child is connected to necessary medical, social, educational and community agencies and resources.

Medical Therapy

The California Children's Services Medical Therapy Program (CCS MTP) provides physical and occupational therapy and other services to children with medically eligible conditions from birth to age 21. The purpose of the Medical Therapy Program is to promote and develop the child’s functional skills and physical independence.

Information on transitioning out of CCS

At 18 and 21 years of age, children/youth have special needs. At age 18, your child becomes an adult. At age 21, your child can no longer participate in CCS. We want to make sure we support young adults during these transition times.

 

FAQ

    There are no fees for children who have full-scope Medi-Cal insurance. Other families may need to pay a small fee based on family size and income.​

    Anyone can refer your child or youth to CCS (i.e. parent, teacher, soc​ial worker). Most of the time a doctor or health insurance plan will refer your child or youth to CCS.

    CCS can help you find and pay for medical services that may include the following: hospital and physician care; x-ray and laboratory services; medical supplies and equipment; medications; home health care; physical and occupational therapy; orthodontic care; confidential HIV testing and monitoring (All services except emergencies need CCS approval before the services are given).

    No, autism is not a CCS-covered diagnosis. Current, detailed information on medical eligibility and conditions that are covered can be found on the state medical eligibility web page.​

    You must meet one of the following:

    • Have a family income of $40,000 or less;
    • Your child already has full-scope Medi-Cal;
    • Your medical fees are more than 20% of your family income; or
    • You adopted a child with a known CCS eligible medical condition.

    Children that has an HMO may be eligible for CCS, if the requested services are not a benefit of their HMO. Children with HMOs are eligible for MTU services.​


     

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