CCS: California Children's Services

Sharon Grandinette, M.S.

What is CCS?

CCS is a statewide, tax-supported program under the California Department of Health Services. It offers specialized medical care providing medical case management, physical/ occupational therapy services and financial assistance for children with qualifying health conditions including children with certain physical limitations and chronic health conditions and diseases. The program has been in continuous operation since it was established in 1927 by the state legislature.

CCS covers medical conditions that are physical or require medical, surgical or rehabilitative services. There also may be certain criteria that determine if a medical condition is eligible. Examples include:
  • Conditions involving the heart (congenital heart disease)
  • Neoplasms (cancers, tumors)
  • Disorders of the blood (hemophilia, sickle cell anemia)
  • Endocrine nutritional & metabolic diseases (thyroid problems, PKU, diabetes)
  • Disorders of the genito-urinary system (serious chronic kidney problems)
  • Disorders of the gastrointestinal system (chronic inflammatory disease, diseases of the liver)
  • Serious birth defects (cleft/lip palate; spina bifida)
  • Disorders of the nervous system (CP, uncontrolled seizures)
  • Disorders of the sense organs (hearing loss, glaucoma, cataracts)
  • Disorders of the musculoskeletal system & connective tissues (rheumatoid arthritis)
  • Severe disorders of the immune system (HIV infection)
  • Disabling conditions of poisonings requiring intensive care or rehabilitation (severe head injuries, severe burns)
  • Complications of premature birth requiring an intensive level of care
  • Disorders of the skin & subcutaneous tissue
  • Medical handicapping malocclusion (severely crooked teeth)

What are the Goals of CCS?

CCS has four main goals that include: 1) to locate children who may need the specialized medical care and rehabilitation program benefits; 2) to prevent disabling conditions in children through early diagnosis and treatment; 3) to help families obtain quality medical care and financial assistance to enable the maximum development in their children and, 4) to maximize function for children with severe physically disabling conditions.

Who Can Refer a Child for CCS Services?

Referrals can be made to the CCS agency in the county where a child lives by anyone, including the family, school or public health nurse, family doctor or physician specialist. It is important that the referral be made as soon as possible since CCS does not pay for any medical care that is provided before the date of referral.

Who Qualifies for CCS?

The program is open to anyone who is:
  • Under 21 year of age
  • Has or may have a medical condition that is covered by CCS
  • Is a resident of California
  • Has a family adjusted gross income that is less than $40,000 per year or the child has Healthy Family Coverage
  • Has a family adjusted gross income that is more than $40,000 per year with out of pocket expenses expected to exceed 20% of family income
Family income is NOT a factor for children who:
  • Need a diagnostic service to confirm an eligible medical condition
  • Were adopted with a known CCS eligible medical condition; or
  • Are applying only for services through the MTP-Medical Therapy Program; or
  • Are Medi-Cal beneficiaries, full scope, no share of cost; or
  • Are Healthy Family subscribers

Can a Child Qualify for CCS even with Private Insurance?

Yes, a child can have both private insurance and CCS coverage, but insurance coverage is primary. However, children with HMO/PHP/EPO/POS coverage are not eligible for CCS diagnostic treatment services related to the CCS eligible conditions unless a valid exclusion letter is received from the administrative office of the insurance company. The child must meet residency and financial eligibility before CCS can authorize services.

What Services are Provided?

Treatment such as doctor services, hospital and surgical care, physical therapy and occupational therapy tests, X-rays, orthopedic appliances and medical equipment are commonly provided to children who are eligible. In addition, medical case management is offered to help obtain services from medical specialists and care for a child when medically referred to other agencies, including public health nursing and regional centers; or to a Medical Therapy Program (MTP) which can provide physical therapy and/or occupational therapy through schools for children who are medically eligible.

What is the Medical Therapy Program (MTP)?

The MTP is a special program within California Children’s Services that includes Occupational Therapy (OT) and Physical Therapy (PT) for children with eligible conditions. Therapy services are provided at rehabilitation units located in public schools. These units are called “Medical Therapy Units” (MTU).

Eligible conditions which would qualify for CCS and the MTP include, but are not limited to: cerebral palsy, spina bifida, muscular dystrophy, rheumatoid arthritis, spinal cord injuries, arthrogryposis, and osteogenesis imperfecta. The MTP is available to children from birth to 21 years old with eligible conditions.

What is the Difference Between the therapy provided by CCS at the MTU and the therapy provided by school based occupational and physical therapists?

What is the Difference Between the therapy provided by CCS at the MTU and the therapy provided by school based occupational and physical therapists?

CCS provides medically relevant occupational and physical therapy while schools provide educationally necessary occupational and physical therapy. Students can receive both CCS and school based therapies provided there is no duplication in service. Goals written in an IEP needs to reflect those differences.

Medically relevant Occupational Therapy (OT) provided at an MTU is therapy provided for the main purpose of improving self-help skills or Activities of Daily Living (ADL). OT uses many ways to improve the dysfunction that causes impairment in ADLs, such as playing with play dough to increase finger strength to allow a child to be able to manage pants snaps.

Medically relevant Physical Therapy (PT) provided at an MTU is therapy provided for the main purpose of improving mobility and ambulation. PT may provide exercises on a large ball to increase trunk control and overall strength to allow a child to walk either unassisted or with crutches.

School based therapy is designed to enhance a student’s ability to fully access and be successful in the learning environment. In OT, this could include working on handwriting or fine motor skills so that the student can complete written assignments, help the child organize himself in the environment, work with the teacher to modify the classroom and/or adapt learning materials to facilitate successful participation. School based PT might address gait training with a walker in empty and crowded hallways, motor planning and motor control activities for timely exchange of books and class supplies from the locker, as well as collaboration with the physical education teacher to improve strength and balance for safe movement through the cafeteria lunch line.

For more information on CCS go to:

This article is from the CAPHI Newsletter, Winter 2006.