Approve the California Children's Services Medical Therapy Program Plan (CCS-MTP) plan for 2022-23 providing effective and efficient comprehensive systems for vulnerable populations to improve their healthcare options and reduce healthcare costs. (No general fund impact) (Sullivan)

The System of Care Division (SCD) of the California Department of Health Care Services (DHCS) is responsible for the administration and oversight of programs that focus on fragile children and adults with special health care needs including Children’s Medical Services (CMS) Programs comprised of the California Children’s Services (CCS) and Child Health Disability and Prevention (CHDP) Programs. The CCS Program includes the Medical Therapy Program (MTP). For the Fiscal Year 22-23, the DHCS requested County’s local CCS and MTP submit the Annual Plan separately from the CHDP program. This separate submission is a change from previous years. The CCS and MTP programs will submit to the DHCS an Annual Plan that includes local CCS and MTP program budgets and staffing documents. Submission of the CCS and MTP Annual Plan is contingent on the release by DHCS of the program allocations and Plan and Fiscal Guidelines. For FY 22-23, this was provided by the DHCS on November 18, 2022.

The CCS Program provides diagnostic and treatment, medical case management, and physical and occupational therapy services to children under age 21 with CCS-eligible medical conditions. Yolo County CCS is responsible for assuring that children with medically eligible conditions receive necessary and appropriate health care. Examples of CCS-eligible conditions include, but are not limited to, chronic medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae.

On January 1, 2019, Yolo County CCS started the implementation of Senate Bill 586. This bill authorized the Department of Health Care Services (DHCS) to establish changes in the CCS program to provide healthcare coordination for Medi-Cal CCS clients with all medical conditions. This program is called the Whole Child Model (WCM). Yolo County CCS continues to determine medical, financial, and residential eligibility to the entire CCS caseload. The responsibility of managed care coordination for the CCS Medi-Cal clients was transferred from CCS to Partnership Health Plan of California (PHC). However, we continue to provide care coordination of the non-Medi-Cal clients with CCS-eligible conditions. Currently, CCS provides a network of CCS-paneled specialty and subspecialty providers and special care center services to approximately 730 children with special health care needs.

CCS also provides Medical Therapy services that are delivered at public schools.  The CCS Medical Therapy Program (MTP) provides physical therapy, occupational therapy, and Medical Therapy Conference (MTC) services to children who meet specific medical eligibility criteria. These services are provided in an outpatient clinic setting known as the Medical Therapy Unit (MTU) which is located at public school sites. A central MTU site is located at Greengate School in Woodland, and a satellite MTU site is located at Golden Gate Middle School in West Sacramento.

Board approval is needed so that CMS can continue providing effective and efficient comprehensive systems for vulnerable populations to improve their healthcare options and reduce healthcare costs. Only the Board of Supervisors can enter the County into a binding contract with the State. Therefore, the Chairman’s signature is required for the plan’s submission.

The Partnership Health Plan of California (PHC), a county-organized health care system for Medi-Cal recipients, is responsible for the payments of CCS-authorized Medi-Cal patients. Yolo County CCS and Special Education Local Plan Area (SELPA) have an Interagency Agreement in order to facilitate interagency cooperation in providing medically necessary Occupational Therapy (OT) and Physical Therapy (PT) services to eligible special education children. Yolo County CCS refers eligible CCS children to the Yolo County Health and Human Services Agency (HHSA) to apply for Medi-Cal benefits.