Are You Eligible?

A client gets CCS services if the clients meets all four CCS eligibility rules:

1. Age eligible: the child is under 21 years old.

2. Medically eligible: the child has a physical disability or medical condition that is covered by CCS. This is called having a "CCS eligible condition." CCS covers many serious health and physical conditions. 

The following criteria will help you determine if your child is eligible for CCS:

• Conditions involving the heart (congenital heart disease)
• Neoplasms (cancers, tumors)
• Disorders of the blood (hemophilia, sickle cell anemia)
• Endocrine, nutritional, and metabolic diseases (thyroid problems, phenylketonuria (PKU), diabetes)
• Disorders of the genitourinary 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 sense organs (hearing loss, glaucoma, cataracts)
• Disorders of the nervous system (cerebral palsy, uncontrolled seizures)
• Disorders of the musculoskeletal system and connective tissues (rheumatoid arthritis, muscular dystrophy)
• Severe disorders of the immune system (HIV infection)
• Disabling conditions or poisonings requiring intensive care or rehabilitation (severe head, brain, or spinal cord injuries, severe burns)
• Complications of premature birth requiring an intensive level of care
• Disorders of the skin and subcutaneous tissue (severe hemangioma)

3. Residentially eligible: The client is a resident of Riverside County. Each county in California has a CCS program, and if you move to another county, we will help you transfer to that county's CCS program.

4. Financially eligible:
The client has

• Medi-Cal 
  • please note If client does not have Medi-Cal they will need to apply to Medi-Cal as part of the eligibility requirment
• Family's adjusted gross income is less than $40,000 
• If over $40,000 the out-of-pocket medical expenses are expected to be more than 20 % of family's adjusted gross income for the client's CCS eligible condition.
• Diagnostic services to find out if there is a health problem covered by CCS 
• CCS Medical Therapy Program (MTU) services only 
• Was adopted with a known health problem that is covered by CCS

FEES

Some families may pay:
An annual assessment fee of $20 AND
An enrollment fee, using a sliding scale based on
family income and size.

The amount of the enrollment fee depends on how much money a family makes and how big the family is. For example, a family of three earning $40,000 will pay an enrollment fee of $300 plus the $20 assessment fee each year.

A family will not pay these fees if the child has one of the following:

1. Full-scope Medi-Cal with no Share Of Cost

2. CCS Medical Therapy Program (MTU) services only if client has IEP/IFSP

3. Was adopted with a known health problem that is covered by CCS

NOTE: A signed application form gives the family legal rights to appeal.