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
- 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
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.