CHA News Article

DHCS Revises Proposed Statutory Language On ‘Whole Child Model’ Proposal

The California Department of Health Care Services (DHCS) has released revisions to proposed language on its ‘Whole Child Model’ proposal, designed to focus on the full range of children’s needs rather than only their California Children’s Services (CCS) program-eligible conditions. DHCS has proposed implementation of a Whole-Child Model for County-Organized Health Systems no sooner than January 2017, and a three-year managed care carve-out extension for remaining counties until at least January 2019. According to DHCS, the revised statutory language is intended to further strengthen consumer protections for children and families by:

  • Providing further accountability and transparency for health plan decisions about care for children and youth with special health care needs by requiring a clinical advisory committee for each health plan to review treatment authorizations and other clinical issues related to CCS conditions. The advisory committee will be comprised of the plan’s medical director, the CCS county medical director and paneled CCS providers.
  • Lengthening the implementation timeline for Orange County by extending the carve-out through July 2017 to provide the additional time needed for full readiness.
  • Requiring the completion and submission of a formal evaluation prior to any further integrated contracts for CCS and managed care, after the current proposal is implemented in Whole-Child Model counties.
  • Strengthening requirements for health plans to provide access to CCS paneled providers.
  • Building on existing DHCS activities to provide transparency in managed care contracts by making CCS-specific contract provisions available to the stakeholders/public.

Comments on the proposal may be submitted to DHCS in letter  format by email at CCSRedesign@dhcs.ca.gov or by mail at:

Department of Health Care Services
     Systems of Care Division
     P.O. Box 997413, MS 8100
     Sacramento, CA  95899

Additional information is available on the DHCS CCS redesign website.

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