Learn About The
Whole-Child Model

Latest Updates

CalOptima Delay

On November 9, 2019, the Department of Health Care Services (DHCS) announced its intention to implement the Whole-Child Model (WCM) in three phases, with CalOptima’s transition taking place in Phase 3 on July 1, 2019, six months later than originally planned with Phase 2 on January 1, 2019. CalOptima will conduct member and provider outreach about this change. Until WCM implementation on July 1, 2019, members eligible for California Children’s Services (CCS) who are also enrolled in CalOptima will continue to receive services for their CCS conditions through the county CCS program.

Family Engagement Events, October 10–24, 2018

CalOptima hosted five WCM Family Engagement Events throughout Orange County during the month of October. Members receiving CCS services and their parents or guardians were invited to attend one of the five events to learn more about the transition to WCM under CalOptima. Guests also had an opportunity to connect with their health network at the events.

  • You can see the presentation here.

Previous Updates

CalOptima is committed to keeping our stakeholders informed and providing opportunities for feedback. Our most recent efforts for Whole-Child Model include:

General Stakeholder Meeting, July 25, 2018

CalOptima hosted a General Stakeholder Meeting to share information about its integration of CCS into CalOptima Medi-Cal through the WCM program. CalOptima’s Chief Executive Officer Michael Schrader, Chief Medical Officer Richard Helmer, M.D., and Chief Operating Officer Ladan Khamseh provided updates regarding member experience, provider impact and WCM preparation. Of the approximately 100 attendees, 97 percent felt they learned something new about WCM and CalOptima’s approach and 97 percent planned to share and apply the information in their workplace.

  • You can see the presentation here.

About the Whole-Child Model

California Children’s Services (CCS) is a statewide program for children with certain medical conditions. CCS provides medical care, case management, physical/occupational therapy and financial assistance. Currently, CCS services are carved out (separated) from most Medi-Cal managed care plans, including CalOptima.

The Orange County Health Care Agency (OC HCA) manages the local CCS program. It provides case management, eligibility determination, service authorization and direct therapy under the Medical Therapy Program.

On July 1, 2018, CCS became a Medi-Cal managed care plan benefit in select counties. The goal is to improve health care coordination for the whole child, rather than handle CCS conditions separately. This approach is known as the Whole-Child Model.

No sooner than July 1, 2019, Medi-Cal members’ needs related to CCS services will be part of CalOptima’s Medi-Cal plan. Under this model, OCHCA will continue to determine eligibility and manage the Medical Therapy Program.

CalOptima regularly meets with OCHCA about the CCS transition in Orange County. There are ongoing discussions about implementation, and decisions pending further guidance from the state.

The priority for CalOptima and OCHCA is to make sure there is a seamless transition for the children and families involved.

Whole-Child Model Family Advisory Committee

CalOptima created a Whole-Child Model Family Advisory Committee (WCM FAC). Committee members include CCS family representatives/members, community-based organizations, and/or consumer advocates.

General Information

Click on the links below to learn more about the Whole-Child Model and how it will affect CalOptima members and providers.

October 2018 Family Engagement Event MaterialsPDF File Indicator Image

July 25, 2018 General Stakeholder Meeting MaterialsPDF File Indicator Image

June 14-15, 2018 Community-Based Organization Stakeholder Meeting MaterialsPDF File Indicator Image

February 26-28, 2018 Family Event MaterialsPDF File Indicator Image

January 25, 2018 Stakeholder Meeting MaterialsPDF File Indicator Image

Resources

Click on the links below to learn more about CCS and the Whole-Child Model. These programs are coordinated by DHCS, OCHCA and CalOptima.

DHCS - Whole-Child Model

DHCS - CCS Advisory Group

DHCS - CCS Program Overview

OCHCA - CCS Information and Resources

OCHCA - Provider FAQ

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