Learn About The
Whole-Child Model

Latest Updates

Member Notices

The transition from California Children’s Services (CCS) to Whole-Child Model will occur on January 1, 2019. Members will receive three notices, prior to January 1, 2019, to inform them about the transition. Members currently enrolled in CCS and their families/guardians should have received the first notice (90-day notice) from the Department of Health Care Services (DHCS). The notice included information about the transition, next steps, and frequently asked questions.

  • The DHCS 90-day notice can be found here: DHCS CCS WCM 90-day notice
  • From CalOptima, members can expect to receive a:
    • 60-day notice around November 1, 2018
    • 30-day notice around December 1, 2018

For questions regarding the notices, contact the CalOptima Customer Service department at: 1-888-587-8088

Family Engagement Events, October 10–24, 2018

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

  • The event flier can be accessed 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 California Children’s Services into CalOptima Medi-Cal through the Whole-Child Model program, effective no sooner than January 1, 2019. CalOptima’s Chief Executive Officer Michael Schrader, Chief Medical Officer Dr. Richard Helmer, and Chief Operating Officer Ladan Khamseh provided updates regarding member experience, provider impact and WCM preparation. Of the approximately 100 attendees, 97% felt they learned something new about WCM and CalOptima’s approach and 97% 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. 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 January 1, 2019, Medi-Cal members’ needs related to CCS services will be part of CalOptima’s Medi-Cal plan. Under this model, OC HCA will continue to determine eligibility, and manage the Medical Therapy Program.

CalOptima regularly meets with OC HCA 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 OC HCA 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.

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

February 24, 2017 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

September 14, 2016 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

June 10, 2016 Memo From Michael Schrader, CalOptima CEOPDF File Indicator Image

March 25, 2016 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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