1 11 CHDP DIRECTOR/DEPUTY DIRECTOR TRAINING SECTION I Program Overview 1 7/1/2010

Organizational Charts 7/1/2010 2

3 33 Children’s Medical Services (CMS) Organizational Chart Director Public Health Medical Administrator Various Health Program Managers – Medical & Nurse Consultants Administrator Children’s Medical Services Programs Various Public Health Medical Officers Program Support Section Program Development Section Statewide Programs Section Regional Operations Section Information Technology Section Secretary Administration Unit Clerical Support Unit Provider Services Unit I Information Technology Unit Information Systems Unit Contract Staff Sacramento Oakland Southern California Specialty Programs Hearing & Audiology Services Genetically Handicapped Persons Program Policy & Analysis Unit Research Unit Statewide Consultation Unit 3 7/1/2010

4 44 CMS Programs 4 7/1/2010

Mission, Vision & Goals 7/1/2010 5

6 6 CMS Mission and Vision 6 Mission: Assuring the health of California’s children Vision Statement: CMS is the leader in assuring the health of California’s children through access to services for all children in an environment committed to excellence, in partnership with families and communities, as supported by information and communication. 7/1/2010

7 7 CMS Goals 7  Goal 1: Families, children, and providers will be given assistance in using new and ongoing CMS program services, and access and navigate changing health care systems to assure effective, continuous care delivery.  Goal 2: Health and support services for children with special physical, emotional and social health needs will be addressed efficiently and effectively by qualified CMS providers, private and public offices, and clinics, special care centers, regional centers, medical therapy programs and through home agencies. 7/1/2010

8 8 CMS Goals 8  Goal 3: Clinical preventive services will be provided to children eligible for CMS programs.  Goal 4: CMS outreach activities will be conducted to assure that eligible children and their families are informed of program services in a manner that is culturally and linguistically competent. 7/1/2010

Relationship Between State & Local Programs 7/1/2010 9

10 Relationship: State & Local Programs 10  CMS is a branch of the Systems of Care Division of the California Department of Health Care Services (DHCS).  CMS Branch is responsible for three major statewide programs:  Child Health and Disability Prevention Program (CHDP) which includes the Health Care Program for Children in Foster Care (HCPCFC)  California Children’s Services (CCS) which includes the Medical Therapy Program (MTP)  Genetically Handicapped Persons Program (GHPP) 7/1/2010

11 Relationship: State & Local Programs 11 The CMS Branch is also responsible for implementation, monitoring, and oversight of the Newborn Hearing Screening Program (NHSP) and special grants to serve special needs children such as the High Risk Infant Follow-Up (HRIF) Program. 7/1/2010

Organizational Structure of State Program 7/1/

13 CMS Branch Sections 13  Information Technology Section  Program Support Section  Regional Operations Section  Statewide Programs Section  Program Development Section 7/1/2010

14 Information Technology Section 14 The Information Technology Section is responsible for all aspects of information technology support. 7/1/2010

15 Program Support Section 15 The Program Support Section is comprised of three units and has responsibility for a variety of activities in support of Branch operations. The units and functions are as follows:  Administration Unit – monitors all fiscal concerns, MOUs, IAAs, contracts, and related training  Provider Services – for CHDP, CCS, GHPP, Fiscal Intermediary reimbursement issues and training  Clerical Support – for Branch staff 7/1/2010

16 Regional Operations Section (ROS)  ROS is comprised of three CMS regional offices located in Sacramento, Oakland, and Los Angeles.  Regional office professional staff have oversight responsibilities and offer technical assistance and program consultation for local CCS and CHDP programs.  Local CHDP programs are operated by the 58 County Departments of Health plus three cities that operate their own CHDP programs: Berkeley, Pasadena and Long Beach.  ROS monitors compliance with federal and state regulations. 7/1/2010

17 Statewide Programs Section 17 The Statewide Programs Section is responsible for administration of specialty programs with statewide responsibilities. There are three units within the section:  Specialty Programs Unit – HCPCFC  Hearing & Audiology – NHSP  GHPP – Provides medical & administrative case management 7/1/2010

18 Program Development Section 18 The Program Development Section is responsible for the development and implementation of program policy, regulations, and procedures for the programs administered by the Branch. 7/1/2010

CHDP History 7/1/

20 CHDP History 20 Many years ago studies were conducted to identify why many young men were medically ineligible for the draft. The results of these studies were reported in the late 1960s, identifying the need for early detection of disease and disease prevention. This led to the well-child health assessment being added to the Federal Medicaid program in /1/2010

21 CHDP Timeline 1967 Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) established by Congress 1973 AB 2068 adopted CHDP in California 1989 AB 75 expanded CHDP services to all low income children under 200% of poverty level 1994 Vaccines for Children Program started 2000 Foster Care Program added to CHDP 2003 Gateway process implemented 21 7/1/2010

CHDP Program Overview 7/1/

23 CHDP Program Description 23  The CHDP Program oversees the screening and follow-up components of the federally mandated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for Medi-Cal and income eligible children and youth in California.  The CHDP Program provides complete health assessments for the early detection and prevention of disease and disabilities for eligible children and youth. 7/1/2010

24 CHDP Eligibility  Children from birth to age 19 not enrolled in Medi-Cal who meet the income requirements  Medi-Cal participants from birth to age 21  Newborns born to mothers on Medi-Cal 24 7/1/2010

25 Health Assessment Components  Health and Developmental History  Unclothed Physical Exam  Developmental Assessment  Nutritional Assessment  Oral Health Assessment  Vision and Hearing Screenings  PPD / Immunizations  Lab Tests  Health Education /Anticipatory Guidance  Referrals 25 7/1/2010

26 CHDP Gateway 26 In July 2003, the CHDP program began using the CHDP Gateway, an automated pre-enrollment process for non Medi-Cal, uninsured, low income children. The CHDP Gateway serves as the entry point for these children to enroll in ongoing continuous health care coverage through Medi-Cal or the Healthy Families program. 7/1/2010

Executive Committee 7/1/

28 CHDP Executive Committee The CHDP Executive Committee serves the function of advising the CMS Branch Chief and State program staff on matters pertaining to the Program. It allows for two-way communication between the State Branch and the local programs. 28 7/1/2010

CHDP Executive Committee Purpose  To review and comment on CHDP financial and policy matters, and to review legislation affecting the program  To review and comment on CHDP issues, including guidelines, regulations, standards, and operating policies  To provide expertise about CHDP issues  To recommend program changes to the CMS Branch Chief and department administration 7/1/

CHDP Executive Committee Purpose  To review and comment on other CHDP program issues which have been referred by the representatives of the CHDP Regional Associations  The local CHDP programs are organized regionally by the State as follows: Northern, Bay Area, Central, and Southern  To review and approve educational and resource materials developed by Sub-Committees of the Executive Committee in the absence of review and approval authority by the State CMS Branch 7/1/

31 CHDP Executive Committee Representation includes:  Northern – 2 representatives  Bay Area – 2 representatives  Central – 2 representatives  Southern – 2 representatives  Small counties – 1 representative  Large county (Los Angeles) – 1 representative The regional representatives (Directors or Deputy Directors) are voting members and rotate responsibilities for chair and vice chair. 31 7/1/2010

32 CHDP Executive Committee 32 Other attendees include:  State staff  Members or other representatives from associations related to health care for children  Representatives from the subcommittees  Local program staff may attend as non-voting members 7/1/2010

33 CHDP Executive Committee 33 There are four standing subcommittees to the Executive Committee: Subcommittees:  Nutrition  Health Education  Dental  Foster Care The Chairman or a designee of each subcommittee attends the Executive Committee. Subcommittee goals, objectives and scopes of work are reviewed annually by the Executive Committee. 7/1/2010

Legislative Authority 7/1/

35 Legislative Authority 35 Enabling legislation of the CHDP program  Reference: Health and Safety Code, Sections , , , , and through Health and Safety Code CHDP program regulations that implement, interpret, or make specific the enabling legislation  Reference: California Code of Regulations (CCR), Title 17, Sections 6800 through 6874California Code of Regulations (CCR) Medi-Cal regulations pertaining to the availability and reimbursement of EPSDT services through the CHDP program  Reference: CCR, Title 22, Sections and 51532CCR 7/1/2010

Funding 7/1/

37 Funding Sources 37  Medi-Cal children/youth under age 21 receive services under the Federal Title XIX program known as the EPSDT program. The EPSDT program is part of the Medi-Cal program and is funded by state general and federal funds. 7/1/2010

38 Funding Sources 38  Low-income children/youth under age 19 with family incomes up to 200 percent of the federal income guidelines, and without preventive health care coverage may be temporarily enrolled through the CHDP Gateway process into full scope, no-cost temporary Medi-Cal for the month of their CHDP health assessment and the following month. These services are funded by state general and federal funds under the EPSDT and Healthy Families (Title XXI) program.  Low-income children/youth not eligible through the CHDP Gateway pre-enrollment process for the Medi-Cal or Healthy Families program receive CHDP services paid for by state general funds. 7/1/2010