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CHDP DIRECTOR/DEPUTY DIRECTOR TRAINING SECTION I

Program Overview

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Organizational Charts

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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 TechnologySection

Secretary

Administration Unit

ClericalSupport Unit

ProviderServices Unit

IInformation

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

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CMS Programs

CMS

CCS

MTP

CHDP

HCPCFC

GHPP NHSP HRIF

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Mission, Vision & Goals

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CMS Mission and Vision6

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.

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CMS Goals7

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

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CMS Goals8

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.

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Relationship Between State & Local Programs

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Relationship: State & Local Programs

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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)

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Relationship: State & Local Programs11

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.

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Organizational Structure of State Program

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CMS Branch Sections13

Information Technology Section Program Support Section Regional Operations Section Statewide Programs Section Program Development Section

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Information Technology Section14

The Information Technology Section is responsible for all aspects of information technology support.

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Program Support Section15

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

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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.

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Statewide Programs Section

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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 &

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Program Development Section

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

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CHDP History

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CHDP History20

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 1972.7/1/2010

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CHDP Timeline

1967 Early, Periodic, Screening, Diagnosis and Treatment (EPSDT) established by Congress

1973 AB 2068 adopted CHDP in California1989 AB 75 expanded CHDP services to all low

income children under 200% of poverty level

1994 Vaccines for Children Program started2000 Foster Care Program added to CHDP2003 Gateway process implemented

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CHDP Program Overview

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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.

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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

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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

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CHDP Gateway26

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.

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Executive Committee

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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.

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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

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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

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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.

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CHDP Executive Committee

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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

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CHDP Executive Committee

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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.

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Legislative Authority

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Legislative Authority35

Enabling legislation of the CHDP program Reference: Health and Safety Code, Sections 104395, 105300,

105305, 120475, and 124025 through 124110

CHDP program regulations that implement, interpret, or make specific the enabling legislation

Reference: California Code of Regulations (CCR), Title 17, Sections 6800 through 6874

Medi-Cal regulations pertaining to the availability and reimbursement of EPSDT services through the CHDP program

Reference: CCR, Title 22, Sections 51340 and 51532

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Funding

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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.

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Funding Sources38

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.

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