CenCal Health and California Children's Services Roll out the Whole Child Model
Beginning on July 1, 2018, California Children's Services (CCS) will become a Medi-Cal Managed Care Plan Benefit under CenCal Health. All CCS patients living in San Luis Obispo County who are CenCal Health members on full scope Medi-Cal will automatically be transitioned into the Whole Child Model program. For CCS patients who are not CenCal Health members, services will continue to be provided by San Luis Obispo County Public Health's CCS Program.
CCS is a statewide program for children in California under the age of 21 who qualify for support based on financial need, residency and specific medical conditions. Any child-serving provider can refer a child to CCS. The goal of the Whole Child Model is a patient and family centered approach aimed to streamline the care coordination between CCS and Medi-Cal managed care providers for primary, specialty and behavioral health services for CCS and non-CCS conditions.
Continuity Under the Whole Child Model San Luis Obispo County Public Health's CCS Program (SLO County CCS) will remain responsible for determining eligibility for CCS and for the Medical Therapy Programs. All CCS benefits will remain intact.
Maintenance services such as lodging, parking fees, and meals will continue under CenCal Health, as will transportation services through CenCal's new transportation broker Ventura Transit System. The High Risk Infant Follow-Up (HRIF) Program also will remain the same under the Whole Child Model, with SLO County CCS still making the eligibility determination.
Funding for travel, parking, lodging, and meals will still be available under CenCal's Maintenance and Transportation benefit. While there are limits on the per diem, under CenCal there is no annual maximum.
As in the past, new CCS providers are required to be paneled by the Department of Health Care Services CCS program. For more information about becoming a CCS provider, visit the DHCS website.
Changes Under the Whole Child Model CCS patients will be assigned a new case manager through CenCal Health. Families were sent a Health Risk Assessment questionnaire last month which will be used to determine the case management of the patient. Families should return this form quickly to establish case management.
Treatment Authorization Requests for CCS services will be submitted through CenCal's provider portal, as will billing claims.
NICU and acuity assessment and authorization will now fall under the auspices of CenCal Health under the Whole Child Model.
How You Can Help It is important that each family fill out the Health Risk Assessment form so that CenCal Health can determine their child's needs. Please encourage your CCS families to complete this questionnaire and return it to CenCal as soon as possible.
While pharmacy benefits for CCS patients will remain the same, some families may find that pharmacies are unclear on the new billing procedure. Whole Child Model clients encountering problems at the pharmacy are encouraged to stay on site and contact CenCal Member Services for support.
CenCal Health and SLO County CCS have made a concerted effort to inform their clients of the Whole Child Model. Numerous notices were sent out to CCS families along with an outreach call to each member family. Families are encouraged to visit the CenCal website or contact Member Services for more information. If a client has not received an outreach phone call or has any questions or issues, please contact CenCal's Member Services at (877) 814-1861.
New CenCal Health Transportation Services Free Transportation for Qualified CenCal Members
CenCal Health is partnering with Ventura Transit System to provide free non-medical transportation (NMT) to members who have no transportation to any Medi-Cal benefit service. In addition to doctor appointments, covered services include mental health appointments, substance abuse programs, dental appointments, pharmacy and medical supply pick ups, and other contracted providers such as lactation consultants. Members requiring transportation service should call Ventura Transit System (VTS) five to seven days in advance of needing service. VTS will then screen the request to determine the level of need, coordinate with the member's physicianfor appropriate transport and authorization, and contact local contracted providers. Local transportation contractors include Easy Lift, Smooth Transportation, and Ride On. Ventura Transit System: (855) 659-4600
Non-emergency medical transport (NEMT) is also provided for members who are physically or medically unable to to get to services by car, bus, or taxi. Medical transport needs completion of an authorization form by a doctor; members should contact VTS or CenCal Health for details.
New Workplace Resources for Family Leave and Lactation Employee Rights, Family Leave and Disability Information
Family Leave and lactation workplace rights have recently changed to include small businesses and there are increases to the disability insurance benefits.
As of January 1, 2018 employees in small businesses with a minimum of 20 workers now have access to 12 weeks unpaid family leave. Employees requesting leave must have 1,250 hours on the job prior to requesting leave. Family Leave does not have to be taken in 12 consecutive weeks.
California recently increased the wage benefits under disability and eliminated the one week waiting period for all family leave claims. Employees can use the online Disability Insurance and Family Leave Calculator to determine their benefits. Disability benefits are provided for up to six weeks.
Family Resource Centers are located throughout SLO County and offer support in meeting basic needs, assistance through crises, and case management services. Family advocates can assist with Medi-Cal forms and other health-related issues. For a complete listing, Download the SLO County FRC Directory.
First 5 SLO Community Happenings
Stay up to date with First 5 SLO's Community Happenings! From exciting family friendly events, to provider trainings and workshops First 5 SLO has it covered. Click here learn more
Help for Immigrant Families Immigrant families continue to be concerned about their families' abilities to peacefully live, work and be educated in our country. With the recent announcement by the Trump administration phasing out the DACA program, families have been asking even more questions. Please visit the Immigration and Health Reform section of our website for more information.
For more information regarding recent immigration information please contact us.
Free Summer Meal Programs in SLO County for Students
For many children, participation in Free or Reduced Price School Meals reduces food insecurity during the school year. The summer time can mean less food for children, though. Fortunately, access to free breakfast and lunch is still available over summer through four school districts and the Cambria Connection within SLO County. Paso Robles Join USD is offering meals in both Paso Robles and Atascadero, while Lillian Larson Elementary School is hosting meals through San Miguel Joint USD. San Luis Coastal has numerous breakfast and lunch sites in SLO, Morro Bay and Los Osos. Lucia Mar USD is feeding students in Arroyo Grande, Oceano, Grover Beach, Nipomo and Pismo. The Cambria Connection is supplying lunches at various sites, and requests that interested families call for details at (805) 927-1654.
The summer breakfast and lunch programs are free to children and teens of all ages, up to 18 years of age. Nearly every site is open to all children regardless of income level. No paperwork or application is required by families, and no one will be asked to show an ID. All meals meet the USDA nutrition guidelines. Note that some sites serve meals through mid-July while others are open until mid-August. Click here to view a database of programs available countywide, or download flyers from individual districts: San Luis Coastal USD Summer Meals PDF Lucia Mar USD Summer Meals PDF Paso Robles Joint USD Summer Meals PDF San Miguel Joint USD Summer Meals PDF Cambria Connection (805) 927-1654
Promoting Healthy Immigrant Communities Key Take-Aways from Our Forums
Earlier this spring the Health Access Training Project hosted two forums on Promoting Healthy Immigrant Communities. Speakers presented on a number of services for immigrant families and provided insights on how to work with families in times of stress. The overarching theme that emerged from both forums is that families in our immigrant communities have been under-utilizing services they both need and qualify for. Rapidly changing immigration laws and policy pronouncements have created a climate of fear and confusion among SLO County's most vulnerable families. Below are the key take-aways from the forums to promote a healthy immigrant community: Informed Eligibility: Many agencies are noticing fewer families applying for services or are asking to be removed from programs. In fact, immigrant and children's eligibility for programs such as Med-Cal, CalFresh, housing and other related services have not changed. Since eligibility is determined on an individual basis, not for the entire family, it's important to have eligible members in a family apply for available programs, without regard for whether some family members may not be eligible. Know Your Rights: Distribution of the Immigrant Legal Resource Center's (ILRC) Know Your Rights cards have been helpful to reduce some fear in the immigrant community. Numerous agencies reported that informing clients about their rights if they are detained has become necessary as well. Family preparedness plans also help reduce stress during uncertain times. Please visit the SLO Health Access Training website Immigrant Rights Resource list to find links to numerous resources for immigrant families. Immigration Status is Confidential: Immigration status at all family serving agencies is confidential (unless legally requested by law enforcement with a valid warrant). Many entities have found that families fear requesting basic and necessary services since they erroneously believe that it will reveal their immigration status to an authority. Universal Messaging: Paz Padilla of Catholic Charities noted that all agencies need to come together to "create trust" in our immigrant community by having all child serving providers delivering the same factual information. A universal message of support will help dispel rumors and anxiety for families. As advocates for underserved children, the various child serving agencies in San Luis Obispo County are working hard to ensure children are healthy and safe. Being knowledgeable about available services and referring clients to other agencies in a timely manner is important to the health of children in our immigrant communities.
The Health Access Training Project is a project of First 5 of San Luis Obispo County which advocates for quality programs and services to support children from prenatal to age five, ensuring that every child is healthy and ready to learn in school.