California Children’s Services Program: county designation.

Assembly Member Hadwick’s proposal would authorize counties with populations under 2,000 to designate another county to administer the California Children’s Services program, provided the other county consents, otherwise meets established standards, and neither county participates in the Whole Child Model. The department would adopt regulations to implement this new inter-county designation, including requirements for written intercounty agreements, and may issue provider bulletins or guidelines to implement the provision prior to formal regulations.

Currently, the county board of supervisors designates the CCS administering agency, with counties under 200,000 able to operate independently or jointly with the department and larger counties administering the program independently. The new option adds a pathway for extremely small counties to partner with another county to administer CCS, subject to mutual consent, adherence to standards, and the non-participation of either county in the Whole Child Model framework.

Regarding Medi-Cal integration, the bill establishes a transition framework for CCS services in Whole Child Model counties once readiness requirements are met: the designated county agency and the Medi-Cal managed care plan would transition CCS services into the Medi-Cal contract for children enrolled in Medi-Cal with CCS, while the designated county retains responsibility for CCS eligibility determinations. In Whole Child Model counties, the case management, care coordination, provider referrals, and service authorization functions of CCS would be assumed by the Medi-Cal plan, with a written transition plan; the CCS Medical Therapy program would continue to oversee medically necessary occupational and physical therapy services.

Implementation would proceed with regulatory development and interim guidance, not a new state appropriation, and involves oversight by the department and fiscal analysis by legislative committees. The department may use all-county letters or similar guidance before regulations are adopted, and semiannual status reports to the Legislature would continue until regulations are in place. The changes maintain the existing CCS framework for eligibility and OT/PT services while expanding governance options for very small counties and aligning CCS operations with Medi-Cal managed care in applicable counties.