CCS Stakeholder Potential Priorities...11 Appendix 26 CCS Stakeholder Potential Priorities CCS Stakeholder Potential Priorities, 1/6/15 UCSF Family Health Outcomes Project 12 Physician

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Appendix 26 CCS Stakeholder Potential Priorities

CCS Stakeholder Potential Priorities, 1/6/15 UCSF Family Health Outcomes Project

Priority: Increase family access to educational

information and information about accessing CCS

services, including what services are covered by

CCS, availability of and access to services offered

by health plans, and family support groups

Priority: Increase family partnership in decision

making and improving satisfaction with services

Priority: Establish a state-funded CCS parent

advisory committee to provide ongoing input for

continuous quality improvement

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Priority: Increase number of family-centered medical homes for CSCHN and the number/% of CCS children who have a designated medical home, and have CCS develop standard/regulations for certifying medical homes for CSHCN

Priority: Increase reimbursement rates for Medi-Cal and CCS services

Priority: Reassess which conditions should be CCS eligible

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Priority: Increase access of CCS children to 24-7 medical consultation and urgent care services from the child’s usual sources of primary and specialty care to decrease unnecessary ER visits and hospitalizations

Priority: Increase the use of technology (i.e.

telehealth) to expand access to CCS paneled providers

Priority: Increase timely access of CCS children to

durable medical equipment

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Priority: Expand the number of qualified providers participating in the CCS program, e.g., medical specialists, primary care physicians, audiologists, occupational and physical therapists, and nutritionists

Priority: Increase access of CCS children to

preventive health care services (primary care, well child care, immunizations, screening) as recommended by the AAP and develop data system to track

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Priority: Increase access to CCS services by

increasing the financial eligibility limit ($40,000

limit)

Priority: Implement a system of standards of

service delivery for all children with CCS medically

eligible conditions regardless of insurance

coverage.

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Priority: Develop and implement strategies to facilitate reimbursing providers in a more timely fashion.

Priority: Develop and implement to identify/create IT and other solutions to facilitate more rapid determinations of eligibility and authorizations and communication between CCS and providers

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Priority: Work with Medi-Cal at the state level to establish more efficient policies and procedures for how Medi-Cal managed care plans work the CCS program (i.e. need from denials from CCS) to reduce ‘ping ponging’ between providers and payors

Priority: With adequate funding, have CCS cover the whole child instead of just care for the child’s CCS eligible medical condition

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Priority: Increase the capacity of the State CCS program to more quickly panel providers and make eligibility and authorization determinations, to update and enforce CCS standards, and to work with Counties to adopt strategies and best practices to reduce variation between Counties and implement administrative efficiencies.

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Priority: Increase access to transition services for CCS

youth, 17-21 years of age, including help with finding

adult primary and specialty care providers

Priority: Work with medical providers to identify

methods, materials and protocols to increase

transition planning services provided to CCS youth

Priority: Expand CCS eligibility for certain conditions

(i.e. sickle cell anemia) until age 25

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Develop strategies to ensure the availability of

translation services for all CCS clients when

needed

Establish dedicated funding for counties to employ

a parent liaison to help CCS families navigate the

system, with a particular focus on non-English

speaking families

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12

Physician

Supply

Access to Care

Cost of care

Budget cuts, Reduced staff, delays in paneling

Lack of Primary Care/ Medical

Home





Select recorder to enter info into the laptop

Select recorder for butcher block

Select presenter to report back for the group

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Review draft list of priorities and:

◦ Add priorities if needed

◦ Delete priorities if not needed

◦ Reword listed priorities

GOAL: Manageable list of priorities

for Stakeholder’s to rank

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Additional analyses of data for top priority areas

Inclusion and sharing of additional data – i.e. CA

AAP survey on caring for CSHCN

Continued involvement of stakeholders and state

and local CCS staff in the development of action

plans

Establish performance measures to evaluate

implementation of action plans

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Documents

CCS Stakeholder Potential Priorities...11 Appendix 26 CCS Stakeholder Potential Priorities CCS Stakeholder Potential Priorities, 1/6/15 UCSF Family Health Outcomes Project 12 Physician