1 11 chdp director/deputy director training section i program overview 1 7/1/2010
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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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