What is the Whole Child Model (WCM) program?
Whole Child Model is a state program for California Children Services (CCS). Starting January 1, 2025, Partnership HealthPlan of California members who have been getting CCS care through their county will get these services through Partnership's Whole Child Model program. This applies to eligible members in Butte, Colusa, Glenn, Nevada, Placer, Plumas, Sierra, Sutter, Tehama, and Yuba counties. Partnership will help these families with CCS care and Medi-Cal covered services.
How
does this affect my child’s health care?
All your child’s care needs (CCS and Medi-Cal covered services) will be covered
and managed by Partnership.
If my child's benefits change to straight Medi-Cal, will he/she still be in WCM?
No. Children who have straight Medi-Cal will not be in Whole Child Model.
Who qualifies for Whole Child Model?
A child would qualify if he/she is:
• Under the age of 21
• A Partnership member
• Eligible for CCS
Who decides who can get CCS?
Your county’s CCS program.
How will members know of the changes to the CCS program under Whole Child Model?
Through the following:
• Department of Health Care Services (DHCS) letter
• Partnership letters
• Partnership meetings for those who are affected
• Partnership’s website
• By calling Partnership Member Services at (800) 863-4155
Will Whole Child Model members have access to the CCS provider network?
Yes.
How can I find out if a provider is paneled by CCS?
CCS paneled specialty providers are providers who have been trained and certified to provide care to CCS members. This information is available at the DHCS California Children's Services website at: https://www.dhcs.ca.gov/services/ccs/Pages/CCSProviders.aspx.
Will CCS members be assigned to a PCP?
Whole Child Model program members are asked to choose a local medical home. They may see their CCS-paneled specialty providers as needed.
Will my child receive transportation benefits under Whole Child Model?
Yes.
Will Partnership cover the same benefits and services that CCS did?
Yes, Partnership will provide the same benefits that CCS members got from their county programs.
How will this change affect the Medical Therapy Program (MTP)?
The MTP will keep giving the therapy services in your county and will suggest the right equipment. Partnership will review all requests for equipment.
Will I need approval from Partnership to see a specialist?
No.
What will happen to services the county CCS program has already authorized for 2025?
Partnership will honor and pay for all services approved by the county's CCS program using continuity of care benefits.
Will a CCS member have a case manager or care coordinator?
Yes, you have access to Partnership's Care Coordination Department when you need help with case management.
Will my child still be able to get CCS medications under Partnership managed care?
Medicines covered under the CCS benefit will be covered by Medi-Cal Rx. Medi-Cal Rx can be reached at 1 (800) 977-2273, 24 hours a day, 7 days week. For TTY, dial 711, available Monday – Friday 8 a.m. – 5 p.m.
What is Partnership's approach to CCS members who are aging out of the CCS program?
Partnership's Care Coordination Department will help make sure families have a smooth transition into adult services.
Will CCS members under Partnership managed care be able to access the appeal and fair hearing process?
Yes.
