Whole Child Model (WCM) and California Children’s Services (CCS)
As of July 1, 2018, CenCal Health began administering The Whole Child Model (WCM) for the California Children’s Services (CCS) Program for all eligible members. The WCM is a delivery system that will provide comprehensive, coordinated services for children and youth with special health care needs. This integration focuses on the whole-child, including the child’s full range of needs as well as their CCS condition.
CenCal Health will be responsible for payment, authorizations and care coordination of services for CenCal Health CCS eligible members. Eligibility will continue to be determined by Santa Barbara and San Luis Obispo County CCS Department.
Please view the information below, or view our recent CCS Provider Presentation, the recorded training video, in addition our CCS Resource Packet. Together, we support the children in our communities who need it most!
Below is a list of CCS program providers located within CenCal Health’s service area of Santa Barbara and San Luis Obispo County. All providers that give services to our CenCal Health CCS eligible members are required to be CCS-paneled. These providers are trained health care staff who know how to care for our CCS members with special health care needs.
- CCS Paneled Primary Care Providers (PCP)
- CCS Paneled Specialist
- CCS Paneled Allied Provider
- CCS Paneled DME Suppliers
- CCS Paneled Hospitals
- Becoming a California Children’s Services (CCS) Provider
- California Children’s Services (CCS) Provider Lists
For additional assistance, please contact CenCal Health’s Provider Services Department at (805) 562-1676. Our list’s above are subject to changes based on the provider paneling and CenCal Health contract status.
California Children’s Service Eligibility
Santa Barbara and San Luis Obispo County, CCS Eligibility Case Workers assist with all questions regarding a child’s CCS eligibility and annual review
Santa Barbara (805) 681-5360
San Luis Obispo (805) 781-5527
Department of Social Services
Department of Social Services assist with questions regarding a child’s Medi-Cal eligibility or annual re-determination. Please make sure that all parents complete their annual paperwork to make sure they keep their child’s Medi-Cal benefits.
Santa Barbara County Business Service Center 1 (866) 404-4007
San Luis Obispo County Local Offices:
Arroyo Grande (805) 474-6000
San Luis Obispo (805) 781-1600
Morro Bay (805) 772-6405
Paso Robles (805) 237-3110
Atascadero (805) 461-6000
Effective July 1, 2018, CenCal Health will be responsible for the care coordination of CenCal Health eligible CCS members. We will be responsible for review and determination of authorizations, and processing for all eligible CCS claims and pharmacy services in both Santa Barbara and San Luis Obispo Counties.
Member Services 1 (877) 814-1861
Health Services (805) 562-1082
Pharmacy Services (805) 562-1080
Claims & Billing (805) 562-1083
Provider Services (805) 562-1676
CenCal Health will be responsible for the review and approval of authorizations, related to medical services, pharmacy services, durable medical equipment (DME), as well as processing claims for CCS eligible CenCal Health members in both counties.
CenCal Health Resources
- Claims & Billing
- Pharmacy Services
- CCS Qualifying Conditions
- Whole Child Model (WCM) & CCS Readiness Seminar Presentation
Reminder: CenCal Health will honor all referrals and services authorized via a Service Authorization Request (SAR) by the County CCS Program prior to July 1, 2018. Once expired, providers should follow the standard process of obtaining a RAF from the assigned PCP or obtain a TAR for a procedures requiring an authorization.
Department of Health Care Service (DHCS) Resources
- DHCS California Children’s Services (CCS) Program Overview
- DHCS CCS Whole-Child Model (WCM)
- DHCS Frequently Asked Questions
- CCS Program Details
County Health Resources
- County of Santa Barbara CCS or call (805) 681-5360
- County of San Luis Obispo CCS or call (805) 781-5527
For authorization questions and status, please contact CenCal Health’s Health Services Department at (805) 562-1082. For assistance please contact the Provider Services Department at (805) 562-1676.