There are approximately 200,000 children enrolled in the California Children’s Services (CCS) program, and many of them require access to medically necessary Durable Medical Equipment (DME) and medical supplies. This issue brief for advocates provides the framework for accessing DME and medical supplies through the CCS program. The authors share an overview of the CCS program, including existing guidance on how to access services in Whole Child Model and traditional CCS counties; considerations when children have Medi-Cal and/or other health coverage; and navigating the right to appeal denials for DME and supplies.
The authors note that accessing DME through the CCS program can be a challenging process for beneficiaries and advocates due to structural complications and complexities in the rules. More guidance by the state is recommended, especially around the areas of care coordination and due process rights for beneficiaries with CCS and Medi-Cal coverage.
