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Effective Date: November 1, 2009 November 1, 2009 November 1, 2009 those who wish to deliver complete health care, if they meet the criteria outlined in Section 6860 of Title XXI. It also identifies providers who may be providing substandard services and can require corrective action in order to continue program participation. Specialized Services. The CCS program develops standards for provider participation under the authority of Section 123925 of the Health and Safety Code. Providers, from individual pediatric specialists and sub-specialists to hospital inpatient facilities, wishing to participate in the program apply to have their qualifications reviewed and assessed. CCS state program staff perform on-site review of hospital facilities and special care centers that includes the determination of the appropriateness of the professional staff delivering care to CCS-eligible children and the quality of the health care provided (generally through the review of medical records). The CCS program staff authorizes paneled and approved providers to deliver services to eligible children. CCS case management, through its prior authorization requirements, can insure that children with serious physically handicapping conditions are receiving health care services from the appropriate type and level of provider. The requirements for provider selection, quality improvements systems and documentation that are used for a similar population in the Medi-Cal program will be required of county Mental Health Plans under this program. In addition, California has been a national leader in the implementation of a performance outcome system for children with serious emotional disturbance. Children with serious emotional disturbance receiving Mental Health Plan services under Title XXI will be included in this effort. Families will be able to work with the Mental Health Plans on a formal or informal basis to resolve problems. COUNTY CHILDREN’S HEALTH INSURANCE PROGRAM (C-CHIP) MRMIB will monitor quality standards in the C-CHIP projects through: • Analysis and trending of reports from health, dental and vision plans. MRMIB staff will collect and analyze a variety of reports generated by participating plans, regulatory entities, and external review Approval Date: HFP Family Contribution Increase HFP Co-Payment Increase HFP Limited Dental Plan Choice for New Subscribers

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