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27 handicapping conditions, while county mental health departments will provide appropriate services to meet the needs of seriously emotionally disturbed children. Both programs will reimburse providers for these specialized services.

Children receiving such services will continue to have their primary health needs served through their Managed Care Plan. Allowing those specialized services to be provided as a complement to, but outside of, the managed care setting is consistent with Federal mandates that prohibit mandatory enrollment of children with special medical needs in managed care.

Mental Health. A basic benefit package of mental health services will be provided by the health care plans. This basic package for mental health treatment includes 20 outpatient visits, and 30 inpatient mental health days per year. While it is anticipated that the great majority of the mental health needs of children will be met under their Managed Care Plan, it is recognized that some seriously emotionally disturbed children will require more specialized mental health services. Allowing such services to be provided outside of the managed care setting is consistent with regulations that prohibit mandatory enrollment of children with special needs into managed care. Consistent with the treatment of similarly situated privately insured populations, these children are eligible for specialized mental health services through the county mental health system of care. Children with serious emotional disturbances (estimated at between 3-5 percent of the general population) will be referred by the health care plan to the county mental health program for treatments, pursuant to a Memorandum of Understanding (MOU) between the two organizations, for any needed additional mental health services. The required MOU will formalize this important arrangement. The county mental health program will coordinate the delivery of mental health and other health care services with the health care plan for those children who meet the criteria of serious emotional disturbance.

County mental health programs will provide mental health treatment services directly or through contracts with private organizations and individual providers. The requirements for provider selection and quality improvement for these mental health services will be consistent with those used for the Medi-Cal program for a similar population.

California Children’s Services Program. Integrating the CCS program into CHIP is a logical way to ensure that uninsured low income children with serious health conditions will continue to have access to a program highly respected by the medical community because of its focus on high quality care. Children with chronic, serious, and complex physically handicapping conditions are best served by systems and programs that have been organized specifically to serve them. It is important that care not be disrupted and that continuity and quality of services be maintained. With these goals in mind, plans will be required to refer CCS-eligible children to the CCS program for the treatment of CCS-eligible conditions.