State Codes and Statutes

Statutes > California > Hsc > 123800-123995

HEALTH AND SAFETY CODE
SECTION 123800-123995



123800.  This article shall be known and may be cited as the Robert
W. Crown California Children's Services Act.



123805.  The department shall establish and administer a program of
services for physically defective or handicapped persons under the
age of 21 years, in cooperation with the federal government through
its appropriate agency or instrumentality, for the purpose of
developing, extending and improving the services. The department
shall receive all funds made available to it by the federal
government, the state, its political subdivisions or from other
sources. The department shall have power to supervise those services
included in the state plan that are not directly administered by the
state. The department shall cooperate with the medical, health,
nursing and welfare groups and organizations concerned with the
program, and any agency of the state charged with the administration
of laws providing for vocational rehabilitation of physically
handicapped children.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.


123810.  The department succeeds to and is vested with the duties,
purposes, responsibilities, and jurisdiction heretofore exercised by
the State Department of Benefit Payments with respect to moneys,
funds, and appropriations available to the department for the
purposes of processing, audit, and payment of claims received for the
purposes of this article.



123815.  The department shall have possession and control of all
records, papers, equipment, and supplies held for the benefit or use
of the Director of Benefit Payments in the performance of his duties,
powers, purposes, responsibilities, and jurisdiction that are vested
in the department by Section 123810.


123820.  All officers and employees of the Director of Benefit
Payments who on July 1, 1978, are serving in the state civil service,
other than as temporary employees, and engaged in the performance of
a function vested in the department by Section 123810 shall be
transferred to the department. The status, positions, and rights of
these persons shall not be affected by the transfer and shall be
retained by them as officers and employees of the department pursuant
to the State Civil Service Act, except as to positions exempt from
civil service.


123822.  All claims for services provided under this article shall
be submitted to the state fiscal intermediary for payment no later
than January 1, 1999. The State Department of Health Services shall
work in cooperation with the counties to develop a timeline for
implementing the centralized billing system. If a department review
of those counties participating in the centralized billing system
demonstrates that as of January 1, 2000, any county has incurred
increased costs as a result of submitting claims for services to the
state fiscal intermediary, that county may be exempt from this
section.


123825.  It is the intent of the Legislature through this article to
provide, to the extent practicable, for the necessary medical
services required by physically handicapped children whose parents
are unable to pay for these services, wholly or in part. This article
shall also include the necessary services rendered by the program to
physically handicapped children treated in public schools that
provide services for physically handicapped children.



123830.  "Handicapped child," as used in this article, means a
physically defective or handicapped person under the age of 21 years
who is in need of services. The director shall establish those
conditions coming within a definition of "handicapped child" except
as the Legislature may otherwise include in the definition.
Phenylketonuria, hyaline membrane disease, cystic fibrosis, and
hemophilia shall be among these conditions.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.



123835.  The department shall keep the program abreast of advances
in medical science, leading to the inclusion of other handicapping
conditions and services within the limits of and consistent with the
most beneficial use of funds appropriated for this purpose. With the
approval of the agency administrator the department may carry out
pilot studies to determine the need for, or the feasibility of,
including other handicapping conditions and services in the program
within the limits of available funds appropriated for the program.



123840.  "Services," as used in this article, means any or all of
the following:
   (a) Expert diagnosis.
   (b) Medical treatment.
   (c) Surgical treatment.
   (d) Hospital care.
   (e) Physical therapy.
   (f) Occupational therapy.
   (g) Special treatment.
   (h) Materials.
   (i) Appliances and their upkeep, maintenance, care and
transportation.
   (j) Maintenance, transportation, or care incidental to any other
form of "services."



123845.  "California Children's Services Program," as used in this
article, means the program of services established and operated
pursuant to this article.


123850.  The board of supervisors of each county shall designate the
county department of public health or the county department of
social welfare as the designated agency to administer the California
Children's Services Program. Counties with total population under
200,000 persons may administer the county program independently or
jointly with the department. Counties with a total population in
excess of 200,000 persons shall administer the county program
independently. Except as otherwise provided in this article, the
director shall establish standards relating to the local
administration and minimum services to be offered by counties in the
conduct of the California Children's Services Program.



123853.  (a) The department may enter into contracts with one or
more manufacturers on a negotiated or bid basis as the purchaser, but
not the dispenser or distributor, of factor replacement therapies
under the California Children's Services Program for the purpose of
enabling the department to obtain the full range of available
therapies and services required for clients with hematological
disorders at the most favorable price and to enable the department,
notwithstanding any other provision of state law, to obtain
discounts, rebates, or refunds from the manufacturers based upon the
large quantities purchased under the program. Nothing in this
subdivision shall interfere with the usual and customary distribution
practices of factor replacement therapies. In order to achieve
maximum cost savings, the Legislature hereby determines that an
expedited contract process under this section is necessary.
Therefore, a contract under this subdivision may be on a negotiated
basis and shall be exempt from Chapter 2 (commencing with Section
10290) of Part 2 of Division 2 of the Public Contract Code and
Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3
of the Government Code. Contracts entered pursuant to this
subdivision shall be confidential and shall be exempt from disclosure
under the California Public Records Act (Chapter 3.5 (commencing
with Section 6250) of Division 7 of Title 1 of the Government Code).
   (b) (1) Factor replacement therapy manufacturers shall calculate
and pay interest on late or unpaid rebates. The interest shall not
apply to any prior period adjustments of unit rebate amounts or
department utilization adjustments. Manufacturers shall calculate and
pay interest on late or unpaid rebates for quarters that begin on or
after the effective date of the act that added this subdivision.
   (2) Following the final resolution of any dispute regarding the
amount of a rebate, any underpayment by a manufacturer shall be paid
with interest calculated pursuant to paragraph (4), and any
overpayment, together with interest at the rate calculated pursuant
to paragraph (4), shall be credited by the department against future
rebates due.
   (3) Interest pursuant to paragraphs (1) and (2) shall begin
accruing 38 calendar days from the date of mailing the invoice,
including supporting utilization data sent to the manufacturer.
Interest shall continue to accrue until the date of mailing of the
manufacturer's payment.
   (4) Interest rates and calculations pursuant to paragraphs (1) and
(2) shall be identical to interest rates and calculations set forth
in the federal Centers for Medicare and Medicaid Services' Medicaid
Drug Rebate Program Releases or regulations.
   (c) If the department has not received a rebate payment, including
interest, within 180 days of the date of mailing of the invoice,
including supporting utilization data, a factor replacement therapy
manufacturer's contract with the department shall be deemed to be in
default and the contract may be terminated in accordance with the
terms of the contract. This subdivision does not limit the department'
s right to otherwise terminate a contract in accordance with the
terms of that contract.
   (d) The department may enter into contracts on a bid or negotiated
basis with manufacturers, distributors, dispensers, or suppliers of
pharmaceuticals, appliances, durable medical equipment, medical
supplies, and other product-type health care services and
laboratories for the purpose of obtaining the most favorable prices
to the state and to assure adequate access and quality of the product
or service. In order to achieve maximum cost savings, the
Legislature hereby determines that an expedited contract process
under this subdivision is necessary. Therefore, contracts under this
subdivision may be on a negotiated basis and shall be exempt from the
provisions of Chapter 2 (commencing with Section 10290) of Part 2 of
Division 2 of the Public Contract Code and Chapter 6 (commencing
with Section 14825) of Part 5.5 of Division 3 of the Government Code.
   (e) The department may contract with one or more manufacturers of
each multisource prescribed product or supplier of outpatient
clinical laboratory services on a bid or negotiated basis. Contracts
for outpatient clinical laboratory services shall require that the
contractor be a clinical laboratory licensed or certified by the
State of California or certified under Section 263a of Title 42 of
the United States Code. Nothing in this subdivision shall be
construed as prohibiting the department from contracting with less
than all manufacturers or clinical laboratories, including just one
manufacturer or clinical laboratory, on a bid or negotiated basis.




123855.  The department or designated county agency shall cooperate
with, or arrange through, local public or private agencies and
providers of medical care to seek out handicapped children, bringing
them expert diagnosis near their homes. Case finding shall include,
but not be limited to, children with impaired sense of hearing. This
section does not give the department or designated agency power to
require medical or other form of physical examination without consent
of parent or guardian.



123860.  In accordance with applicable regulations of the United
States Children's Bureau, the department and designated county
agencies shall provide a diagnosis for handicapped children. Within
the limits of available funds, the department and designated local
agencies may accept for diagnosis a handicapped child believed to
have a severe chronic disease or severe physical handicap, as
determined by the director, irrespective of whether the child
actually has an eligible medical condition specified in Section
123830. The department shall cause a record to be kept listing all
conditions diagnosed by the program and shall publish the information
annually, including data on the number and kinds of diagnosed
medical conditions that do not come within the definition of
"handicapped child" as specified in Section 123830.



123865.  Whenever the parents or estate of a handicapped child is
wholly or partly unable to furnish for the child necessary services,
the parents or guardian may apply to the agency of the county that
has been designated by the board of supervisors of the county of
residence under the terms of Section 123850 to administer the
provisions for handicapped children. Residence shall be determined in
accordance with Sections 243 and 244 of the Government Code.



123870.  (a) The department shall establish standards of financial
eligibility for treatment services under the California Children's
Services Program (CCS program).
   (1) Financial eligibility for treatment services under this
program shall be limited to persons in families with an adjusted
gross income of forty thousand dollars ($40,000) or less in the most
recent tax year, as calculated for California state income tax
purposes. If a person is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code), the financial documentation required for that
program in Section 2699.6600 of Title 10 of the California Code of
Regulations may be used instead of the person's California state
income tax return. However, the director may authorize treatment
services for persons in families with higher incomes if the estimated
cost of care to the family in one year is expected to exceed 20
percent of the family's adjusted gross income.
   (2) Children enrolled in the Healthy Families Program who have a
CCS program eligible medical condition under Section 123830, and
whose families do not meet the financial eligibility requirements of
paragraph (1), shall be deemed financially eligible for CCS program
benefits.
   (b) Necessary medical therapy treatment services under the
California Children's Services Program rendered in the public schools
shall be exempt from financial eligibility standards and enrollment
fee requirements for the services when rendered to any handicapped
child whose educational or physical development would be impeded
without the services.
   (c) All counties shall use the uniform standards for financial
eligibility and enrollment fees established by the department. All
enrollment fees shall be used in support of the California Children's
Services Program.
   (d) Annually, every family with a child eligible to receive
services under this article shall pay a fee of twenty dollars ($20),
that shall be in addition to any other program fees for which the
family is liable. This assessment shall not apply to any child who is
eligible for full scope Medi-Cal benefits without a share of cost,
for children receiving therapy through the California Children's
Services Program as a related service in their individualized
education plans, for children from families having incomes of less
than 100 percent of the federal poverty level, or for children
covered under the Healthy Families Program.



123872.  In addition to the other eligibility requirements set forth
in this article, prior to being determined financially eligible for
services under this article, the applicant family shall agree to
repay the California Children's Services Program for any treatment
services authorized by the program in an amount not to exceed the
proceeds of any judgment, award, or settlement for damages as a
result of a lawsuit or pursuant to an agreement relating to a
California Children's Services medically eligible condition.



123875.  When the California Children's Service medical therapy unit
conference team, based on a medical referral recommending medically
necessary occupational or physical therapy in accordance with
subdivision (b) of Section 7575 of the Government Code, finds that a
handicapped child, as defined in Section 123830, needs medically
necessary occupational or physical therapy, that child shall be
determined to be eligible for therapy services. If the California
Children's Services medical consultant disagrees with the
determination of eligibility by the California Children's Services
medical therapy unit conference team, the medical consultant shall
communicate with the conference team to ask for further justification
of its determination, and shall weigh the conference team's
arguments in support of its decision in reaching his or her own
determination.
   This section shall not change eligibility criteria for the
California Children's Services programs as described in Sections
123830 and 123860.
   This section shall not apply to children diagnosed as specific
learning disabled, unless they otherwise meet the eligibility
criteria of the California Children's Services.



123880.  The department and designated agencies shall not deny
eligibility or aid under the California Children's Services Program
because an otherwise eligible person is receiving treatment services
under a teaching program at an accredited medical school facility or
accredited school or college of podiatric medicine, whether or not
all or part of the treatment services are performed by the staff at
the facility, school, or college, provided that treatment services at
the facility, school, or college are under the general supervision
of a California Children's Services Program panel physician and
surgeon, including a family physician, and podiatrist.



123885.  Panel members as set forth in Section 123880 shall be
board-certified and have expertise in the care of children.



123890.  (a) The state department shall not deny a hospital's
request to provide treatment to burn victims who are eligible under
the California Children's Services Program solely on the basis that
the hospital does not have separate facilities for child and adult
burn victims, provided that the hospital has approval from the
department to operate a burn center pursuant to Section 1255.
   (b) Subdivision (a) shall only be applied to burn units located in
hospitals where there are no regional burn centers, or any other
existing burn center, within an 85-mile radius of the hospital.
   (c) Subdivision (a) shall only apply if the hospital seeking the
exemption had a state-approved burn center in operation as of January
1, 1982, and if there is no hospital specializing in children's
services within an 85-mile radius of the hospital seeking the
subdivision (a) exemption.
   (d) Hospitals having qualified and received a subdivision (a)
exemption, shall demonstrate, at the request of the department, that
the nursing staff providing burn care to children victims have
satisfactorily completed post-graduate training in pediatrics.




123895.  The designated agency shall determine the financial
eligibility of the family according to standards established by the
department. The agency will also determine if the parents are
residents of the county, if the guardian of the child is a resident
of the county, or if the emancipated minor is a resident of the
county where application for services is made. If the agency finds
that the family, guardian, or emancipated minor is a resident of the
county and financially eligible for services, it shall make a record
of the facts and shall certify this child for care under the program.



123900.  (a) Beginning September 1, 1991, in addition to any other
standards of eligibility pursuant to this article, each family with a
child otherwise eligible to receive services under this article
shall pay an annual enrollment fee as a requirement for eligibility
for services, except as specified in subdivision (f).
   (b) The department shall determine the annual enrollment fee, that
shall be a sliding fee scale based upon family size and income, and
shall be adjusted by the department to reflect changes in the federal
poverty level.
   (c) "Family size" shall include the child, his or her natural or
adoptive parents, siblings, and other family members who live
together and whose expenses are dependent upon the family income.
   (d) "Family income" for purposes of this article, shall include
the total gross income, or their equivalents, of the child and his or
her natural or adoptive parents.
   (e) Payment of the enrollment fee is a condition of program
participation. The enrollment fee is independent of any other
financial obligation to the program.
   (f) The enrollment fee shall not be charged in any of the
following cases:
   (1) The only services required are for diagnosis to determine
eligibility for services, or are for medically necessary therapy
pursuant to Section 123875.
   (2) The child is otherwise eligible to receive services and is
eligible for full Medi-Cal benefits at the time of application or
reapplication.
   (3) The family of the child otherwise eligible to receive services
under this article has a gross annual income of less than 200
percent of the federal poverty level.
   (4) The family of a child otherwise eligible to receive services
under this article who is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code).
   (g) Failure to pay or to arrange for payment of the enrollment fee
within 60 days of the due date shall result in disenrollment and
ineligibility for coverage of treatment services 60 days after the
due date of the required payment.
   (h) The county shall apply the enrollment fee scale established by
the department and shall collect the enrollment fee. The county may
arrange with the family for periodic payment during the year if a
lump-sum payment will be a hardship for the family. The agency
director of California Children's Services may, on a case-by-case
basis, waive or reduce the amount of a family's enrollment fee if, in
the director's judgment, payment of the fee will result in undue
hardship.
   (i) By thirty days after the effective date of this section or
August 1, 1991, whichever is later, the department shall advance to
each county, as a one-time startup amount, five dollars and fifty
cents ($5.50) for each county child who was receiving services under
this article on June 30, 1990, and who was not a Medi-Cal
beneficiary. This one-time payment shall be in addition to the 4.1
percent of the gross total expenditures for diagnoses, treatment, and
therapy by counties allowed under subdivision (c) of Section 123955.
   (j) Each county shall submit to the state, as part of its
quarterly claim for reimbursement, an accounting of all revenues due
and revenues collected as enrollment fees.



123905.  A county of under 200,000 population, administering its
county program jointly with the department, shall forward to the
department a statement certifying the family of the handicapped child
as financially eligible for treatment services. The department shall
authorize necessary services within the limits of available funds.
Payment for services shall be made by the department, with
reimbursement from the county for its proportionate share as
specified in this article.



123910.  The department may, without the possession of a county
certification, pay the expenses for services required by any
physically handicapped child out of any funds received by it through
gift, devise, or bequest or from private, state, federal, or other
grant or source.
   The department may authorize or contract with any person or
institution properly qualified to furnish services to handicapped
children. It may pay for services out of any funds appropriated for
the purpose or from funds it may receive by gift, devise, or bequest.
   The department may receive gifts, legacies, and bequests and
expend them for the purpose of this article, but not for
administrative expense.



123915.  When the department provides, or arranges for the provision
of, services to physically handicapped children directly, as in the
case of nonresident physically handicapped children, it shall enter
into an agreement with parents, guardians or persons responsible for
the care of handicapped children for payment of the enrollment fee.




123920.  Upon the request of another state or of a federal agency,
the department may pay the expenses of services required by any
physically handicapped child who is not a resident of the state;
provided, that the cost of the services is fully covered by special
grants or allotments received from the state or federal agency for
that purpose.



123925.  The department and designated agencies shall maintain
surveillance and supervision over the services provided handicapped
children under authorization by the program to assure a high quality
of service and shall cause a record to be kept showing the condition
and improvement of these handicapped children.



123929.  (a) Except as otherwise provided in this section and
Section 14133.05 of the Welfare and Institutions Code, California
Children's Services Program services provided pursuant to this
article require prior authorization by the department or its
designee. Prior authorization is contingent on determination by the
department or its designee of all of the following:
   (1) The child receiving the services is confirmed to be medically
eligible for the CCS program.
   (2) The provider of the services is approved in accordance with
the standards of the CCS program.
   (3) The services authorized are medically necessary to treat the
child's CCS-eligible medical condition.
   (b) Effective July 1, 2004, the department or its designee may
approve a request for a treatment authorization that is otherwise in
conformance with subdivision (a) for services for a child
participating in the Healthy Families Program pursuant to clause (ii)
of subparagraph (A) of paragraph (6) of subdivision (a) of Section
12693.70 of the Insurance Code, received by the department or its
designee after the requested treatment has been provided to the
child.
   (c) Effective July 1, 2004, if a provider of services who meets
the requirements of paragraph (2) of subdivision (a) incurs costs for
services described in paragraph (3) of subdivision (a) to treat a
child described in subdivision (b) who is subsequently determined to
be medically eligible for the CCS program as determined by the
department or its designee, the department may reimburse the provider
for those costs. Reimbursement under this section shall conform to
the requirements of Section 14105.18 of the Welfare and Institutions
Code.



123930.  This article does not authorize any treatment service
without the written consent of a parent or guardian except as a
person under 18 years of age is an emancipated minor.



123935.  A handicapped child shall not be denied services pursuant
to this article because he or she is mentally retarded.



123940.  (a) (1) Annually, the board of supervisors shall
appropriate a sum of money for services for handicapped children of
the county, including diagnosis, treatment, and therapy services for
physically handicapped children in public schools, equal to 25
percent of the actual expenditures for the county program under this
article for the 1990-91 fiscal year, except as specified in paragraph
(2).
   (2) If the state certifies that a smaller amount is needed in
order for the county to pay 25 percent of costs of the county's
program from this source. The smaller amount certified by the state
shall be the amount that the county shall appropriate.
   (b) In addition to the amount required by subdivision (a), the
county shall allocate an amount equal to the amount determined
pursuant to subdivision (a) for purposes of this article from
revenues allocated to the county pursuant to Chapter 6 (commencing
with Section 17600) of Division 9 of the Welfare and Institutions
Code.
   (c) (1) The state shall match county expenditures for this article
from funding provided pursuant to subdivisions (a) and (b).
   (2) County expenditures shall be waived for payment of services
for children who are eligible pursuant to paragraph (2) of
subdivision (a) of Section 123870.
   (d) The county may appropriate and expend moneys in addition to
those set forth in subdivision (a) and (b) and the state shall match
the expenditures, on a dollar-for-dollar basis, to the extent that
state funds are available for this article.
   (e) Nothing in this section shall require the county to expend
more than the amount set forth in subdivision (a) plus the amount set
forth in subdivision (b) nor shall it require the state to expend
more than the amount of the match set forth in subdivision (c).



123945.  For those counties with a total appropriation of county
funds not exceeding one hundred twenty-five thousand dollars
($125,000), and upon the expenditure of the county funds equivalent
to a county appropriation pursuant to Section 123940, the department
may, to the extent funds are available from state appropriated funds
for the California Children's Services Program and upon certification
of the county that there are insufficient revenues from the account
established pursuant to Chapter 6 (commencing with Section 17600) of
Division 9 of the Welfare and Institutions Code, pay for services for
cases deemed by the department to represent emergencies or cases
where medical care cannot be delayed without great harm to the child.




123950.  The designated county agency shall administer the
medical-therapy program in local public schools for physically
handicapped children. As provided in Section 123940, the state and
counties will share in the cost of support of therapist salaries in
these schools in the ratio of one dollar ($1) of state or federal
funds reimbursed quarterly to one dollar ($1) of county funds. The
director shall establish standards for the maximum number of
therapists employed in the schools eligible for state financial
support in this program, the services to be provided, and the county
administrative services subject to reimbursement by the state.
   The department may adopt regulations to implement this section as
emergency regulations in accordance with Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code. For the purposes of the Administrative Procedure Act, the
adoption of the regulations shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, and general welfare. Notwithstanding Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, these emergency regulations shall not be subject to
the review and approval of the Office of Administrative Law.
   Notwithstanding any other provision of law, if the department
determines that emergency regulations are necessary to implement any
part of this article, there shall be deemed to be good cause for the
regulations to take effect prior to public notice and hearing.
   Notwithstanding subdivision (h) of Section 11346.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing. The
regulations shall become effective immediately upon filing by the
Secretary of State.
   The Office of Administrative Law shall provide for the printing
and publication of these regulations in the California Code of
Regulations. Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
these regulations shall not be repealed by the Office of
Administrative Law and shall remain in effect until revised or
repealed by the department.



123955.  (a) The state and the counties shall share in the cost of
administration of the California Children's Services Program at the
local level.
   (b) (1) The director shall adopt regulations establishing minimum
standards for the administration, staffing, and local implementation
of this article subject to reimbursement by the state.
   (2) The standards shall allow necessary flexibility in the
administration of county programs, taking into account the
variability of county needs and resources, and shall be developed and
revised jointly with state and county representatives.
   (c) The director shall establish minimum standards for
administration, staffing and local operation of the program subject
to reimbursement by the state.
   (d) Until July 1, 1992, reimbursable administrative costs, to be
paid by the state to counties, shall not exceed 4.1 percent of the
gross total expenditures for diagnosis, treatment and therapy by
counties as specified in Section 123940.
   (e) Beginning July 1, 1992, this subdivision shall apply with
respect to all of the following:
   (1) Counties shall be reimbursed by the state for 50 percent of
the amount required to meet state administrative standards for that
portion of the county caseload under this article that is ineligible
for Medi-Cal to the extent funds are available in the state budget
for the California Children's Services Program.
   (2) On or before September 15 of each year, each county program
implementing this article shall submit an application for the
subsequent fiscal year that provides information as required by the
state to determine if the county administrative staff and budget meet
state standards.
   (3) The state shall determine the maximum amount of state funds
available for each county from state funds appropriated for CCS
county administration. If the amount appropriated for any fiscal year
in the Budget Act for county administration under this article
differs from the amounts approved by the department, each county
shall submit a revised application in a form and at the time
specified by the department.
   (f) The department and counties shall maximize the use of federal
funds for administration, of the programs implemented pursuant to
this article, including using state and county funds to match funds
claimable under Title 19 of the Social Security Act.



123960.  The department shall require of participating local
governments the provision of program data including, but not limited
to, the number of children treated, the kinds of disabilities, and
the costs of treatment, to enable the department, the Department of
Finance, and the Legislature to evaluate in a timely fashion and to
adequately fund the California Children's Services Program.



123965.  A handicapped child placed for adoption, determined to be
financially eligible for care at the time of placement, shall not be
denied services pursuant to this article based upon the income of the
adopting parents, nor shall the adopting parents be required to
enter into any agreement to pay toward the costs of services
authorized for the care. This section shall only apply to physical
handicaps present, and diagnosed, at the time of adoption. Residence,
for the purposes of this section, shall be that of the adopting
parents.


123970.  The department and the placing adoption agency at the time
of placement shall notify all prospective adopting parents in
writing, that funds received under the California Children's Services
Program shall terminate if the adopting parents move out of the
state. However, the department and the placing adoption agency shall
advise the prospective adopting parents that they may be eligible for
the funds in the new state, subject to any applicable
qualifications.


123975.  (a) The department, in consultation with selected
representatives of participating neonatal intensive care units, shall
establish a system to screen all newborns and infants for hearing
loss as defined in subdivision (e) of Section 124116 and create and
maintain a system of assessment and followup services for newborns
and infants identified by the screening in approved neonatal
intensive care units participating in the California Children's
Services Program. Screening, assessment and followup services and
reporting of these services shall be provided in a manner consistent
with Article 6.5 (commencing with Section 124115) of Chapter 3.
   This section shall not be applicable to a newborn child whose
parent or guardian objects to the tests on the ground that the tests
conflict with his or her religious beliefs or practices.
   (b) It is the intent of the Legislature, in enacting this section,
to ensure the establishment and maintenance of protocols and quality
of standards.
   (c) The department shall implement this section for newborns and
infants in neonatal intensive care units participating in the
California Children's Services Program.



123980.  If the recipient of services provided by the California
Children's Services Program, his or her guardian, conservator,
personal representative, estate, or survivors, or any of them brings
an action against a third person who may be liable for the injury,
notice of institution of legal proceedings, notice of settlement, and
all other notices required by this code shall be given to the State
Director of Health Services in Sacramento and to the county-managed
California Children's Services Program. The director may provide
notice to the Attorney General. All of these notices shall be given
by the attorney retained to assert the beneficiary's claim, or by the
injured party beneficiary, his or her guardian, conservator,
personal representative, estate, or survivors, if no attorney is
retained.



123982.  Except as otherwise provided by law, the amount of any
judgment, award, or settlement relating to a medical condition for
which treatment services have been provided under the California
Children's Services Program shall be subject to a claim by the state
department and the designated county agency for reimbursement of the
costs of the benefits provided, and to any lien filed against that
judgment, award, or settlement. The department or the county
designated agency, through its civil legal adviser, may, to enforce
this right, institute and prosecute legal proceedings against the
person who has received benefits under this article, his or her
guardian, conservator, or other personal representative, or his or
her estate. In the event of a judgment, award, or settlement in a
suit or claim against a third person who is liable for the medical
condition for which treatment services have been provided under the
California Children's Services Program, the court or other agency
shall first order paid from the judgment, award, or settlement the
actual costs of the care and treatment furnished, or to be furnished,
under the California Children's Services Program.



123985.  (a) A bone marrow transplant for the treatment of cancer
shall be reimbursable under this article, when all of the following
conditions are met:
   (1) The bone marrow transplant is recommended by the recipient's
attending physician.
   (2) The bone marrow transplant is performed in a hospital that is
approved for participation in the California Children's Services
program.
   (3) The bone marrow transplant is a reasonable course of treatment
and is approved by the appropriate hospital medical policy
committee.
   (4) The bone marrow transplant has been deemed appropriate for the
recipient by the program's medical consultant. The medical
consultant shall not disapprove the bone marrow transplant solely on
the basis that it is classified as experimental or investigational.
   (b) The program shall provide reimbursement for both donor and
recipient surgery.
   (c) Any county that has a population of not more than 600,000, as
determined by the most recent decennial census conducted by the
United States Bureau of the Census, shall be exempt from complying
with the 25-percent matching requirement provided for under this
article, for any bone marrow transplant reimbursable under this
section.



123990.  The department shall adopt regulations to implement the
amendments of this article in 1991. The adoption of the regulations
shall be deemed to be an emergency, and necessary for the immediate
preservation of the public peace, health, safety, and general
welfare.



123995.  (a) The department shall require all applicants to the
program who may be eligible for cash grant assistance or for Medi-Cal
benefits to apply for Medi-Cal.
   (b) This section shall not be interpreted to prohibit the coverage
of services in emergency cases.


State Codes and Statutes

Statutes > California > Hsc > 123800-123995

HEALTH AND SAFETY CODE
SECTION 123800-123995



123800.  This article shall be known and may be cited as the Robert
W. Crown California Children's Services Act.



123805.  The department shall establish and administer a program of
services for physically defective or handicapped persons under the
age of 21 years, in cooperation with the federal government through
its appropriate agency or instrumentality, for the purpose of
developing, extending and improving the services. The department
shall receive all funds made available to it by the federal
government, the state, its political subdivisions or from other
sources. The department shall have power to supervise those services
included in the state plan that are not directly administered by the
state. The department shall cooperate with the medical, health,
nursing and welfare groups and organizations concerned with the
program, and any agency of the state charged with the administration
of laws providing for vocational rehabilitation of physically
handicapped children.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.


123810.  The department succeeds to and is vested with the duties,
purposes, responsibilities, and jurisdiction heretofore exercised by
the State Department of Benefit Payments with respect to moneys,
funds, and appropriations available to the department for the
purposes of processing, audit, and payment of claims received for the
purposes of this article.



123815.  The department shall have possession and control of all
records, papers, equipment, and supplies held for the benefit or use
of the Director of Benefit Payments in the performance of his duties,
powers, purposes, responsibilities, and jurisdiction that are vested
in the department by Section 123810.


123820.  All officers and employees of the Director of Benefit
Payments who on July 1, 1978, are serving in the state civil service,
other than as temporary employees, and engaged in the performance of
a function vested in the department by Section 123810 shall be
transferred to the department. The status, positions, and rights of
these persons shall not be affected by the transfer and shall be
retained by them as officers and employees of the department pursuant
to the State Civil Service Act, except as to positions exempt from
civil service.


123822.  All claims for services provided under this article shall
be submitted to the state fiscal intermediary for payment no later
than January 1, 1999. The State Department of Health Services shall
work in cooperation with the counties to develop a timeline for
implementing the centralized billing system. If a department review
of those counties participating in the centralized billing system
demonstrates that as of January 1, 2000, any county has incurred
increased costs as a result of submitting claims for services to the
state fiscal intermediary, that county may be exempt from this
section.


123825.  It is the intent of the Legislature through this article to
provide, to the extent practicable, for the necessary medical
services required by physically handicapped children whose parents
are unable to pay for these services, wholly or in part. This article
shall also include the necessary services rendered by the program to
physically handicapped children treated in public schools that
provide services for physically handicapped children.



123830.  "Handicapped child," as used in this article, means a
physically defective or handicapped person under the age of 21 years
who is in need of services. The director shall establish those
conditions coming within a definition of "handicapped child" except
as the Legislature may otherwise include in the definition.
Phenylketonuria, hyaline membrane disease, cystic fibrosis, and
hemophilia shall be among these conditions.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.



123835.  The department shall keep the program abreast of advances
in medical science, leading to the inclusion of other handicapping
conditions and services within the limits of and consistent with the
most beneficial use of funds appropriated for this purpose. With the
approval of the agency administrator the department may carry out
pilot studies to determine the need for, or the feasibility of,
including other handicapping conditions and services in the program
within the limits of available funds appropriated for the program.



123840.  "Services," as used in this article, means any or all of
the following:
   (a) Expert diagnosis.
   (b) Medical treatment.
   (c) Surgical treatment.
   (d) Hospital care.
   (e) Physical therapy.
   (f) Occupational therapy.
   (g) Special treatment.
   (h) Materials.
   (i) Appliances and their upkeep, maintenance, care and
transportation.
   (j) Maintenance, transportation, or care incidental to any other
form of "services."



123845.  "California Children's Services Program," as used in this
article, means the program of services established and operated
pursuant to this article.


123850.  The board of supervisors of each county shall designate the
county department of public health or the county department of
social welfare as the designated agency to administer the California
Children's Services Program. Counties with total population under
200,000 persons may administer the county program independently or
jointly with the department. Counties with a total population in
excess of 200,000 persons shall administer the county program
independently. Except as otherwise provided in this article, the
director shall establish standards relating to the local
administration and minimum services to be offered by counties in the
conduct of the California Children's Services Program.



123853.  (a) The department may enter into contracts with one or
more manufacturers on a negotiated or bid basis as the purchaser, but
not the dispenser or distributor, of factor replacement therapies
under the California Children's Services Program for the purpose of
enabling the department to obtain the full range of available
therapies and services required for clients with hematological
disorders at the most favorable price and to enable the department,
notwithstanding any other provision of state law, to obtain
discounts, rebates, or refunds from the manufacturers based upon the
large quantities purchased under the program. Nothing in this
subdivision shall interfere with the usual and customary distribution
practices of factor replacement therapies. In order to achieve
maximum cost savings, the Legislature hereby determines that an
expedited contract process under this section is necessary.
Therefore, a contract under this subdivision may be on a negotiated
basis and shall be exempt from Chapter 2 (commencing with Section
10290) of Part 2 of Division 2 of the Public Contract Code and
Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3
of the Government Code. Contracts entered pursuant to this
subdivision shall be confidential and shall be exempt from disclosure
under the California Public Records Act (Chapter 3.5 (commencing
with Section 6250) of Division 7 of Title 1 of the Government Code).
   (b) (1) Factor replacement therapy manufacturers shall calculate
and pay interest on late or unpaid rebates. The interest shall not
apply to any prior period adjustments of unit rebate amounts or
department utilization adjustments. Manufacturers shall calculate and
pay interest on late or unpaid rebates for quarters that begin on or
after the effective date of the act that added this subdivision.
   (2) Following the final resolution of any dispute regarding the
amount of a rebate, any underpayment by a manufacturer shall be paid
with interest calculated pursuant to paragraph (4), and any
overpayment, together with interest at the rate calculated pursuant
to paragraph (4), shall be credited by the department against future
rebates due.
   (3) Interest pursuant to paragraphs (1) and (2) shall begin
accruing 38 calendar days from the date of mailing the invoice,
including supporting utilization data sent to the manufacturer.
Interest shall continue to accrue until the date of mailing of the
manufacturer's payment.
   (4) Interest rates and calculations pursuant to paragraphs (1) and
(2) shall be identical to interest rates and calculations set forth
in the federal Centers for Medicare and Medicaid Services' Medicaid
Drug Rebate Program Releases or regulations.
   (c) If the department has not received a rebate payment, including
interest, within 180 days of the date of mailing of the invoice,
including supporting utilization data, a factor replacement therapy
manufacturer's contract with the department shall be deemed to be in
default and the contract may be terminated in accordance with the
terms of the contract. This subdivision does not limit the department'
s right to otherwise terminate a contract in accordance with the
terms of that contract.
   (d) The department may enter into contracts on a bid or negotiated
basis with manufacturers, distributors, dispensers, or suppliers of
pharmaceuticals, appliances, durable medical equipment, medical
supplies, and other product-type health care services and
laboratories for the purpose of obtaining the most favorable prices
to the state and to assure adequate access and quality of the product
or service. In order to achieve maximum cost savings, the
Legislature hereby determines that an expedited contract process
under this subdivision is necessary. Therefore, contracts under this
subdivision may be on a negotiated basis and shall be exempt from the
provisions of Chapter 2 (commencing with Section 10290) of Part 2 of
Division 2 of the Public Contract Code and Chapter 6 (commencing
with Section 14825) of Part 5.5 of Division 3 of the Government Code.
   (e) The department may contract with one or more manufacturers of
each multisource prescribed product or supplier of outpatient
clinical laboratory services on a bid or negotiated basis. Contracts
for outpatient clinical laboratory services shall require that the
contractor be a clinical laboratory licensed or certified by the
State of California or certified under Section 263a of Title 42 of
the United States Code. Nothing in this subdivision shall be
construed as prohibiting the department from contracting with less
than all manufacturers or clinical laboratories, including just one
manufacturer or clinical laboratory, on a bid or negotiated basis.




123855.  The department or designated county agency shall cooperate
with, or arrange through, local public or private agencies and
providers of medical care to seek out handicapped children, bringing
them expert diagnosis near their homes. Case finding shall include,
but not be limited to, children with impaired sense of hearing. This
section does not give the department or designated agency power to
require medical or other form of physical examination without consent
of parent or guardian.



123860.  In accordance with applicable regulations of the United
States Children's Bureau, the department and designated county
agencies shall provide a diagnosis for handicapped children. Within
the limits of available funds, the department and designated local
agencies may accept for diagnosis a handicapped child believed to
have a severe chronic disease or severe physical handicap, as
determined by the director, irrespective of whether the child
actually has an eligible medical condition specified in Section
123830. The department shall cause a record to be kept listing all
conditions diagnosed by the program and shall publish the information
annually, including data on the number and kinds of diagnosed
medical conditions that do not come within the definition of
"handicapped child" as specified in Section 123830.



123865.  Whenever the parents or estate of a handicapped child is
wholly or partly unable to furnish for the child necessary services,
the parents or guardian may apply to the agency of the county that
has been designated by the board of supervisors of the county of
residence under the terms of Section 123850 to administer the
provisions for handicapped children. Residence shall be determined in
accordance with Sections 243 and 244 of the Government Code.



123870.  (a) The department shall establish standards of financial
eligibility for treatment services under the California Children's
Services Program (CCS program).
   (1) Financial eligibility for treatment services under this
program shall be limited to persons in families with an adjusted
gross income of forty thousand dollars ($40,000) or less in the most
recent tax year, as calculated for California state income tax
purposes. If a person is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code), the financial documentation required for that
program in Section 2699.6600 of Title 10 of the California Code of
Regulations may be used instead of the person's California state
income tax return. However, the director may authorize treatment
services for persons in families with higher incomes if the estimated
cost of care to the family in one year is expected to exceed 20
percent of the family's adjusted gross income.
   (2) Children enrolled in the Healthy Families Program who have a
CCS program eligible medical condition under Section 123830, and
whose families do not meet the financial eligibility requirements of
paragraph (1), shall be deemed financially eligible for CCS program
benefits.
   (b) Necessary medical therapy treatment services under the
California Children's Services Program rendered in the public schools
shall be exempt from financial eligibility standards and enrollment
fee requirements for the services when rendered to any handicapped
child whose educational or physical development would be impeded
without the services.
   (c) All counties shall use the uniform standards for financial
eligibility and enrollment fees established by the department. All
enrollment fees shall be used in support of the California Children's
Services Program.
   (d) Annually, every family with a child eligible to receive
services under this article shall pay a fee of twenty dollars ($20),
that shall be in addition to any other program fees for which the
family is liable. This assessment shall not apply to any child who is
eligible for full scope Medi-Cal benefits without a share of cost,
for children receiving therapy through the California Children's
Services Program as a related service in their individualized
education plans, for children from families having incomes of less
than 100 percent of the federal poverty level, or for children
covered under the Healthy Families Program.



123872.  In addition to the other eligibility requirements set forth
in this article, prior to being determined financially eligible for
services under this article, the applicant family shall agree to
repay the California Children's Services Program for any treatment
services authorized by the program in an amount not to exceed the
proceeds of any judgment, award, or settlement for damages as a
result of a lawsuit or pursuant to an agreement relating to a
California Children's Services medically eligible condition.



123875.  When the California Children's Service medical therapy unit
conference team, based on a medical referral recommending medically
necessary occupational or physical therapy in accordance with
subdivision (b) of Section 7575 of the Government Code, finds that a
handicapped child, as defined in Section 123830, needs medically
necessary occupational or physical therapy, that child shall be
determined to be eligible for therapy services. If the California
Children's Services medical consultant disagrees with the
determination of eligibility by the California Children's Services
medical therapy unit conference team, the medical consultant shall
communicate with the conference team to ask for further justification
of its determination, and shall weigh the conference team's
arguments in support of its decision in reaching his or her own
determination.
   This section shall not change eligibility criteria for the
California Children's Services programs as described in Sections
123830 and 123860.
   This section shall not apply to children diagnosed as specific
learning disabled, unless they otherwise meet the eligibility
criteria of the California Children's Services.



123880.  The department and designated agencies shall not deny
eligibility or aid under the California Children's Services Program
because an otherwise eligible person is receiving treatment services
under a teaching program at an accredited medical school facility or
accredited school or college of podiatric medicine, whether or not
all or part of the treatment services are performed by the staff at
the facility, school, or college, provided that treatment services at
the facility, school, or college are under the general supervision
of a California Children's Services Program panel physician and
surgeon, including a family physician, and podiatrist.



123885.  Panel members as set forth in Section 123880 shall be
board-certified and have expertise in the care of children.



123890.  (a) The state department shall not deny a hospital's
request to provide treatment to burn victims who are eligible under
the California Children's Services Program solely on the basis that
the hospital does not have separate facilities for child and adult
burn victims, provided that the hospital has approval from the
department to operate a burn center pursuant to Section 1255.
   (b) Subdivision (a) shall only be applied to burn units located in
hospitals where there are no regional burn centers, or any other
existing burn center, within an 85-mile radius of the hospital.
   (c) Subdivision (a) shall only apply if the hospital seeking the
exemption had a state-approved burn center in operation as of January
1, 1982, and if there is no hospital specializing in children's
services within an 85-mile radius of the hospital seeking the
subdivision (a) exemption.
   (d) Hospitals having qualified and received a subdivision (a)
exemption, shall demonstrate, at the request of the department, that
the nursing staff providing burn care to children victims have
satisfactorily completed post-graduate training in pediatrics.




123895.  The designated agency shall determine the financial
eligibility of the family according to standards established by the
department. The agency will also determine if the parents are
residents of the county, if the guardian of the child is a resident
of the county, or if the emancipated minor is a resident of the
county where application for services is made. If the agency finds
that the family, guardian, or emancipated minor is a resident of the
county and financially eligible for services, it shall make a record
of the facts and shall certify this child for care under the program.



123900.  (a) Beginning September 1, 1991, in addition to any other
standards of eligibility pursuant to this article, each family with a
child otherwise eligible to receive services under this article
shall pay an annual enrollment fee as a requirement for eligibility
for services, except as specified in subdivision (f).
   (b) The department shall determine the annual enrollment fee, that
shall be a sliding fee scale based upon family size and income, and
shall be adjusted by the department to reflect changes in the federal
poverty level.
   (c) "Family size" shall include the child, his or her natural or
adoptive parents, siblings, and other family members who live
together and whose expenses are dependent upon the family income.
   (d) "Family income" for purposes of this article, shall include
the total gross income, or their equivalents, of the child and his or
her natural or adoptive parents.
   (e) Payment of the enrollment fee is a condition of program
participation. The enrollment fee is independent of any other
financial obligation to the program.
   (f) The enrollment fee shall not be charged in any of the
following cases:
   (1) The only services required are for diagnosis to determine
eligibility for services, or are for medically necessary therapy
pursuant to Section 123875.
   (2) The child is otherwise eligible to receive services and is
eligible for full Medi-Cal benefits at the time of application or
reapplication.
   (3) The family of the child otherwise eligible to receive services
under this article has a gross annual income of less than 200
percent of the federal poverty level.
   (4) The family of a child otherwise eligible to receive services
under this article who is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code).
   (g) Failure to pay or to arrange for payment of the enrollment fee
within 60 days of the due date shall result in disenrollment and
ineligibility for coverage of treatment services 60 days after the
due date of the required payment.
   (h) The county shall apply the enrollment fee scale established by
the department and shall collect the enrollment fee. The county may
arrange with the family for periodic payment during the year if a
lump-sum payment will be a hardship for the family. The agency
director of California Children's Services may, on a case-by-case
basis, waive or reduce the amount of a family's enrollment fee if, in
the director's judgment, payment of the fee will result in undue
hardship.
   (i) By thirty days after the effective date of this section or
August 1, 1991, whichever is later, the department shall advance to
each county, as a one-time startup amount, five dollars and fifty
cents ($5.50) for each county child who was receiving services under
this article on June 30, 1990, and who was not a Medi-Cal
beneficiary. This one-time payment shall be in addition to the 4.1
percent of the gross total expenditures for diagnoses, treatment, and
therapy by counties allowed under subdivision (c) of Section 123955.
   (j) Each county shall submit to the state, as part of its
quarterly claim for reimbursement, an accounting of all revenues due
and revenues collected as enrollment fees.



123905.  A county of under 200,000 population, administering its
county program jointly with the department, shall forward to the
department a statement certifying the family of the handicapped child
as financially eligible for treatment services. The department shall
authorize necessary services within the limits of available funds.
Payment for services shall be made by the department, with
reimbursement from the county for its proportionate share as
specified in this article.



123910.  The department may, without the possession of a county
certification, pay the expenses for services required by any
physically handicapped child out of any funds received by it through
gift, devise, or bequest or from private, state, federal, or other
grant or source.
   The department may authorize or contract with any person or
institution properly qualified to furnish services to handicapped
children. It may pay for services out of any funds appropriated for
the purpose or from funds it may receive by gift, devise, or bequest.
   The department may receive gifts, legacies, and bequests and
expend them for the purpose of this article, but not for
administrative expense.



123915.  When the department provides, or arranges for the provision
of, services to physically handicapped children directly, as in the
case of nonresident physically handicapped children, it shall enter
into an agreement with parents, guardians or persons responsible for
the care of handicapped children for payment of the enrollment fee.




123920.  Upon the request of another state or of a federal agency,
the department may pay the expenses of services required by any
physically handicapped child who is not a resident of the state;
provided, that the cost of the services is fully covered by special
grants or allotments received from the state or federal agency for
that purpose.



123925.  The department and designated agencies shall maintain
surveillance and supervision over the services provided handicapped
children under authorization by the program to assure a high quality
of service and shall cause a record to be kept showing the condition
and improvement of these handicapped children.



123929.  (a) Except as otherwise provided in this section and
Section 14133.05 of the Welfare and Institutions Code, California
Children's Services Program services provided pursuant to this
article require prior authorization by the department or its
designee. Prior authorization is contingent on determination by the
department or its designee of all of the following:
   (1) The child receiving the services is confirmed to be medically
eligible for the CCS program.
   (2) The provider of the services is approved in accordance with
the standards of the CCS program.
   (3) The services authorized are medically necessary to treat the
child's CCS-eligible medical condition.
   (b) Effective July 1, 2004, the department or its designee may
approve a request for a treatment authorization that is otherwise in
conformance with subdivision (a) for services for a child
participating in the Healthy Families Program pursuant to clause (ii)
of subparagraph (A) of paragraph (6) of subdivision (a) of Section
12693.70 of the Insurance Code, received by the department or its
designee after the requested treatment has been provided to the
child.
   (c) Effective July 1, 2004, if a provider of services who meets
the requirements of paragraph (2) of subdivision (a) incurs costs for
services described in paragraph (3) of subdivision (a) to treat a
child described in subdivision (b) who is subsequently determined to
be medically eligible for the CCS program as determined by the
department or its designee, the department may reimburse the provider
for those costs. Reimbursement under this section shall conform to
the requirements of Section 14105.18 of the Welfare and Institutions
Code.



123930.  This article does not authorize any treatment service
without the written consent of a parent or guardian except as a
person under 18 years of age is an emancipated minor.



123935.  A handicapped child shall not be denied services pursuant
to this article because he or she is mentally retarded.



123940.  (a) (1) Annually, the board of supervisors shall
appropriate a sum of money for services for handicapped children of
the county, including diagnosis, treatment, and therapy services for
physically handicapped children in public schools, equal to 25
percent of the actual expenditures for the county program under this
article for the 1990-91 fiscal year, except as specified in paragraph
(2).
   (2) If the state certifies that a smaller amount is needed in
order for the county to pay 25 percent of costs of the county's
program from this source. The smaller amount certified by the state
shall be the amount that the county shall appropriate.
   (b) In addition to the amount required by subdivision (a), the
county shall allocate an amount equal to the amount determined
pursuant to subdivision (a) for purposes of this article from
revenues allocated to the county pursuant to Chapter 6 (commencing
with Section 17600) of Division 9 of the Welfare and Institutions
Code.
   (c) (1) The state shall match county expenditures for this article
from funding provided pursuant to subdivisions (a) and (b).
   (2) County expenditures shall be waived for payment of services
for children who are eligible pursuant to paragraph (2) of
subdivision (a) of Section 123870.
   (d) The county may appropriate and expend moneys in addition to
those set forth in subdivision (a) and (b) and the state shall match
the expenditures, on a dollar-for-dollar basis, to the extent that
state funds are available for this article.
   (e) Nothing in this section shall require the county to expend
more than the amount set forth in subdivision (a) plus the amount set
forth in subdivision (b) nor shall it require the state to expend
more than the amount of the match set forth in subdivision (c).



123945.  For those counties with a total appropriation of county
funds not exceeding one hundred twenty-five thousand dollars
($125,000), and upon the expenditure of the county funds equivalent
to a county appropriation pursuant to Section 123940, the department
may, to the extent funds are available from state appropriated funds
for the California Children's Services Program and upon certification
of the county that there are insufficient revenues from the account
established pursuant to Chapter 6 (commencing with Section 17600) of
Division 9 of the Welfare and Institutions Code, pay for services for
cases deemed by the department to represent emergencies or cases
where medical care cannot be delayed without great harm to the child.




123950.  The designated county agency shall administer the
medical-therapy program in local public schools for physically
handicapped children. As provided in Section 123940, the state and
counties will share in the cost of support of therapist salaries in
these schools in the ratio of one dollar ($1) of state or federal
funds reimbursed quarterly to one dollar ($1) of county funds. The
director shall establish standards for the maximum number of
therapists employed in the schools eligible for state financial
support in this program, the services to be provided, and the county
administrative services subject to reimbursement by the state.
   The department may adopt regulations to implement this section as
emergency regulations in accordance with Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code. For the purposes of the Administrative Procedure Act, the
adoption of the regulations shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, and general welfare. Notwithstanding Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, these emergency regulations shall not be subject to
the review and approval of the Office of Administrative Law.
   Notwithstanding any other provision of law, if the department
determines that emergency regulations are necessary to implement any
part of this article, there shall be deemed to be good cause for the
regulations to take effect prior to public notice and hearing.
   Notwithstanding subdivision (h) of Section 11346.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing. The
regulations shall become effective immediately upon filing by the
Secretary of State.
   The Office of Administrative Law shall provide for the printing
and publication of these regulations in the California Code of
Regulations. Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
these regulations shall not be repealed by the Office of
Administrative Law and shall remain in effect until revised or
repealed by the department.



123955.  (a) The state and the counties shall share in the cost of
administration of the California Children's Services Program at the
local level.
   (b) (1) The director shall adopt regulations establishing minimum
standards for the administration, staffing, and local implementation
of this article subject to reimbursement by the state.
   (2) The standards shall allow necessary flexibility in the
administration of county programs, taking into account the
variability of county needs and resources, and shall be developed and
revised jointly with state and county representatives.
   (c) The director shall establish minimum standards for
administration, staffing and local operation of the program subject
to reimbursement by the state.
   (d) Until July 1, 1992, reimbursable administrative costs, to be
paid by the state to counties, shall not exceed 4.1 percent of the
gross total expenditures for diagnosis, treatment and therapy by
counties as specified in Section 123940.
   (e) Beginning July 1, 1992, this subdivision shall apply with
respect to all of the following:
   (1) Counties shall be reimbursed by the state for 50 percent of
the amount required to meet state administrative standards for that
portion of the county caseload under this article that is ineligible
for Medi-Cal to the extent funds are available in the state budget
for the California Children's Services Program.
   (2) On or before September 15 of each year, each county program
implementing this article shall submit an application for the
subsequent fiscal year that provides information as required by the
state to determine if the county administrative staff and budget meet
state standards.
   (3) The state shall determine the maximum amount of state funds
available for each county from state funds appropriated for CCS
county administration. If the amount appropriated for any fiscal year
in the Budget Act for county administration under this article
differs from the amounts approved by the department, each county
shall submit a revised application in a form and at the time
specified by the department.
   (f) The department and counties shall maximize the use of federal
funds for administration, of the programs implemented pursuant to
this article, including using state and county funds to match funds
claimable under Title 19 of the Social Security Act.



123960.  The department shall require of participating local
governments the provision of program data including, but not limited
to, the number of children treated, the kinds of disabilities, and
the costs of treatment, to enable the department, the Department of
Finance, and the Legislature to evaluate in a timely fashion and to
adequately fund the California Children's Services Program.



123965.  A handicapped child placed for adoption, determined to be
financially eligible for care at the time of placement, shall not be
denied services pursuant to this article based upon the income of the
adopting parents, nor shall the adopting parents be required to
enter into any agreement to pay toward the costs of services
authorized for the care. This section shall only apply to physical
handicaps present, and diagnosed, at the time of adoption. Residence,
for the purposes of this section, shall be that of the adopting
parents.


123970.  The department and the placing adoption agency at the time
of placement shall notify all prospective adopting parents in
writing, that funds received under the California Children's Services
Program shall terminate if the adopting parents move out of the
state. However, the department and the placing adoption agency shall
advise the prospective adopting parents that they may be eligible for
the funds in the new state, subject to any applicable
qualifications.


123975.  (a) The department, in consultation with selected
representatives of participating neonatal intensive care units, shall
establish a system to screen all newborns and infants for hearing
loss as defined in subdivision (e) of Section 124116 and create and
maintain a system of assessment and followup services for newborns
and infants identified by the screening in approved neonatal
intensive care units participating in the California Children's
Services Program. Screening, assessment and followup services and
reporting of these services shall be provided in a manner consistent
with Article 6.5 (commencing with Section 124115) of Chapter 3.
   This section shall not be applicable to a newborn child whose
parent or guardian objects to the tests on the ground that the tests
conflict with his or her religious beliefs or practices.
   (b) It is the intent of the Legislature, in enacting this section,
to ensure the establishment and maintenance of protocols and quality
of standards.
   (c) The department shall implement this section for newborns and
infants in neonatal intensive care units participating in the
California Children's Services Program.



123980.  If the recipient of services provided by the California
Children's Services Program, his or her guardian, conservator,
personal representative, estate, or survivors, or any of them brings
an action against a third person who may be liable for the injury,
notice of institution of legal proceedings, notice of settlement, and
all other notices required by this code shall be given to the State
Director of Health Services in Sacramento and to the county-managed
California Children's Services Program. The director may provide
notice to the Attorney General. All of these notices shall be given
by the attorney retained to assert the beneficiary's claim, or by the
injured party beneficiary, his or her guardian, conservator,
personal representative, estate, or survivors, if no attorney is
retained.



123982.  Except as otherwise provided by law, the amount of any
judgment, award, or settlement relating to a medical condition for
which treatment services have been provided under the California
Children's Services Program shall be subject to a claim by the state
department and the designated county agency for reimbursement of the
costs of the benefits provided, and to any lien filed against that
judgment, award, or settlement. The department or the county
designated agency, through its civil legal adviser, may, to enforce
this right, institute and prosecute legal proceedings against the
person who has received benefits under this article, his or her
guardian, conservator, or other personal representative, or his or
her estate. In the event of a judgment, award, or settlement in a
suit or claim against a third person who is liable for the medical
condition for which treatment services have been provided under the
California Children's Services Program, the court or other agency
shall first order paid from the judgment, award, or settlement the
actual costs of the care and treatment furnished, or to be furnished,
under the California Children's Services Program.



123985.  (a) A bone marrow transplant for the treatment of cancer
shall be reimbursable under this article, when all of the following
conditions are met:
   (1) The bone marrow transplant is recommended by the recipient's
attending physician.
   (2) The bone marrow transplant is performed in a hospital that is
approved for participation in the California Children's Services
program.
   (3) The bone marrow transplant is a reasonable course of treatment
and is approved by the appropriate hospital medical policy
committee.
   (4) The bone marrow transplant has been deemed appropriate for the
recipient by the program's medical consultant. The medical
consultant shall not disapprove the bone marrow transplant solely on
the basis that it is classified as experimental or investigational.
   (b) The program shall provide reimbursement for both donor and
recipient surgery.
   (c) Any county that has a population of not more than 600,000, as
determined by the most recent decennial census conducted by the
United States Bureau of the Census, shall be exempt from complying
with the 25-percent matching requirement provided for under this
article, for any bone marrow transplant reimbursable under this
section.



123990.  The department shall adopt regulations to implement the
amendments of this article in 1991. The adoption of the regulations
shall be deemed to be an emergency, and necessary for the immediate
preservation of the public peace, health, safety, and general
welfare.



123995.  (a) The department shall require all applicants to the
program who may be eligible for cash grant assistance or for Medi-Cal
benefits to apply for Medi-Cal.
   (b) This section shall not be interpreted to prohibit the coverage
of services in emergency cases.



State Codes and Statutes

State Codes and Statutes

Statutes > California > Hsc > 123800-123995

HEALTH AND SAFETY CODE
SECTION 123800-123995



123800.  This article shall be known and may be cited as the Robert
W. Crown California Children's Services Act.



123805.  The department shall establish and administer a program of
services for physically defective or handicapped persons under the
age of 21 years, in cooperation with the federal government through
its appropriate agency or instrumentality, for the purpose of
developing, extending and improving the services. The department
shall receive all funds made available to it by the federal
government, the state, its political subdivisions or from other
sources. The department shall have power to supervise those services
included in the state plan that are not directly administered by the
state. The department shall cooperate with the medical, health,
nursing and welfare groups and organizations concerned with the
program, and any agency of the state charged with the administration
of laws providing for vocational rehabilitation of physically
handicapped children.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.


123810.  The department succeeds to and is vested with the duties,
purposes, responsibilities, and jurisdiction heretofore exercised by
the State Department of Benefit Payments with respect to moneys,
funds, and appropriations available to the department for the
purposes of processing, audit, and payment of claims received for the
purposes of this article.



123815.  The department shall have possession and control of all
records, papers, equipment, and supplies held for the benefit or use
of the Director of Benefit Payments in the performance of his duties,
powers, purposes, responsibilities, and jurisdiction that are vested
in the department by Section 123810.


123820.  All officers and employees of the Director of Benefit
Payments who on July 1, 1978, are serving in the state civil service,
other than as temporary employees, and engaged in the performance of
a function vested in the department by Section 123810 shall be
transferred to the department. The status, positions, and rights of
these persons shall not be affected by the transfer and shall be
retained by them as officers and employees of the department pursuant
to the State Civil Service Act, except as to positions exempt from
civil service.


123822.  All claims for services provided under this article shall
be submitted to the state fiscal intermediary for payment no later
than January 1, 1999. The State Department of Health Services shall
work in cooperation with the counties to develop a timeline for
implementing the centralized billing system. If a department review
of those counties participating in the centralized billing system
demonstrates that as of January 1, 2000, any county has incurred
increased costs as a result of submitting claims for services to the
state fiscal intermediary, that county may be exempt from this
section.


123825.  It is the intent of the Legislature through this article to
provide, to the extent practicable, for the necessary medical
services required by physically handicapped children whose parents
are unable to pay for these services, wholly or in part. This article
shall also include the necessary services rendered by the program to
physically handicapped children treated in public schools that
provide services for physically handicapped children.



123830.  "Handicapped child," as used in this article, means a
physically defective or handicapped person under the age of 21 years
who is in need of services. The director shall establish those
conditions coming within a definition of "handicapped child" except
as the Legislature may otherwise include in the definition.
Phenylketonuria, hyaline membrane disease, cystic fibrosis, and
hemophilia shall be among these conditions.
   The reference to "the age of 21 years" in this section is
unaffected by Section 1 of Chapter 1748 of the Statutes of 1971 or
any other provision of that chapter.



123835.  The department shall keep the program abreast of advances
in medical science, leading to the inclusion of other handicapping
conditions and services within the limits of and consistent with the
most beneficial use of funds appropriated for this purpose. With the
approval of the agency administrator the department may carry out
pilot studies to determine the need for, or the feasibility of,
including other handicapping conditions and services in the program
within the limits of available funds appropriated for the program.



123840.  "Services," as used in this article, means any or all of
the following:
   (a) Expert diagnosis.
   (b) Medical treatment.
   (c) Surgical treatment.
   (d) Hospital care.
   (e) Physical therapy.
   (f) Occupational therapy.
   (g) Special treatment.
   (h) Materials.
   (i) Appliances and their upkeep, maintenance, care and
transportation.
   (j) Maintenance, transportation, or care incidental to any other
form of "services."



123845.  "California Children's Services Program," as used in this
article, means the program of services established and operated
pursuant to this article.


123850.  The board of supervisors of each county shall designate the
county department of public health or the county department of
social welfare as the designated agency to administer the California
Children's Services Program. Counties with total population under
200,000 persons may administer the county program independently or
jointly with the department. Counties with a total population in
excess of 200,000 persons shall administer the county program
independently. Except as otherwise provided in this article, the
director shall establish standards relating to the local
administration and minimum services to be offered by counties in the
conduct of the California Children's Services Program.



123853.  (a) The department may enter into contracts with one or
more manufacturers on a negotiated or bid basis as the purchaser, but
not the dispenser or distributor, of factor replacement therapies
under the California Children's Services Program for the purpose of
enabling the department to obtain the full range of available
therapies and services required for clients with hematological
disorders at the most favorable price and to enable the department,
notwithstanding any other provision of state law, to obtain
discounts, rebates, or refunds from the manufacturers based upon the
large quantities purchased under the program. Nothing in this
subdivision shall interfere with the usual and customary distribution
practices of factor replacement therapies. In order to achieve
maximum cost savings, the Legislature hereby determines that an
expedited contract process under this section is necessary.
Therefore, a contract under this subdivision may be on a negotiated
basis and shall be exempt from Chapter 2 (commencing with Section
10290) of Part 2 of Division 2 of the Public Contract Code and
Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3
of the Government Code. Contracts entered pursuant to this
subdivision shall be confidential and shall be exempt from disclosure
under the California Public Records Act (Chapter 3.5 (commencing
with Section 6250) of Division 7 of Title 1 of the Government Code).
   (b) (1) Factor replacement therapy manufacturers shall calculate
and pay interest on late or unpaid rebates. The interest shall not
apply to any prior period adjustments of unit rebate amounts or
department utilization adjustments. Manufacturers shall calculate and
pay interest on late or unpaid rebates for quarters that begin on or
after the effective date of the act that added this subdivision.
   (2) Following the final resolution of any dispute regarding the
amount of a rebate, any underpayment by a manufacturer shall be paid
with interest calculated pursuant to paragraph (4), and any
overpayment, together with interest at the rate calculated pursuant
to paragraph (4), shall be credited by the department against future
rebates due.
   (3) Interest pursuant to paragraphs (1) and (2) shall begin
accruing 38 calendar days from the date of mailing the invoice,
including supporting utilization data sent to the manufacturer.
Interest shall continue to accrue until the date of mailing of the
manufacturer's payment.
   (4) Interest rates and calculations pursuant to paragraphs (1) and
(2) shall be identical to interest rates and calculations set forth
in the federal Centers for Medicare and Medicaid Services' Medicaid
Drug Rebate Program Releases or regulations.
   (c) If the department has not received a rebate payment, including
interest, within 180 days of the date of mailing of the invoice,
including supporting utilization data, a factor replacement therapy
manufacturer's contract with the department shall be deemed to be in
default and the contract may be terminated in accordance with the
terms of the contract. This subdivision does not limit the department'
s right to otherwise terminate a contract in accordance with the
terms of that contract.
   (d) The department may enter into contracts on a bid or negotiated
basis with manufacturers, distributors, dispensers, or suppliers of
pharmaceuticals, appliances, durable medical equipment, medical
supplies, and other product-type health care services and
laboratories for the purpose of obtaining the most favorable prices
to the state and to assure adequate access and quality of the product
or service. In order to achieve maximum cost savings, the
Legislature hereby determines that an expedited contract process
under this subdivision is necessary. Therefore, contracts under this
subdivision may be on a negotiated basis and shall be exempt from the
provisions of Chapter 2 (commencing with Section 10290) of Part 2 of
Division 2 of the Public Contract Code and Chapter 6 (commencing
with Section 14825) of Part 5.5 of Division 3 of the Government Code.
   (e) The department may contract with one or more manufacturers of
each multisource prescribed product or supplier of outpatient
clinical laboratory services on a bid or negotiated basis. Contracts
for outpatient clinical laboratory services shall require that the
contractor be a clinical laboratory licensed or certified by the
State of California or certified under Section 263a of Title 42 of
the United States Code. Nothing in this subdivision shall be
construed as prohibiting the department from contracting with less
than all manufacturers or clinical laboratories, including just one
manufacturer or clinical laboratory, on a bid or negotiated basis.




123855.  The department or designated county agency shall cooperate
with, or arrange through, local public or private agencies and
providers of medical care to seek out handicapped children, bringing
them expert diagnosis near their homes. Case finding shall include,
but not be limited to, children with impaired sense of hearing. This
section does not give the department or designated agency power to
require medical or other form of physical examination without consent
of parent or guardian.



123860.  In accordance with applicable regulations of the United
States Children's Bureau, the department and designated county
agencies shall provide a diagnosis for handicapped children. Within
the limits of available funds, the department and designated local
agencies may accept for diagnosis a handicapped child believed to
have a severe chronic disease or severe physical handicap, as
determined by the director, irrespective of whether the child
actually has an eligible medical condition specified in Section
123830. The department shall cause a record to be kept listing all
conditions diagnosed by the program and shall publish the information
annually, including data on the number and kinds of diagnosed
medical conditions that do not come within the definition of
"handicapped child" as specified in Section 123830.



123865.  Whenever the parents or estate of a handicapped child is
wholly or partly unable to furnish for the child necessary services,
the parents or guardian may apply to the agency of the county that
has been designated by the board of supervisors of the county of
residence under the terms of Section 123850 to administer the
provisions for handicapped children. Residence shall be determined in
accordance with Sections 243 and 244 of the Government Code.



123870.  (a) The department shall establish standards of financial
eligibility for treatment services under the California Children's
Services Program (CCS program).
   (1) Financial eligibility for treatment services under this
program shall be limited to persons in families with an adjusted
gross income of forty thousand dollars ($40,000) or less in the most
recent tax year, as calculated for California state income tax
purposes. If a person is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code), the financial documentation required for that
program in Section 2699.6600 of Title 10 of the California Code of
Regulations may be used instead of the person's California state
income tax return. However, the director may authorize treatment
services for persons in families with higher incomes if the estimated
cost of care to the family in one year is expected to exceed 20
percent of the family's adjusted gross income.
   (2) Children enrolled in the Healthy Families Program who have a
CCS program eligible medical condition under Section 123830, and
whose families do not meet the financial eligibility requirements of
paragraph (1), shall be deemed financially eligible for CCS program
benefits.
   (b) Necessary medical therapy treatment services under the
California Children's Services Program rendered in the public schools
shall be exempt from financial eligibility standards and enrollment
fee requirements for the services when rendered to any handicapped
child whose educational or physical development would be impeded
without the services.
   (c) All counties shall use the uniform standards for financial
eligibility and enrollment fees established by the department. All
enrollment fees shall be used in support of the California Children's
Services Program.
   (d) Annually, every family with a child eligible to receive
services under this article shall pay a fee of twenty dollars ($20),
that shall be in addition to any other program fees for which the
family is liable. This assessment shall not apply to any child who is
eligible for full scope Medi-Cal benefits without a share of cost,
for children receiving therapy through the California Children's
Services Program as a related service in their individualized
education plans, for children from families having incomes of less
than 100 percent of the federal poverty level, or for children
covered under the Healthy Families Program.



123872.  In addition to the other eligibility requirements set forth
in this article, prior to being determined financially eligible for
services under this article, the applicant family shall agree to
repay the California Children's Services Program for any treatment
services authorized by the program in an amount not to exceed the
proceeds of any judgment, award, or settlement for damages as a
result of a lawsuit or pursuant to an agreement relating to a
California Children's Services medically eligible condition.



123875.  When the California Children's Service medical therapy unit
conference team, based on a medical referral recommending medically
necessary occupational or physical therapy in accordance with
subdivision (b) of Section 7575 of the Government Code, finds that a
handicapped child, as defined in Section 123830, needs medically
necessary occupational or physical therapy, that child shall be
determined to be eligible for therapy services. If the California
Children's Services medical consultant disagrees with the
determination of eligibility by the California Children's Services
medical therapy unit conference team, the medical consultant shall
communicate with the conference team to ask for further justification
of its determination, and shall weigh the conference team's
arguments in support of its decision in reaching his or her own
determination.
   This section shall not change eligibility criteria for the
California Children's Services programs as described in Sections
123830 and 123860.
   This section shall not apply to children diagnosed as specific
learning disabled, unless they otherwise meet the eligibility
criteria of the California Children's Services.



123880.  The department and designated agencies shall not deny
eligibility or aid under the California Children's Services Program
because an otherwise eligible person is receiving treatment services
under a teaching program at an accredited medical school facility or
accredited school or college of podiatric medicine, whether or not
all or part of the treatment services are performed by the staff at
the facility, school, or college, provided that treatment services at
the facility, school, or college are under the general supervision
of a California Children's Services Program panel physician and
surgeon, including a family physician, and podiatrist.



123885.  Panel members as set forth in Section 123880 shall be
board-certified and have expertise in the care of children.



123890.  (a) The state department shall not deny a hospital's
request to provide treatment to burn victims who are eligible under
the California Children's Services Program solely on the basis that
the hospital does not have separate facilities for child and adult
burn victims, provided that the hospital has approval from the
department to operate a burn center pursuant to Section 1255.
   (b) Subdivision (a) shall only be applied to burn units located in
hospitals where there are no regional burn centers, or any other
existing burn center, within an 85-mile radius of the hospital.
   (c) Subdivision (a) shall only apply if the hospital seeking the
exemption had a state-approved burn center in operation as of January
1, 1982, and if there is no hospital specializing in children's
services within an 85-mile radius of the hospital seeking the
subdivision (a) exemption.
   (d) Hospitals having qualified and received a subdivision (a)
exemption, shall demonstrate, at the request of the department, that
the nursing staff providing burn care to children victims have
satisfactorily completed post-graduate training in pediatrics.




123895.  The designated agency shall determine the financial
eligibility of the family according to standards established by the
department. The agency will also determine if the parents are
residents of the county, if the guardian of the child is a resident
of the county, or if the emancipated minor is a resident of the
county where application for services is made. If the agency finds
that the family, guardian, or emancipated minor is a resident of the
county and financially eligible for services, it shall make a record
of the facts and shall certify this child for care under the program.



123900.  (a) Beginning September 1, 1991, in addition to any other
standards of eligibility pursuant to this article, each family with a
child otherwise eligible to receive services under this article
shall pay an annual enrollment fee as a requirement for eligibility
for services, except as specified in subdivision (f).
   (b) The department shall determine the annual enrollment fee, that
shall be a sliding fee scale based upon family size and income, and
shall be adjusted by the department to reflect changes in the federal
poverty level.
   (c) "Family size" shall include the child, his or her natural or
adoptive parents, siblings, and other family members who live
together and whose expenses are dependent upon the family income.
   (d) "Family income" for purposes of this article, shall include
the total gross income, or their equivalents, of the child and his or
her natural or adoptive parents.
   (e) Payment of the enrollment fee is a condition of program
participation. The enrollment fee is independent of any other
financial obligation to the program.
   (f) The enrollment fee shall not be charged in any of the
following cases:
   (1) The only services required are for diagnosis to determine
eligibility for services, or are for medically necessary therapy
pursuant to Section 123875.
   (2) The child is otherwise eligible to receive services and is
eligible for full Medi-Cal benefits at the time of application or
reapplication.
   (3) The family of the child otherwise eligible to receive services
under this article has a gross annual income of less than 200
percent of the federal poverty level.
   (4) The family of a child otherwise eligible to receive services
under this article who is enrolled in the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2 of the
Insurance Code).
   (g) Failure to pay or to arrange for payment of the enrollment fee
within 60 days of the due date shall result in disenrollment and
ineligibility for coverage of treatment services 60 days after the
due date of the required payment.
   (h) The county shall apply the enrollment fee scale established by
the department and shall collect the enrollment fee. The county may
arrange with the family for periodic payment during the year if a
lump-sum payment will be a hardship for the family. The agency
director of California Children's Services may, on a case-by-case
basis, waive or reduce the amount of a family's enrollment fee if, in
the director's judgment, payment of the fee will result in undue
hardship.
   (i) By thirty days after the effective date of this section or
August 1, 1991, whichever is later, the department shall advance to
each county, as a one-time startup amount, five dollars and fifty
cents ($5.50) for each county child who was receiving services under
this article on June 30, 1990, and who was not a Medi-Cal
beneficiary. This one-time payment shall be in addition to the 4.1
percent of the gross total expenditures for diagnoses, treatment, and
therapy by counties allowed under subdivision (c) of Section 123955.
   (j) Each county shall submit to the state, as part of its
quarterly claim for reimbursement, an accounting of all revenues due
and revenues collected as enrollment fees.



123905.  A county of under 200,000 population, administering its
county program jointly with the department, shall forward to the
department a statement certifying the family of the handicapped child
as financially eligible for treatment services. The department shall
authorize necessary services within the limits of available funds.
Payment for services shall be made by the department, with
reimbursement from the county for its proportionate share as
specified in this article.



123910.  The department may, without the possession of a county
certification, pay the expenses for services required by any
physically handicapped child out of any funds received by it through
gift, devise, or bequest or from private, state, federal, or other
grant or source.
   The department may authorize or contract with any person or
institution properly qualified to furnish services to handicapped
children. It may pay for services out of any funds appropriated for
the purpose or from funds it may receive by gift, devise, or bequest.
   The department may receive gifts, legacies, and bequests and
expend them for the purpose of this article, but not for
administrative expense.



123915.  When the department provides, or arranges for the provision
of, services to physically handicapped children directly, as in the
case of nonresident physically handicapped children, it shall enter
into an agreement with parents, guardians or persons responsible for
the care of handicapped children for payment of the enrollment fee.




123920.  Upon the request of another state or of a federal agency,
the department may pay the expenses of services required by any
physically handicapped child who is not a resident of the state;
provided, that the cost of the services is fully covered by special
grants or allotments received from the state or federal agency for
that purpose.



123925.  The department and designated agencies shall maintain
surveillance and supervision over the services provided handicapped
children under authorization by the program to assure a high quality
of service and shall cause a record to be kept showing the condition
and improvement of these handicapped children.



123929.  (a) Except as otherwise provided in this section and
Section 14133.05 of the Welfare and Institutions Code, California
Children's Services Program services provided pursuant to this
article require prior authorization by the department or its
designee. Prior authorization is contingent on determination by the
department or its designee of all of the following:
   (1) The child receiving the services is confirmed to be medically
eligible for the CCS program.
   (2) The provider of the services is approved in accordance with
the standards of the CCS program.
   (3) The services authorized are medically necessary to treat the
child's CCS-eligible medical condition.
   (b) Effective July 1, 2004, the department or its designee may
approve a request for a treatment authorization that is otherwise in
conformance with subdivision (a) for services for a child
participating in the Healthy Families Program pursuant to clause (ii)
of subparagraph (A) of paragraph (6) of subdivision (a) of Section
12693.70 of the Insurance Code, received by the department or its
designee after the requested treatment has been provided to the
child.
   (c) Effective July 1, 2004, if a provider of services who meets
the requirements of paragraph (2) of subdivision (a) incurs costs for
services described in paragraph (3) of subdivision (a) to treat a
child described in subdivision (b) who is subsequently determined to
be medically eligible for the CCS program as determined by the
department or its designee, the department may reimburse the provider
for those costs. Reimbursement under this section shall conform to
the requirements of Section 14105.18 of the Welfare and Institutions
Code.



123930.  This article does not authorize any treatment service
without the written consent of a parent or guardian except as a
person under 18 years of age is an emancipated minor.



123935.  A handicapped child shall not be denied services pursuant
to this article because he or she is mentally retarded.



123940.  (a) (1) Annually, the board of supervisors shall
appropriate a sum of money for services for handicapped children of
the county, including diagnosis, treatment, and therapy services for
physically handicapped children in public schools, equal to 25
percent of the actual expenditures for the county program under this
article for the 1990-91 fiscal year, except as specified in paragraph
(2).
   (2) If the state certifies that a smaller amount is needed in
order for the county to pay 25 percent of costs of the county's
program from this source. The smaller amount certified by the state
shall be the amount that the county shall appropriate.
   (b) In addition to the amount required by subdivision (a), the
county shall allocate an amount equal to the amount determined
pursuant to subdivision (a) for purposes of this article from
revenues allocated to the county pursuant to Chapter 6 (commencing
with Section 17600) of Division 9 of the Welfare and Institutions
Code.
   (c) (1) The state shall match county expenditures for this article
from funding provided pursuant to subdivisions (a) and (b).
   (2) County expenditures shall be waived for payment of services
for children who are eligible pursuant to paragraph (2) of
subdivision (a) of Section 123870.
   (d) The county may appropriate and expend moneys in addition to
those set forth in subdivision (a) and (b) and the state shall match
the expenditures, on a dollar-for-dollar basis, to the extent that
state funds are available for this article.
   (e) Nothing in this section shall require the county to expend
more than the amount set forth in subdivision (a) plus the amount set
forth in subdivision (b) nor shall it require the state to expend
more than the amount of the match set forth in subdivision (c).



123945.  For those counties with a total appropriation of county
funds not exceeding one hundred twenty-five thousand dollars
($125,000), and upon the expenditure of the county funds equivalent
to a county appropriation pursuant to Section 123940, the department
may, to the extent funds are available from state appropriated funds
for the California Children's Services Program and upon certification
of the county that there are insufficient revenues from the account
established pursuant to Chapter 6 (commencing with Section 17600) of
Division 9 of the Welfare and Institutions Code, pay for services for
cases deemed by the department to represent emergencies or cases
where medical care cannot be delayed without great harm to the child.




123950.  The designated county agency shall administer the
medical-therapy program in local public schools for physically
handicapped children. As provided in Section 123940, the state and
counties will share in the cost of support of therapist salaries in
these schools in the ratio of one dollar ($1) of state or federal
funds reimbursed quarterly to one dollar ($1) of county funds. The
director shall establish standards for the maximum number of
therapists employed in the schools eligible for state financial
support in this program, the services to be provided, and the county
administrative services subject to reimbursement by the state.
   The department may adopt regulations to implement this section as
emergency regulations in accordance with Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code. For the purposes of the Administrative Procedure Act, the
adoption of the regulations shall be deemed an emergency and
necessary for the immediate preservation of the public peace, health,
safety, and general welfare. Notwithstanding Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code, these emergency regulations shall not be subject to
the review and approval of the Office of Administrative Law.
   Notwithstanding any other provision of law, if the department
determines that emergency regulations are necessary to implement any
part of this article, there shall be deemed to be good cause for the
regulations to take effect prior to public notice and hearing.
   Notwithstanding subdivision (h) of Section 11346.1 and Section
11349.6 of the Government Code, the department shall transmit these
regulations directly to the Secretary of State for filing. The
regulations shall become effective immediately upon filing by the
Secretary of State.
   The Office of Administrative Law shall provide for the printing
and publication of these regulations in the California Code of
Regulations. Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
these regulations shall not be repealed by the Office of
Administrative Law and shall remain in effect until revised or
repealed by the department.



123955.  (a) The state and the counties shall share in the cost of
administration of the California Children's Services Program at the
local level.
   (b) (1) The director shall adopt regulations establishing minimum
standards for the administration, staffing, and local implementation
of this article subject to reimbursement by the state.
   (2) The standards shall allow necessary flexibility in the
administration of county programs, taking into account the
variability of county needs and resources, and shall be developed and
revised jointly with state and county representatives.
   (c) The director shall establish minimum standards for
administration, staffing and local operation of the program subject
to reimbursement by the state.
   (d) Until July 1, 1992, reimbursable administrative costs, to be
paid by the state to counties, shall not exceed 4.1 percent of the
gross total expenditures for diagnosis, treatment and therapy by
counties as specified in Section 123940.
   (e) Beginning July 1, 1992, this subdivision shall apply with
respect to all of the following:
   (1) Counties shall be reimbursed by the state for 50 percent of
the amount required to meet state administrative standards for that
portion of the county caseload under this article that is ineligible
for Medi-Cal to the extent funds are available in the state budget
for the California Children's Services Program.
   (2) On or before September 15 of each year, each county program
implementing this article shall submit an application for the
subsequent fiscal year that provides information as required by the
state to determine if the county administrative staff and budget meet
state standards.
   (3) The state shall determine the maximum amount of state funds
available for each county from state funds appropriated for CCS
county administration. If the amount appropriated for any fiscal year
in the Budget Act for county administration under this article
differs from the amounts approved by the department, each county
shall submit a revised application in a form and at the time
specified by the department.
   (f) The department and counties shall maximize the use of federal
funds for administration, of the programs implemented pursuant to
this article, including using state and county funds to match funds
claimable under Title 19 of the Social Security Act.



123960.  The department shall require of participating local
governments the provision of program data including, but not limited
to, the number of children treated, the kinds of disabilities, and
the costs of treatment, to enable the department, the Department of
Finance, and the Legislature to evaluate in a timely fashion and to
adequately fund the California Children's Services Program.



123965.  A handicapped child placed for adoption, determined to be
financially eligible for care at the time of placement, shall not be
denied services pursuant to this article based upon the income of the
adopting parents, nor shall the adopting parents be required to
enter into any agreement to pay toward the costs of services
authorized for the care. This section shall only apply to physical
handicaps present, and diagnosed, at the time of adoption. Residence,
for the purposes of this section, shall be that of the adopting
parents.


123970.  The department and the placing adoption agency at the time
of placement shall notify all prospective adopting parents in
writing, that funds received under the California Children's Services
Program shall terminate if the adopting parents move out of the
state. However, the department and the placing adoption agency shall
advise the prospective adopting parents that they may be eligible for
the funds in the new state, subject to any applicable
qualifications.


123975.  (a) The department, in consultation with selected
representatives of participating neonatal intensive care units, shall
establish a system to screen all newborns and infants for hearing
loss as defined in subdivision (e) of Section 124116 and create and
maintain a system of assessment and followup services for newborns
and infants identified by the screening in approved neonatal
intensive care units participating in the California Children's
Services Program. Screening, assessment and followup services and
reporting of these services shall be provided in a manner consistent
with Article 6.5 (commencing with Section 124115) of Chapter 3.
   This section shall not be applicable to a newborn child whose
parent or guardian objects to the tests on the ground that the tests
conflict with his or her religious beliefs or practices.
   (b) It is the intent of the Legislature, in enacting this section,
to ensure the establishment and maintenance of protocols and quality
of standards.
   (c) The department shall implement this section for newborns and
infants in neonatal intensive care units participating in the
California Children's Services Program.



123980.  If the recipient of services provided by the California
Children's Services Program, his or her guardian, conservator,
personal representative, estate, or survivors, or any of them brings
an action against a third person who may be liable for the injury,
notice of institution of legal proceedings, notice of settlement, and
all other notices required by this code shall be given to the State
Director of Health Services in Sacramento and to the county-managed
California Children's Services Program. The director may provide
notice to the Attorney General. All of these notices shall be given
by the attorney retained to assert the beneficiary's claim, or by the
injured party beneficiary, his or her guardian, conservator,
personal representative, estate, or survivors, if no attorney is
retained.



123982.  Except as otherwise provided by law, the amount of any
judgment, award, or settlement relating to a medical condition for
which treatment services have been provided under the California
Children's Services Program shall be subject to a claim by the state
department and the designated county agency for reimbursement of the
costs of the benefits provided, and to any lien filed against that
judgment, award, or settlement. The department or the county
designated agency, through its civil legal adviser, may, to enforce
this right, institute and prosecute legal proceedings against the
person who has received benefits under this article, his or her
guardian, conservator, or other personal representative, or his or
her estate. In the event of a judgment, award, or settlement in a
suit or claim against a third person who is liable for the medical
condition for which treatment services have been provided under the
California Children's Services Program, the court or other agency
shall first order paid from the judgment, award, or settlement the
actual costs of the care and treatment furnished, or to be furnished,
under the California Children's Services Program.



123985.  (a) A bone marrow transplant for the treatment of cancer
shall be reimbursable under this article, when all of the following
conditions are met:
   (1) The bone marrow transplant is recommended by the recipient's
attending physician.
   (2) The bone marrow transplant is performed in a hospital that is
approved for participation in the California Children's Services
program.
   (3) The bone marrow transplant is a reasonable course of treatment
and is approved by the appropriate hospital medical policy
committee.
   (4) The bone marrow transplant has been deemed appropriate for the
recipient by the program's medical consultant. The medical
consultant shall not disapprove the bone marrow transplant solely on
the basis that it is classified as experimental or investigational.
   (b) The program shall provide reimbursement for both donor and
recipient surgery.
   (c) Any county that has a population of not more than 600,000, as
determined by the most recent decennial census conducted by the
United States Bureau of the Census, shall be exempt from complying
with the 25-percent matching requirement provided for under this
article, for any bone marrow transplant reimbursable under this
section.



123990.  The department shall adopt regulations to implement the
amendments of this article in 1991. The adoption of the regulations
shall be deemed to be an emergency, and necessary for the immediate
preservation of the public peace, health, safety, and general
welfare.



123995.  (a) The department shall require all applicants to the
program who may be eligible for cash grant assistance or for Medi-Cal
benefits to apply for Medi-Cal.
   (b) This section shall not be interpreted to prohibit the coverage
of services in emergency cases.